Symbiotic cardiac pacemaker

Biomimetic strategies and technologies for artificial tactile sensory systems

The sense of touch events, achieved by artificial tactile sensory systems (ATSSs), is a milestone in the progress of human-machine interactions. However, it has been a challenge for ATSSs to serve functions comparable with the human tactile perception system (HTPS). The biomimetic strategies and technologies inspired by HTPS are considered an optimal solution to this challenge. Recent studies have reported bioinspired strategies for improving specific aspects of ATSS performance, such as feature collection, signal conversion, and information computation. Here, we present a systematic interpretation of biomechanisms for HTPSs, and correspondingly, address biomimetic strategies and technologies contributing to ATSSs as an integral system. This review will benefit the development and application of ATSSs in the future.

Recent Advances in Triboelectric Nanogenerators: From Technological Progress to Commercial Applications

Serious climate changes and energy-related environmental problems are currently critical issues in the world. In order to reduce carbon emissions and save our environment, renewable energy harvesting technologies will serve as a key solution in the near future. Among them, triboelectric nanogenerators (TENGs), which is one of the most promising mechanical energy harvesters by means of contact electrification phenomenon, are explosively developing due to abundant wasting mechanical energy sources and a number of superior advantages in a wide availability and selection of materials, relatively simple device configurations, and low-cost processing. Significant experimental and theoretical efforts have been achieved toward understanding fundamental behaviors and a wide range of demonstrations since its report in 2012. As a result, considerable technological advancement has been exhibited and it advances the timeline of achievement in the proposed roadmap. Now, the technology has reached the stage of prototype development with verification of performance beyond the lab scale environment toward its commercialization. In this review, distinguished authors in the world worked together to summarize the state of the art in theory, materials, devices, systems, circuits, and applications in TENG fields. The great research achievements of researchers in this field around the world over the past decade are expected to play a major role in coming to fruition of unexpectedly accelerated technological advances over the next decade.

Agro-waste to sustainable energy: A green strategy of converting agricultural waste to nano-enabled energy applications

The rising demands of the growing population have raised two significant global challenges viz. energy crisis and solid-waste management, ultimately leading to environmental deterioration. Agricultural waste (agro-waste) contributes to a large amount of globally produced solid waste, contaminating the environment, and raising human-health issues on improper management. It is essential for a circular economy to meet sustainable development goals and to design strategies to convert agro-waste into energy using nanotechnology-based processing strategies, by addressing the two significant challenges. This review illustrates the nano-strategic aspects of state-of-the-art agro-waste applications for energy harvesting and storage. It details the fundamentals related to converting agro-waste into energy resources in the form of green nanomaterials, biofuels, biogas, thermal energy, solar energy, triboelectricity, green hydrogen, and energy storage modules in supercapacitors and batteries. Besides, it highlights the challenges associated with agro-waste-to-green energy modules with their possible alternate solutions and advanced prospects. This comprehensive review will serve as a fundamental structure to guide future research on smart agro-waste management and nanotechnological innovations dedicated to its utilization for green energy applications without harming the environment. The nanomaterials assisted generation and storage of energy from agro-waste is touted to be the near-future of smart solid-waste management strategy for green and circular economy.

Multiangle, self-powered sensor array for monitoring head impacts

Mild concussions occur frequently and may come with long-term cognitive, affective, and physical sequelae. However, the diagnosis of mild concussions lacks objective assessment and portable monitoring techniques. Here, we propose a multiangle self-powered sensor array for real-time monitoring of head impact to further assist in clinical analysis and prevention of mild concussions. The array uses triboelectric nanogenerator technology, which converts impact force from multiple directions into electrical signals. With an average sensitivity of 0.214 volts per kilopascal, a response time of 30 milliseconds, and a minimum resolution of 1.415 kilopascals, the sensors exhibit excellent sensing capability over a range of 0 to 200 kilopascals. Furthermore, the array enables reconstructed head impact mapping and injury grade assessment via a prewarning system. By gathering standardized data, we expect to build a big data platform that will permit in-depth research of the direct and indirect effects between head impacts and mild concussions in the future.

Evolution of nanostructured skin patches towards multifunctional wearable platforms for biomedical applications

Recent advances in the field of skin patches have promoted the development of wearable and implantable bioelectronics for long-term, continuous healthcare management and targeted therapy. However, the design of electronic skin (e-skin) patches with stretchable components is still challenging and requires an in-depth understanding of the skin-attachable substrate layer, functional biomaterials and advanced self-powered electronics. In this comprehensive review, we present the evolution of skin patches from functional nanostructured materials to multi-functional and stimuli-responsive patches towards flexible substrates and emerging biomaterials for e-skin patches, including the material selection, structure design and promising applications. Stretchable sensors and self-powered e-skin patches are also discussed, ranging from electrical stimulation for clinical procedures to continuous health monitoring and integrated systems for comprehensive healthcare management. Moreover, an integrated energy harvester with bioelectronics enables the fabrication of self-powered electronic skin patches, which can effectively solve the energy supply and overcome the drawbacks induced by bulky battery-driven devices. However, to realize the full potential offered by these advancements, several challenges must be addressed for next-generation e-skin patches. Finally, future opportunities and positive outlooks are presented on the future directions of bioelectronics. It is believed that innovative material design, structure engineering, and in-depth study of fundamental principles can foster the rapid evolution of electronic skin patches, and eventually enable self-powered close-looped bioelectronic systems to benefit mankind.

Surface-Embedding of Mo Microparticles for Robust and Conductive Biodegradable Fiber Electrodes: Toward 1D Flexible Transient Electronics

Fiber-based implantable electronics are one of promising candidates for in vivo biomedical applications thanks to their unique structural advantages. However, development of fiber-based implantable electronic devices with biodegradable capability remains a challenge due to the lack of biodegradable fiber electrodes with high electrical and mechanical properties. Here, a biocompatible and biodegradable fiber electrode which simultaneously exhibits high electrical conductivity and mechanical robustness is presented. The fiber electrode is fabricated through a facile approach that incorporates a large amount of Mo microparticles into outermost volume of a biodegradable polycaprolactone (PCL) fiber scaffold in a concentrated manner. The biodegradable fiber electrode simultaneously exhibits a remarkable electrical performance (≈43.5 Ω cm^-1 ), mechanical robustness, bending stability, and durability for more than 4000 bending cycles based on the Mo/PCL conductive layer and intact PCL core in the fiber electrode. The electrical behavior of the biodegradable fiber electrode under the bending deformation is analyzed by an analytical prediction and a numerical simulation. In addition, the biocompatible properties and degradation behavior of the fiber electrode are systematically investigated. The potential of biodegradable fiber electrode is demonstrated in various applications such as an interconnect, a suturable temperature sensor, and an in vivo electrical stimulator.

Nonadjacent Wireless Electrotherapy for Tissue Repair by a 3D-Printed Bioresorbable Fully Soft Triboelectric Nanogenerator

Electrotherapy is a promising tissue repair technique. However, electrotherapy devices are frequently complex and must be placed adjacent to injured tissue, thereby limiting their clinical application. Here, we propose a general strategy to facilitate tissue repair by modulating endogenous electric fields with nonadjacent (approximately 44 mm) wireless electrotherapy through a 3D-printed entirely soft and bioresorbable triboelectric nanogenerator based stimulator, without any electrical accessories, which has biomimetic mechanical properties similar to those of soft tissue. In addition, the feasibility of using the stimulator to construct an electrical double layer with tissue for nonadjacent wireless electrotherapy was demonstrated by skin and muscle injury models. The treated groups showed significantly improved tissue repair compared with the control group. In conclusion, we developed a promising electrotherapy strategy and may inspire next-generation electrotherapy for tissue repair.

Water-soluble conjugated polymers for bioelectronic systems

Bioelectronics is an interdisciplinary field of research that aims to establish a synergy between electronics and biology. Contributing to a deeper understanding of bioelectronic processes and the built bioelectronic systems, a variety of new phenomena, mechanisms and concepts have been derived in the field of biology, medicine, energy, artificial intelligence science, etc. Organic semiconductors can promote the applications of bioelectronics in improving original performance and creating new features for organisms due to their excellent photoelectric and electrical properties. Recently, water-soluble conjugated polymers (WSCPs) have been employed as a class of ideal interface materials to regulate bioelectronic processes between biological systems and electronic systems, relying on their satisfying ionic conductivity, water-solubility, good biocompatibility and the additional mechanical and electrical properties. In this review, we summarize the prominent contributions of WSCPs in the aspect of the regulation of bioelectronic processes and highlight the latest advances in WSCPs for bioelectronic applications, involving biosynthetic systems, photosynthetic systems, biophotovoltaic systems, and bioelectronic devices. The challenges and outlooks of WSCPs in designing high-performance bioelectronic systems are also discussed.

Biocompatible Material-Based Flexible Biosensors: From Materials Design to Wearable/Implantable Devices and Integrated Sensing Systems

Human beings have a greater need to pursue life and manage personal or family health in the context of the rapid growth of artificial intelligence, big data, the Internet of Things, and 5G/6G technologies. The application of micro biosensing devices is crucial in connecting technology and personalized medicine. Here, the progress and current status from biocompatible inorganic materials to organic materials and composites are reviewed and the material-to-device processing is described. Next, the operating principles of pressure, chemical, optical, and temperature sensors are dissected and the application of these flexible biosensors in wearable/implantable devices is discussed. Different biosensing systems acting in vivo and in vitro, including signal communication and energy supply are then illustrated. The potential of in-sensor computing for applications in sensing systems is also discussed. Finally, some essential needs for commercial translation are highlighted and future opportunities for flexible biosensors are considered.

Reshaping the Endogenous Electric Field to Boost Wound Repair via Electrogenerative Dressing

The endogenous electric field (EF) generated by transepithelial potential difference plays a decisive role in wound reepithelialization. For patients with large or chronic wounds, negative-pressure wound therapy (NPWT) is the most effective clinical method in inflammation control by continuously removing the necrotic tissues or infected substances, thus creating a proproliferative microenvironment beneficial for wound reepithelialization. However, continuous negative-pressure drainage causes electrolyte loss and weakens the endogenous EF, which in turn hinders wound reepithelialization. Here, an electrogenerative dressing (EGD) is developed by integrating triboelectric nanogenerators with NPWT. By converting the negative-pressure-induced mechanical deformation into electricity, EGD produces a stable and high-safety EF that can trigger a robust epithelial electrotactic response and drive the macrophages toward a reparative M2 phenotype in vitro. Translational medicine studies confirm that EGD completely reshapes the wound EF weakened by NPWT, and promotes wound closure by facilitating an earlier transition of inflammation/proliferation and guiding epithelial migration and proliferation to accelerate reepithelialization. Long-term EGD therapy remarkably advances tissue remodeling with mature epithelium, orderly extracellular matrix, and less scar formation. Compared with the golden standard of NPWT, EGD orchestrates all the essential wound stages in a noninvasive manner, presenting an excellent prospect in clinical wound therapy.

Wireless and battery-free technologies for neuroengineering

Tethered and battery-powered devices that interface with neural tissues can restrict natural motions and prevent social interactions in animal models, thereby limiting the utility of these devices in behavioural neuroscience research. In this Review Article, we discuss recent progress in the development of miniaturized and ultralightweight devices as neuroengineering platforms that are wireless, battery-free and fully implantable, with capabilities that match or exceed those of wired or battery-powered alternatives. Such classes of advanced neural interfaces with optical, electrical or fluidic functionality can also combine recording and stimulation modalities for closed-loop applications in basic studies or in the practical treatment of abnormal physiological processes.

Wireless Self-Powered Optogenetic System for Long-Term Cardiac Neuromodulation to Improve Post-MI Cardiac Remodeling and Malignant Arrhythmia

Autonomic imbalance is an important characteristic of patients after myocardial infarction (MI) and adversely contributes to post-MI cardiac remodeling and ventricular arrhythmias (VAs). A previous study proved that optogenetic modulation could precisely inhibit cardiac sympathetic hyperactivity and prevent acute ischemia-induced VAs. Here, a wireless self-powered optogenetic modulation system is introduced, which achieves long-term precise cardiac neuromodulation in ambulatory canines. The wireless self-powered optical system based on a triboelectric nanogenerator is powered by energy harvested from body motion and realized the effective optical illumination that is required for optogenetic neuromodulation (ON). It is further demonstrated that long-term ON significantly mitigates MI-induced sympathetic remodeling and hyperactivity, and improves a variety of clinically relevant outcomes such as improves ventricular dysfunction, reduces infarct size, increases electrophysiological stability, and reduces susceptibility to VAs. These novel insights suggest that wireless ON holds translational potential for the clinical treatment of arrhythmia and other cardiovascular diseases related to sympathetic hyperactivity. Moreover, this innovative self-powered optical system may provide an opportunity to develop implantable/wearable and self-controllable devices for long-term optogenetic therapy.

Fractal structured charge-excitation triboelectric nanogenerators for powering portable electronic devices

Effective power management on the outputs of triboelectric nanogenerators (TENGs) is critical for their practical applications due to the large impedance and unbalanced load matching. Recently proposed voltage multiplying circuits for external-charge excitation and self-charge excitation are usually unstable and require reversal for device restarting and common switched-capacitor-converters usually cause large switching losses. In this work, we fabricated a fractal structured charge-excitation circuit for TENGs using diodes and capacitors. The fractal switched-capacitor-converter coupled with voltage regulator diodes can greatly boost the output charge and current of the TENG without reverse starting. The managed output performance of the TENG can be controlled by the electronic component parameters and external operating frequency. Through the component and condition optimization, the fractal structured charge-excitation TENG (FSC-TENG) can achieve nearly 5.8 times charge boosting and almost 16.8 times power boosting in the pulsed mode. Furthermore, the FSC-TENG successfully drove a hygrothermograph and was integrated into a yoga mat for harvesting human-body motion energy to power an electronic watch and a pedometer. The FSC-TENG with good charge accumulation properties and stability is a promising candidate for practical self-powered applications.

Capacitive-piezoresistive hybrid flexible pressure sensor based on conductive micropillar arrays with high sensitivity over a wide dynamic range

Flexible pressure sensors are the foundation of wearable/implantable biosensing and human-machine interfaces, and mainly comprise piezoresistive-, capacitive-, piezoelectric-, and triboelectric-type sensors. As each type of sensor exhibits different electro-mechanical behaviors, it is challenging to detect various physiological mechanical signals that cover a large pressure range using a given sensor configuration, or even a single type of sensor. Here, we report a capacitive-piezoresistive hybrid flexible pressure sensor based on face-to-face-mounted conductive micropillar arrays as a solution to this challenge. The sensor exhibited high sensitivity over a wide dynamic range of five orders of magnitude, which covers almost the full range of physiological mechanical signals. A process for fabricating large-scale and morphologically homogeneous conductive micropillar arrays was first developed and refined. This track-etched-membrane-based process provides a facile, cost-effective, and highly flexible way to precisely adjust the morphology, modulus, and conductivity of the micropillars according to the application requirements. Subsequently, conductive-micropillar-array-based pressure sensors (MAPS) were developed and optimized to attain all-round sensing performance. The pillar contact behaviors generated significant variations in both the capacitance and resistance of the MAPS in the low-pressure regime (10^-4-0.2 kPa), providing high sensitivity in both the capacitive and piezoresistive working modes. The vertical contact, bending and thickening of the pillars under medium pressure (0.2-16 kPa) led to a continuous linear response in both modes. Configuration and optimization enabled the MAPS to detect acoustic pressure (<1 Pa), milligram weights, soft touch (<1 kPa), arterial pulses (1-16 kPa preload), joint motions and plantar pressure (∼100 kPa), and the hybrid sensing mode allowed the MAPS to work in a desirable way. In this work, the piezoresistive mode was mainly employed for a higher accuracy and sampling rate, and can apparently simplify IC design for wearable applications. The circuit converts the resistive variations into electrical signals via the voltage division method and directly reads out the signals after further amplification, filtering and transmission. The improved facile and highly adjustable fabrication process, as well as the flexible hybrid sensing strategy, will benefit the unified design, batch production, quantifiable optimization, and functional diversity of wearable/implantable bioelectronics.

Future regenerative medicine developments and their therapeutic applications

Although the currently available pharmacological assays can cure most pathological disorders, they have limited therapeutic value in relieving certain disorders like myocardial infarct, peripheral vascular disease, amputated limbs, or organ failure (e.g. renal failure). Pilot studies to overcome such problems using regenerative medicine (RM) delivered promising data. Comprehensive investigations of RM in zebrafish or reptilians are necessary for better understanding. However, the precise mechanisms remain poorly understood despite the tremendous amount of data obtained using the zebrafish model investigating the exact mechanisms behind their regenerative capability. Indeed, understanding such mechanisms and their application to humans can save millions of lives from dying due to potentially life-threatening events. Recent studies have launched a revolution in replacing damaged human organs via different approaches in the last few decades. The newly established branch of medicine (known as Regenerative Medicine aims to enhance natural repair mechanisms. This can be done through the application of several advanced broad-spectrum technologies such as organ transplantation, tissue engineering, and application of Scaffolds technology (support vascularization using an extracellular matrix), stem cell therapy, miRNA treatment, development of 3D mini-organs (organoids), and the construction of artificial tissues using nanomedicine and 3D bio-printers. Moreover, in the next few decades, revolutionary approaches in regenerative medicine will be applied based on artificial intelligence and wireless data exchange, soft intelligence biomaterials, nanorobotics, and even living robotics capable of self-repair. The present work presents a comprehensive overview that summarizes the new and future advances in the field of RM.

A self-powered multifunctional dressing for active infection prevention and accelerated wound healing

Interruption of the wound healing process due to pathogenic infection remains a major health care challenge. The existing methods for wound management require power sources that hinder their utilization outside of clinical settings. Here, a next generation of wearable self-powered wound dressing is developed, which can be activated by diverse stimuli from the patient's body and provide on-demand treatment for both normal and infected wounds. The highly tunable dressing is composed of thermocatalytic bismuth telluride nanoplates (Bi₂Te₃ NPs) functionalized onto carbon fiber fabric electrodes and triggered by the surrounding temperature difference to controllably generate hydrogen peroxide to effectively inhibit bacterial growth at the wound site. The integrated electrodes are connected to a wearable triboelectric nanogenerator (TENG) to provide electrical stimulation for accelerated wound closure by enhancing cellular proliferation, migration, and angiogenesis. The reported self-powered dressing holds great potential in facilitating personalized and user-friendly wound care with improved healing outcomes.

Toward Large-Scale Energy Harvesting by a UV-Curable Organic-Coating-Based Triboelectric Nanogenerator

Triboelectric nanogenerators (TENGs) stand out as an attractive form of technology for the efficient harvest of mechanical energy and the powering of wearable devices due to their light weight, simplicity, high power density, and efficient vibration energy scavenging capabilities. However, the requirement for micro/nanostructures and/or complex and expensive instruments hinders their cheap mass production, thus limiting their practical applications. By using a simple, cost-effective, fast spray-coating process, we develop high-performance UV-curable triboelectric coatings for large-scale energy harvesting. The effect of different formulations and coating compositions on the triboelectric output is investigated to design triboelectric coatings with high output performance. The TENG based on a hybrid coating exhibits high output performance of 54.5 μA current, 1228.9 V voltage, 163.6 nC transferred charge and 3.51 mW output power. Moreover, the hybrid coatings show good long-term output stability. All the results indicate that the designed triboelectric coatings show great potential for large-scale energy harvesting with the advantages of cost-effectiveness, fast fabrication, easy mass production and long-term stability.

Recent progress of electroactive interface in neural engineering

Neural tissue is an electrical responsible organ. The electricity plays a vital role in the growth and development of nerve tissue, as well as the repairing after diseases. The interface between the nervous system and external device for information transmission is called neural electroactive interface. With the development of new materials and fabrication technologies, more and more new types of neural interfaces are developed and the interfaces can play crucial roles in treating many debilitating diseases such as paralysis, blindness, deafness, epilepsy, and Parkinson's disease. Neural interfaces are developing toward flexibility, miniaturization, biocompatibility, and multifunctionality. This review presents the development of neural electrodes in terms of different materials for constructing electroactive neural interfaces, especially focus on the piezoelectric materials-based indirect neuromodulation due to their features of wireless control, excellent effect, and good biocompatibility. We discussed the challenges we need to consider before the application of these new interfaces in clinical practice. The perspectives about future directions for developing more practical electroactive interface in neural engineering are also discussed in this review. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement.

Electrically conductive carbon-based (bio)-nanomaterials for cardiac tissue engineering

A proper self-regenerating capability is lacking in human cardiac tissue which along with the alarming rate of deaths associated with cardiovascular disorders makes tissue engineering critical. Novel approaches are now being investigated in order to speedily overcome the challenges in this path. Tissue engineering has been revolutionized by the advent of nanomaterials, and later by the application of carbon-based nanomaterials because of their exceptional variable functionality, conductivity, and mechanical properties. Electrically conductive biomaterials used as cell bearers provide the tissue with an appropriate microenvironment for the specific seeded cells as substrates for the sake of protecting cells in biological media against attacking mechanisms. Nevertheless, their advantages and shortcoming in view of cellular behavior, toxicity, and targeted delivery depend on the tissue in which they are implanted or being used as a scaffold. This review seeks to address, summarize, classify, conceptualize, and discuss the use of carbon-based nanoparticles in cardiac tissue engineering emphasizing their conductivity. We considered electrical conductivity as a key affecting the regeneration of cells. Correspondingly, we reviewed conductive polymers used in tissue engineering and specifically in cardiac repair as key biomaterials with high efficiency. We comprehensively classified and discussed the advantages of using conductive biomaterials in cardiac tissue engineering. An overall review of the open literature on electroactive substrates including carbon-based biomaterials over the last decade was provided, tabulated, and thoroughly discussed. The most commonly used conductive substrates comprising graphene, graphene oxide, carbon nanotubes, and carbon nanofibers in cardiac repair were studied.

Applications of Smart Material Sensors and Soft Electronics in Healthcare Wearables for Better User Compliance

The need for innovation in the healthcare sector is essential to meet the demand of a rapidly growing population and the advent of progressive chronic ailments. Over the last decade, real-time monitoring of health conditions has been prioritized for accurate clinical diagnosis and access to accelerated treatment options. Therefore, the demand for wearable biosensing modules for preventive and monitoring purposes has been increasing over the last decade. Application of machine learning, big data analysis, neural networks, and artificial intelligence for precision and various power-saving approaches are used to increase the reliability and acceptance of smart wearables. However, user compliance and ergonomics are key areas that need focus to make the wearables mainstream. Much can be achieved through the incorporation of smart materials and soft electronics. Though skin-friendly wearable devices have been highlighted recently for their multifunctional abilities, a detailed discussion on the integration of smart materials for higher user compliance is still missing. In this review, we have discussed the principles and applications of sustainable smart material sensors and soft electronics for better ergonomics and increased user compliance in various healthcare devices. Moreover, the importance of nanomaterials and nanotechnology is discussed in the development of smart wearables.

Triboelectric and Piezoelectric Nanogenerators for Self-Powered Healthcare Monitoring Devices: Operating Principles, Challenges, and Perspectives

The internet of medical things (IoMT) is used for the acquisition, processing, transmission, and storage of medical data of patients. The medical information of each patient can be monitored by hospitals, family members, or medical centers, providing real-time data on the health condition of patients. However, the IoMT requires monitoring healthcare devices with features such as being lightweight, having a long lifetime, wearability, flexibility, safe behavior, and a stable electrical performance. For the continuous monitoring of the medical signals of patients, these devices need energy sources with a long lifetime and stable response. For this challenge, conventional batteries have disadvantages due to their limited-service time, considerable weight, and toxic materials. A replacement alternative to conventional batteries can be achieved for piezoelectric and triboelectric nanogenerators. These nanogenerators can convert green energy from various environmental sources (e.g., biomechanical energy, wind, and mechanical vibrations) into electrical energy. Generally, these nanogenerators have simple transduction mechanisms, uncomplicated manufacturing processes, are lightweight, have a long lifetime, and provide high output electrical performance. Thus, the piezoelectric and triboelectric nanogenerators could power future medical devices that monitor and process vital signs of patients. Herein, we review the working principle, materials, fabrication processes, and signal processing components of piezoelectric and triboelectric nanogenerators with potential medical applications. In addition, we discuss the main components and output electrical performance of various nanogenerators applied to the medical sector. Finally, the challenges and perspectives of the design, materials and fabrication process, signal processing, and reliability of nanogenerators are included.

Self-Powered, Implantable, and Wirelessly Controlled NO Generation System for Intracranial Neuroglioma Therapy

Gas therapy is an emerging technology for improving cancer therapy with high efficiency and low side effects. However, due to the existence of the gatekeeper of the blood-brain barrier (BBB) and the limited availability of current drug delivery systems, there still have been no reports on gas therapy for intracranial neuroglioma. Herein, an integrated, self-powered, and wirelessly controlled gas-therapy system is reported, which is composed of a self-powered triboelectric nanogenerator (TENG) and an implantable nitric oxide (NO) releasing device for intracranial neuroglioma therapy. In the system, the patient self-driven TENG converts the mechanical energy of body movements into electricity as a sustainable and self-controlled power source. When delivering energy to light a light-emitting diode in the implantable NO releasing device via wireless control, the encapsulated NO donor s-nitrosoglutathione (GSNO) can generate NO gas to locally kill the glioma cells. The efficacy of the proof-of-concept system in subcutaneous 4T1 breast cancer model in mice and intracranial glioblastoma multiforme in rats is verified. This self-powered gas-therapy system has great potential to be an effective adjuvant treatment modality to inhibit tumor growth, relapse, and invasion via teletherapy.

Fully rubbery Schottky diode and integrated devices

A fully rubbery stretchable diode, particularly entirely based on stretchy materials, is a crucial device for stretchable integrated electronics in a wide range of applications, ranging from energy to biomedical, to integrated circuits, and to robotics. However, its development has been very nascent. Here, we report a fully rubbery Schottky diode constructed all based on stretchable electronic materials, including a liquid metal cathode, a rubbery semiconductor, and a stretchable anode. The rubbery Schottky diode exhibited a forward current density of 6.99 × 10-3 A/cm2 at 5 V and a rectification ratio of 8.37 × 104 at ±5 V. Stretchy rectifiers and logic gates based on the rubbery Schottky diodes were developed and could retain their electrical performance even under 30% tensile stretching. With the rubbery diodes, fully rubbery integrated electronics, including an active matrix multiplexed tactile sensor and a triboelectric nanogenerator-based power management system, are further demonstrated.

Biomechanical Sensing Systems for Cardiac Activity Monitoring

Cardiovascular disease is consistently ranked high among the causes of death on a global scale. Monitoring of cardiovascular signs throughout the course of a long period of time and in real time is necessary in order to discover anomalies and begin early intervention at the appropriate time. To this purpose, a significant amount of interest among researchers has been directed toward the creation of flexible sensors that may be worn or implanted and are capable of constant, immediate observation of a variety of main physiological indicators. The real-time readings of the heart and arteries' pressure fluctuations can be reflected directly by mechanical sensors, which are one of the many types of sensors. Potential benefits of mechanical sensors include excellent accuracy and considerable versatility. Capacitive, piezoresistive, piezoelectric, and triboelectric principles are the foundations of the four types of mechanical sensors that are discussed in this article as recent developments for the purpose of monitoring the cardiovascular system. The biomechanical systems that are present in the cardiovascular system are then detailed, along with their monitoring, and this includes blood and endocardial pressure, pulse wave, and heart rhythm. In conclusion, we examine the usefulness of the use of continuous health monitoring for the treatment of vascular disease and highlight the difficulties associated with its translation into clinical practice.

Improved pharmacodynamics of epidermal growth factor via microneedles-based self-powered transcutaneous electrical stimulation

Epidermal growth factor is an excellent drug for promoting wound healing; however, its conventional administration strategies are associated with pharmacodynamic challenges, such as low transdermal permeability, reduction, and receptor desensitization. Here, we develop a microneedle-based self-powered transcutaneous electrical stimulation system (mn-STESS) by integrating a sliding free-standing triboelectric nanogenerator with a microneedle patch to achieve improved epidermal growth factor pharmacodynamics. We show that the mn-STESS facilitates drug penetration and utilization by using microneedles to pierce the stratum corneum. More importantly, we find that it converts the mechanical energy of finger sliding into electricity and mediates transcutaneous electrical stimulation through microneedles. We demonstrate that the electrical stimulation applied by mn-STESS acts as an "adjuvant" that suppresses the reduction of epidermal growth factor by glutathione and upregulates its receptor expression in keratinocyte cells, successfully compensating for receptor desensitization. Collectively, this work highlights the promise of self-powered electrical adjuvants in improving drug pharmacodynamics, creating combinatorial therapeutic strategies for traditional drugs.

Subcutaneous power supply by NIR-II light

Implantable medical devices are wished to be recharged via contactless power transfer technologies without interventional operations. Superior to subcutaneous power supply by visible light or electromagnetic wave, second near-infrared (NIR-II) light is predicted to possess 60 times subcutaneous power transmission but hard to be utilized. Here we report a photo-thermal-electric converter via the combination of photothermal conversion and thermoelectric conversion. It is able to generate an output power as high as 195 mW under the coverage of excised tissues, presenting advantages of non-invasion, high output power, negligible biological damage, and deep tissue penetration. As an in vivo demonstration, the output power of a packaged converter in the abdominal cavity of a rabbit reaches 20 mW under NIR-II light irradiation through the rabbit skin with a thickness of 8.5 mm. This value is high enough to recharge an implanted high-power-consumption wireless camera and transfer video signal out of body in real-time.

Bioelectronic medicine: Preclinical insights and clinical advances

The nervous system maintains homeostasis and health. Homeostatic disruptions underlying the pathobiology of many diseases can be controlled by bioelectronic devices targeting CNS and peripheral neural circuits. New insights into the regulatory functions of the nervous system and technological developments in bioelectronics drive progress in the emerging field of bioelectronic medicine. Here, we provide an overview of key aspects of preclinical research, translation, and clinical advances in bioelectronic medicine.

Morphing-to-Adhesion Polysaccharide Hydrogel for Adaptive Biointerfaces

Reliable functions of medical implants highly depend on biocompatible, conformal, and stable biointerfaces for seamless biointegration with biological tissues. Though flexible biointerfaces based on synthetic hydrogels have shown promise in optimizing implant biointegration via surgical suturing, physical attachment, or manual preshaping, they still suffer from poor adaptability, such as tissue damage by surgical suturing, low bioactivity, and difficulties in conformal contact and stable fixation, especially for specific tissues of large surface curvatures. Here, we report a bilayer hydrogel-based adaptive biointerface (HAB) made of two polysaccharide derivates, N-hydroxysuccinimide (NHS) ester-activated alginate and chitosan, harnessing dual advantages of their different swelling and active groups. Leveraging on the differential swelling between the two hydrogel layers and covalent linkages with active groups at hydrogel interfaces, HABs can be programmed into sealed tubes with tunable diameters via water-induced compliable shape morphing and instant interfacial adhesion. We further demonstrate that the polysaccharide-based morphing-to-adhesion HAB possesses outstanding bioactivity in directing cellular focal adhesion and intercellular junction, versatile geometrical adaptability to diverse tubular tissues with a wide range of surface curvatures (2.8 × 10²-1.3 × 10³ m^-1), and excellent mechanical stability in high load-/shear-bearing physiological environments (blood flow volume: 85 mm·s^-1). HABs overcome the limitations of existing biointerfaces in terms of poor bioactivity and difficult biointegration with biological tissues of large surface curvatures, holding promise to open new avenues for adaptive biointerfaces and reliable medical implants.

Humidity-sensitive chemoelectric flexible sensors based on metal-air redox reaction for health management

Numerous studies have shown flexible electronics play important roles in health management. The way of power supply is always an essential factor of devices and self-powered ones are very attractive because of the fabrication easiness, usage comfort and aesthetics of the system. In this work, based on the metal-air redox reaction, which is usually used in designing metal-air batteries, we design a self-powered chemoelectric humidity sensor where a silk fibroin (SF) and LiBr gel matrix containing parallel aligned graphene oxide (GO) flakes serve as the electrolyte. The abundant hydrophilic groups in GO/SF and the hygroscopicity of LiBr lead to tight dependence of the output current on the humidity, enabling the sensor high sensitivity (0.09 μA/s/1%), fast response (1.05 s) and quick recovery (0.80 s). As proofs of concept, we design an all-in-one respiratory monitoring-diagnosing-treatment system and a non-contact human-machine interface, demonstrating the applications of the chemoelectric humidity sensor in health management.

Self-powered sensors are of interest in wearable technology and other applications. Here, the authors report on the creation of a metal-air redox reaction humidity sensor where the conductance and charge generated is influenced by the amount of absorbed water and demonstrate application in respiration monitoring.

Mechanical Sensors for Cardiovascular Monitoring: From Battery-Powered to Self-Powered

Cardiovascular disease is one of the leading causes of death worldwide. Long-term and real-time monitoring of cardiovascular indicators is required to detect abnormalities and conduct early intervention in time. To this end, the development of flexible wearable/implantable sensors for real-time monitoring of various vital signs has aroused extensive interest among researchers. Among the different kinds of sensors, mechanical sensors can reflect the direct information of pressure fluctuations in the cardiovascular system with the advantages of high sensitivity and suitable flexibility. Herein, we first introduce the recent advances of four kinds of mechanical sensors for cardiovascular system monitoring, based on capacitive, piezoresistive, piezoelectric, and triboelectric principles. Then, the physio-mechanical mechanisms in the cardiovascular system and their monitoring are described, including pulse wave, blood pressure, heart rhythm, endocardial pressure, etc. Finally, we emphasize the importance of real-time physiological monitoring in the treatment of cardiovascular disease and discuss its challenges in clinical translation.

Artificial tactile perception smart finger for material identification based on triboelectric sensing

Tactile perception includes the direct response of tactile corpuscles to environmental stimuli and psychological parameters associated with brain recognition. To date, several artificial haptic-based sensing techniques can accurately measure physical stimuli. However, quantifying the psychological parameters of tactile perception to achieve texture and roughness identification remains challenging. Here, we developed a smart finger with surpassed human tactile perception, which enabled accurate identification of material type and roughness through the integration of triboelectric sensing and machine learning. In principle, as each material has different capabilities to gain or lose electrons, a unique triboelectric fingerprint output will be generated when the triboelectric sensor is in contact with the measured object. The construction of a triboelectric sensor array could further eliminate interference from the environment, and the accuracy rate of material identification was as high as 96.8%. The proposed smart finger provides the possibility to impart artificial tactile perception to manipulators or prosthetics.

Flexible lead-free piezoelectric arrays for high-efficiency wireless ultrasonic energy transfer and communication

Implantable medical electronics (IMEs) are now becoming increasingly prevalent for diagnostic and therapeutic purposes. Despite extensive efforts, a primary challenge for IMEs is reliable wireless power and communication to provide well-controlled, therapeutically relevant effects. Ultrasonic energy transfer and communication (UETC) employing traveling ultrasound waves to transmit energy has emerged as a promising wireless strategy for IMEs. Nevertheless, conventional UETC systems are rigid, bulky, and based on toxic lead-based piezoelectric materials, raising efficiency and safety concerns. Here, we present a novel transcutaneous UETC system based on a two-dimensional flexible lead-free piezoelectric array (f-LFPA) that hybridizes high-performance (piezoelectric coefficient d₃₃ ≈ 503 pC N^-1) (K,Na)NbO₃-based eco-friendly piezo-units with soft structural components. The newly developed lead-free piezo-unit exhibits submicron ferroelectric domains and superior energy harvesting figures of merit (d₃₃g₃₃ ≈ 20 000 × 10^-15 m² N^-1), resulting in the prepared f-LFPA demonstrating a high output voltage of 22.4 V, a power density of 0.145 W cm^-2, and a signal-to-noise ratio of more than 30 dB within the FDA safety limits, while maintaining the flexibility for wide-angle receiving. Further ex vivo experiment demonstrates the adequate power supply capabilities of the f-LFPA and its possible application in future implantable eco-friendly bioelectronics for diagnostics, therapy, and real-time monitoring.

A Facile, Fabric Compatible, and Flexible Borophene Nanocomposites for Self-Powered Smart Assistive and Wound Healing Applications

Smart fabrics that can harvest ambient energy and provide diverse sensing functionality via triboelectric effects have evoked great interest for next-generation healthcare electronics. Herein, a novel borophene/ecoflex nanocomposite is developed as a promising triboelectric material with tailorability, durability, mechanical stability, and flexibility. The addition of borophene nanosheets enables the borophene/ecoflex nanocomposite to exhibit tunable surface triboelectricity investigated by Kelvin probe force microscopy. The borophene/ecoflex nanocomposite is further fabricated into a fabric-based triboelectric nanogenerator (B-TENG) for mechanical energy harvesting, medical assistive system, and wound healing applications. The durability of B-TENG provides consistent output performance even after severe deformation treatments, such as folding, stretching, twisting, and washing procedures. Moreover, the B-TENG is integrated into a smart keyboard configuration combined with a robotic system to perform an upper-limb medical assistive interface. Furthermore, the B-TENG is also applied as an active gait phase sensing system for instantaneous lower-limb gait phase visualization. Most importantly, the B-TENG can be regarded as a self-powered in vitro electrical stimulation device to conduct continuous wound monitoring and therapy. The as-designed B-TENG not only demonstrates great potential for multifunctional self-powered healthcare sensors, but also for the promising advancements toward wearable medical assistive and therapeutic systems.

Body Temperature Enhanced Adhesive, Antibacterial and Recyclable Ionic Hydrogel for Epidermal Electrophysiological Monitoring

Hydrogel-based epidermal electrodes have attracted widespread attention in health monitoring and human-machine interfaces for their good biocompatibility, skin-matched Young's modulus, and stable in situ electrophysiological recording performance. However, it is difficult to make the exact conformal attachment between skin and electrodes because of the hair, wrinkles as well as complex, curved contours of the skin. This also results in signal distortion and large noise. Here, a body temperature enhanced skin-adhesive epidermal electrode is proposed based on non-covalent cross-linked network ionic hydrogel. The ionic hydrogel is fabricated by the polyvinyl alcohol (PVA), branched polyethyleneimine (b-PEI) and calcium chloride (CaCl₂ ), which demonstrates impressive performances including ultra-stretchability of 1291%, great adhesion to skin and other non-biological materials, stable conductivity of 3.09 S/m, recyclability and outstanding antibacterial ability, simultaneously. Specifically, the adhesion of the ionic hydrogel behaves as temperature-sensitive and could be enhanced by body temperature. Furthermore, the ionic hydrogel is utilized as epidermal electrodes, which displays seductive capability to record multifarious electrophysiological signals with high signal-to-noise ratio and ultra-low detection limit, including electrocardiogram (ECG), electromyogram (EMG) and electroencephalogram (EEG). The as-proposed body temperature enhanced skin-adhesive ionic hydrogel brings intelligent functions and broadens the way for epidermal electronics, promoting the development of healthcare electronics. This article is protected by copyright. All rights reserved.

Conductive Materials with Elaborate Micro/Nanostructures for Bioelectronics

Bioelectronics, an emerging field with the mutual penetration of biological systems and electronic sciences, allows the quantitative analysis of complicated biosignals together with the dynamic regulation of fateful biological functions. In this area, the development of conductive materials with elaborate micro/nanostructures has been of great significance to the improvement of high-performance bioelectronic devices. Thus, here, a comprehensive and up-to-date summary of relevant research studies on the fabrication and properties of conductive materials with micro/nanostructures and their promising applications and future opportunities in bioelectronic applications is presented. In addition, a critical analysis of the current opportunities and challenges regarding the future developments of conductive materials with elaborate micro/nanostructures for bioelectronic applications is also presented.

From Triboelectric Nanogenerator to Polymer-Based Biosensor: A Review

Nowadays, self-powered wearable biosensors that are based on triboelectric nanogenerators (TENGs) are playing an important role in the continuous efforts towards the miniaturization, energy saving, and intelligence of healthcare devices and Internets of Things (IoTs). In this review, we cover the remarkable developments in TENG−based biosensors developed from various polymer materials and their functionalities, with a focus on wearable and implantable self-powered sensors for health monitoring and therapeutic devices. The functions of TENGs as power sources for third-party biosensors are also discussed, and their applications in a number of related fields are concisely illustrated. Finally, we conclude the review with a discussion of the challenges and problems of leveraging TENG−based intelligent biosensors.

Glucose-sensitive delivery of tannic acid by a photo-crosslinked chitosan hydrogel film for antibacterial and anti-inflammatory therapy

A glucose-sensitive antibacterial and anti-inflammatory hydrogel film with controlled release of tannic acid (TA) was synthesized using chitosan (CS). Specifically, the photo-crosslinked CS hydrogel was first obtained and then immersed in TA solution to generate composite hydrogel film with enhanced mechanical properties. Subsequently, N-hydroxysuccinimide/1-ethyl-3-(3-dimethylaminopropyl) carbodiimide based coupling chemistry was used to covalently crosslink glucose oxidase (GOx) to CS to obtain glucose sensitivity. The physicochemical properties, including chemical composition, enzyme-related characteristics, glucose responsiveness, and mechanical strength, were thoroughly investigated, followed by the cytotoxicity, antibacterial and anti-inflammatory tests. The results showed that the GOx immobilized on the film surface by covalent bonding gave better stability than those that were physically adsorbed. In addition, it could quickly and correspondingly modify its inner pore structure in response to the glucose stimulus and then control the loaded TA release. Meanwhile, the TA addition could enhance the film's mechanical properties. The composite hydrogel film demonstrated adequate biocompatibility and can inhibit NO, IL-6, and TNF-α production in stimulated macrophages, as well as Porphyromonas gingivalis growth, demonstrating effective antibacterial and anti-inflammatory activity.

Coupled Multiphysics Modelling of Sensors for Chemical, Biomedical, and Environmental Applications with Focus on Smart Materials and Low-Dimensional Nanostructures

Low-dimensional nanostructures have many advantages when used in sensors compared to the traditional bulk materials, in particular in their sensitivity and specificity. In such nanostructures, the motion of carriers can be confined from one, two, or all three spatial dimensions, leading to their unique properties. New advancements in nanosensors, based on low-dimensional nanostructures, permit their functioning at scales comparable with biological processes and natural systems, allowing their efficient functionalization with chemical and biological molecules. In this article, we provide details of such sensors, focusing on their several important classes, as well as the issues of their designs based on mathematical and computational models covering a range of scales. Such multiscale models require state-of-the-art techniques for their solutions, and we provide an overview of the associated numerical methodologies and approaches in this context. We emphasize the importance of accounting for coupling between different physical fields such as thermal, electromechanical, and magnetic, as well as of additional nonlinear and nonlocal effects which can be salient features of new applications and sensor designs. Our special attention is given to nanowires and nanotubes which are well suited for nanosensor designs and applications, being able to carry a double functionality, as transducers and the media to transmit the signal. One of the key properties of these nanostructures is an enhancement in sensitivity resulting from their high surface-to-volume ratio, which leads to their geometry-dependant properties. This dependency requires careful consideration at the modelling stage, and we provide further details on this issue. Another important class of sensors analyzed here is pertinent to sensor and actuator technologies based on smart materials. The modelling of such materials in their dynamics-enabled applications represents a significant challenge as we have to deal with strongly nonlinear coupled problems, accounting for dynamic interactions between different physical fields and microstructure evolution. Among other classes, important in novel sensor applications, we have given our special attention to heterostructures and nucleic acid based nanostructures. In terms of the application areas, we have focused on chemical and biomedical fields, as well as on green energy and environmentally-friendly technologies where the efficient designs and opportune deployments of sensors are both urgent and compelling.

Advanced Implantable Biomedical Devices Enabled by Triboelectric Nanogenerators

Implantable biomedical devices (IMDs) play essential roles in healthcare. Subject to the limited battery life, IMDs cannot achieve long-term in situ monitoring, diagnosis, and treatment. The proposal and rapid development of triboelectric nanogenerators free IMDs from the shackles of batteries and spawn a self-powered healthcare system. This review aims to overview the development of IMDs based on triboelectric nanogenerators, divided into self-powered biosensors, in vivo energy harvesting devices, and direct electrical stimulation therapy devices. Meanwhile, future challenges and opportunities are discussed according to the development requirements of current-level self-powered IMDs to enhance output performance, develop advanced triboelectric nanogenerators with multifunctional materials, and self-driven close-looped diagnosis and treatment systems.

Progress of Advanced Devices and Internet of Things Systems as Enabling Technologies for Smart Homes and Health Care

In the Internet of Things (IoT) era, various devices (e.g., sensors, actuators, energy harvesters, etc.) and systems have been developed toward the realization of smart homes/buildings and personal health care. These advanced devices can be categorized into ambient devices and wearable devices based on their usage scenarios, to enable motion tracking, health monitoring, daily care, home automation, fall detection, intelligent interaction, assistance, living convenience, and security in smart homes. With the rapidly increasing number of such advanced devices and IoT systems, achieving fully self-sustained and multimodal intelligent systems is becoming more and more important to realize a sustainable and all-in-one smart home platform. Hence, in this Review, we systematically present the recent progress of the development of advanced materials, fabrication techniques, devices, and systems for enabling smart home and health care applications. First, advanced polymer, fiber, and fabric materials as well as their respective fabrication techniques for large-scale manufacturing are discussed. After that, functional devices classified into ambient devices (at home ambiance such as door, floor, table, chair, bed, toilet, window, wall, etc.) and wearable devices (on body parts such as finger, wrist, arm, throat, face, back, etc.) are presented for diverse monitoring and auxiliary applications. Next, the current developments of self-sustained systems and intelligent systems are reviewed in detail, indicating two promising research directions in this field. Last, conclusions and outlook pinpointed on the existing challenges and opportunities are provided for the research community to consider.

New strategies for energy supply of cardiac implantable devices

Background

Heart disease and atrial fibrillation are the leading causes of death worldwide. Patient morbidity and mortality associated with cardiovascular disease can be reduced by more accurate and continuous diagnostic and therapeutic tools provided by cardiovascular implantable electronic devices (CIEDs).

Objectives

Long-term operation of CIEDs continues to be a challenge due to limited battery life and the associated risk of device failure. To overcome this issue, new approaches for autonomous battery supply are being investigated.

Results

Here, the state of the art in CIED power supply is presented and an overview of current strategies for autonomous power supply in the cardiovascular field is given, using the body as a sustainable energy source. Finally, future challenges and potentials as well as advanced features for CIEDs are discussed.

Conclusion

CIEDs need to fulfil more requirements for diagnostic and telemetric functions, which leads to higher energy requirements. Ongoing miniaturization and improved sensor technologies will help in the development of new devices.