Soft implantable drug delivery device integrated wirelessly with wearable devices to treat fatal seizures

Development of nano- and microdevices for the next generation of biotechnology, wearables and miniaturized instrumentation

This is a short communication based on recent high-impact publications related to how various chemical materials and substrate modifications could be tuned for nano- and microdevices, where their application for high point-of-care bioanalysis and further applications in life science is discussed. Hence, they have allowed different high-impact research topics in a variety of fields, from the control of nanoscale to functional microarchitectures embedded in various support materials to obtain a device for a given application or use. Thus, their incorporation in standard instrumentation is shown, as well as in new optical setups to record different classical and non-classical light, signaling, and energy modes at a variety of wavelengths and energy levels. Moreover, the development of miniaturized instrumentation was also contemplated. In order to develop these different levels of technology, the chemistry, physics and engineering of materials were discussed. In this manner, a number of subjects that allowed the design and manufacture of devices could be found. The following could be mentioned by way of example: (i) nanophotonics; (ii) design, synthesis and tuning of advanced nanomaterials; (iii) classical and non-classical light generation within the near field; (iv) microfluidics and nanofluidics; (v) signal waveguiding; (vi) quantum-, nano- and microcircuits; (vii) materials for nano- and microplatforms, and support substrates and their respective modifications for targeted functionalities. Moreover, nano-optics in in-flow devices and chips for biosensing were discussed, and perspectives on biosensing and single molecule detection (SMD) applications. In this perspective, new insights about precision nanomedicine based on genomics and drug delivery systems were obtained, incorporating new advanced diagnosis methods based on lab-on-particles, labs-on-a-chip, gene therapies, implantable devices, portable miniaturized instrumentation, single molecule detection for biophotonics, and neurophotonics. In this manner, this communication intends to highlight recent reports and developments of nano- and microdevices and further approaches towards the incorporation of developments in nanophotonics and biophotonics in the design of new materials based on different strategies and enhanced techniques and methods. Recent proofs of concept are discussed that could allow new substrates for device manufacturing. Thus, physical phenomena and materials chemistry with accurate control within the nanoscale were introduced into the discussion. In this manner, new potential sources of ideas and strategies for the next generation of technology in many research and development fields are showcased.

This is a short communication based on recent high-impact publications related to how various chemical materials and substrate modifications could be tuned for nano- and microdevices, where their application for high point-of-care bioanalysis and further applications in life science is discussed.

Intrinsically stretchable electronics with ultrahigh deformability to monitor dynamically moving organs

Intrinsically stretchable electronics represent an attractive platform for next-generation implantable devices by reducing the mechanical mismatch and the immune responses with biological tissues. Despite extensive efforts, soft implantable electronic devices often exhibit an obvious trade-off between electronic performances and mechanical deformability because of limitations of commonly used compliant electronic materials. Here, we introduce a scalable approach to create intrinsically stretchable and implantable electronic devices featuring the deployment of liquid metal components for ultrahigh stretchability up to 400% tensile strain and excellent durability against repetitive deformations. The device architecture further shows long-term stability under physiological conditions, conformal attachments to internal organs, and low interfacial impedance. Successful electrophysiological mapping on rapidly beating hearts demonstrates the potential of intrinsically stretchable electronics for widespread applications in health monitoring, disease diagnosis, and medical therapies.

Highly-integrated, miniaturized, stretchable electronic systems based on stacked multilayer network materials

Elastic stretchability and function density represent two key figures of merits for stretchable inorganic electronics. Various design strategies have been reported to provide both high levels of stretchability and function density, but the function densities are mostly below 80%. While the stacked device layout can overcome this limitation, the soft elastomers used in previous studies could highly restrict the deformation of stretchable interconnects. Here, we introduce stacked multilayer network materials as a general platform to incorporate individual components and stretchable interconnects, without posing any essential constraint to their deformations. Quantitative analyses show a substantial enhancement (e.g., by ~7.5 times) of elastic stretchability of serpentine interconnects as compared to that based on stacked soft elastomers. The proposed strategy allows demonstration of a miniaturized electronic system (11 mm by 10 mm), with a moderate elastic stretchability (~20%) and an unprecedented areal coverage (~110%), which can serve as compass display, somatosensory mouse, and physiological-signal monitor.

An Ultra-Low-Cost RCL-Meter

An ultra-low-cost RCL meter, aimed at IoT applications, was developed, and was used to measure electrical components based on standard techniques without the need of additional electronics beyond the AVR® micro-controller hardware itself and high-level routines. The models and pseudo-routines required to measure admittance parameters are described, and a benchmark between the ATmega328P and ATmega32U4 AVR® micro-controllers was performed to validate the resistance and capacitance measurements. Both ATmega328P and ATmega32U4 micro-controllers could measure isolated resistances from 0.5 Ω to 80 MΩ and capacitances from 100 fF to 4.7 mF. Inductance measurements are estimated at between 0.2 mH to 1.5 H. The accuracy and range of the measurements of series and parallel RC networks are demonstrated. The relative accuracy (ar) and relative precision (pr) of the measurements were quantified. For the resistance measurements, typically ar, pr < 10% in the interval 100 Ω−100 MΩ. For the capacitance, measured in one of the modes (fast mode), ar < 20% and pr < 5% in the range 100 fF−10 nF, while for the other mode (transient mode), typically ar < 20% in the range 10 nF−10 mF and pr < 5% for 100 pF−10 mF. ar falls below 5% in some sub-ranges. The combination of the two capacitance modes allows for measurements in the range 100 fF−10 mF (11 orders of magnitude) with ar < 20%. Possible applications include the sensing of impedimetric sensor arrays targeted for wearable and in-body bioelectronics, smart agriculture, and smart cities, while complying with small form factor and low cost.

Microelectromechanical Systems (MEMS) for Biomedical Applications

The significant advancements within the electronics miniaturization field have shifted the scientific interest towards a new class of precision devices, namely microelectromechanical systems (MEMS). Specifically, MEMS refers to microscaled precision devices generally produced through micromachining techniques that combine mechanical and electrical components for fulfilling tasks normally carried out by macroscopic systems. Although their presence is found throughout all the aspects of daily life, recent years have witnessed countless research works involving the application of MEMS within the biomedical field, especially in drug synthesis and delivery, microsurgery, microtherapy, diagnostics and prevention, artificial organs, genome synthesis and sequencing, and cell manipulation and characterization. Their tremendous potential resides in the advantages offered by their reduced size, including ease of integration, lightweight, low power consumption, high resonance frequency, the possibility of integration with electrical or electronic circuits, reduced fabrication costs due to high mass production, and high accuracy, sensitivity, and throughput. In this context, this paper aims to provide an overview of MEMS technology by describing the main materials and fabrication techniques for manufacturing purposes and their most common biomedical applications, which have evolved in the past years.

Soft Bioelectronics Based on Nanomaterials

Recent advances in nanostructured materials and unconventional device designs have transformed the bioelectronics from a rigid and bulky form into a soft and ultrathin form and brought enormous advantages to the bioelectronics. For example, mechanical deformability of the soft bioelectronics and thus its conformal contact onto soft curved organs such as brain, heart, and skin have allowed researchers to measure high-quality biosignals, deliver real-time feedback treatments, and lower long-term side-effects in vivo. Here, we review various materials, fabrication methods, and device strategies for flexible and stretchable electronics, especially focusing on soft biointegrated electronics using nanomaterials and their composites. First, we summarize top-down material processing and bottom-up synthesis methods of various nanomaterials. Next, we discuss state-of-the-art technologies for intrinsically stretchable nanocomposites composed of nanostructured materials incorporated in elastomers or hydrogels. We also briefly discuss unconventional device design strategies for soft bioelectronics. Then individual device components for soft bioelectronics, such as biosensing, data storage, display, therapeutic stimulation, and power supply devices, are introduced. Afterward, representative application examples of the soft bioelectronics are described. A brief summary with a discussion on remaining challenges concludes the review.

Batteryless, Miniaturized Implantable Glucose Sensor Using a Fluorescent Hydrogel

We propose a biomedical sensor system for continuous monitoring of glucose concentration. Despite recent advances in implantable biomedical devices, mm sized devices have yet to be developed due to the power limitation of the device in a tissue. We here present a mm sized wireless system with backscattered frequency-modulation communication that enables a low-power operation to read the glucose level from a fluorescent hydrogel sensor. The configuration of the reader structure is optimized for an efficient wireless power transfer and data communication, miniaturizing the entire implantable device to 3 × 6 mm 2 size. The operation distance between the reader and the implantable device reaches 2 mm with a transmission power of 33 dBm. We demonstrate that the frequency of backscattered signals changes according to the light intensity of the fluorescent glucose sensor. We envision that the present wireless interface can be applied to other fluorescence-based biosensors to make them highly comfortable, biocompatible, and stable within a body.

Implantable system for chronotherapy

Diurnal variation in enzymes, hormones, and other biological mediators has long been recognized in mammalian physiology. Developments in pharmacobiology over the past few decades have shown that timing drug delivery can enhance drug efficacy. Here, we report the development of a battery-free, refillable, subcutaneous, and trocar-compatible implantable system that facilitates chronotherapy by enabling tight control over the timing of drug administration in response to external mechanical actuation. The external wearable system is coupled to a mobile app to facilitate control over dosing time. Using this system, we show the efficacy of bromocriptine on glycemic control in a diabetic rat model. We also demonstrate that antihypertensives can be delivered through this device, which could have clinical applications given the recognized diurnal variation of hypertension-related complications. We anticipate that implants capable of chronotherapy will have a substantial impact on our capacity to enhance treatment effectiveness for a broad range of chronic conditions.

Flexible artificial Si-In-Zn-O/ion gel synapse and its application to sensory-neuromorphic system for sign language translation

We propose a flexible artificial synapse based on a silicon-indium-zinc-oxide (SIZO)/ion gel hybrid structure directly fabricated on a polyimide substrate, where the channel conductance is effectively modulated via ion movement in the ion gel. This synaptic operation is possible because of the low-temperature deposition process of the SIZO layer (<150°C) and the surface roughness improvement of the poly(4-vinylphenol) buffer layer (12.29→1.81 nm). The flexible synaptic device exhibits extremely stable synaptic performance under high mechanical (bending 1500 times with a radius of 5 mm) and electrical stress (application of voltage pulses 10⁴ times) without any degradation. Last, a sensory-neuromorphic system for sign language translation, which consists of stretchable resistive sensors and flexible artificial synapses, is designed and successfully evaluated via training and recognition simulation using hand sign patterns obtained by stretchable sensors (maximum recognition rate, 99.4%).

Flexible hybrid integration enabled on-skin electronics for wireless monitoring of electrophysiology and motion

On-skin electronics are promising in human motion and vital sign monitoring, disease diagnosis and treatment. On-skin systems are soft and stretchable, and can maintain electrical performances during bending, stretching or twisting, etc. However, current integrated circuit based fabrication processes are not compatible with stretchable substrate, and recently proposed flexible hybrid integration methods typically involve complicated fabrication processes or structural design, and do not support high integration density. Herein, we report a series of flexible hybrid integration strategies which endow the on-skin electronics with advantages of high integration density of electric components, facile fabrications, high stretchability and reliability. Proposed strategies include: 1. High I/O density with highly stretchable and conductive composite materials as interconnects; 2. Multi-layer structures enabled by stretchable and conductive via-holes; 3. High reliability approach for chip attachment onto stretchable substrate; 4. Design and fabrication of strain separation structure. Based on these methods, an on-skin flexible hybrid electronic system (FHES) is fabricated to collect electrocardiogram (ECG) and acceleration data, wirelessly transmit and display the data in real time on a mobile phone application through Bluetooth communication. We also verify the accuracy and stability of the FHES through the measurements of ECG and acceleration data from human skin under various conditions. The flexible hybrid integration schemes proposed can be adopted for the development of a variety of on-skin systems for biomedical applications.

Ultrasound-Powered Implants: A Critical Review of Piezoelectric Material Selection and Applications

Ultrasound-powered implants (UPIs) represent cutting edge power sources for implantable medical devices (IMDs), as their powering strategy allows for extended functional lifetime, decreased size, increased implant depth, and improved biocompatibility. IMDs are limited by their reliance on batteries. While batteries proved a stable power supply, batteries feature relatively large sizes, limited life spans, and toxic material compositions. Accordingly, energy harvesting and wireless power transfer (WPT) strategies are attracting increasing attention by researchers as alternative reliable power sources. Piezoelectric energy scavenging has shown promise for low power applications. However, energy scavenging devices need be located near sources of movement, and the power stream may suffer from occasional interruptions. WPT overcomes such challenges by more stable, on-demand power to IMDs. Among the various forms of WPT, ultrasound powering offers distinct advantages such as low tissue-mediated attenuation, a higher approved safe dose (720 mW cm^-2 ), and improved efficiency at smaller device sizes. This study presents and discusses the state-of-the-art in UPIs by reviewing piezoelectric materials and harvesting devices including lead-based inorganic, lead-free inorganic, and organic polymers. A comparative discussion is also presented of the functional material properties, architecture, and performance metrics, together with an overview of the applications where UPIs are being deployed.

Recent Advances in Printing Technologies of Nanomaterials for Implantable Wireless Systems in Health Monitoring and Diagnosis

The development of wireless implantable sensors and integrated systems, enabled by advances in flexible and stretchable electronics technologies, is emerging to advance human health monitoring, diagnosis, and treatment. Progress in material and fabrication strategies allows for implantable electronics for unobtrusive monitoring via seamlessly interfacing with tissues and wirelessly communicating. Combining new nanomaterials and customizable printing processes offers unique possibilities for high-performance implantable electronics. Here, this report summarizes the recent progress and advances in nanomaterials and printing technologies to develop wireless implantable sensors and electronics. Advances in materials and printing processes are reviewed with a focus on challenges in implantable applications. Demonstrations of wireless implantable electronics and advantages based on these technologies are discussed. Lastly, existing challenges and future directions of nanomaterials and printing are described.

Wireless Power Transfer and Telemetry for Implantable Bioelectronics

Implantable bioelectronic devices are becoming useful and prospective solutions for various diseases owing to their ability to monitor or manipulate body functions. However, conventional implantable devices (e.g., pacemaker and neurostimulator) are still bulky and rigid, which is mostly due to the energy storage component. In addition to mechanical mismatch between the bulky and rigid implantable device and the soft human tissue, another significant drawback is that the entire device should be surgically replaced once the initially stored energy is exhausted. Besides, retrieving physiological information across a closed epidermis is a tricky procedure. However, wireless interfaces for power and data transfer utilizing radio frequency (RF) microwave offer a promising solution for resolving such issues. While the RF interfacing devices for power and data transfer are extensively investigated and developed using conventional electronics, their application to implantable bioelectronics is still a challenge owing to the constraints and requirements of in vivo environments, such as mechanical softness, small module size, tissue attenuation, and biocompatibility. This work elucidates the recent advances in RF-based power transfer and telemetry for implantable bioelectronics to tackle such challenges.

Soft Wearable Healthcare Materials and Devices

In spite of advances in electronics and internet technologies, current healthcare remains hospital-centred. Disruptive technologies are required to translate state-of-art wearable devices into next-generation patient-centered diagnosis and therapy. In this review, recent advances in the emerging field of soft wearable materials and devices are summarized. A prerequisite for such future healthcare devices is the need of novel materials to be mechanically compliant, electrically conductive, and biologically compatible. It is begun with an overview of the two viable design strategies reported in the literatures, which is followed by description of state-of-the-art wearable healthcare devices for monitoring physical, electrophysiological, chemical, and biological signals. Self-powered wearable bioenergy devices are also covered and sensing systems, as well as feedback-controlled wearable closed-loop biodiagnostic and therapy systems. Finally, it is concluded with an overall summary and future perspective.

Recent Advances of Energy Solutions for Implantable Bioelectronics

The emerging field of implantable bioelectronics has attracted widespread attention in modern society because it can improve treatment outcomes, reduce healthcare costs, and lead to an improvement in the quality of life. However, their continuous operation is often limited by conventional bulky and rigid batteries with a limited lifespan, which must be surgically removed after completing their missions and/or replaced after being exhausted. Herein, this paper gives a comprehensive review of recent advances in nonconventional energy solutions for implantable bioelectronics, emphasizing the miniaturized, flexible, biocompatible, and biodegradable power devices. According to their source of energy, the promising alternative energy solutions are sorted into three main categories, including energy storage devices (batteries and supercapacitors), internal energy-harvesting devices (including biofuel cells, piezoelectric/triboelectric energy harvesters, thermoelectric and biopotential power generators), and external wireless power transmission technologies (including inductive coupling/radiofrequency, ultrasound-induced, and photovoltaic devices). Their fundamentals, materials strategies, structural design, output performances, animal experiments, and typical biomedical applications are also discussed. It is expected to offer complementary power sources to extend the battery lifetime of bioelectronics while acting as an independent power supply. Thereafter, the existing challenges and perspectives associated with these powering devices are also outlined, with a focus on implantable bioelectronics.

Flexible and biodegradable electronic implants for diagnosis and treatment of brain diseases

In the diagnosis and treatment of brain diseases, implantable devices have immense potential for intracranial sensing of brain activity and application of controlled therapy for providing feedback to the sensing. Flexible materials are preferred for implantable devices, as they can minimise implanted device-brain tissue mechanical mismatch. Moreover, biodegradable implantable devices can reduce potential immunological side-effects. Biodegradability also helps avoid the burdensome secondary surgery for retrieving the implanted device. In this study, we reviewed recent advancements related to the use of flexible and biodegradable type of implantable devices for the diagnosis and treatment of brain diseases. Representative cases of intracranial sensing and feedback therapy are introduced, and then a brief discussion concludes the review.

A Design Strategy for Intrinsically Stretchable High-Performance Polymer Semiconductors: Incorporating Conjugated Rigid Fused-Rings with Bulky Side Groups

Strategies to improve stretchability of polymer semiconductors, such as introducing flexible conjugation-breakers or adding flexible blocks, usually result in degraded electrical properties. In this work, we propose a concept to address this limitation, by introducing conjugated rigid fused-rings with optimized bulky side groups and maintaining a conjugated polymer backbone. Specifically, we investigated two classes of rigid fused-ring systems, namely, benzene-substituted dibenzothiopheno[6,5-b:6',5'-f]thieno[3,2-b]thiophene (Ph-DBTTT) and indacenodithiophene (IDT) systems, and identified molecules displaying optimized electrical and mechanical properties. In the IDT system, the polymer PIDT-3T-OC12-10% showed promising electrical and mechanical properties. In fully stretchable transistors, the polymer PIDT-3T-OC12-10% showed a mobility of 0.27 cm² V^-1 s^-1 at 75% strain and maintained its mobility after being subjected to hundreds of stretching-releasing cycles at 25% strain. Our results underscore the intimate correlation between chemical structures, mechanical properties, and charge carrier mobility for polymer semiconductors. Our described molecular design approach will help to expedite the next generation of intrinsically stretchable high-performance polymer semiconductors.

Conducting polymer nanoparticles for a voltage-controlled release of pharmacological chaperones

Pharmacological chaperones (PCs) are low-molecular weight chemical molecules used in patients for the treatment of some rare diseases caused primarily by protein instability. A controlled and on-demand release of PCs via nanoparticles is an alternative for cases in which long treatments are needed and prolonged oral administration could have adverse effects. In this work, pyrimethamine (PYR), which is a potent PC consisting of pyrimidine-2,4-diamine substituted at position 5 by a p-chlorophenyl group and at position 6 by an ethyl group, was successfully loaded in electroresponsive poly(3,4-ethylenedioxythiophene) nanoparticles (PEDOT NPs). The PYR-loading capacity was 11.4 ± 1.5%, with both loaded and unloaded PEDOT NPs exhibiting similar sizes (215 ± 3 and 203 ± 1 nm, respectively) and net surface charges (-26 ± 7 and -29 ± 6 mV, respectively). In the absence of electrical stimulus, the release of PC from loaded NPs is very low (1.6% in 24 h and 18% in 80 days) in aqueous environments. Instead, electrical stimuli that sustained for 30 min enhanced the release of PYR, which was ∼50% when the voltage was scanned from -0.5 V to 0.5 V (cyclic voltammetry) and ∼35% when a constant voltage of 1.0 V was applied (chronoamperometry).