Multifunctional materials for implantable and wearable photonic healthcare devices

Transfer printing technologies for soft electronics

Soft electronics have received increasing attention in recent years, owing to their wide range of applications in dynamic nonplanar surface integration electronics that include skin electronics, implantable devices, and soft robotics. Transfer printing is a widely used assembly technology for micro- and nano-fabrication, which enables the integration of functional devices with flexible or elastomeric substrates for the manufacturing of soft electronics. Through advanced materials and process design, numerous impressive studies related to transfer printing strategies and applications have been proposed. Herein, a discussion of transfer printing technologies toward soft electronics in terms of mechanisms and example demonstrations is provided. Moreover, the perspectives on the potential challenges and future directions of this field are briefly discussed.

Paradigm shift in future biophotonics for imaging and therapy: Miniature living lasers to cellular scale optoelectronics

Advancements in light technology, devices and its applications have tremendously changed the facets of biomedical science and engineering to provide powerful diagnostic and therapeutic capabilities ranging from basic research to clinics. Recent novel innovations and concepts in the field of material science, biomedical optics, processing technology and nanotechnology have enabled increasingly sophisticated technologies such as cellular scale, wireless, remotely controlled micro device for in vivo integrations. This review deals with such futuristic applications of biophotonics like miniature living lasers, wireless remotely controlled implantable and cellular optoelectronics for novel imaging, diagnostic and therapeutic applications. We begin with an overview of the competency and progress in biophotonics as one of the most active frontiers in advanced analytical, diagnostic and therapeutic modalities. This is further followed by comprehensive discussion on recent advances, importance and applications, towards miniaturization size of laser to integrate into live cells as biological lasers, and wearable and implantable optoelectronic devices. Such applications form a novel biocompatible platform for intracellular sensing, cytometry and imaging devices. Further, the opportunities and possible challenges for future research directions to transform this basic research to clinical applications are also discussed.

Ultra-Stable, Endurable, and Flexible Sb2TexSe3-x Phase Change Devices for Memory Application and Wearable Electronics

Flexible memory and wearable electronics represent an emerging technology, thanks to their reliability, compatibility, and superior performance. Here, an Sb₂Te_xSe_3-x (STSe) phase change material was grown on flexible mica, which not only exhibited superior nature in thermal stability for phase change memory application but also revealed novel function performance in wearable electronics, thanks to its excellent mechanical reliability and endurance. The thermal stability of Sb₂Te₃ was improved obviously with the crystallization temperature elevated 60 K after Se doping, for the enhanced charge localization and stronger bonding energy, which was validated by the Vienna ab initio simulation package calculations. Based on the ultra-stability of STSe, the STSe-based phase change memory shows 65 000 reversible phase change ability. Moreover, the assembled flexible device can show real-time monitoring and recoverability response in sensing human activities in different parts of the body, which proves its effective reusability and potential as wearable electronics. Most importantly, the STSe device presents remarkable working reliability, reflected by excellent endurance over 100 s and long retention over 100 h. These results paved a novel way to utilize STSe phase change materials for flexible memory and wearable electronics with extreme thermal and mechanical stability and brilliant performance.

Arrayed Heterostructures of MoS2 Nanosheets Anchored TiN Nanowires as Efficient Pseudocapacitive Anodes for Fiber-Shaped Ammonium-Ion Asymmetric Supercapacitors

Nonmetallic ammonium ions that feature high safety, low molar mass, and small hydrated radius properties have shown great advantages in wearable aqueous supercapacitors. The construction of high-energy-density flexible ammonium-ion asymmetric supercapacitors (AASCs) is promising but still challenging due to the lack of high-capacitance pseudocapacitive anodes. Herein, freestanding core-shell heterostructures supported on carbon nanotube fibers were designed by anchoring MoS₂ nanosheets on nanowires (MoS₂@TiN/CNTF) as anodes for AASCs. With contributions of abundant active sites and conspicuous synergistic effects of multiple components for arrayed heterostructure engineering, the developed MoS₂@TiN/CNTF anodes exhibit a specific capacitance of 1102.5 mF cm^-2 at 2 mA cm^-2. Theoretical calculations confirm the dramatic enhancement of the binding strength of ammonium ions on the MoS₂ shell layer at the heterostructure, where a built-in electric field exists to accelerate the charge transfer. By utilizing a MnO₂/CNTF cathode and NH₄Cl/poly(vinyl alcohol) (PVA) as a gel electrolyte, quasi-solid-state fiber-shaped AASCs were successfully constructed, achieving a specific capacitance of 351.2 mF cm^-2 and an energy density of 195.1 μWh cm^-2, outperforming most recently reported fiber-shaped supercapacitors. This work provides a promising strategy to rationally design heterostructure engineering of MoS₂@TiN nanoarrays toward advanced anodes for application in next-generation AASCs.

A Photoactivated Sorafenib-Ruthenium(II) Prodrug for Resistant Hepatocellular Carcinoma Therapy through Ferroptosis and Purine Metabolism Disruption

The curative effect of sorafenib in hepatocellular carcinoma (HCC) is limited and sorafenib resistance remains a major obstacle for HCC. To overcome this obstacle, a new photoactive sorafenib-Ru(II) complex Ru-Sora has been designed. Upon irradiation (λ = 465 nm), Ru-Sora rapidly releases sorafenib and generates reactive oxygen species, which can oxidize intracellular substances such as GSH. Cellular experiments show that irradiated Ru-Sora is highly cytotoxic toward Hep-G2 cells, including sorafenib-resistant Hep-G2-SR cells. Compared to sorafenib, Ru-Sora has a significant photoactivated chemotherapeutic effect against Hep-G2-SR cancer cells and 3D Hep-G2 multicellular tumor spheroids. Furthermore, Ru-Sora inducing apoptosis and ferroptosis is proved by GSH depletion, GPX4 downregulation, and lipid peroxide accumulation. Metabolomics results suggest that Ru-Sora exerts photocytotoxicity by disrupting the purine metabolism, which is expected to inhibit tumor development. This study provides a promising strategy for enhancing chemotherapy and combating drug-resistant HCC disease.

Wireless Stand-Alone Trimodal Interactive Display Enabled by Direct Capacitive Coupling

With recent advances in interactive displays, the development of a stand-alone interactive display with no electrical interconnection is of great interest. Here, a wireless stand-alone interactive display (WiSID), enabled by direct capacitive coupling, consisting of three layers: two in-plane metal electrodes separated by a gap, a composite layer for field-induced electroluminescence (EL) and inverse piezoelectric sound, and a stimuli-responsive layer, from bottom to top, is presented. Alternating current power necessary for field-induced EL and inverse piezoelectric sound is wirelessly transferred from a power unit, with two in-plane electrodes remotely separated from the WiSID. The unique in-plane power transfer through the stimuli-sensitive polar bridge allows stand-alone operation of the WiSID, making it suitable for the wireless dynamic monitoring of medical fluids. Moreover, a haptic wireless stand-alone trimodal interactive display mounted on a human finger is demonstrated, whereby touch is wirelessly displayed in various outputs of EL, inverse piezoelectric sound, and tactile vibration, making it suitable for a wireless three-mode smart braille display.

Hyaluronate-Black Phosphorus-Upconversion Nanoparticle Complex for Non-invasive Theranosis of Skin Cancer

Despite the wide investigation on black phosphorus (BP) for biophotonic applications, the finite depth of light penetration has limited further development of BP-based photomedicines. Here, we developed a hyaluronate-BP-upconversion nanoparticle (HA-BP-UCNP) complex for near-infrared (NIR) light-mediated multimodal theranosis of skin cancer with photoacoustic (PA) bioimaging, photodynamic therapy (PDT), and photothermal therapy (PTT). In contrast to the conventional BP-based skin cancer theranosis, the HA-BP-UCNP complex could be non-invasively delivered into the tumor tissue to induce the cancer cell apoptosis upon NIR light irradiation. The PA imaging of BP successfully visualized the non-invasive transdermal delivery of the HA-BP-UCNP complex into the mice skin. HA in the complex facilitated the transdermal delivery of BP into the tumor tissue under the skin. Upon 980 nm NIR light irradiation, the UCNP converted the light to UV-blue light to generate reactive oxygen species by sensitizing BP in the HA-BP-UCNP complex for PDT. Remarkably, 808 nm NIR irradiation with PTT triggered the apoptosis of tumor cells. Taken together, we could confirm the feasibility of the HA-BP-UCNP complex for NIR light-mediated multimodal theranosis of skin cancers.

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.

Bending-Insensitive Intrinsically Flexible Ultraviolet Encoding Devices Based on Piezoelectric Nanogenerator-Supplied Liquid Crystalline Polymer Fabrics

It is significantly challenging for state-of-the-art wearable electronics to stably monitor physicochemical signals under dynamic motions. Herein, a bending-insensitive, self-powered, and intrinsically flexible UV detector has been realized based on well-designed oriented composite fabrics, consisting of ionic liquid (IL)-containing liquid crystalline polymers (ILCPs) and piezoelectric poly(vinylidene fluoride-trifluoroethylene) [P(VDF-TrFE)] nanogenerators. The novel composite fabrics establish effective UV illuminance-internal stress-electric signal conversion by coupling resistive and piezoelectric effects, with a fast response time of 190 ms. Particularly, benefiting from the intrinsic flexibility of composite fabrics, the ILCP/P(VDF-TrFE) device can maintain stable performance under dynamic bending even if the frequency is up to 2.5 Hz, with a bending insensitivity of less than 1% performance variation under 1.0 mW cm^-2 UV light. Combined with the Internet of Things and the American Standard Code for Information Interchange (ASCII), wearable encoding electronics have been successfully implemented with a printing speed of 3.2 s per character under dynamic bending.

A Personalized Electronic Tattoo for Healthcare Realized by On-the-Spot Assembly of an Intrinsically Conductive and Durable Liquid-Metal Composite

Conventional electronic (e-) skins are a class of thin-film electronics mainly fabricated in laboratories or factories, which is incapable of rapid and simple customization for personalized healthcare. Here a new class of e-tattoos is introduced that can be directly implemented on the skin by facile one-step coating with various designs at multi-scale depending on the purpose of the user without a substrate. An e-tattoo is realized by attaching Pt-decorated carbon nanotubes on gallium-based liquid-metal particles (CMP) to impose intrinsic electrical conductivity and mechanical durability. Tuning the CMP suspension to have low-zeta potential, excellent wettability, and high-vapor pressure enables conformal and intimate assembly of particles directly on the skin in 10 s. Low-cost, ease of preparation, on-skin compatibility, and multifunctionality of CMP make it highly suitable for e-tattoos. Demonstrations of electrical muscle stimulators, photothermal patches, motion artifact-free electrophysiological sensors, and electrochemical biosensors validate the simplicity, versatility, and reliability of the e-tattoo-based approach in biomedical engineering.

Flexible passive integrated photonic devices with superior optical and mechanical performance

Flexible integrated photonics is a rapidly emerging technology with a wide range of possible applications in the fields of flexible optical interconnects, conformal multiplexing sensing, health monitoring, and biotechnology. One major challenge in developing mechanically flexible integrated photonics is the functional component within an integrated photonic circuit with superior performance. In this work, several essential flexible passive devices for such a circuit were designed and fabricated based on a multi-neutral-axis mechanical design and a monolithic integration technique. The propagation loss of the waveguide is calculated to be 4.2 dB/cm. In addition, we demonstrate a microring resonator, waveguide crossing, multimode interferometer (MMI), and Mach-Zehnder interferometer (MZI) for use at 1.55 µm, each exhibiting superior optical and mechanical performance. These results represent a significant step towards further exploring a complete flexible photonic integrated circuit.

Inorganic-Organic Hybrid Phototransistor Array with Enhanced Photogating Effect for Dynamic Near-Infrared Light Sensing and Image Preprocessing

Narrow-band-gap organic semiconductors have emerged as appealing near-infrared (NIR) sensing materials by virtue of their unique optoelectronic properties. However, their limited carrier mobility impedes the implementation of large-area, dynamic NIR sensor arrays. In this work, high-performance inorganic-organic hybrid phototransistor arrays are achieved for NIR sensing, by taking advantage of the high electron mobility of In₂O₃ and the strong NIR absorption of a BTPV-4F:PTB7-Th bulk heterojunction (BHJ) with an enhanced photogating effect. As a result, the hybrid phototransistors reach a high responsivity of 1393.0 A W^-1, a high specific detectivity of 4.8 × 10¹² jones, and a fast response of 0.72 ms to NIR light (900 nm). Meanwhile, an integrated 16 × 16 phototransistor array with a one-transistor-one-phototransistor (1T1PT) architecture is achieved. On the basis of the enhanced photogating effect, the phototransistor array can not only achieve real-time, dynamic NIR light mapping but also implement image preprocessing, which is promising for advanced NIR image sensors.

Comparison between Piezoelectric and Piezoresistive Wearable Gait Monitoring Techniques

Insole plantar stress detection (PSD) techniques play an important role in gait monitoring. Among the various insole PSD methods, piezoelectric- and piezoresistive-based architectures are broadly used in medical scenes. Each year, a growing number of new research outcomes are reported. Hence, a deep understanding of these two kinds of insole PSD sensors and state-of-the-art work would strongly benefit the researchers in this highly interdisciplinary field. In this context, this review article is composed of the following aspects. First, the mechanisms of the two techniques and corresponding comparisons are explained and discussed. Second, advanced materials which could enhance the performance of current piezoelectric and piezoresistive insole prototypes are introduced. Third, suggestions for designing insole PSD prototypes/products for different diseases are offered. Last, the current challenge and potential future trends are provided.

Programmable CRISPR-Cas9 microneedle patch for long-term capture and real-time monitoring of universal cell-free DNA

Recent advances in biointerfaces have led to the development of wearable devices that can provide insights into personal health. As wearable modules, microneedles can extract analytes of interest from interstitial fluid in a minimally invasive fashion. However, some microneedles are limited by their ability to perform highly effective extraction and real-time monitoring for macromolecule biomarkers simultaneously. Here we show the synergetic effect of CRISPR-activated graphene biointerfaces, and report an on-line wearable microneedle patch for extraction and in vivo long-term monitoring of universal cell-free DNA. In this study, this wearable system enables real-time monitoring of Epstein-Barr virus, sepsis, and kidney transplantation cell-free DNA, with anti-interference ability of 60% fetal bovine serum, and has satisfactory stable sensitivity for 10 days in vivo. The experimental results of immunodeficient mouse models shows the feasibility and practicability of this proposed method. This wearable patch holds great promise for long-term in vivo monitoring of cell-free DNA and could potentially be used for early disease screening and prognosis.

Real-time sensing of biomarkers via the use of wearable devices is a major aim of personalised medicine. Here, authors demonstrate an on-line wearable microneedle patch for real-time capture and monitoring of universal cell-free DNA.

Recent Advances in Flexible RF MEMS

Microelectromechanical systems (MEMS) that are based on flexible substrates are widely used in flexible, reconfigurable radio frequency (RF) systems, such as RF MEMS switches, phase shifters, reconfigurable antennas, phased array antennas and resonators, etc. When attempting to accommodate flexible deformation with the movable structures of MEMS, flexible RF MEMS are far more difficult to structurally design and fabricate than rigid MEMS devices or other types of flexible electronics. In this review, we survey flexible RF MEMS with different functions, their flexible film materials and their fabrication process technologies. In addition, a fabrication process for reconfigurable three-dimensional (3D) RF devices based on mechanically guided assembly is introduced. The review is very helpful to understand the overall advances in flexible RF MEMS, and serves the purpose of providing a reference source for innovative researchers working in this field.

Upconversion nanomaterials and delivery systems for smart photonic medicines and healthcare devices

In the past decade, upconversion (UC) nanomaterials have been extensively investigated for the applications to photomedicines with their unique features including biocompatibility, near-infrared (NIR) to visible conversion, photostability, controllable emission bands, and facile multi-functionality. These characteristics of UC nanomaterials enable versatile light delivery for deep tissue biophotonic applications. Among various stimuli-responsive delivery systems, the light-responsive delivery process has been greatly advantageous to develop spatiotemporally controllable on-demand "smart" photonic medicines. UC nanomaterials are classified largely to two groups depending on the photon UC pathway and compositions: inorganic lanthanide-doped UC nanoparticles and organic triplet-triplet annihilation UC (TTA-UC) nanomaterials. Here, we review the current-state-of-art inorganic and organic UC nanomaterials for photo-medicinal applications including photothermal therapy (PTT), photodynamic therapy (PDT), photo-triggered chemo and gene therapy, multimodal immunotherapy, NIR mediated neuromodulations, and photochemical tissue bonding (PTB). We also discuss the future research direction of this field and the challenges for further clinical development.

Fast Self-Assembly of Photonic Crystal Hydrogel for Wearable Strain and Temperature Sensor

Structural colors from photonic crystals (PCs) have attracted emerging attention in the research area of wearable sensors. Conventional self-assembly of PC takes days to weeks. Here, a fast self-assembly method of PC with horizontal precipitation of silica nanoparticles (NPs) in a polydimethylsiloxane fence, which can be completed within 1-4 h depending on the fence parameters, is introduced. The resultant PC exhibits tunable structural colors in the entire visible spectrum. With infiltration of composite hydrogels containing acrylic acid, acrylamide, chitosan, and carbon nanotubes (CNTs) into the gaps of NPs to form an inverse opal PC, a structural color hydrogel that can quickly respond to different stimuli, including strain and temperature, is obtained. Moreover, with the addition of CNTs, the composite PC hydrogel can also output an electronic signal together with optical color changes. Based on these extraordinary responsive behaviors, the PC hydrogel sensor for quantitative feedback to external stimuli of stretching, bending, pressing, and thermal stimuli, with brilliant color change and electronic signal outputs simultaneously, is demonstrated. This fast-assembled PC hydrogel with excellent responsive properties has great potential for applications in wearable devices, mechanical sensors, temperature sensors, and colorimetric displays.

Integrated Analytical System for Clinical Single-Cell Analysis

High-dimensional analyses of cancers can potentially be used to better define cancer subtypes, analyze the complex tumor microenvironment, and perform cancer cell pathway analyses for drug trials. Unfortunately, integrated systems that allow such analyses in serial fine needle aspirates within a day or at point-of-care currently do not exist. To achieve this, an integrated immunofluorescence single-cell analyzer (i2SCAN) for deep profiling of directly harvested cells is developed. By combining a novel cellular imaging system, highly cyclable bioorthogonal FAST antibody panels, and integrated computational analysis, it is shown that same-day analysis is possible in thousands of harvested cells. It is demonstrated that the i2SCAN approach allows comprehensive analysis of breast cancer samples obtained by fine needle aspiration or core tissues. The method is a rapid, robust, and low-cost solution to high-dimensional analysis of scant clinical specimens.

Materials and device design for advanced phototherapy systems

Phototherapy has recently emerged as a promising solution for cancer treatment due to its multifunctionality and minimal invasiveness. Notwithstanding the limited penetration depth of light through skin, the ability of photopharmaceutical device systems to deliver light to desired lesions is important. The device system deploys advanced biocompatible materials and fabrication technologies for electronics, and eventually enables more efficient phototherapy. In this review, we focus on diverse optical electronics to illuminate the lesion site with light. Then, moving on to the phototherapy, we highlight photo-thermal therapy with light absorbing materials, photo-activated chemotherapy with light sensitive materials, and photo-dynamic therapy using photosensitizers. Furthermore, we introduce a drug delivery system that can deliver these photopharmaceutical agents spatiotemporally to the tumor site. To this end, we provide a general overview of materials and devices for phototherapy and discuss critical issues and pending limitations of such phototherapy.

Recent progress in electrospun nanomaterials for wearables

Wearables have garnered significant attention in recent years not only as consumer electronics for entertainment, communications, and commerce but also for real-time continuous health monitoring. This has been spurred by advances in flexible sensors, transistors, energy storage, and harvesting devices to replace the traditional, bulky, and rigid electronic devices. However, engineering smart wearables that can seamlessly integrate with the human body is a daunting task. Some of the key material attributes that are challenging to meet are skin conformability, breathability, and biocompatibility while providing tunability of its mechanical, electrical, and chemical properties. Electrospinning has emerged as a versatile platform that can potentially address these challenges by fabricating nanofibers with tunable properties from a polymer base. In this article, we review advances in wearable electronic devices and systems that are developed using electrospinning. We cover various applications in multiple fields including healthcare, biomedicine, and energy. We review the ability to tune the electrical, physiochemical, and mechanical properties of the nanofibers underlying these applications and illustrate strategies that enable integration of these nanofibers with human skin.

Gaining control over conjugated polymer morphology to improve the performance of organic electronics

Conjugated polymers (CPs) are widely used in various domains of organic electronics. However, the performance of organic electronic devices can be variable due to the lack of precise predictive control over the polymer microstructure. While the chemical structure of CPs is important, CP microstructure also plays an important role in determining the charge-transport, optical and mechanical properties suitable for a target device. Understanding the interplay between CP microstructure and the resulting properties, as well as predicting and targeting specific polymer morphologies, would allow current comprehension of organic electronic device performance to be improved and potentially enable more facile device optimization and fabrication. In this Feature Article, we highlight the importance of investigating CP microstructure, discuss previous developments in the field, and provide an overview of the key aspects of the CP microstructure-property relationship, carried out in our group over recent years.

Bimetallic Nanocatalysts Immobilized in Nanoporous Hydrogels for Long-Term Robust Continuous Glucose Monitoring of Smart Contact Lens

Smart contact lenses for continuous glucose monitoring (CGM) have great potential for huge clinical impact. To date, their development has been limited by challenges in accurate detection of glucose without hysteresis for tear glucose monitoring to track the blood glucose levels. Here, long-term robust CGM in diabetic rabbits is demonstrated by using bimetallic nanocatalysts immobilized in nanoporous hydrogels in smart contact lenses. After redox reaction of glucose oxidase, the nanocatalysts facilitate rapid decomposition of hydrogen peroxide and nanoparticle-mediated charge transfer with drastically improved diffusion via rapid swelling of nanoporous hydrogels. The ocular glucose sensors result in high sensitivity, fast response time, low detection limit, low hysteresis, and rapid sensor warming-up time. In diabetic rabbits, smart contact lens can detect tear glucose levels consistent with blood glucose levels measured by a glucometer and a CGM device, reflecting rapid concentration changes without hysteresis. The CGM in a human demonstrates the feasibility of smart contact lenses for further clinical applications.

Transient, Implantable, Ultrathin Biofuel Cells Enabled by Laser-Induced Graphene and Gold Nanoparticles Composite

Transient power sources with excellent biocompatibility and bioresorablility have attracted significant attention. Here, we report high-performance, transient glucose enzymatic biofuel cells (TEBFCs) based on the laser-induced graphene (LIG)/gold nanoparticles (Au NPs) composite electrodes. Such LIG electrodes can be easily fabricated from polyimide (PI) with an infrared CO₂ laser and exhibit a low impedance (16 Ω). The resulted TEBFC yields a high open circuit potential (OCP) of 0.77 V and a maximum power density of 483.1 μW/cm². The TEBFC not only exhibits a quick response time that enables reaching the maximum OCP within 1 min but also owns a long lifetime over 28 days in vitro. The excellent biocompatibility and transient performance from in vitro and in vivo tests allow long-term implantation of TEBFCs in rats for energy harvesting. The TEBFCs with advanced processing methods provide a promising power solution for transient electronics.

Cutting-Edge Progress in Stimuli-Responsive Bioadhesives: From Synthesis to Clinical Applications

With the advent of "intelligent" materials, the design of smart bioadhesives responding to chemical, physical, or biological stimuli has been widely developed in biomedical applications to minimize the risk of wounds reopening, chronic pain, and inflammation. Intelligent bioadhesives are free-flowing liquid solutions passing through a phase shift in the physiological environment due to stimuli such as light, temperature, pH, and electric field. They possess great merits, such as ease to access and the ability to sustained release as well as the spatial transfer of a biomolecule with reduced side effects. Tissue engineering, wound healing, drug delivery, regenerative biomedicine, cancer therapy, and other fields have benefited from smart bioadhesives. Recently, many disciplinary attempts have been performed to promote the functionality of smart bioadhesives and discover innovative compositions. However, according to our knowledge, the development of multifunctional bioadhesives for various biomedical applications has not been adequately explored. This review aims to summarize the most recent cutting-edge strategies (years 2015-2021) developed for stimuli-sensitive bioadhesives responding to external stimuli. We first focus on five primary categories of stimuli-responsive bioadhesive systems (pH, thermal, light, electric field, and biomolecules), their properties, and limitations. Following the introduction of principal criteria for smart bioadhesives, their performances are discussed, and certain smart polymeric materials employed in their creation in 2015 are studied. Finally, advantages, disadvantages, and future directions regarding smart bioadhesives for biomedical applications are surveyed.

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.

Combinatorial wound healing therapy using adhesive nanofibrous membrane equipped with wearable LED patches for photobiomodulation

Wound healing is the dynamic tissue regeneration process replacing devitalized and missing tissue layers. With the development of photomedicine techniques in wound healing, safe and noninvasive photobiomodulation therapy is receiving attention. Effective wound management in photobiomodulation is challenged, however, by limited control of the geometrical mismatches on the injured skin surface. Here, adhesive hyaluronic acid-based gelatin nanofibrous membranes integrated with multiple light-emitting diode (LED) arrays are developed as a skin-attachable patch. The nanofibrous wound dressing is expected to mimic the three-dimensional structure of the extracellular matrix, and its adhesiveness allows tight coupling between the wound sites and the flexible LED patch. Experimental results demonstrate that our medical device accelerates the initial wound healing process by the synergetic effects of the wound dressing and LED irradiation. Our proposed technology promises progress for wound healing management and other biomedical applications.

Host-guest liquid gating mechanism with specific recognition interface behavior for universal quantitative chemical detection

Universal visual quantitative chemical detection technology has emerged as an increasingly crucial tool for convenient testing with immediate results in the fields of environmental assessment, homeland security, clinical drug testing and health care, particularly in resource-limited settings. Here, we show a host-guest liquid gating mechanism to translate molecular interface recognition behavior into visually quantifiable detection signals. Quantitative chemical detection is achieved, which has obvious advantages for constructing a portable, affordable, on-site sensing platform to enable the visual quantitative testing of target molecules without optical/electrical equipment. Experiments and theoretical calculations confirm the specificity and scalability of the system. This mechanism can also be tailored by the rational design of host-guest complexes to quantitatively and visually detect various molecules. With the advantages of versatility and freedom from additional equipment, this detection mechanism has the potential to revolutionize environmental monitoring, food safety analysis, clinical drug testing, and more.

In field, visual, chemical detection is of use for a wide range of possible applications. Here, the authors report on the creation of a host-guest liquid gating mechanism where detection of the target host triggers gate opening allowing for gas through the liquid gate, which can be used for visual detection.

Tissue-Like Optoelectronic Neural Interface Enabled by PEDOT:PSS Hydrogel for Cardiac and Neural Stimulation

Optoelectronic biointerfaces have made a significant impact on modern science and technology from understanding the mechanisms of the neurotransmission to the recovery of the vision for blinds. They are based on the cell interfaces made of organic or inorganic materials such as silicon, graphene, oxides, quantum dots, and π-conjugated polymers, which are dry and stiff unlike a cell/tissue environment. On the other side, wet and soft hydrogels have recently been started to attract significant attention for bioelectronics because of its high-level tissue-matching biomechanics and biocompatibility. However, it is challenging to obtain optimal opto-bioelectronic devices by using hydrogels requiring device, heterojunction, and hydrogel engineering. Here, an optoelectronic biointerface integrated with a poly(3,4-ethylenedioxythiophene):poly(styrene sulfonate), PEDOT:PSS, hydrogel that simultaneously achieves efficient, flexible, stable, biocompatible, and safe photostimulation of cells is demonstrated. Besides their interfacial tissue-like biomechanics, ≈34 kPa, and high-level biocompatibility, hydrogel-integration facilitates increase in charge injection amounts sevenfolds with an improved responsivity of 156 mA W^-1 , stability under mechanical bending , and functional lifetime over three years. Finally, these devices enable stimulation of individual hippocampal neurons and photocontrol of beating frequency of cardiac myocytes via safe charge-balanced capacitive currents. Therefore, hydrogel-enabled optoelectronic biointerfaces hold great promise for next-generation wireless neural and cardiac implants.

An Electroluminodynamic Flexible Device for Highly Efficient Eradication of Drug-Resistant Bacteria

Photodynamic therapy (PDT) has attracted wide attention in antibacterial applications due to its advantages of spatial-temporal selectivity, noninvasiveness, and low incidence to develop drug resistance. To make it more convenient, universal, and manipulatable for clinical application, a conceptually antibacterial strategy, namely "electroluminodynamic therapy" (ELDT), is presented by nanoassembly of an electroluminescent (EL) material and a photosensitizer, which is capable of generating reactive oxygen species (ROS) in situ under an electric field, i.e., the fluorescence emitted by the EL molecules excites the photosensitizer to generate singlet oxygen (¹ O₂ ), for the oxidative damage of pathogens. Based on the scheme of ELDT, a flexible therapeutic device is fabricated through a hydrogel loading with ELDT nanoagents, followed by integration with a flexible battery, satisfying the requirements of being light and wearable for wound dressings. The ELDT-based flexible device presents potent ROS-induced killing efficacies against drug-resistant bacteria (>99.9%), so as to effectively inhibit the superficial infection and promote the wound healing. This research reveals a proof-of-concept ELDT strategy as a prospective alternative to PDT, which avoids the utilization of a physical light source, and achieves convenient and effective killing of drug-resistant bacteria through a hydrogel-based flexible therapeutic device.

Diagnostic Features and Potential Applications of PPG Signal in Healthcare: A Systematic Review

Recent research indicates that Photoplethysmography (PPG) signals carry more information than oxygen saturation level (SpO2) and can be utilized for affordable, fast, and noninvasive healthcare applications. All these encourage the researchers to estimate its feasibility as an alternative to many expansive, time-wasting, and invasive methods. This systematic review discusses the current literature on diagnostic features of PPG signal and their applications that might present a potential venue to be adapted into many health and fitness aspects of human life. The research methodology is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020. To this aim, papers from 1981 to date are reviewed and categorized in terms of the healthcare application domain. Along with consolidated research areas, recent topics that are growing in popularity are also discovered. We also highlight the potential impact of using PPG signals on an individual's quality of life and public health. The state-of-the-art studies suggest that in the years to come PPG wearables will become pervasive in many fields of medical practices, and the main domains include cardiology, respiratory, neurology, and fitness. Main operation challenges, including performance and robustness obstacles, are identified.

Exosome-mediated delivery of transforming growth factor-β receptor 1 kinase inhibitors and toll-like receptor 7/8 agonists for combination therapy of tumors

In this study, combination therapy with the transforming growth factor-β receptor I (TGFβRI) kinase inhibitor SD-208 and a toll-like receptor (TLR)-7/8 agonist resiquimod (R848) was examined along with serum-derived exosomes (EXOs) as versatile carriers. SD-208-encapsulated EXOs (SD-208/EXOs) and R848-encapsulated EXOs (R848/EXOs) were successfully prepared with a size of 87 ± 8 nm and 51 ± 4 nm, respectively, which were stable in aqueous solution at pH 7.4. SD-208/EXOs and R848/EXOs reduced the migration of cancer cells (B16F10 and PC-3) and triggered the release of proinflammatory cytokines from stimulated macrophages and dendritic cells, respectively. The fluorescent dye-labeled EXOs showed significantly improved penetration through the PC-3/fibroblast co-culture spheroids and enhanced accumulation in the B16F10 mouse tumor model compared with the free fluorescent dye. In addition, the combination therapy of R848/EXOs (R848 dose of 0.36 mg/kg) and SD-208/EXOs (SD-208 dose of 0.75 mg/kg) reduced tumor growth and improved survival rate at low doses in the B16F10 tumor xenograft model. Taken together, the combination therapy using the TGFβRI kinase inhibitor and TLR 7/8 agonist with EXOs may serve as a promising strategy to treat melanoma and prostate cancer. STATEMENT OF SIGNIFICANCE: Owing to the prevalence of several non-responding cancers that resist treatment, it is necessary to identify a novel combined treatment strategy with biomaterials to maximize therapeutic efficacy and minimize the undesirable side effects. In this study, we aimed to examine the use of the TGFβRI kinase inhibitor SD-208 and the TLR7/8 agonist resiquimod (R848) encapsulated within serum-derived EXOs for their synergistic antitumor effects. We first demonstrated that combined treatment with SD-208 and R848 can be a convincing strategy to circumvent tumor growth in vivo using serum-derived exosomes as promising carriers. Therefore, we believe this manuscript would be of great interest to the biomaterial communities especially who are studying immunotherapy.

Generation of multiple triplet states in an orthogonal bodipy dimer: a breakthrough spectroscopic and theoretical approach

Generation of triplet states in assemblies of organic chromophores is extremely appealing for their potential use in optoelectronic applications. In this work, we investigate the intricacies of triplet state generation in an orthogonal BODIPY dimer by combining delayed photoemission techniques with electronic structure calculations. Our analysis provides a deep understanding of the electronic states involved, and describes different competing deactivation channels beyond prompt radiative decay. In particular, we identify charge-transfer (CT) mediated intersystem crossing (ISC) as the most likely mechanism for the triplet state generation in this system. The different emission bands at long times can be associated with delayed fluorescence, CT emission and phosphorescence from multiple low-energy triplets. Interestingly, the dependence of the yield of triplet state population and emission profiles with the solvent polarity evidences the decisive role of the CT configuration in the fate of the photoactivated dimer, controlling the relative ISC, reverse ISC, and internal conversion efficiencies. Overall, the present results provide a rather complete description of the delayed photophysics in the BODIPY dimer, but are not able to fully rationalize the unexpected photoluminescence recorded at long wavelengths (≥ 900 nm). We hypothesize that the origin of this emission, not present in BODIPY monomers, emerges from intermonomer interactions triggered by intramolecular distortions opening up a new vision in the controverted mechanism driving the photophysical behavior from orthogonally linked organic monomers.

A 2D material-based transparent hydrogel with engineerable interference colours

Transparent hydrogels are key materials for many applications, such as contact lens, imperceptible soft robotics and invisible wearable devices. Introducing large and engineerable optical anisotropy offers great prospect for endowing them with extra birefringence-based functions and exploiting their applications in see-through flexible polarization optics. However, existing transparent hydrogels suffer from limitation of low and/or non-fine engineerable birefringence. Here, we invent a transparent magneto-birefringence hydrogel with large and finely engineerable optical anisotropy. The large optical anisotropy factor of the embedded magnetic two-dimensional material gives rise to the large magneto-birefringence of the hydrogel in the transparent condition of ultra-low concentration, which is several orders of magnitude larger than usual transparent magnetic hydrogels. High transparency, large and tunable optical anisotropy cooperatively permit the magnetic patterning of interference colours in the hydrogel. The hydrogel also shows mechanochromic and thermochromic property. Our finding provides an entry point for applying hydrogel in optical anisotropy and colour centred fields, with several proof-of-concept applications been demonstrated.

Though transparent hydrogels with tunable optical anisotropy are attractive for soft robotics, wearable devices and optical applications, achieving large birefringence has been a challenge. Here, the authors report a transparent hydrogel with large, uniform and magnetically tunable birefringence.

Multifunctionally wearable monitoring with gelatin hydrogel electronics of liquid metals

Hydrogel-based flexible electronics have been of widespread interest in recent years. However, current hydrogel electronics have limitations, such as poor biocompatibility, non-reusability, low electrical response to deformation and being single-function. GelMA is a gelatin-based hydrogel that has been widely used in the biological field, such as in tissue repair and drug delivery. Could it be a good choice for high biocompatibility wearable electronics? Here, by controlling the replacement rate of amine and hydroxy functionalities, we made the common brittle GelMA into a highly stretchable hydrogel. And we report for the first time GelMA hydrogel electronics with liquid metals (LMGE), which could be fabricated by simply injecting liquid metals into the internal microchannels of the GelMA hydrogels (GelMA-30). With the unique biocompatibility, outstanding air and ion permeability, and great mechanical properties of GelMA-30, as well as the low toxicity, high conductivity and high rheology of liquid metals, LMGE can not only monitor movement changes and even the heartbeat of rats, but can also be used as a wireless monitor to supervise secretions produced during human exercise. The design of LMGE provides a general strategy for the manufacture of bio-flexible hydrogel electronics, which opens the way for the development of multi-functional biomimetic materials for integrated monitoring and repair for biomedical applications.

Smart Wireless Near-Infrared Light Emitting Contact Lens for the Treatment of Diabetic Retinopathy

Diabetic retinopathy is currently treated by highly invasive repeated therapeutic injections and surgical interventions without complete vision recovery. Here, a noninvasive smart wireless far red/near-infrared (NIR) light emitting contact lens developed successfully for the repeated treatment of diabetic retinopathy with significantly improved compliance. A far red/NIR light emitting diode (LED) is connected with an application-specific integrated circuit chip, wireless power, and communication systems on a PET film, which is embedded in a silicone elastomer contact lens by thermal crosslinking. After in vitro characterization, it is confirmed that the retinal vascular hyper-permeability induced by diabetic retinopathy in rabbits is reduced to a statistically significant level by simply repeated wearing of smart far red/NIR LED contact lens for 8 weeks with 120 µW light irradiation for 15 min thrice a week. Histological analysis exhibits the safety and feasibility of LED contact lenses for treating diabetic retinopathy. This platform technology for smart LED contact lens would be harnessed for various biomedical photonic applications.

A Degradable-Renewable Ionic Skin Based on Edible Glutinous Rice Gel

Traditional wearable devices are commonly nonrecyclable and nondegradable, resulting in energy waste and environmental pollution. Here, a household degradable and renewable ionic skin based on edible glutinous rice gel is developed for a strain, temperature and salivary enzyme activity sensor. This gel depends on intermolecular and intramolecular H-bonds among amylopectin and amylose, and this presents excellent skin-like properties, including stretchability, self-healing property, and adhesion to various substrates. The glutinous rice gel-based skin sensor can be used to monitor vital signs and physiological parameters such as body temperature and heart rate. The sensor also achieves specific speech recognition and detects temperature and body micromovements, which provides the potential to reconstruct language or sensory/motor functions. More importantly, because of the excellent biocompatibility and degradability, the sensor can directly detect the activity of human salivary amylase, which is useful for diagnosing pancreas-, kidney-, and spleen-related diseases in the elderly. Finally, the raw material of ionic skin that originates from traditional grains is degradable and renewable as well as it can be used to prepare household wearable devices. Hence, this work not only extends the application of wearable electronics in daily life but also facilitates health monitoring in the elderly and improves their quality of life.

A Mechanically Interlocking Strategy Based on Conductive Microbridges for Stretchable Electronics

Stretchable electronics incorporating critical sensing, data transmission, display and powering functionalities, is crucial to emerging wearable healthcare applications. To date, methods to achieve stretchability of individual functional devices have been extensively investigated. However, integration strategies of these stretchable devices to achieve all-stretchable systems are still under exploration, in which the reliable stretchable interconnection is a key element. Here, solderless stretchable interconnections based on mechanically interlocking microbridges are developed to realize the assembly of individual stretchable devices onto soft patternable circuits toward multifunctional all-stretchable platforms. This stretchable interconnection can effectively bridge interlayer conductivity with tight adhesion through both conductive microbridges and selectively distributed adhesive polymer. Consequently, enhanced stretchability up to a strain of 35% (R/R₀  ≤ 5) is shown, compared with conventional solder-assisted connections which lose electrical conduction at a strain of less than 5% (R/R₀  ≈ 30). As a proof of concept, a self-powered all-stretchable data-acquisition platform is fabricated by surface mounting a stretchable strain sensor and a supercapacitor onto a soft circuit through solderless interconnections. This solderless interconnecting strategy for surface-mountable devices can be utilized as a valuable technology for the integration of stretchable devices to achieve all-soft multifunctional systems.

Recent Advances in Multiresponsive Flexible Sensors towards E-skin: A Delicate Design for Versatile Sensing

Multiresponsive flexile sensors with strain, temperature, humidity, and other sensing abilities serving as real electronic skin (e-skin) have manifested great application potential in flexible electronics, artificial intelligence (AI), and Internet of Things (IoT). Although numerous flexible sensors with sole sensing function have already been reported since the concept of e-skin, that mimics the sensing features of human skin, was proposed about a decade ago, the ones with more sensing capacities as new emergences are urgently demanded. However, highly integrated and highly sensitive flexible sensors with multiresponsive functions are becoming a big thrust for the detection of human body motions, physiological signals (e.g., skin temperature, blood pressure, electrocardiograms (ECG), electromyograms (EMG), sweat, etc.) and environmental stimuli (e.g., light, magnetic field, volatile organic compounds (VOCs)), which are vital to real-time and all-round human health monitoring and management. Herein, this review summarizes the design, manufacturing, and application of multiresponsive flexible sensors and presents the future challenges of fabricating these sensors for the next-generation e-skin and wearable electronics.

Bio-inspired flexible electronics for smart E-skin

"Learning from nature" provides endless inspiration for scientists to invent new materials and devices. Here, we review state-of-the-art technologies in flexible electronics, with a focus on bio-inspired smart skins. This review focuses on the development of E-skin for sensing a variety of parameters such as mechanical loads, temperature, light, and biochemical cues, with a trend of increased integration of multiple functions. It highlights the most recent advances in flexible electronics inspired by animals such as chameleons, squids, and octopi whose bodies have remarkable camouflage, mimicry, or self-healing attributes. Implantable devices, being overlapped with smart E-skin in a broad sense, are included in this review. This review outlines the remaining challenges in flexible electronics and the prospects for future development for biomedical applications. STATEMENT OF SIGNIFICANCE: This article reviews the state-of-the-art technologies of bio-inspired smart electronic skin (E-skin) developed in a "learning-mimicking-creating" (LMC) cycle. We emphasize the most recent innovations in the development of E-skin for sensing physical changes and biochemical cues, and for integrating multiple sensing modalities. We discuss the achievements in implantable materials, wireless communication, and device design pertaining to implantable flexible electronics. This review will provide prospective insights integrating material, electronics, and mechanical engineering viewpoints to foster new ideas for next-generation smart E-skin.

A Review on Solution-Processed Organic Phototransistors and Their Recent Developments

Today, more disciplines are intercepting each other, giving rise to “cross-disciplinary” research. Technological advancements in material science and device structure and production have paved the way towards development of new classes of multi-purpose sensory devices. Organic phototransistors (OPTs) are photo-activated sensors based on organic field-effect transistors that convert incident light signals into electrical signals. The organic semiconductor (OSC) layer and three-electrode structure of an OPT offer great advantages for light detection compared to conventional photodetectors and photodiodes, due to their signal amplification and noise reduction characteristics. Solution processing of the active layer enables mass production of OPT devices at significantly reduced cost. The chemical structure of OSCs can be modified accordingly to fulfil detection at various wavelengths for different purposes. Organic phototransistors have attracted substantial interest in a variety of fields, namely biomedical, medical diagnostics, healthcare, energy, security, and environmental monitoring. Lightweight and mechanically flexible and wearable OPTs are suitable alternatives not only at clinical levels but also for point-of-care and home-assisted usage. In this review, we aim to explain different types, working mechanism and figures of merit of organic phototransistors and highlight the recent advances from the literature on development and implementation of OPTs for a broad range of research and real-life applications.

Peter L, Chan C, Mikhailova T, Bexheti V, Kapadia A, Carbery WP, Ng K, Maity P. Microfluidic-Supported Synthesis of Anisotropic Polyvinyl Methacrylate Nanoparticles via Interfacial Agents

For polymer particles, recent studies emphasized that the particle shape—not size—plays the dominant role in novel applications in fields ranging from nanotechnology, biomedicine, to photonics, which has intensified the quest...

Ferroptosis promotes sonodynamic therapy: a platinum(ii)–indocyanine sonosensitizer

Sonodynamic therapy (SDT) has unique advantages in deep tumour ablation due to its deep penetration depth, showing great preclinical and clinical potential. Herein, a platinum(ii)–cyanine complex has been designed to investigate its potential as a SDT anticancer agent. It generates singlet oxygen (¹O₂) under ultrasound (US) irradiation or light irradiation, and exhibits US-cytotoxicity in breast cancer 4T1 cells but with negligible dark-cytotoxicity. Mechanistic investigations reveal that Pt-Cy reduces the cellular GSH and GPX4, and triggers cancer cell ferroptosis under US irradiation. The metabolomics analysis illustrates that Pt-Cy upon US treatment significantly dysregulates glutathione metabolism, and finally induces ferroptosis. In vivo studies further demonstrate that Pt-Cy inhibits tumor growth under US irradiation and its efficiency for SDT is better than that for PDT in vivo. This is the first example of platinum(ii) complexes for sonodynamic therapy. This work extends the biological applications of metal complexes from PDT to SDT.

A novel platinum(ii)–cyanine complex showed a greater excellent sonodynamic therapeutic effect than photodynamic therapy in vivo. This work expands the biological applications of metal complexes from traditional photodynamic therapy to sonodynamic therapy.

Optical coherence tomography-guided confocal Raman microspectroscopy for rapid measurements in tissues

We report a joint system with both confocal Raman spectroscopy (CRS) and optical coherence tomography (OCT) modules capable of quickly addressing the region of interest in a tissue for targeted Raman measurements from OCT. By using an electrically tunable lens in the Raman module, the focus of the module can be adjusted to address any specific depth indicated in an OCT image in a few milliseconds. We demonstrate the performance of the joint system in the depth dependent measurements of an ex vivo swine tissue and in vivo human skin. This system can be useful in measuring samples embedded with small targets, for example, to identify tumors in skin in vivo and assessment of tumor margins, in which OCT can be used to perform initial real-time screening with high throughput based on morphological features to identify suspicious targets then CRS is guided to address the targets in real time and fully characterize their biochemical fingerprints for confirmation.

Transparent Photovoltaics for Self-Powered Bioelectronics and Neuromorphic Applications

Inspired by the brain, future computation depends on creating a neuromorphic device that is energy-efficient for information processing and capable of sensing and learning. The current computation-chip platform is not capable of self-power and neuromorphic functionality; therefore, a need exists for a new platform that provides both. This Perspective illustrates potential transparent photovoltaics as a platform to achieve scalable, multimodal sensory, self-sustainable neural systems (e.g., visual cortex, nociception, and electronic skin). We present herein a strategy to harvest solar power using a transparent photovoltaic device that provides neuromorphic functionality to implement versatile, sustainable, integrative, and practical applications. The proposed solid-inorganic heterostructure platform is indispensable for achieving a variety of biosensors, sensory systems, neuromorphic computing, and machine learning.

Artificial Intelligence-Enabled Caregiving Walking Stick Powered by Ultra-Low-Frequency Human Motion

The increasing population of the elderly and motion-impaired people brings a huge challenge to our social system. However, the walking stick as their essential tool has rarely been investigated into its potential capabilities beyond basic physical support, such as activity monitoring, tracing, and accident alert. Here, we report a walking stick powered by ultra-low-frequency human motion and equipped with deep-learning-enabled advanced sensing features to provide a healthcare-monitoring platform for motion-impaired users. A linear-to-rotary structure is designed to achieve highly efficient energy harvesting from the linear motion of a walking stick with ultralow frequency. Besides, two kinds of self-powered triboelectric sensors are proposed and integrated to extract the motion features of the walking stick. Augmented sensing functionalities with high accuracies have been enabled by deep-learning-based data analysis, including identity recognition, disability evaluation, and motion status distinguishing. Furthermore, a self-sustainable Internet of Things (IoT) system with global positioning system tracing and environmental temperature and humidity amenity sensing functions is obtained. Combined with the aforementioned functionalities, this walking stick is demonstrated in various usage scenarios as a caregiver for real-time well-being status and activity monitoring. The caregiving walking stick shows the potential of being an intelligent aid for motion-impaired users to help them live life with adequate autonomy and safety.

Electronic Textiles for Wearable Point-of-Care Systems

Traditional public health systems are suffering from limited, delayed, and inefficient medical services, especially when confronted with the pandemic and the aging population. Fusing traditional textiles with diagnostic, therapeutic, and protective medical devices can unlock electronic textiles (e-textiles) as point-of-care platform technologies on the human body, continuously monitoring vital signs and implementing round-the-clock treatment protocols in close proximity to the patient. This review comprehensively summarizes the research advances on e-textiles for wearable point-of-care systems. We start with a brief introduction to emphasize the significance of e-textiles in the current healthcare system. Then, we describe textile sensors for diagnosis, textile therapeutic devices for medical treatment, and textile protective devices for prevention, by highlighting their working mechanisms, representative materials, and clinical application scenarios. Afterward, we detail e-textiles' connection technologies as the gateway for real-time data transmission and processing in the context of 5G technologies and Internet of Things. Finally, we provide new insights into the remaining challenges and future directions in the field of e-textiles. Fueled by advances in chemistry and materials science, textile-based diagnostic devices, therapeutic devices, protective medical devices, and communication units are expected to interact synergistically to construct intelligent, wearable point-of-care textile platforms, ultimately illuminating the future of healthcare system in the Internet of Things era.