Bioresorbable silicon electronic sensors for the brain

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.

Ultra-conformal skin electrodes with synergistically enhanced conductivity for long-time and low-motion artifact epidermal electrophysiology

Accurate and imperceptible monitoring of electrophysiological signals is of primary importance for wearable healthcare. Stiff and bulky pregelled electrodes are now commonly used in clinical diagnosis, causing severe discomfort to users for long-time using as well as artifact signals in motion. Here, we report a ~100 nm ultra-thin dry epidermal electrode that is able to conformably adhere to skin and accurately measure electrophysiological signals. It showed low sheet resistance (~24 Ω/sq, 4142 S/cm), high transparency, and mechano-electrical stability. The enhanced optoelectronic performance was due to the synergistic effect between graphene and poly (3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS), which induced a high degree of molecular ordering on PEDOT and charge transfer on graphene by strong π-π interaction. Together with ultra-thin nature, this dry epidermal electrode is able to accurately monitor electrophysiological signals such as facial skin and brain activity with low-motion artifact, enabling human-machine interfacing and long-time mental/physical health monitoring.

Novel dry electrodes with enhanced mechano-electrical stability and conformability are attractive for long-time electrophysiological signal monitoring. Here, the authors report polymer-covered CVD-grown graphene with enhanced optoelectronic performance for biopotential monitoring.

Nano- and Microscale Optical and Electrical Biointerfaces and Their Relevance to Energy Research

Different research fields in energy sciences, such as photovoltaics for solar energy conversion, supercapacitors for energy storage, electrocatalysis for clean energy conversion technologies, and materials-bacterial hybrid for CO₂ fixation have been under intense investigations over the past decade. In recent years, new platforms for biointerface designs have emerged from the energy conversion and storage principles. This paper reviews recent advances in nano- and microscale materials/devices for optical and electrical biointerfaces. First, a connection is drawn between biointerfaces and energy science, and how these two distinct research fields can be connected is summarized. Then, a brief overview of current available tools for biointerface studies is presented. Third, three representative biointerfaces are reviewed, including neural, cardiac, and bacterial biointerfaces, to show how to apply these tools and principles to biointerface design and research. Finally, two possible future research directions for nano- and microscale biointerfaces are proposed.

Stretchable, Stable, and Degradable Silk Fibroin Enabled by Mesoscopic Doping for Finger Motion Triggered Color/Transmittance Adjustment

As a kind of biocompatible material with long history, silk fibroin is one of the ideal platforms for on-skin and implantable electronic devices, especially for self-powered systems. In this work, to solve the intrinsic brittleness as well as poor chemical stability of pure silk fibroin film, mesoscopic doping of regenerated silk fibroin is introduced to promote the secondary structure transformation, resulting in huge improvement in mechanical flexibility (∼250% stretchable and 1000 bending cycles) and chemical stability (endure 100 °C and 3-11 pH). Based on such doped silk film (SF), a flexible, stretchable and fully bioabsorbable triboelectric nanogenerator (TENG) is developed to harvest biomechanical energy in vitro or in vivo for intelligent wireless communication, for example, such TENG can be attached on the fingers to intelligently control the electrochromic function of rearview mirrors, in which the transmittance can be easily adjusted by changing contact force or area. This robust TENG shows great potential application in intelligent vehicle, smart home and health care systems.

Advanced Materials in Wireless, Implantable Electrical Stimulators That Offer Rapid Rates of Bioresorption for Peripheral Axon Regeneration

Injured peripheral nerves typically exhibit unsatisfactory and incomplete functional outcomes, and there are no clinically approved therapies for improving regeneration. Post-operative electrical stimulation (ES) increases axon regrowth, but practical challenges from the cost of extended operating room time to the risks and pitfalls associated with transcutaneous wire placement have prevented broad clinical adoption. This study presents a possible solution in the form of advanced bioresorbable materials for thin, flexible, wireless implant that provides precisely controlled ES of the injured nerve for a brief time in the immediate post-operative period. Afterward, rapid, complete and safe modes of bioresorption naturally and quickly eliminate all of the constituent materials in their entirety, without the need for surgical extraction. The unusually high rate of bioresorption follows from the use of a unique, bilayer enclosure that combines two distinct formulations of a biocompatible form of polyanhydride as an encapsulating structure, to accelerate the resorption of active components and confine fragments until complete resorption. Results from mouse models of tibial nerve transection with re-anastomosis indicate that this system offers levels of performance and efficacy that match those of conventional wired stimulators, but without the need to extend the operative period or to extract the device hardware.

Bioresorbable Photonics: Materials, Devices and Applications

Bio-photonic devices that utilize the interaction between light and biological substances have been emerging as an important tool for clinical diagnosis and/or therapy. At the same time, implanted biodegradable photonic devices can be disintegrated and resorbed after a predefined operational period, thus avoiding the risk and cost associated with the secondary surgical extraction. In this paper, the recent progress on biodegradable photonics is reviewed, with a focus on material strategies, device architectures and their biomedical applications. We begin with a brief introduction of biodegradable photonics, followed by the material strategies for constructing biodegradable photonic devices. Then, various types of biodegradable photonic devices with different functionalities are described. After that, several demonstration examples for applications in intracranial pressure monitoring, biochemical sensing and drug delivery are presented, revealing the great potential of biodegradable photonics in the monitoring of human health status and the treatment of human diseases. We then conclude with the summary of this field, as well as current challenges and possible future directions.

Wireless sensors for continuous, multimodal measurements at the skin interface with lower limb prostheses

Precise form-fitting of prosthetic sockets is important for the comfort and well-being of persons with limb amputations. Capabilities for continuous monitoring of pressure and temperature at the skin-prosthesis interface can be valuable in the fitting process and in monitoring for the development of dangerous regions of increased pressure and temperature as limb volume changes during daily activities. Conventional pressure transducers and temperature sensors cannot provide comfortable, irritation-free measurements because of their relatively rigid construction and requirements for wired interfaces to external data acquisition hardware. Here, we introduce a millimeter-scale pressure sensor that adopts a soft, three-dimensional design that integrates into a thin, flexible battery-free, wireless platform with a built-in temperature sensor to allow operation in a noninvasive, imperceptible fashion directly at the skin-prosthesis interface. The sensor system mounts on the surface of the skin of the residual limb, in single or multiple locations of interest. A wireless reader module attached to the outside of the prosthetic socket wirelessly provides power to the sensor and wirelessly receives data from it, for continuous long-range transmission to a standard consumer electronic device such as a smartphone or tablet computer. Characterization of both the sensor and the system, together with theoretical analysis of the key responses, illustrates linear, accurate responses and the ability to address the entire range of relevant pressures and to capture skin temperature accurately, both in a continuous mode. Clinical application in two prosthesis users demonstrates the functionality and feasibility of this soft, wireless system.

Adaptive and multifunctional hydrogel hybrid probes for long-term sensing and modulation of neural activity

To understand the underlying mechanisms of progressive neurophysiological phenomena, neural interfaces should interact bi-directionally with brain circuits over extended periods of time. However, such interfaces remain limited by the foreign body response that stems from the chemo-mechanical mismatch between the probes and the neural tissues. To address this challenge, we developed a multifunctional sensing and actuation platform consisting of multimaterial fibers intimately integrated within a soft hydrogel matrix mimicking the brain tissue. These hybrid devices possess adaptive bending stiffness determined by the hydration states of the hydrogel matrix. This enables their direct insertion into the deep brain regions, while minimizing tissue damage associated with the brain micromotion after implantation. The hydrogel hybrid devices permit electrophysiological, optogenetic, and behavioral studies of neural circuits with minimal foreign body responses and tracking of stable isolated single neuron potentials in freely moving mice over 6 months following implantation.

In Vitro Models for Studying Respiratory Host-Pathogen Interactions

Respiratory diseases and lower respiratory tract infections are among the leading cause of death worldwide and, especially given the recent severe acute respiratory syndrome coronavirus-2 pandemic, are of high and prevalent socio-economic importance. In vitro models, which accurately represent the lung microenvironment, are of increasing significance given the ethical concerns around animal work and the lack of translation to human disease, as well as the lengthy time to market and the attrition rates associated with clinical trials. This review gives an overview of the biological and immunological components involved in regulating the respiratory epithelium system in health, disease, and infection. The evolution from 2D to 3D cell biology and to more advanced technological integrated models for studying respiratory host-pathogen interactions are reviewed and provide a reference point for understanding the in vitro modeling requirements. Finally, the current limitations and future perspectives for advancing this field are presented.

Flexoelectricity in soft elastomers and the molecular mechanisms underpinning the design and emergence of giant flexoelectricity

Soft robotics requires materials that are capable of large deformation and amenable to actuation with external stimuli such as electric fields. Energy harvesting, biomedical devices, flexible electronics, and sensors are some other applications enabled by electroactive soft materials. The phenomenon of flexoelectricity is an enticing alternative that refers to the development of electric polarization in dielectrics when subjected to strain gradients. In particular, flexoelectricity offers a direct linear coupling between a highly desirable deformation mode (flexure) and electric stimulus. Unfortunately, barring some exceptions, the flexoelectric effect is quite weak and rather substantial bending curvatures are required for an appreciable electromechanical response. Most experiments in the literature appear to confirm modest flexoelectricity in polymers although perplexingly, a singular work has measured a "giant" effect in elastomers under some specific conditions. Due to the lack of an understanding of the microscopic underpinnings of flexoelectricity in elastomers and a commensurate theory, it is not currently possible to either explain the contradictory experimental results on elastomers or pursue avenues for possible design of large flexoelectricity. In this work, we present a statistical-mechanics theory for the emergent flexoelectricity of elastomers consisting of polar monomers. The theory is shown to be valid in broad generality and leads to key insights regarding both giant flexoelectricity and material design. In particular, the theory shows that, in standard elastomer networks, combining stretching and bending is a mechanism for obtaining giant flexoelectricity, which also explains the aforementioned, surprising experimental discovery.

Recent Progress on Bioresorbable Passive Electronic Devices and Systems

Bioresorbable electronic devices and/or systems are of great appeal in the field of biomedical engineering due to their unique characteristics that can be dissolved and resorbed after a predefined period, thus eliminating the costs and risks associated with the secondary surgery for retrieval. Among them, passive electronic components or systems are attractive for the clear structure design, simple fabrication process, and ease of data extraction. This work reviews the recent progress on bioresorbable passive electronic devices and systems, with an emphasis on their applications in biomedical engineering. Materials strategies, device architectures, integration approaches, and applications of bioresorbable passive devices are discussed. Furthermore, this work also overviews wireless passive systems fabricated with the combination of various passive components for vital sign monitoring, drug delivering, and nerve regeneration. Finally, we conclude with some perspectives on future fundamental studies, application opportunities, and remaining challenges of bioresorbable passive electronics.

All-polymeric transient neural probe for prolonged in-vivo electrophysiological recordings

Transient bioelectronics has grown fast, opening possibilities never thought before. In medicine, transient implantable devices are interesting because they could eliminate the risks related to surgical retrieval and reduce the chronic foreign body reaction. Despite recent progress in this area, the potential of transient bioelectronics is still limited by their short functional lifetime owed to the fast dissolution rate of degradable metals, which is typically a few days or weeks. Here we report that a switch from degradable metals to an entirely polymer-based approach allows for a slower degradation process and a longer lifetime of the transient probe, thus opening new possibilities for transient medical devices. As a proof-of-concept, we fabricated all-polymeric transient neural probes that can monitor brain activity in mice for a few months, rather than a few days or weeks. Also, we extensively evaluated the foreign body reaction around the implant during the probe degradation. This kind of devices might pave the way for several applications in neuroprosthetics.

Application of a sub-0.1-mm3 implantable mote for in vivo real-time wireless temperature sensing

There has been increasing interest in wireless, miniaturized implantable medical devices for in vivo and in situ physiological monitoring. Here, we present such an implant that uses a conventional ultrasound imager for wireless powering and data communication and acts as a probe for real-time temperature sensing, including the monitoring of body temperature and temperature changes resulting from therapeutic application of ultrasound. The sub-0.1-mm³, sub-1-nW device, referred to as a mote, achieves aggressive miniaturization through the monolithic integration of a custom low-power temperature sensor chip with a microscale piezoelectric transducer fabricated on top of the chip. The small displaced volume of these motes allows them to be implanted or injected using minimally invasive techniques with improved biocompatibility. We demonstrate their sensing functionality in vivo for an ultrasound neurostimulation procedure in mice. Our motes have the potential to be adapted to the distributed and localized sensing of other clinically relevant physiological parameters.

Biodegradable Metallic Glass for Stretchable Transient Electronics

Biodegradable electronics are disposable green devices whose constituents decompose into harmless byproducts, leaving no residual waste and minimally invasive medical implants requiring no removal surgery. Stretchable and flexible form factors are essential in biointegrated electronic applications for conformal integration with soft and expandable skins, tissues, and organs. Here a fully biodegradable MgZnCa metallic glass (MG) film is proposed for intrinsically stretchable electrodes with a high yield limit exploiting the advantages of amorphous phases with no crystalline defects. The irregular dissolution behavior of this amorphous alloy regarding electrical conductivity and morphology is investigated in aqueous solutions with different ion species. The MgZnCa MG nanofilm shows high elastic strain (≈2.6% in the nano-tensile test) and offers enhanced stretchability (≈115% when combined with serpentine geometry). The fatigue resistance in repeatable stretching also improves owing to the wide range of the elastic strain limit. Electronic components including the capacitor, inductor, diode, and transistor using the MgZnCa MG electrode support its integrability to transient electronic devices. The biodegradable triboelectric nanogenerator of MgZnCa MG operates stably over 50 000 cycles and its fatigue resistant applications in mechanical energy harvesting are verified. In vitro cell toxicity and in vivo inflammation tests demonstrate the biocompatibility in biointegrated use.

Micrometer-scale transient ion transport for real-time pH assay in living rat brains

Ion transport has been widely used for various applications such as sensing, desalination and energy conversion; however, nearly all applications are based on steady-state ion transport. Herein, we for the first time demonstrate the capability of transient ion transport for in vivo sensing with both high spatial (∼μm) and temporal (∼ms) resolution by using pH as the model target. Transient ion transport behavior (i.e., time-dependent ion current change) was observed by applying high-frequency pulse potential. Importantly, we proposed the ion distribution transient model for this time-dependent ion transport behavior. With this model, the temporal resolution of the as-developed pH microsensor based on ion current was improved to the ms level, thus satisfying the requirement of neurochemical recording. Moreover, our microsensor features good reproducibility, selectivity, and reversibility, and can thus real-time monitor the pH change in living rat brains. This study demonstrates the first example of in vivo sensing based on ion transport, opening a new way to neurochemical monitoring with ultrahigh spatiotemporal resolution. This study is also helpful to understand the transient process of asymmetric ion transport.

Foreign Body Reaction to Implanted Biomaterials and Its Impact in Nerve Neuroprosthetics

The implantation of any foreign material into the body leads to the development of an inflammatory and fibrotic process-the foreign body reaction (FBR). Upon implantation into a tissue, cells of the immune system become attracted to the foreign material and attempt to degrade it. If this degradation fails, fibroblasts envelop the material and form a physical barrier to isolate it from the rest of the body. Long-term implantation of medical devices faces a great challenge presented by FBR, as the cellular response disrupts the interface between implant and its target tissue. This is particularly true for nerve neuroprosthetic implants-devices implanted into nerves to address conditions such as sensory loss, muscle paralysis, chronic pain, and epilepsy. Nerve neuroprosthetics rely on tight interfacing between nerve tissue and electrodes to detect the tiny electrical signals carried by axons, and/or electrically stimulate small subsets of axons within a nerve. Moreover, as advances in microfabrication drive the field to increasingly miniaturized nerve implants, the need for a stable, intimate implant-tissue interface is likely to quickly become a limiting factor for the development of new neuroprosthetic implant technologies. Here, we provide an overview of the material-cell interactions leading to the development of FBR. We review current nerve neuroprosthetic technologies (cuff, penetrating, and regenerative interfaces) and how long-term function of these is limited by FBR. Finally, we discuss how material properties (such as stiffness and size), pharmacological therapies, or use of biodegradable materials may be exploited to minimize FBR to nerve neuroprosthetic implants and improve their long-term stability.

Wireless and battery-free platforms for collection of biosignals

Recent progress in biosensors have quantitively expanded current capabilities in exploratory research tools, diagnostics and therapeutics. This rapid pace in sensor development has been accentuated by vast improvements in data analysis methods in the form of machine learning and artificial intelligence that, together, promise fantastic opportunities in chronic sensing of biosignals to enable preventative screening, automated diagnosis, and tools for personalized treatment strategies. At the same time, the importance of widely accessible personal monitoring has become evident by recent events such as the COVID-19 pandemic. Progress in fully integrated and chronic sensing solutions is therefore increasingly important. Chronic operation, however, is not truly possible with tethered approaches or bulky, battery-powered systems that require frequent user interaction. A solution for this integration challenge is offered by wireless and battery-free platforms that enable continuous collection of biosignals. This review summarizes current approaches to realize such device architectures and discusses their building blocks. Specifically, power supplies, wireless communication methods and compatible sensing modalities in the context of most prevalent implementations in target organ systems. Additionally, we highlight examples of current embodiments that quantitively expand sensing capabilities because of their use of wireless and battery-free architectures.

Scalable Superior Chemical Sensing Performance of Stretchable Ionotronic Skin via a π-Hole Receptor Effect

Skin-attachable gas sensors provide a next-generation wearable platform for real-time protection of human health by monitoring environmental and physiological chemicals. However, the creation of skin-like wearable gas sensors, possessing high sensitivity, selectivity, stability, and scalability (4S) simultaneously, has been a big challenge. Here, an ionotronic gas-sensing sticker (IGS) is demonstrated, implemented with free-standing polymer electrolyte (ionic thermoplastic polyurethane, i-TPU) as a sensing channel and inkjet-printed stretchable carbon nanotube electrodes, which enables the IGS to exhibit high sensitivity, selectivity, stability (against mechanical stress, humidity, and temperature), and scalable fabrication, simultaneously. The IGS demonstrates reliable sensing capability against nitrogen dioxide molecules under not only harsh mechanical stress (cyclic bending with the radius of curvature of 1 mm and cyclic straining at 50%), but also environmental conditions (thermal aging from -45 to 125 °C for 1000 cycles and humidity aging for 24 h at 85% relative humidity). Further, through systematic experiments and theoretical calculations, a π-hole receptor mechanism is proposed, which can effectively elucidate the origin of the high sensitivity (up to parts per billion level) and selectivity of the ionotronic sensing system. Consequently, this work provides a guideline for the design of ionotronic materials for the achievement of high-performance and skin-attachable gas-sensor platforms.

Emerging intraoral biosensors

Biomedical devices that involved continuous and real-time health-care monitoring have drawn much attention in modern medicine, of which skin electronics and implantable devices are widely investigated. Skin electronics are characterized for their non-invasive access to the physiological signals, and implantable devices are superior at the diagnosis and therapy integration. Despite the significant progress achieved, many gaps remain to be explored to provide a more comprehensive overview of human health. As the connecting point of the outer environment and human systems, the oral cavity contains many unique biomarkers that are absent in skin or inner organs, and hence, this could become a promising alternative locus for designing health-care monitoring devices. In this review, we outline the status of the oral cavity during the communication of the environment and human systems and compare the intraoral devices with skin electronics and implantable devices from the biophysical and biochemical aspects. We further summarize the established diagnosis database and technologies that could be adopted to design intraoral biosensors. Finally, the challenges and potential opportunities for intraoral biosensors are discussed. Intraoral biosensors could become an important complement for existing biomedical devices to constitute a more reliable health-care monitoring system.

A Biodegradable Secondary Battery and its Biodegradation Mechanism for Eco-Friendly Energy-Storage Systems

The production of rechargeable batteries is rapidly expanding, and there are going to be new challenges in the near future about how the potential environmental impact caused by the disposal of the large volume of the used batteries can be minimized. Herein, a novel strategy is proposed to address these concerns by applying biodegradable device technology. An eco-friendly and biodegradable sodium-ion secondary battery (SIB) is developed through extensive material screening followed by the synthesis of biodegradable electrodes and their seamless assembly with an unconventional biodegradable separator, electrolyte, and package. Each battery component decomposes in nature into non-toxic compounds or elements via hydrolysis and/or fungal degradation, with all of the biodegradation products naturally abundant and eco-friendly. Detailed biodegradation mechanisms and toxicity influence of each component on living organisms are determined. In addition, this new SIB delivers performance comparable to that of conventional non-degradable SIBs. The strategy and findings suggest a novel eco-friendly biodegradable paradigm for large-scale rechargeable battery systems.

From Diagnosis to Treatment: Recent Advances in Patient-Friendly Biosensors and Implantable Devices

Patient-friendly medical diagnostics and treatments have been receiving a great deal of interest due to their rapid and cost-effective health care applications with minimized risk of infection, which has the potential to replace conventional hospital-based medical procedures. In particular, the integration of recently developed materials into health care devices allows the rapid development of point-of-care (POC) sensing platforms and implantable devices with special functionalities. In this review, the recent advances in biosensors for patient-friendly diagnosis and implantable devices for patient-friendly treatment are discussed. Comprehensive analysis of portable and wearable biosensing platforms for patient-friendly health monitoring and disease diagnosis is provided, including topics such as materials selection, device structure and integration, and biomarker detection strategies. Moreover, specific challenges related to each biological fluid for wearable biosensor-based POC applications are presented. Also, advances in implantable devices, including recent materials development and wireless communication strategies, are discussed. Furthermore, various patient-friendly surgical and treatment approaches are reviewed, such as minimally invasive insertion and mounting, in vivo electrical and optical modulations, and post-operation health monitoring. Finally, the challenges and future perspectives toward the development of the patient-friendly diagnosis and treatment are provided.

Soft, Wireless and subdermally implantable recording and neuromodulation tools

Progress in understanding neuronal interaction and circuit behavior of the central and peripheral nervous system strongly relies on the advancement of tools that record and stimulate with high fidelity and specificity. Currently, devices used in exploratory research predominantly utilize cables or tethers to provide pathways for power supply, data communication, stimulus delivery and recording, which constrains the scope and use of such devices. In particular, the tethered connection, mechanical mismatch to surrounding soft tissues and bones frustrate the interface leading to irritation and limitation of motion of the subject, which in the case of fundamental and preclinical studies, impacts naturalistic behaviors of animals and precludes the use in experiments involving social interaction and ethologically relevant three-dimensional environments, limiting the use of current tools to mostly rodents and exclude species such as birds and fish. This review explores the current state-of-the-art in wireless, subdermally implantable tools that quantitively expand capabilities in analysis and perturbation of the central and peripheral nervous system by removing tethers and externalized features of implantable neuromodulation and recording tools. Specifically, the review explores power harvesting strategies, wireless communication schemes, and soft materials and mechanics that enable the creation of such devices and discuss their capabilities in the context of freely-behaving subjects. Highlights of this class of devices includes wireless battery-free and fully implantable operation with capabilities in cell specific recording, multimodal neural stimulation and electrical, optogenetic and pharmacological neuromodulation capabilities. We conclude with discussion on translation of such technologies which promises routes towards broad dissemination.

Implanted Flexible Electronics: Set Device Lifetime with Smart Nanomaterials

Flexible electronics is one of the most attractive and anticipated markets in the internet-of-things era, covering a broad range of practical and industrial applications from displays and energy harvesting to health care devices. The mechanical flexibility, combined with high performance electronics, and integrated on a soft substrate offer unprecedented functionality for biomedical applications. This paper presents a brief snapshot on the materials of choice for niche flexible bio-implanted devices that address the requirements for both biodegradable and long-term operational streams. The paper also discusses potential future research directions in this rapidly growing field.

Textile Triboelectric Nanogenerators for Wearable Pulse Wave Monitoring

Arterial pulse waves are regarded as vital diagnostic tools in the assessment of cardiovascular disease (CVD). Because of their high sensitivity, rapid response time, wearability, and low cost, textile triboelectric nanogenerators (TENGs) are emerging as a compelling biotechnology for wearable pulse wave monitoring. We discuss sensing mechanisms for pulse-to-electricity conversion, analytical models for calculating cardiovascular parameters, and application scenarios for textile TENGs. We provide a prospective on the challenges that limit the wider application of this technology and suggest some future research directions. In the future, textile TENGs are expected to make an impact in the fields of wearable pulse wave monitoring and CVD diagnosis.

Soft Electronics Based on Stretchable and Conductive Nanocomposites for Biomedical Applications

Research on the field of implantable electronic devices that can be directly applied in the body with various functionalities is increasingly intensifying due to its great potential for various therapeutic applications. While conventional implantable electronics generally include rigid and hard conductive materials, their surrounding biological objects are soft and dynamic. The mechanical mismatch between implanted devices and biological environments induces damages in the body especially for long-term applications. Stretchable electronics with outstanding mechanical compliance with biological objects effectively improve such limitations of existing rigid implantable electronics. In this article, the recent progress of implantable soft electronics based on various conductive nanocomposites is systematically described. In particular, representative fabrication approaches of conductive and stretchable nanocomposites for implantable soft electronics and various in vivo applications of implantable soft electronics are focused on. To conclude, challenges and perspectives of current implantable soft electronics that should be considered for further advances are discussed.

Wearable Biosensors: An Alternative and Practical Approach in Healthcare and Disease Monitoring

With the increasing prevalence of growing population, aging and chronic diseases continuously rising healthcare costs, the healthcare system is undergoing a vital transformation from the traditional hospital-centered system to an individual-centered system. Since the 20th century, wearable sensors are becoming widespread in healthcare and biomedical monitoring systems, empowering continuous measurement of critical biomarkers for monitoring of the diseased condition and health, medical diagnostics and evaluation in biological fluids like saliva, blood, and sweat. Over the past few decades, the developments have been focused on electrochemical and optical biosensors, along with advances with the non-invasive monitoring of biomarkers, bacteria and hormones, etc. Wearable devices have evolved gradually with a mix of multiplexed biosensing, microfluidic sampling and transport systems integrated with flexible materials and body attachments for improved wearability and simplicity. These wearables hold promise and are capable of a higher understanding of the correlations between analyte concentrations within the blood or non-invasive biofluids and feedback to the patient, which is significantly important in timely diagnosis, treatment, and control of medical conditions. However, cohort validation studies and performance evaluation of wearable biosensors are needed to underpin their clinical acceptance. In the present review, we discuss the importance, features, types of wearables, challenges and applications of wearable devices for biological fluids for the prevention of diseased conditions and real-time monitoring of human health. Herein, we summarize the various wearable devices that are developed for healthcare monitoring and their future potential has been discussed in detail.

Tiny 2D silicon quantum sheets: a brain photonic nanoagent for orthotopic glioma theranostics

We report that atomically thin two-dimensional silicon quantum sheets (2D Si QSs), prepared by a scalable approach coupling chemical delithiation and cryo-assisted exfoliation, can serve as a high-performance brain photonic nanoagent for orthotopic glioma theranostics. With the lateral size of approximately 14.0 nm and thickness of about 1.6 nm, tiny Si QSs possess high mass extinction coefficient of 27.5 L g^-1 cm^-1 and photothermal conversion efficiency of 47.2% at 808 nm, respectively, concurrently contributing to the best photothermal performance among the reported 2D mono-elemental materials (Xenes). More importantly, Si QSs with low toxicity maintain the trade-off between stability and degradability, paving the way for practical clinical translation in consideration of both storage and action of nanoagents. In vitro Transwell filter experiment reveals that Si QSs could effectively go across the bEnd.3 cells monolayer. Upon the intravenous injection of Si QSs, orthotopic brain tumors are effectively inhibited under the precise guidance of photoacoustic imaging, and the survival lifetime of brain tumor-bearing mice is increased by two fold. Atomically thin Si QSs with strong light-harvesting capability are expected to provide an effective and robust 2D photonic nanoplatform for the management of brain diseases.

Biodegradable Materials for Sustainable Health Monitoring Devices

The recent advent of biodegradable materials has offered huge opportunity to transform healthcare technologies by enabling sensors that degrade naturally after use. The implantable electronic systems made from such materials eliminate the need for extraction or reoperation, minimize chronic inflammatory responses, and hence offer attractive propositions for future biomedical technology. The eco-friendly sensor systems developed from degradable materials could also help mitigate some of the major environmental issues by reducing the volume of electronic or medical waste produced and, in turn, the carbon footprint. With this background, herein we present a comprehensive overview of the structural and functional biodegradable materials that have been used for various biodegradable or bioresorbable electronic devices. The discussion focuses on the dissolution rates and degradation mechanisms of materials such as natural and synthetic polymers, organic or inorganic semiconductors, and hydrolyzable metals. The recent trend and examples of biodegradable or bioresorbable materials-based sensors for body monitoring, diagnostic, and medical therapeutic applications are also presented. Lastly, key technological challenges are discussed for clinical application of biodegradable sensors, particularly for implantable devices with wireless data and power transfer. Promising perspectives for the advancement of future generation of biodegradable sensor systems are also presented.

Bioresorbable Multilayer Photonic Cavities as Temporary Implants for Tether-Free Measurements of Regional Tissue Temperatures

Objective and Impact Statement. Real-time monitoring of the temperatures of regional tissue microenvironments can serve as the diagnostic basis for treating various health conditions and diseases. Introduction. Traditional thermal sensors allow measurements at surfaces or at near-surface regions of the skin or of certain body cavities. Evaluations at depth require implanted devices connected to external readout electronics via physical interfaces that lead to risks for infection and movement constraints for the patient. Also, surgical extraction procedures after a period of need can introduce additional risks and costs. Methods. Here, we report a wireless, bioresorbable class of temperature sensor that exploits multilayer photonic cavities, for continuous optical measurements of regional, deep-tissue microenvironments over a timeframe of interest followed by complete clearance via natural body processes. Results. The designs decouple the influence of detection angle from temperature on the reflection spectra, to enable high accuracy in sensing, as supported by in vitro experiments and optical simulations. Studies with devices implanted into subcutaneous tissues of both awake, freely moving and asleep animal models illustrate the applicability of this technology for in vivo measurements. Conclusion. The results demonstrate the use of bioresorbable materials in advanced photonic structures with unique capabilities in tracking of thermal signatures of tissue microenvironments, with potential relevance to human healthcare.

A Review: Electrode and Packaging Materials for Neurophysiology Recording Implants

To date, a wide variety of neural tissue implants have been developed for neurophysiology recording from living tissues. An ideal neural implant should minimize the damage to the tissue and perform reliably and accurately for long periods of time. Therefore, the materials utilized to fabricate the neural recording implants become a critical factor. The materials of these devices could be classified into two broad categories: electrode materials as well as packaging and substrate materials. In this review, inorganic (metals and semiconductors), organic (conducting polymers), and carbon-based (graphene and carbon nanostructures) electrode materials are reviewed individually in terms of various neural recording devices that are reported in recent years. Properties of these materials, including electrical properties, mechanical properties, stability, biodegradability/bioresorbability, biocompatibility, and optical properties, and their critical importance to neural recording quality and device capabilities, are discussed. For the packaging and substrate materials, different material properties are desired for the chronic implantation of devices in the complex environment of the body, such as biocompatibility and moisture and gas hermeticity. This review summarizes common solid and soft packaging materials used in a variety of neural interface electrode designs, as well as their packaging performances. Besides, several biopolymers typically applied over the electrode package to reinforce the mechanical rigidity of devices during insertion, or to reduce the immune response and inflammation at the device-tissue interfaces are highlighted. Finally, a benchmark analysis of the discussed materials and an outlook of the future research trends are concluded.

Phototriggerable Transient Electronics via Fullerene-Mediated Degradation of Polymer:Fullerene Encapsulation Layer

Transient electronics is an emerging class of electronics that has attracted a lot of attention because of its potential as an environmental-friendly alternative to the existing end-of-life product disposal or treatments. However, the controlled degradation of transient electronics under environmentally benign conditions remains a challenge. In this work, the tunable degradation of transient electronics including passive resistor devices and active memory devices was realized by photodegradable thin polymer films comprising fullerene derivatives, [6,6]-phenyl-C61-butyric acid methyl esters (PCBM). The photodegradation of polymer:PCBM under an aqueous environment is triggered by ultraviolet (UV) light. Experimental results demonstrate that the addition of PCBM in commodity polymers, including but not limited to polystyrene, results in a catalytic effect on polymer photodegradation when triggered by UV light. The degradation mechanism of transient electronics is ascribed to the photodegradation of polymer:PCBM encapsulation layers caused by the synergistic effect between UV and water exposure. The polymer:PCBM encapsulation system presented herein offers a simple way to achieve the realization of light-triggered device degradation for bioapplication and expands the material options for tailorable degradation of transient electronics.

Expecting the unexpected: high pressure crystallization significantly boosts up triboelectric outputs of microbial polyesters

Polyhydroxybutyrate (PHB) with special wrinkled spherulites enables significant improvement in triboelectric outputs of the microbial polyester.

The future of near-field communication-based wireless sensing

Near-field communication emerged as a high-security, wireless, short-range, data exchange technology nearly two decades ago; its ability to simultaneously transfer power and data between devices offers exciting opportunities for the design of miniature, battery-free and disposable sensing systems in health care and food quality monitoring.

Conductive Hydrogel for a Photothermal-Responsive Stretchable Artificial Nerve and Coalescing with a Damaged Peripheral Nerve

Modern development of flexible electronics has made use of bioelectronic materials as artificial tissue in vivo. As hydrogels are more similar to nerve tissue, functional hydrogels have become a promising candidate for bioelectronics. Meanwhile, interfacing functional hydrogels and living tissues is at the forefront of bioelectronics. The peripheral nerve injury often leads to paralysis, chronic pain, neurologic disorders, and even disability, because it has affected the bioelectrical signal transmission between the brain and the rest of body. Here, a kind of light-stimuli-responsive and stretchable conducting polymer hydrogel (CPH) is developed to explore artificial nerve. The conductivity of CPH can be enhanced when illuminated by near-infrared light, which can promote the conduction of the bioelectrical signal. When CPH is mechanically elongated, it still has high durability of conductivity and, thus, can accommodate unexpected strain of nerve tissues in motion. Thereby, CPH can better serve as an implant of the serious peripheral nerve injury in vivo, especially in the case that the length of the missing nerve exceeds 10 mm.

Flexible/Stretchable Supercapacitors with Novel Functionality for Wearable Electronics

With the miniaturization of personal wearable electronics, considerable effort has been expended to develop high-performance flexible/stretchable energy storage devices for powering integrated active devices. Supercapacitors can fulfill this role owing to their simple structures, high power density, and cyclic stability. Moreover, a high electrochemical performance can be achieved with flexible/stretchable supercapacitors, whose applications can be expanded through the introduction of additional novel functionalities. Here, recent advances in and future prospects for flexible/stretchable supercapacitors with innate functionalities are covered, including biodegradability, self-healing, shape memory, energy harvesting, and electrochromic and temperature tolerance, which can contribute to reducing e-waste, ensuring device integrity and performance, enabling device self-charging following exposure to surrounding stimuli, displaying the charge status, and maintaining the performance under a wide range of temperatures. Finally, the challenges and perspectives of high-performance all-in-one wearable systems with integrated functional supercapacitors for future practical application are discussed.

Advanced Materials and Systems for Biodegradable, Transient Electronics

Transient electronics refers to an emerging class of advanced technology, defined by an ability to chemically or physically dissolve, disintegrate, and degrade in actively or passively controlled fashions to leave environmentally and physiologically harmless by-products in environments, particularly in bio-fluids or aqueous solutions. The unusual properties that are opposite to operational modes in conventional electronics for a nearly infinite time frame offer unprecedented opportunities in research areas of eco-friendly electronics, temporary biomedical implants, data-secure hardware systems, and others. This review highlights the developments of transient electronics, including materials, manufacturing strategies, electronic components, and transient kinetics, along with various potential applications.

Biodegradable Optical Fiber in a Soft Optoelectronic Device for Wireless Optogenetic Applications

Optogenetics is a new neuroscience technology that uses light-responsive proteins to stimulate neurons with light and control the emotions and/or behavior of animals. There are a few approaches to deliver light to neurons in vivo, including a using an optical fiber that can send light from an external source to a target neuron, directly inserting a light-emitting device, and shooting light to penetrate tissue from the outside. Among these methods, inserting a wireless light-emitting device that is capable of being used for an experiment while leaving an animal completely free is a method that has been studied in recent years. At the same time, the possibility of causing mechanical and thermal damage to neural tissues has been highlighted as an issue due to the stiffness of robust injection tools and the photoelectric efficiency of light-emitting diodes (LEDs). In this study, we developed a device that can send light from a wireless light-emitting device to a target neuron without mechanical and thermal effects and analyzed the optical and thermal characteristics of the device to be used for optogenetic studies.

Stretchable, dynamic covalent polymers for soft, long-lived bioresorbable electronic stimulators designed to facilitate neuromuscular regeneration

Bioresorbable electronic stimulators are of rapidly growing interest as unusual therapeutic platforms, i.e., bioelectronic medicines, for treating disease states, accelerating wound healing processes and eliminating infections. Here, we present advanced materials that support operation in these systems over clinically relevant timeframes, ultimately bioresorbing harmlessly to benign products without residues, to eliminate the need for surgical extraction. Our findings overcome key challenges of bioresorbable electronic devices by realizing lifetimes that match clinical needs. The devices exploit a bioresorbable dynamic covalent polymer that facilitates tight bonding to itself and other surfaces, as a soft, elastic substrate and encapsulation coating for wireless electronic components. We describe the underlying features and chemical design considerations for this polymer, and the biocompatibility of its constituent materials. In devices with optimized, wireless designs, these polymers enable stable, long-lived operation as distal stimulators in a rat model of peripheral nerve injuries, thereby demonstrating the potential of programmable long-term electrical stimulation for maintaining muscle receptivity and enhancing functional recovery.

Three-Decade Evaluation of Cerebrospinal Fluid Pressure in Open-Angle Glaucoma at a Tertiary Care Center

Elevated intraocular pressure (IOP) is the most prevalent risk factor for primary open-angle glaucoma. However, IOP alone does not fully describe a mechanical basis for disease in patients with normal tension glaucoma or primary open-angle glaucoma. The translaminar pressure difference (TLPD) theory proposes that the pressure gradient generated by the difference of IOP and cerebrospinal fluid pressure (CSFp) acting at the level of the optic nerve can lead to cupping and glaucoma when IOP is higher than normal and/or CSFp is lower than normal. The study results to date have generally supported the TLPD theory; however, varying methods, populations, and sample sizes make it difficult to compare results. To further assess whether there is an association between low CSFp and open-angle glaucoma, 30 years of clinical data that assess 96,543 lumbar punctures were analyzed. Patients with open-angle glaucoma showed a significantly lower CSFp than randomly selected normal control patients (9.9 ± 3 mm·Hg (n = 86) versus 12.1 ± 3.6 mm·Hg (n = 114), p < 0.001) following adjustment for age and sex. This retrospective study provides strong evidence for an association between open-angle glaucoma and low CSFp.

Printed, Wireless, Soft Bioelectronics and Deep Learning Algorithm for Smart Human-Machine Interfaces

Recent advances in flexible materials and wearable electronics offer a noninvasive, high-fidelity recording of biopotentials for portable healthcare, disease diagnosis, and machine interfaces. Current device-manufacturing methods, however, still heavily rely on the conventional cleanroom microfabrication that requires expensive, time-consuming, and complicated processes. Here, we introduce an additive nanomanufacturing technology that explores a contactless direct printing of aerosol nanomaterials and polymers to fabricate stretchable sensors and multilayered wearable electronics. Computational and experimental studies prove the mechanical flexibility and reliability of soft electronics, considering direct mounting to the deformable human skin with a curvilinear surface. The dry, skin-conformal graphene biosensor, without the use of conductive gels and aggressive tapes, offers an enhanced biopotential recording on the skin and multiple uses (over ten times) with consistent measurement of electromyograms. The combination of soft bioelectronics and deep learning algorithm allows classifying six classes of muscle activities with an accuracy of over 97%, which enables wireless, real-time, continuous control of external machines such as a robotic hand and a robotic arm. Collectively, the comprehensive study of nanomaterials, flexible mechanics, system integration, and machine learning shows the potential of the printed bioelectronics for portable, smart, and persistent human-machine interfaces.

Elastomers without Covalent Cross-Linking: Concatenated Rings Giving Rise to Elasticity

There is intense interest in making mechanically stable elastomers with properties resembling those of human muscles for use in soft robotics. Recently, a polydimethylsiloxane (PDMS) elastomer prepared without the use of cross-linking moieties from heterobifunctional PDMS macromonomers of intermediate molecular weight has been shown to exhibit surprising inherent softness and excellent stability upon both large deformation and swelling, in clear contradiction of classical rubber elasticity theories. In this work, this unexpected elasticity is shown to originate from concatenated rings.

Printable, Highly Sensitive Flexible Temperature Sensors for Human Body Temperature Monitoring: A Review

In recent years, the development and research of flexible sensors have gradually deepened, and the performance of wearable, flexible devices for monitoring body temperature has also improved. For the human body, body temperature changes reflect much information about human health, and abnormal body temperature changes usually indicate poor health. Although body temperature is independent of the environment, the body surface temperature is easily affected by the surrounding environment, bringing challenges to body temperature monitoring equipment. To achieve real-time and sensitive detection of various parts temperature of the human body, researchers have developed many different types of high-sensitivity flexible temperature sensors, perfecting the function of electronic skin, and also proposed many practical applications. This article reviews the current research status of highly sensitive patterned flexible temperature sensors used to monitor body temperature changes. First, commonly used substrates and active materials for flexible temperature sensors have been summarized. Second, patterned fabricating methods and processes of flexible temperature sensors are introduced. Then, flexible temperature sensing performance are comprehensively discussed, including temperature measurement range, sensitivity, response time, temperature resolution. Finally, the application of flexible temperature sensors based on highly delicate patterning are demonstrated, and the future challenges of flexible temperature sensors have prospected.