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

Recent advances in implantable sensors and electronics using printable materials for advanced healthcare

This review article focuses on the recent printing technological progress in healthcare, underscoring the significant potential of implantable devices across diverse applications. Printing technologies have widespread use in developing health monitoring devices, diagnostic systems, and surgical devices. Recent years have witnessed remarkable progress in fabricating low-profile implantable devices, driven by advancements in printing technologies and nanomaterials. The importance of implantable biosensors and bioelectronics is highlighted, specifically exploring printing tools using bio-printable inks for practical applications, including a detailed examination of fabrication processes and essential parameters. This review also justifies the need for mechanical and electrical compatibility between bioelectronics and biological tissues. In addition to technological aspects, this article delves into the importance of appropriate packaging methods to enhance implantable devices' performance, compatibility, and longevity, which are made possible by integrating cutting-edge printing technology. Collectively, we aim to shed light on the holistic landscape of implantable biosensors and bioelectronics, showcasing their evolving role in advancing healthcare through innovative printing technologies.

Printable and flexible integrated sensing systems for wireless healthcare

The rapid development of wearable sensing devices and artificial intelligence has enabled portable and wireless tracking of human health, fulfilling the promise of digitalized healthcare applications. To achieve versatile design and integration of multi-functional modules including sensors and data transmission units onto various flexible platforms, printable technologies emerged as some of the most promising strategies. This review first introduces the commonly utilized printing technologies, followed by discussion of the printable ink formulations and flexible substrates to ensure reliable device fabrication and system integration. The advances of printable sensors for body status monitoring are then discussed. Moreover, the integration of wireless data transmission via printable approaches is also presented. Finally, the challenges in achieving printable sensing devices and wireless integrated systems with competitive performances are considered, so as to realize their practical applications for personalized healthcare.

Recent Progress and Challenges of Implantable Biodegradable Biosensors

Implantable biosensors have evolved to the cutting-edge technology of personalized health care and provide promise for future directions in precision medicine. This is the reason why these devices stand to revolutionize our approach to health and disease management and offer insights into our bodily functions in ways that have never been possible before. This review article tries to delve into the important developments, new materials, and multifarious applications of these biosensors, along with a frank discussion on the challenges that the devices will face in their clinical deployment. In addition, techniques that have been employed for the improvement of the sensitivity and specificity of the biosensors alike are focused on in this article, like new biomarkers and advanced computational and data communicational models. A significant challenge of miniaturized in situ implants is that they need to be removed after serving their purpose. Surgical expulsion provokes discomfort to patients, potentially leading to post-operative complications. Therefore, the biodegradability of implants is an alternative method for removal through natural biological processes. This includes biocompatible materials to develop sensors that remain in the body over longer periods with a much-reduced immune response and better device longevity. However, the biodegradability of implantable sensors is still in its infancy compared to conventional non-biodegradable ones. Sensor design, morphology, fabrication, power, electronics, and data transmission all play a pivotal role in developing medically approved implantable biodegradable biosensors. Advanced material science and nanotechnology extended the capacity of different research groups to implement novel courses of action to design implantable and biodegradable sensor components. But the actualization of such potential for the transformative nature of the health sector, in the first place, will have to surmount the challenges related to biofouling, managing power, guaranteeing data security, and meeting today's rules and regulations. Solving these problems will, therefore, not only enhance the performance and reliability of implantable biodegradable biosensors but also facilitate the translation of laboratory development into clinics, serving patients worldwide in their better disease management and personalized therapeutic interventions.

Flexible and Stretchable Light-Emitting Diodes and Photodetectors for Human-Centric Optoelectronics

Optoelectronic devices with unconventional form factors, such as flexible and stretchable light-emitting or photoresponsive devices, are core elements for the next-generation human-centric optoelectronics. For instance, these deformable devices can be utilized as closely fitted wearable sensors to acquire precise biosignals that are subsequently uploaded to the cloud for immediate examination and diagnosis, and also can be used for vision systems for human-interactive robotics. Their inception was propelled by breakthroughs in novel optoelectronic material technologies and device blueprinting methodologies, endowing flexibility and mechanical resilience to conventional rigid optoelectronic devices. This paper reviews the advancements in such soft optoelectronic device technologies, honing in on various materials, manufacturing techniques, and device design strategies. We will first highlight the general approaches for flexible and stretchable device fabrication, including the appropriate material selection for the substrate, electrodes, and insulation layers. We will then focus on the materials for flexible and stretchable light-emitting diodes, their device integration strategies, and representative application examples. Next, we will move on to the materials for flexible and stretchable photodetectors, highlighting the state-of-the-art materials and device fabrication methods, followed by their representative application examples. At the end, a brief summary will be given, and the potential challenges for further development of functional devices will be discussed as a conclusion.

Recent Development of Implantable Chemical Sensors Utilizing Flexible and Biodegradable Materials for Biomedical Applications

Implantable chemical sensors built with flexible and biodegradable materials exhibit immense potential for seamless integration with biological systems by matching the mechanical properties of soft tissues and eliminating device retraction procedures. Compared with conventional hospital-based blood tests, implantable chemical sensors have the capability to achieve real-time monitoring with high accuracy of important biomarkers such as metabolites, neurotransmitters, and proteins, offering valuable insights for clinical applications. These innovative sensors could provide essential information for preventive diagnosis and effective intervention. To date, despite extensive research on flexible and bioresorbable materials for implantable electronics, the development of chemical sensors has faced several challenges related to materials and device design, resulting in only a limited number of successful accomplishments. This review highlights recent advancements in implantable chemical sensors based on flexible and biodegradable materials, encompassing their sensing strategies, materials strategies, and geometric configurations. The following discussions focus on demonstrated detection of various objects including ions, small molecules, and a few examples of macromolecules using flexible and/or bioresorbable implantable chemical sensors. Finally, we will present current challenges and explore potential future directions.

Memristor-Based Artificial Chips

Memristors, promising nanoelectronic devices with in-memory resistive switching behavior that is assembled with a physically integrated core processing unit (CPU) and memory unit and even possesses highly possible multistate electrical behavior, could avoid the von Neumann bottleneck of traditional computing devices and show a highly efficient ability of parallel computation and high information storage. These advantages position them as potential candidates for future data-centric computing requirements and add remarkable vigor to the research of next-generation artificial intelligence (AI) systems, particularly those that involve brain-like intelligence applications. This work provides an overview of the evolution of memristor-based devices, from their initial use in creating artificial synapses and neural networks to their application in developing advanced AI systems and brain-like chips. It offers a broad perspective of the key device primitives enabling their special applications from the view of materials, nanostructure, and mechanism models. We highlight these demonstrations of memristor-based nanoelectronic devices that have potential for use in the field of brain-like AI, point out the existing challenges of memristor-based nanodevices toward brain-like chips, and propose the guiding principle and promising outlook for future device promotion and system optimization in the biomedical AI field.

Direct-Ink-Writing 3D-Printed Bioelectronics

The development of wearable and implantable bioelectronics has garnered significant momentum in recent years, driven by the ever-increasing demand for personalized health monitoring, remote patient management, and real-time physiological data collection. The elevated sophistication and advancement of these devices have thus led to the use of many new and unconventional materials which cannot be fulfilled through traditional manufacturing techniques. Three-dimension (3D) printing, also known as additive manufacturing, is an emerging technology that opens new opportunities to fabricate next-generation bioelectronic devices. Some significant advantages include its capacity for material versatility and design freedom, rapid prototyping, and manufacturing efficiency with enhanced capabilities. This review provides an overview of the recent advances in 3D printing of bioelectronics, particularly direct ink writing (DIW), encompassing the methodologies, materials, and applications that have emerged in this rapidly evolving field. This review showcases the broad range of bioelectronic devices fabricated through 3D printing including wearable biophysical sensors, biochemical sensors, electrophysiological sensors, energy devices, multimodal systems, implantable devices, and soft robots. This review will also discuss the advantages, existing challenges, and outlook of applying DIW 3D printing for the development of bioelectronic devices toward healthcare applications.

A Biodegradable High-Performance Microsupercapacitor for Environmentally Friendly and Biocompatible Energy Storage

Biodegradable and biocompatible microscale energy storage devices are very crucial for environmentally friendly microelectronics and implantable medical applications. Herein, a biodegradable and biocompatible microsupercapacitor (BB-MSC) with satisfying overall performance is realized via the combination of three-dimensional (3D) printing technique and biodegradable materials. Due to the 3D-interconnected structure of electrodes and elaborated design of electrolyte, the as-prepared BB-MSC exhibits superior overall performance than most of biodegradable devices, including a wide operation voltage of 1.8 V, high areal specific capacitance of 251 mF/cm2, good cycle stability, and favorable low-temperature resistance (-20 °C), demonstrative of reliability and practicality of our devices even in frosty environments. Importantly, the smooth degradation has been realized for the BB-MSC after being buried in natural soil for ∼90 days, and its implantation does not affect the healthy status of SD rats. Therefore, this work explores avenues for the design and construction of environmentally friendly and biocompatible microscale energy storage devices.

3D printed electronics with nanomaterials

A large variety of printing, deposition and writing techniques have been incorporated to fabricate electronic devices in the last decades. This approach, printed electronics, has gained great interest in research and practical applications and is successfully fuelling the growth in materials science and technology. On the other hand, a new player is emerging, additive manufacturing, called 3D printing, introducing a new capability to create geometrically complex constructs with low cost and minimal material waste. Having such tremendous technology in our hands, it was just a matter of time to combine advances of printed electronics technology for the fabrication of unique 3D structural electronics. Nanomaterial patterning with additive manufacturing techniques can enable harnessing their nanoscale properties and the fabrication of active structures with unique electrical, mechanical, optical, thermal, magnetic and biological properties. In this paper, we will briefly review the properties of selected nanomaterials suitable for electronic applications and look closer at the current achievements in the synergistic integration of nanomaterials with additive manufacturing technologies to fabricate 3D printed structural electronics. The focus is fixed strictly on techniques allowing as much as possible fabrication of spatial 3D objects, or at least conformal ones on 3D printed substrates, while only selected techniques are adaptable for 3D printing of electronics. Advances in the fabrication of conductive paths and circuits, passive components, antennas, active and photonic components, energy devices, microelectromechanical systems and sensors are presented. Finally, perspectives for development with new nanomaterials, multimaterial and hybrid techniques, bioelectronics, integration with discrete components and 4D-printing are briefly discussed.

A Biodegradable Bioactive Glass-Based Hydration Sensor for Biomedical Applications

Monitoring changes in edema-associated intracranial pressure that complicates trauma or surgery would lead to improved outcomes. Implantable pressure sensors have been explored, but these sensors require post-surgical removal, leading to the risk of injury to brain tissue. The use of biodegradable implantable sensors would help to eliminate this risk. Here, we demonstrate a bioactive glass (BaG)-based hydration sensor. Fluorine (CaF₂) containing BaG (BaG-F) was produced by adding 5, 10 or 20 wt.% of CaF₂ to a BaG matrix using a melting manufacturing technique. The structure, morphology and electrical properties of the resulting constructs were evaluated to understand the physical and electrical behaviors of this BaG-based sensor. Synthesis process for the production of the BaG-F-based sensor was validated by assessing the structural and electrical properties. The structure was observed to be amorphous and dense, the porosity decreased and grain size increased with increasing CaF₂ content in the BaG matrix. We demonstrated that this BaG-F chemical composition is highly sensitive to hydration, and that the electrical sensitivity (resistive-capacitive) is induced by hydration and reversed by dehydration. These properties make BaG-F suitable for use as a humidity sensor to monitor brain edema and, consequently, provide an alert for increased intracranial pressure.

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.

Preventing Peri-implantitis: The Quest for a Next Generation of Titanium Dental Implants

Titanium and its alloys are frequently the biomaterial of choice for dental implant applications. Although titanium dental implants have been utilized for decades, there are yet unresolved issues pertaining to implant failure. Dental implant failure can arise either through wear and fatigue of the implant itself or peri-implant disease and subsequent host inflammation. In the present report, we provide a comprehensive review of titanium and its alloys in the context of dental implant material, and how surface properties influence the rate of bacterial colonization and peri-implant disease. Details are provided on the various periodontal pathogens implicated in peri-implantitis, their adhesive behavior, and how this relationship is governed by the implant surface properties. Issues of osteointegration and immunomodulation are also discussed in relation to titanium dental implants. Some impediments in the commercial translation for a novel titanium-based dental implant from "bench to bedside" are discussed. Numerous in vitro studies on novel materials, processing techniques, and methodologies performed on dental implants have been highlighted. The present report review that comprehensively compares the in vitro, in vivo, and clinical studies of titanium and its alloys for dental implants.

Fully implantable batteryless soft platforms with printed nanomaterial-based arterial stiffness sensors for wireless continuous monitoring of restenosis in real time

Atherosclerosis is a common cause of coronary artery disease and a significant factor in broader cardiovascular diseases, the leading cause of death. While implantation of a stent is a prevalent treatment of coronary artery disease, a frequent complication is restenosis, where the stented artery narrows and stiffens. Although early detection of restenosis can be achieved by continuous monitoring, no available device offers such capability without surgeries. Here, we report a fully implantable soft electronic system without batteries and circuits, which still enables continuous wireless monitoring of restenosis in real-time with a set of nanomembrane strain sensors in an electronic stent. The low-profile system requires minimal invasive implantation to deploy the sensors into a blood vessel through catheterization. The entirely printed, nanomaterial-based set of soft membrane strain sensors utilizes a sliding mechanism to offer enhanced sensitivity and detection of low strain while unobtrusively integrating with an inductive stent for passive wireless sensing. The performance of the soft sensor platform is demonstrated by wireless monitoring of restenosis in an artery model and an ex-vivo study in a coronary artery of ovine hearts. The capacitive sensor-based artery implantation system offers unique advantages in wireless, real-time monitoring of stent treatments and arterial health for cardiovascular disease.

Microfluidic Invasion Chemotaxis Platform for 3D Neurovascular Co-Culture

Advances in microfabrication and biomaterials have enabled the development of microfluidic chips for studying tissue and organ models. While these platforms have been developed primarily for modeling human diseases, they are also used to uncover cellular and molecular mechanisms through in vitro studies, especially in the neurovascular system, where physiological mechanisms and three-dimensional (3D) architecture are difficult to reconstruct via conventional assays. An extracellular matrix (ECM) model with a stable structure possessing the ability to mimic the natural extracellular environment of the cell efficiently is useful for tissue engineering applications. Conventionally used techniques for this purpose, for example, Matrigels, have drawbacks of owning complex fabrication procedures, in some cases not efficient enough in terms of functionality and expenses. Here, we proposed a fabrication protocol for a GelMA hydrogel, which has shown structural stability and the ability to imitate the natural environment of the cell accurately, inside a microfluidic chip utilizing co-culturing of two human cell lines. The chemical composition of the synthesized GelMA was identified by Fourier transform infrared spectrophotometry (FTIR), its surface morphology was observed by field emission electron microscopy (FESEM), and the structural properties were analyzed by atomic force microscopy (AFM). The swelling behavior of the hydrogel in the microfluidic chip was imaged, and its porosity was examined for 72 h by tracking cell localization using immunofluorescence. GelMA exhibited the desired biomechanical properties, and the viability of cells in both platforms was more than 80% for seven days. Furthermore, GelMA was a viable platform for 3D cell culture studies and was structurally stable over long periods, even when prepared by photopolymerization in a microfluidic platform. This work demonstrated a viable strategy to conduct co-culturing experiments as well as modeling invasion and migration events. This microfluidic assay may have application in drug delivery and dosage optimization studies.

Three-Dimensional Printable, Highly Conductive Ionic Elastomers for High-Sensitivity Iontronics

The development of hydrogels and ionic gels for applications in fields such as soft electronics and wearable sensors is limited by liquid evaporation or leakage. Ionic conductors without volatile liquids are better choices for flexible and transparent devices. Here, a liquid polymer electrolyte (LPE) is prepared from a mixture of lithium bis(trifluoromethane)sulfonimide and polyethylene glycol (PEG) above the melting point of PEG. A three-dimensional (3D) printable solvent-free ionic elastomer (IE) is introduced by photopolymerization of ethyl acrylate and hydroxyethyl acrylate in the prepared LPE. The conductivity is significantly improved by the presence of a high content of the lithium salt. Dynamic cross-linking networks improve the stretchability and resilience of the elastomer. The pattern design capability of the IE is provided by light-curing 3D printing. These features demonstrate that the IE has broad application prospects in flexible sensors, ion skins, and soft robots.

Apatite nanosheets inhibit initial smooth muscle cell proliferation by damaging cell membrane

Understanding how nanostructured coatings interact with cells is related to how they manipulate cell behaviors and is therefore critical for designing better biomaterials. The apatite nanosheets were deposited on metallic substrates via biomimetic precipitation. Cell viability of apatite nanosheets towards to smooth muscle cells (SMCs) were investigated, and the underlying mechanism was proposed. Apatite nanosheets presented inhibitory activity on SMC growth, and caused rupture of cell membranes. On the basis of measuring changes in intracellular calcium ([Ca²⁺]_i), observing cell contraction and apatite nanosheets - SMC interaction, it was found that calcium ions released from apatite led to rises in [Ca²⁺]_i, which induced vigorous SMC contraction on apatite nanosheets. Consequently, the cell membrane of individual SMCs was cut/penetrated by the sharp edges of apatite nanosheets, resulting in cell inactivation. This damage of cell membranes suggests a novel mechanism to manipulate cell viability, and may offer insights for the better design of calcium-based nanostructured coatings or other biomedical applications.

Fully implantable wireless batteryless vascular electronics with printed soft sensors for multiplex sensing of hemodynamics

The continuous monitoring of hemodynamics attainable with wireless implantable devices would improve the treatment of vascular diseases. However, demanding requirements of size, wireless operation, and compatibility with endovascular procedures have limited the development of vascular electronics. Here, we report an implantable, wireless vascular electronic system, consisting of a multimaterial inductive stent and printed soft sensors capable of real-time monitoring of arterial pressure, pulse rate, and flow without batteries or circuits. Developments in stent design achieve an enhanced wireless platform while matching conventional stent mechanics. The fully printed pressure sensors demonstrate fast response times, high durability, and sensing at small bending radii. The device is monitored via inductive coupling at communication distances notably larger than prior vascular sensors. The wireless electronic system is validated in artery models, while minimally invasive catheter implantation is demonstrated in an in vivo rabbit study. Overall, the vascular system offers an adaptable framework for comprehensive monitoring of hemodynamics.