A Soft and Absorbable Temporary Epicardial Pacing Wire

Needle-Like Multifunctional Biphasic Microfiber for Minimally Invasive Implantable Bioelectronics

Implantable bioelectronics has attracted significant attention in electroceuticals and clinical medicine for precise diagnosis and efficient treatment of target diseases. However, conventional rigid implantable devices face challenges such as poor tissue-device interface and unavoidable tissue damage during surgical implantation. Despite continuous efforts to utilize various soft materials to address such issues, their practical applications remain limited. Here, a needle-like stretchable microfiber composed of a phase-convertible liquid metal (LM) core and a multifunctional nanocomposite shell for minimally invasive soft bioelectronics is reported. The sharp tapered microfiber can be stiffened by freezing akin to a conventional needle to penetrate soft tissue with minimal incision. Once implanted in vivo where the LM melts, unlike conventional stiff needles, it regains soft mechanical properties, which facilitate a seamless tissue-device interface. The nanocomposite incorporating with functional nanomaterials exhibits both low impedance and the ability to detect physiological pH, providing biosensing and stimulation capabilities. The fluidic LM embedded in the nanocomposite shell enables high stretchability and strain-insensitive electrical properties. This multifunctional biphasic microfiber conforms to the surfaces of the stomach, muscle, and heart, offering a promising approach for electrophysiological recording, pH sensing, electrical stimulation, and radiofrequency ablation in vivo.

Three-dimensional liquid metal-based neuro-interfaces for human hippocampal organoids

Human hippocampal organoids (hHOs) derived from human induced pluripotent stem cells (hiPSCs) have emerged as promising models for investigating neurodegenerative disorders, such as schizophrenia and Alzheimer's disease. However, obtaining the electrical information of these free-floating organoids in a noninvasive manner remains a challenge using commercial multi-electrode arrays (MEAs). The three-dimensional (3D) MEAs developed recently acquired only a few neural signals due to limited channel numbers. Here, we report a hippocampal cyborg organoid (cyb-organoid) platform coupling a liquid metal-polymer conductor (MPC)-based mesh neuro-interface with hHOs. The mesh MPC (mMPC) integrates 128-channel multielectrode arrays distributed on a small surface area (~2*2 mm). Stretchability (up to 500%) and flexibility of the mMPC enable its attachment to hHOs. Furthermore, we show that under Wnt3a and SHH activator induction, hHOs produce HOPX+ and PAX6+ progenitors and ZBTB20+PROX1+ dentate gyrus (DG) granule neurons. The transcriptomic signatures of hHOs reveal high similarity to the developing human hippocampus. We successfully detect neural activities from hHOs via the mMPC from this cyb-organoid. Compared with traditional planar devices, our non-invasive coupling offers an adaptor for recording neural signals from 3D models.

Bioresorbable molybdenum temporary epicardial pacing wires

Cardiac pacing with temporary epicardial pacing wires (TEPW) is used to treat rhythm disturbances after cardiac surgery. Occasionally, TEPW cannot be mechanically extracted and remain in the thorax, where they may rarely cause serious complications like migration and infection. We aim to develop bioresorbable TEPW that will dissolve over time even if postoperative removal is unsuccessful. In the present study, we demonstrate a completely bioresorbable design using molybdenum (Mo) as electric conductor and the resorbable polymers poly(D, L-lactic-co-glycolic acid) (PLGA) and polycaprolactone (PCL) for electrically insulating double-coating. We compared the pacing properties of these Mo TEPW demonstrators to conventional steel TEPW in Langendorff-perfused rat hearts and observed similar functionality. In vitro, static immersion tests in simulated body fluid for up to 28 days elucidated the degradation behaviour of uncoated Mo strands and the influence of polymer coating thereon. Degradation was considerably reduced in double-coated Mo TEPW compared to the uncoated and the PLGA-coated condition. Furthermore, we confirmed good biocompatibility of Mo degradation products in the form of low cytotoxicity in cell cultures of human cardiomyocytes and cardiac fibroblasts. STATEMENT OF SIGNIFICANCE: Temporary pacing wires are routinely implanted on the heart surface to treat rhythm disturbances in the days following cardiac surgery. Subsequently, these wires are to be removed. When removal attempts are unsuccessful, wires are cut at skin level and the remainders are left inside the chest. Retained fragments may migrate within the body or become a centre of infection. These complications may be prevented using resorbable pacing wires. We manufactured completely resorbable temporary pacing wires using molybdenum as electrical conductor and assessed their function, degradation and biological compatibility. Our study represents an important step in the development of a safer approach to the treatment of rhythm disturbances after cardiac surgery.

Liquid Metal-Polymer Conductor-Based Conformal Cyborg Devices

Gallium-based liquid metal (LM) exhibits exceptional properties such as high conductivity and biocompatibility, rendering it highly valuable for the development of conformal bioelectronics. When combined with polymers, liquid metal-polymer conductors (MPC) offer a versatile platform for fabricating conformal cyborg devices, enabling functions such as sensing, restoration, and augmentation within the human body. This review focuses on the synthesis, fabrication, and application of MPC-based cyborg devices. The synthesis of functional materials based on LM and the fabrication techniques for MPC-based devices are elucidated. The review provides a comprehensive overview of MPC-based cyborg devices, encompassing their applications in sensing diverse signals, therapeutic interventions, and augmentation. The objective of this review is to serve as a valuable resource that bridges the gap between the fabrication of MPC-based conformal devices and their potential biomedical applications.

Stretchable surface electromyography electrode array patch for tendon location and muscle injury prevention

Surface electromyography (sEMG) can provide multiplexed information about muscle performance. If current sEMG electrodes are stretchable, arrayed, and able to be used multiple times, they would offer adequate high-quality data for continuous monitoring. The lack of these properties delays the widespread use of sEMG in clinics and in everyday life. Here, we address these constraints by design of an adhesive dry electrode using tannic acid, polyvinyl alcohol, and PEDOT:PSS (TPP). The TPP electrode offers superior stretchability (~200%) and adhesiveness (0.58 N/cm) compared to current electrodes, ensuring stable and long-term contact with the skin for recording (>20 dB; >5 days). In addition, we developed a metal-polymer electrode array patch (MEAP) comprising liquid metal (LM) circuits and TPP electrodes. The MEAP demonstrated better conformability than commercial arrays, resulting in higher signal-to-noise ratio and more stable recordings during muscle movements. Manufactured using scalable screen-printing, these MEAPs feature a completely stretchable material and array architecture, enabling real-time monitoring of muscle stress, fatigue, and tendon displacement. Their potential to reduce muscle and tendon injuries and enhance performance in daily exercise and professional sports holds great promise.

Electronic exoneuron based on liquid metal for the quantitative sensing of the augmented somatosensory system

The increasing demands in augmented somatosensory have promoted quantitative sensing to be an emerging need for athletic training/performance evaluation and physical rehabilitation. Neurons for the somatosensory system in the human body can capture the information of movements in time but only qualitatively. This work presents an electronic Exo-neuron (EEN) that can spread throughout the limbs for realizing augmented somatosensory by recording both muscular activity and joint motion quantitatively without site constraints or drift instability, even in strenuous activities. Simply based on low-cost liquid metal and clinically used adhesive elastomer, the EEN could be easily fabricated in large areas for limbs. It is thin (~120 μm), soft, stretchable (>500%), and conformal and further shows wide applications in sports, rehabilitation, health care, and entertainment.

Liquid metal integrated PU/CNT fibrous membrane for human health monitoring

Wearable flexible sensors are widely used in several applications such as physiological monitoring, electronic skin, and telemedicine. Typically, flexible sensors that are made of elastomeric thin-films lack sufficient permeability, which leads to skin inflammation, and more importantly, affects signal detection and consequently, reduces the sensitivity of the sensor. In this study, we designed a flexible nanofibrous membrane with a high air permeability (6.10 mm/s), which could be effectively used to monitor human motion signals and physiological signals. More specifically, a flexible membrane with a point (liquid metal nanoparticles)-line (carbon nanotubes)-plane (liquid metal thin-film) multiscale conductive structure was fabricated by combining liquid metal (LM) and carbon nanotubes (CNTs) with a polyurethane (PU) nanofibrous membrane. Interestingly, the excellent conductivity and fluidity of the liquid metal enhanced the sensitivity and stability of the membrane. More precisely, the gauge factor (GF) values of the membrane is 3.0 at 50% strain and 14.0 at 400% strain, which corresponds to a high strain sensitivity within the whole range of deformation. Additionally, the proposed membrane has good mechanical properties with an elongation at a break of 490% and a tensile strength of 12 MPa. Furthermore, the flexible membrane exhibits good biocompatibility and can efficiently monitor human health signals, thereby indicating potential for application in the field of wearable electronic devices.

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

Liquid metal enabled conformal electronics

The application of three-dimensional common electronics that can be directly pasted on arbitrary surfaces in the fields of human health monitoring, intelligent robots and wearable electronic devices has aroused people's interest, especially in achieving stable adhesion of electronic devices on biological dynamic three-dimensional interfaces and high-quality signal acquisition. In recent years, liquid metal (LM) materials have been widely used in the manufacture of flexible sensors and wearable electronic devices because of their excellent tensile properties and electrical conductivity at room temperature. In addition, LM has good biocompatibility and can be used in a variety of biomedical applications. Here, the recent development of LM flexible electronic printing methods for the fabrication of three-dimensional conformal electronic devices on the surface of human tissue is discussed. These printing methods attach LM to the deformable substrate in the form of bulk or micro-nano particles, so that electronic devices can adapt to the deformation of human tissue and other three-dimensional surfaces, and maintain stable electrical properties. Representative examples of applications such as self-healing devices, degradable devices, flexible hybrid electronic devices, variable stiffness devices and multi-layer large area circuits are reviewed. The current challenges and prospects for further development are also discussed.

Recent progress in fiber-based soft electronics enabled by liquid metal

Soft electronics can seamlessly integrate with the human skin which will greatly improve the quality of life in the fields of healthcare monitoring, disease treatment, virtual reality, and human-machine interfaces. Currently, the stretchability of most soft electronics is achieved by incorporating stretchable conductors with elastic substrates. Among stretchable conductors, liquid metals stand out for their metal-grade conductivity, liquid-grade deformability, and relatively low cost. However, the elastic substrates usually composed of silicone rubber, polyurethane, and hydrogels have poor air permeability, and long-term exposure can cause skin redness and irritation. The substrates composed of fibers usually have excellent air permeability due to their high porosity, making them ideal substrates for soft electronics in long-term applications. Fibers can be woven directly into various shapes, or formed into various shapes on the mold by spinning techniques such as electrospinning. Here, we provide an overview of fiber-based soft electronics enabled by liquid metals. An introduction to the spinning technology is provided. Typical applications and patterning strategies of liquid metal are presented. We review the latest progress in the design and fabrication of representative liquid metal fibers and their application in soft electronics such as conductors, sensors, and energy harvesting. Finally, we discuss the challenges of fiber-based soft electronics and provide an outlook on future prospects.

Stretchable Liquid Metal-Based Metal-Polymer Conductors for Fully Screen-Printed Biofuel Cells

We reported a straightforward and low-cost method to fabricate stretchable biofuel cells by using liquid metal-based metal-polymer conductors. The liquid-metal-based metal-polymer conductors had a conductivity of 2.7 × 10⁵ S/m and a stretchability larger than 200%, giving the biofuel cell good conformability to the skin. The glucose biofuel cells (BFCs) yielded a maximum power density as 14.11 μW/cm² at 0.31 V with 0.2 mM glucose, while the lactate BFCs reached 31.00 μW/cm² at 0.51 V with 15 mM lactate. The results of 24 h short circuit current density showed that, with enough biofuel, this patch could be used over the course of an entire day for wearable sensors.

Temporary Epicardial Pacing After Cardiac Surgery

Temporary epicardial pacing frequently is employed after cardiac surgery, and can have a significant impact on a patient's hemodynamics, arrhythmias, and valvulopathies. Given that anesthesiologists often are involved intimately in the initial programming and subsequent management of epicardial pacing in the operating room and intensive care unit, it is important for practitioners to have a detailed understanding of the modes, modifiable intervals, and potential complications that can occur after cardiac surgery. Because this topic has not been reviewed recently in anesthesia literature, the authors attempted to review relevant epicardial pacemaker specifics, discuss modes and parameters that apply to the perioperative period, present an algorithm for mode selection, describe the potential effects of epicardial pacing on valvulopathies and hemodynamics, and, finally, discuss some postoperative considerations.

Surface-Embedded Liquid Metal Electrodes with Abrasion Resistance via Direct Magnetic Printing

Gallium-based liquid metals (LMs) featuring both high conductivity and fluidity are ideal conductors for soft and stretchable electronics. However, their liquid nature is a double-edged sword in many key applications since LMs are inherently prone to mechanical damage. Although additional encapsulation is frequently used for the protection of delicate LM electrodes, it hinders the electrical interfacing with other objects for interconnection, sensing, and stimulation. Here, different from conventional patterning methods that deposit LM on or inside substrates, we for the first time report a simple strategy to create surface-embedded LM of eutectic gallium-indium (EGaIn) circuits with mechanical damage endurance. This was achieved by using direct magnetic printing to overcome the high surface tension of LM, allowing it to be passively filled into the laser-patterned microgrooves on soft substrates. We show that the surface-embedded LM circuits are resistant to mechanical erasure, washing, and peeling. We also show the applications of our surface-embedded LM electrodes in respiration monitoring and electrical stimulation of nerves. This work provides a simple and efficient way to create mechanically reliable LM microelectrodes, holding great promise for wearable and implantable bioelectronics.

Stretchable and Self-Healable Graphene–Polymer Conductive Composite for Wearable EMG Sensor

In bioelectronics, stretchable and self-healable electrodes can reliably measure electrophysiological signals from the human body because they have good modulus matching with tissue and high durability. In particular, the polymer–graphene composite has advantages when it is used as an electrode for bioelectronic sensor devices. However, it has previously been reported that external stimuli such as heat or light are required for the self-healing process of polymer/graphene composites. In this study, we optimized a conducting composite by mixing a self-healing polymer (SHP) and graphene. The composite materials can not only self-heal without external stimulation but also have rapid electrical recovery from repeated mechanical damage such as scratches. In addition, they had stable electrical endurance even when the cyclic test was performed over 200 cycles at 50% strain, so they can be useful for a bioelectronic sensor device with high durability. Finally, we measured the electromyogram signals caused by the movement of arm muscles using our composite, and the measured data were transmitted to a microcontroller to successfully control the movement of the robot’s hand.

Skin Electronics from Biocompatible In Situ Welding Enabled By Intrinsically Sticky Conductors

Welding usually involves high temperatures, toxic solvents, or conditions not compatible with human bodies, which severely limit the fusion of electronics and human tissues. To achieve direct welding of electronics on human skin, the intrinsically sticky conductors that can simultaneously achieve metal-grade electrical conductivity (≈41 7000 S m^-1 ), hydrogel-grade stretchability (>900% strain), and self-adhesiveness (1.8 N cm^-1 ) are reported. The sticky conductors composed of gallium indium alloy and acrylate polymer adhesives have a surface-enriched structure, which can form instant mechanical and electrical connections with different surfaces through gentle pressure without involving conditions that may damage human tissues. Based on the sticky conductors, the in situ welding of electronics on the skin is realized. To demonstrate the feasibility of in situ welding, electronic tattoos are achieved for movement monitoring. Intrinsically sticky electrodes that can resist drying and simultaneously deform with the skin for electrophysiological measurement are also developed.

In Situ Deposition of Skin-Adhesive Liquid Metal Particles with Robust Wear Resistance for Epidermal Electronics

Comfort and mechanical stability are vital for epidermal electronics in daily use. In situ deposition of circuitry without the protection of substrates or encapsulation can produce imperceptible, conformal, and permeable epidermal electronics. However, they are easily destroyed by daily wear because the binding force between deposited materials and skin is usually weak. Here, we in situ deposited skin-adhesive liquid metal particles (ALMP) to fabricate epidermal electronics with robust wear resistance. It represents the most wear-resistant in situ deposited epidermal electronic materials. It can withstand ∼1600 cm, 175 g loaded paper tape wearing by a standard abrasion wear tester. Stretchability, conformality, permeability, and thinness of the ALMP coating provide an imperceptible and comfortable wearing experience. Without degradation of electrical property caused by solvent evaporation, the dry ALMP coating possesses natural advantages over gel electrodes. In situ deposited ALMP is an ideal material for fabricating comfortable epidermal electronics.

Conductive Materials with Elaborate Micro/Nanostructures for Bioelectronics

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

Liquid metal-polymer conductor-based wireless, battery-free epidermal patch

Wearable epidermal patch can seamlessly monitor biological signals in real-time. Here, we report a liquid metal-polymer conductor-based wireless epidermal patch. The epidermal patch is made of a new conductive material called liquid metal-polymer conductors (LMPC). LMPC is made by casting and peeling off polymers from patterned liquid metal particles. Our printable conductors present good stretchability, repeatability, and biocompatibility. We fabricate LMPC-based antenna and wire, which achieves wireless signal communication and power supply. To demonstrate the capability of our LMPC-based antenna and wire, we fabricate an epidermal patch to analyze metabolites, electrolytes, and urea in sweat. When a portable device is close to the epidermal sensor, the device can power and read the sensor through LMPC-based antenna. The epidermal patch exhibited good analytical performance for sweat analysis with a low limit of detection, fast response time, and multiplex detection capabilities. This epidermal patch opens the possibility for a broad range of non-invasive diagnostic tools that can be used for health monitoring in the general population.