Biocompatible Material-Based Flexible Biosensors: From Materials Design to Wearable/Implantable Devices and Integrated Sensing Systems

Piezoelectric Hydrogels: Hybrid Material Design, Properties, and Biomedical Applications

Hydrogels show great potential in biomedical applications due to their inherent biocompatibility, high water content, and resemblance to the extracellular matrix. However, they lack self-powering capabilities and often necessitate external stimulation to initiate cell regenerative processes. In contrast, piezoelectric materials offer self-powering potential but tend to compromise flexibility. To address this, creating a novel hybrid biomaterial of piezoelectric hydrogels (PHs), which combines the advantageous properties of both materials, offers a systematic solution to the challenges faced by these materials when employed separately. Such innovative material system is expected to broaden the horizons of biomedical applications, such as piezocatalytic medicinal and health monitoring applications, showcasing its adaptability by endowing hydrogels with piezoelectric properties. Unique functionalities, like enabling self-powered capabilities and inducing electrical stimulation that mimics endogenous bioelectricity, can be achieved while retaining hydrogel matrix advantages. Given the limited reported literature on PHs, here recent strategies concerning material design and fabrication, essential properties, and distinctive applications are systematically discussed. The review is concluded by providing perspectives on the remaining challenges and the future outlook for PHs in the biomedical field. As PHs emerge as a rising star, a comprehensive exploration of their potential offers insights into the new hybrid biomaterials.

Biocompatible Electronic Skins for Cardiovascular Health Monitoring

Cardiovascular diseases represent a significant threat to the overall well-being of the global population. Continuous monitoring of vital signs related to cardiovascular health is essential for improving daily health management. Currently, there has been remarkable proliferation of technology focused on collecting data related to cardiovascular diseases through daily electronic skin monitoring. However, concerns have arisen regarding potential skin irritation and inflammation due to the necessity for prolonged wear of wearable devices. To ensure comfortable and uninterrupted cardiovascular health monitoring, the concept of biocompatible electronic skin has gained substantial attention. In this review, biocompatible electronic skins for cardiovascular health monitoring are comprehensively summarized and discussed. The recent achievements of biocompatible electronic skin in cardiovascular health monitoring are introduced. Their working principles, fabrication processes, and performances in sensing technologies, materials, and integration systems are highlighted, and comparisons are made with other electronic skins used for cardiovascular monitoring. In addition, the significance of integrating sensing systems and the updating wireless communication for the development of the smart medical field is explored. Finally, the opportunities and challenges for wearable electronic skin are also examined.

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 Advances in Wearable Healthcare Devices: From Material to Application

In recent years, the proliferation of wearable healthcare devices has marked a revolutionary shift in the personal health monitoring and management paradigm. These devices, ranging from fitness trackers to advanced biosensors, have not only made healthcare more accessible, but have also transformed the way individuals engage with their health data. By continuously monitoring health signs, from physical-based to biochemical-based such as heart rate and blood glucose levels, wearable technology offers insights into human health, enabling a proactive rather than a reactive approach to healthcare. This shift towards personalized health monitoring empowers individuals with the knowledge and tools to make informed decisions about their lifestyle and medical care, potentially leading to the earlier detection of health issues and more tailored treatment plans. This review presents the fabrication methods of flexible wearable healthcare devices and their applications in medical care. The potential challenges and future prospectives are also discussed.

Recent Progress in Wearable Near-Sensor and In-Sensor Intelligent Perception Systems

As the Internet of Things (IoT) becomes more widespread, wearable smart systems will begin to be used in a variety of applications in people's daily lives, not only requiring the devices to have excellent flexibility and biocompatibility, but also taking into account redundant data and communication delays due to the use of a large number of sensors. Fortunately, the emerging paradigms of near-sensor and in-sensor computing, together with the proposal of flexible neuromorphic devices, provides a viable solution for the application of intelligent low-power wearable devices. Therefore, wearable smart systems based on new computing paradigms are of great research value. This review discusses the research status of a flexible five-sense sensing system based on near-sensor and in-sensor architectures, considering material design, structural design and circuit design. Furthermore, we summarize challenging problems that need to be solved and provide an outlook on the potential applications of intelligent wearable devices.

Cold-resistant, highly stretchable ionic conductive hydrogels for intelligent motion recognition in winter sports

Conductive hydrogels have attracted much attention for their wide application in the field of flexible wearable sensors due to their outstanding flexibility, conductivity and sensing properties. However, the weak mechanical properties, lack of frost resistance and susceptibility to microbial contamination of traditional conductive hydrogels greatly limit their practical application. In this work, multifunctional polyvinyl alcohol (PVA)/carboxymethyl cellulose (CMC)/poly(acrylamide-co-1-vinyl-3-butylimidazolium bromide) (P(AAm-co-VBIMBr)) (PCPAV) ionic conductive hydrogels with high strength and good conductive, transparent, anti-freezing and antibacterial properties were constructed by introducing a network of chemically crosslinked AAm and VBIMBr copolymers into the base material of PVA and CMC by in situ free radical polymerization. Owing to the multiple interactions between the polymers, including covalent crosslinking, multiple hydrogen bonding interactions, and electrostatic interactions, the obtained ionic conductive hydrogels exhibit a high tensile strength (360.6 kPa), a large elongation at break (810.6%), good toughness, and fatigue resistance properties. The introduction of VBIMBr endows the PCPAV hydrogels with excellent transparency (∼92%), a high ionic conductivity (15.2 mS cm-1), antimicrobial activity and good flexibility and conductivity at sub-zero temperatures. Notably, the PCPAV hydrogels exhibit a wide strain range (0-800%), high strain sensitivity (GF = 3.75), fast response, long-term stability, and fantastic durability, which enable them to detect both large joint movements and minute muscle movements. Based on these advantages, it is believed that the PCPAV-based hydrogel sensors would have potential applications in health monitoring, human motion detection, soft robotics, ionic skins, human-machine interfaces, and other flexible electronic devices.

Electrochemical and Electrical Biosensors for Wearable and Implantable Electronics Based on Conducting Polymers and Carbon-Based Materials

Bioelectronic devices are designed to translate biological information into electrical signals and vice versa, thereby bridging the gap between the living biological world and electronic systems. Among different types of bioelectronics devices, wearable and implantable biosensors are particularly important as they offer access to the physiological and biochemical activities of tissues and organs, which is significant in diagnosing and researching various medical conditions. Organic conducting and semiconducting materials, including conducting polymers (CPs) and graphene and carbon nanotubes (CNTs), are some of the most promising candidates for wearable and implantable biosensors. Their unique electrical, electrochemical, and mechanical properties bring new possibilities to bioelectronics that could not be realized by utilizing metals- or silicon-based analogues. The use of organic- and carbon-based conductors in the development of wearable and implantable biosensors has emerged as a rapidly growing research field, with remarkable progress being made in recent years. The use of such materials addresses the issue of mismatched properties between biological tissues and electronic devices, as well as the improvement in the accuracy and fidelity of the transferred information. In this review, we highlight the most recent advances in this field and provide insights into organic and carbon-based (semi)conducting materials' properties and relate these to their applications in wearable/implantable biosensors. We also provide a perspective on the promising potential and exciting future developments of wearable/implantable biosensors.

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.

Flexible Dry Electrode Based on a Wrinkled Surface That Uses Carbon Nanotube/Polymer Composites for Recording Electroencephalograms

Electroencephalography (EEG) captures minute electrical signals emanating from the brain. These signals are vulnerable to interference from external noise and dynamic artifacts; hence, accurately recording such signals is challenging. Although dry electrodes are convenient, their signals are of limited quality; consequently, wet electrodes are predominantly used in EEG. Therefore, developing dry electrodes for accurately and stably recording EEG signals is crucial. In this study, we developed flexible dry electrodes using polydimethylsiloxane (PDMS)/carbon-nanotube (CNT) composites with isotropically wrinkled surfaces that effectively combine the advantages of wet and dry electrodes. Adjusting the PDMS crosslinker ratio led to good adhesion, resulting in a highly adhesive CNT/PDMS composite with a low Young's modulus that exhibited excellent electrical and mechanical properties owing to its ability to conformally contact skin. The isotropically wrinkled surface also effectively controls dynamic artifacts during EEG signal detection and ensures accurate signal analysis. The results of this study demonstrate that dry electrodes based on flexible CNT/PDMS composites and corrugated structures can outperform wet electrodes. The introduction of such electrodes is expected to enable the accurate analysis and monitoring of EEG signals in various scenarios, including clinical trials.

Bioinspired nanoplatforms for human-machine interfaces: Recent progress in materials and device applications

The panoramic characteristics of human-machine interfaces (HMIs) have prompted the needs to update the biotechnology community with the recent trends, developments, and future research direction toward next-generation bioelectronics. Bioinspired materials are promising for integrating various bioelectronic devices to realize HMIs. With the advancement of scientific biotechnology, state-of-the-art bioelectronic applications have been extensively investigated to improve the quality of life by developing and integrating bioinspired nanoplatforms in HMIs. This review highlights recent trends and developments in the field of biotechnology based on bioinspired nanoplatforms by demonstrating recently explored materials and cutting-edge device applications. Section 1 introduces the recent trends and developments of bioinspired nanomaterials for HMIs. Section 2 reviews various flexible, wearable, biocompatible, and biodegradable nanoplatforms for bioinspired applications. Section 3 furnishes recently explored substrates as carriers for advanced nanomaterials in developing HMIs. Section 4 addresses recently invented biomimetic neuroelectronic, nanointerfaces, biointerfaces, and nano/microfluidic wearable bioelectronic devices for various HMI applications, such as healthcare, biopotential monitoring, and body fluid monitoring. Section 5 outlines designing and engineering of bioinspired sensors for HMIs. Finally, the challenges and opportunities for next-generation bioinspired nanoplatforms in extending the potential on HMIs are discussed for a near-future scenario. We believe this review can stimulate the integration of bioinspired nanoplatforms into the HMIs in addition to wearable electronic skin and health-monitoring devices while addressing prevailing and future healthcare and material-related problems in biotechnologies.

Advances in Bioelectrode Design for Developing Electrochemical Biosensors

The critical performance factors such as selectivity, sensitivity, operational and storage stability, and response time of electrochemical biosensors are governed mainly by the function of their key component, the bioelectrode. Suitable design and fabrication strategies of the bioelectrode interface are essential for realizing the requisite performance of the biosensors for their practical utility. A multifaceted attempt to achieve this goal is visible from the vast literature exploring effective strategies for preparing, immobilizing, and stabilizing biorecognition elements on the electrode surface and efficient transduction of biochemical signals into electrical ones (i.e., current, voltage, and impedance) through the bioelectrode interface with the aid of advanced materials and techniques. The commercial success of biosensors in modern society is also increasingly influenced by their size (and hence portability), multiplexing capability, and coupling in the interface of the wireless communication technology, which facilitates quick data transfer and linked decision-making processes in real-time in different areas such as healthcare, agriculture, food, and environmental applications. Therefore, fabrication of the bioelectrode involves careful selection and control of several parameters, including biorecognition elements, electrode materials, shape and size of the electrode, detection principles, and various fabrication strategies, including microscale and printing technologies. This review discusses recent trends in bioelectrode designs and fabrications for developing electrochemical biosensors. The discussions have been delineated into the types of biorecognition elements and their immobilization strategies, signal transduction approaches, commonly used advanced materials for electrode fabrication and techniques for fabricating the bioelectrodes, and device integration with modern electronic communication technology for developing electrochemical biosensors of commercial interest.

Fully Integrated Point-of-Care Platform for the Self-Monitoring of Phenylalanine in Finger-Prick Blood

Development of point-of-care platforms combining reliability and ease of use is a challenge for the evolution of sensing in healthcare technologies. Here, we report the development and testing of a fully integrated enzymatic colorimetric assay for the sensing of phenylalanine in blood samples from phenylketonuria patients. The platform works with a customized mobile app for data acquisition and visualization and comprises an electronic system and a disposable sensor. The sensing approach is based on specific enzymatic phenylalanine recognition, and the optical transduction method is based on in situ gold nanostructure formation. The phenylketonuria (PKU) smart sensor platform is conceived to perform self-monitoring on phenylalanine levels and real-time therapy tuning, thanks to the direct connection with clinicians. Validation of the technologies with a population of patients affected by PKU, together with the concurrent validation of the platform through centralized laboratories, has confirmed the good analytical performances in terms of sensitivity and specificity, robustness, and utility for phenylalanine sensing. The self-monitoring of phenylalanine for the daily identification of abnormal health conditions could facilitate rapid therapy tuning, improving the wellness of PKU patients.