Wireless electrical stimulation of the vagus nerves by ultrasound-responsive programmable hydrogel nanogenerators for anti-inflammatory therapy in sepsis

Biocompatible triboelectric energy generators (BT-TENGs) for energy harvesting and healthcare applications

Electronic waste (e-waste) has become a significant environmental and societal challenge, necessitating the development of sustainable alternatives. Biocompatible and biodegradable electronic devices offer a promising solution to mitigate e-waste and provide viable alternatives for various applications, including triboelectric nanogenerators (TENGs). This review provides a comprehensive overview of recent advancements in biocompatible, biodegradable, and implantable TENGs, emphasizing their potential as energy scavengers for healthcare devices. The review delves into the fabrication processes of self-powered TENGs using natural biopolymers, highlighting their biodegradability and compatibility with biological tissues. It further explores the biomedical applications of ultrasound-based TENGs, including their roles in wound healing and energy generation. Notably, the review presents the novel application of TENGs for vagus nerve stimulation, demonstrating their potential in neurotherapeutic interventions. Key findings include the identification of optimal biopolymer materials for TENG fabrication, the effectiveness of TENGs in energy harvesting from physiological movements, and the potential of these devices in regenerative medicine. Finally, the review discusses the challenges in scaling up the production of implantable TENGs from biomaterials, addressing issues such as mechanical stability, long-term biocompatibility, and integration with existing medical devices, outlining future research opportunities to enhance their performance and broaden their applications in the biomedical field.

Recent Advances in Implantable Neural Interfaces for Multimodal Electrical Neuromodulation

Electrical neuromodulation plays a pivotal role in enhancing patient outcomes among individuals suffering from neurological disorders. Implantable neural interfaces are vital components of the electrical neuromodulation system to ensure desirable performance; However, conventional devices are limited to a single function and are constructed with bulky and rigid materials, which often leads to mechanical incompatibility with soft tissue and an inability to adapt to the dynamic and complex 3D structures of biological systems. In addition, current implantable neural interfaces utilized in clinical settings primarily rely on wire-based techniques, which are associated with complications such as increased risk of infection, limited positioning options, and movement restrictions. Here, the state-of-art applications of electrical neuromodulation are presented. Material schemes and device structures that can be employed to develop robust and multifunctional neural interfaces, including flexibility, stretchability, biodegradability, self-healing, self-rolling, or morphing are discussed. Furthermore, multimodal wireless neuromodulation techniques, including optoelectronics, mechano-electrics, magnetoelectrics, inductive coupling, and electrochemically based self-powered devices are reviewed. In the end, future perspectives are given.

Advanced Ultrasound Energy Transfer Technologies using Metamaterial Structures

Wireless energy transfer (WET) based on ultrasound-driven generators with enormous beneficial functions, is technologically in progress by the valuation of ultrasonic metamaterials (UMMs) in science and engineering domains. Indeed, novel metamaterial structures can develop the efficiency of mechanical and physical features of ultrasound energy receivers (US-ETs), including ultrasound-driven piezoelectric and triboelectric nanogenerators (US-PENGs and US-TENGs) for advantageous applications. This review article first summarizes the fundamentals, classification, and design engineering of UMMs after introducing ultrasound energy for WET technology. In addition to addressing using UMMs, the topical progress of innovative UMMs in US-ETs is conceptually presented. Moreover, the advanced approaches of metamaterials are reported in the categorized applications of US-PENGs and US-TENGs. Finally, some current perspectives and encounters of UMMs in US-ETs are offered. With this objective in mind, this review explores the potential revolution of reliable integrated energy transfer systems through the transformation of metamaterials into ultrasound-driven active mediums for generators.

Vagus Nerve and Gut-Brain Communication

The vagus nerve, as an important component of the gut-brain axis, plays a crucial role in the communication between the gut and brain. It influences food intake, fat metabolism, and emotion by regulating the gut-brain axis, which is closely associated with the development of gastrointestinal, psychiatric, and metabolism-related disorders. In recent years, significant progress has been made in understanding the vagus-mediated regulatory pathway, highlighting its profound implications in the development of many diseases. Here, we summarize the latest advancements in vagus-mediated gut-brain pathways and the novel interventions targeting the vagus nerve. This will provide valuable insights for future research on treatment of obesity and gastrointestinal and depressive disorders based on vagus nerve stimulation.

[Classification and Application of Ultrasound-Responsive Nanomaterials in Anti-Inflammatory Therapy]

Ultrasound, a high-frequency mechanical wave with excellent tissue penetration, has been widely applied in medical diagnostic imaging. Furthermore, it has been reported that ultrasound has broad prospects for extensive applications in the field of disease treatment in recent years due to its non-invasiveness and high efficiency. Ultrasound-responsive nanomaterials have the unique advantages of a small size and a high reactivity. Such materials have the capability for precision control of drug release under ultrasound stimulation, which provides a new approach to enhancing the efficiency of drug therapy. Therefore, these materials have attracted the attention of a wide range of scholars. Inflammation is a defensive response produced by organisms to deal with injuries. However, excessive inflammatory response may lead to various tissue damages in organisms and even endanger patients' lives. Many studies have demonstrated that limiting the inflammatory response using ultrasound-responsive nanomaterials is a viable way of treating diseases. Currently, there are still challenges in the application of ultrasound-responsive nanomaterials in anti-inflammatory therapy. The design and synthesis process of nanomaterials is complicated, and further verification of the biocompatibility and safety of these materials is needed. Therefore, in this review, we summarized and classified common ultrasound-responsive nanomaterials in the field of anti-inflammation and systematically introduced the properties of different nanomaterials. In addition, the anti-inflammatory applications of ultrasound-responsive nanomaterials in various diseases, such as bone diseases, skin and muscle diseases, autoimmune diseases, and respiratory diseases, are also described in detail. It is expected that this review will provide insights for further research and clinical applications in the realms of precision treatment, targeted drug delivery, and clinical trial validation of ultrasound-responsive nanomaterials used in anti-inflammatory therapies.

Gel-Based Triboelectric Nanogenerators for Flexible Sensing: Principles, Properties, and Applications

The rapid development of the Internet of Things and artificial intelligence technologies has increased the need for wearable, portable, and self-powered flexible sensing devices. Triboelectric nanogenerators (TENGs) based on gel materials (with excellent conductivity, mechanical tunability, environmental adaptability, and biocompatibility) are considered an advanced approach for developing a new generation of flexible sensors. This review comprehensively summarizes the recent advances in gel-based TENGs for flexible sensors, covering their principles, properties, and applications. Based on the development requirements for flexible sensors, the working mechanism of gel-based TENGs and the characteristic advantages of gels are introduced. Design strategies for the performance optimization of hydrogel-, organogel-, and aerogel-based TENGs are systematically summarized. In addition, the applications of gel-based TENGs in human motion sensing, tactile sensing, health monitoring, environmental monitoring, human-machine interaction, and other related fields are summarized. Finally, the challenges of gel-based TENGs for flexible sensing are discussed, and feasible strategies are proposed to guide future research.

Orally Ingested Self-Powered Stimulators for Targeted Gut-Brain Axis Electrostimulation to Treat Obesity and Metabolic Disorders

Obesity is a significant health concern that often leads to metabolic dysfunction and chronic diseases. This study introduces a novel approach to combat obesity using orally ingested self-powered electrostimulators. These electrostimulators consist of piezoelectric BaTiO3 (BTO) particles conjugated with capsaicin (Cap) and aim to activate the vagus nerve. Upon ingestion by diet-induced obese (DIO) mice, the BTO@Cap particles specifically target and bind to Cap-sensitive sensory nerve endings in the gastric mucosa. In response to stomach peristalsis, these particles generate electrical signals. The signals travel via the gut-brain axis, ultimately influencing the hypothalamus. By enhancing satiety signals in the brain, this neuromodulatory intervention reduces food intake, promotes energy metabolism, and demonstrates minimal toxicity. Over a 3-week period of daily treatments, DIO mice treated with BTO@Cap particles show a significant reduction in body weight compared to control mice, while maintaining their general locomotor activity. Furthermore, this BTO@Cap particle-based treatment mitigates various metabolic alterations associated with obesity. Importantly, this noninvasive and easy-to-administer intervention holds potential for addressing other intracerebral neurological diseases.

Seamless Integration of Conducting Hydrogels in Daily Life: From Preparation to Wearable Application

Conductive hydrogels (CHs) have received significant attention for use in wearable devices because they retain their softness and flexibility while maintaining high conductivity. CHs are well suited for applications in skin-contact electronics and biomedical devices owing to their high biocompatibility and conformality. Although highly conductive hydrogels for smart wearable devices are extensively researched, a detailed summary of the outstanding results of CHs is required for a comprehensive understanding. In this review, the recent progress in the preparation and fabrication of CHs is summarized for smart wearable devices. Improvements in the mechanical, electrical, and functional properties of high-performance wearable devices are also discussed. Furthermore, recent examples of innovative and highly functional devices based on CHs that can be seamlessly integrated into daily lives are reviewed.

Developments and Trends of Nanotechnology Application in Sepsis: A Comprehensive Review Based on Knowledge Visualization Analysis

Sepsis, a common life-threatening clinical condition, continues to have high morbidity and mortality rates, despite advancements in management. In response, significant research efforts have been directed toward developing effective strategies. Within this scope, nanotechnology has emerged as a particularly promising field, attracting significant interest for its potential to enhance disease diagnosis and treatment. While several reviews have highlighted the use of nanoparticles in sepsis, comprehensive studies that summarize and analyze the hotspots and research trends are lacking. To identify and further promote the development of nanotechnology in sepsis, a bibliometric analysis was conducted on the relevant literature, assessing research trends and hotspots in the application of nanomaterials for sepsis. Next, a comprehensive review of the subjectively recognized research hotspots in sepsis, including nanotechnology-enhanced biosensors and nanoscale imaging for sepsis diagnostics, and nanoplatforms designed for antimicrobial, immunomodulatory, and detoxification strategies in sepsis therapy, is elucidated, while the potential side effects and toxicity risks of these nanomaterials were discussed. Particular attention is given to biomimetic nanoparticles, which mimic the biological functions of source cells like erythrocytes, immune cells, and platelets to evade immune responses and effectively deliver therapeutic agents, demonstrating substantial translational potential. Finally, current challenges and future perspectives of nanotechnology applications in sepsis with a view to maximizing their great potential in the research of translational medicine are also discussed.

Piezoionic High Performance Hydrogel Generator and Active Protein Absorber via Microscopic Porosity and Phase Blending

Generating electricity in hydrogel is very important but remains difficult. Hydrogel with electricity generation capability is more capable in bio-relevant tasks such as tissue engineering, artificial skin, or medical treatment, because electricity is indispensable in regulating physiological activities. Here, a porous and phase blending hydrogel structure for effective piezoionic electricity generation is developed. Dynamic electric field is generated taking advantage of the difference in streaming speeds of sodium and chloride in the material. Microscopic porosity and hydrophilic-hydrophobic phase blending are the two key factors for prominent piezoionic performance. Voltages as high as 600 mV are first realized in hydrogels in response to medical ultrasound stimulation. The hydrogel structure is also subjective to effective substance exchange and can actively enrich proteins from surroundings under mechanical stimuli. Preliminary applications in neural stimulation, constructing complex spatial-temporal chemical and electric field distribution patterns, mimetic tactile sensor, sample pretreatment in fast detection, and enzyme immobilization are demonstrated.

Biomaterials and bioelectronics for self-powered neurostimulation

Self-powered neurostimulation via biomaterials and bioelectronics innovation has emerged as a compelling approach to explore, repair, and modulate neural systems. This review examines the application of self-powered bioelectronics for electrical stimulation of both the central and peripheral nervous systems, as well as isolated neurons. Contemporary research has adeptly harnessed biomechanical and biochemical energy from the human body, through various mechanisms such as triboelectricity, piezoelectricity, magnetoelasticity, and biofuel cells, to power these advanced bioelectronics. Notably, these self-powered bioelectronics hold substantial potential for delivering neural stimulations that are customized for the treatment of neurological diseases, facilitation of neural regeneration, and the development of neuroprosthetics. Looking ahead, we expect that the ongoing advancements in biomaterials and bioelectronics will drive the field of self-powered neurostimulation toward the realization of more advanced, closed-loop therapeutic solutions, paving the way for personalized and adaptable neurostimulators in the coming decades.

Stimulus-Responsive Hydrogels as Drug Delivery Systems for Inflammation Targeted Therapy

Deregulated inflammations induced by various factors are one of the most common diseases in people's daily life, while severe inflammation can even lead to death. Thus, the efficient treatment of inflammation has always been the hot topic in the research of medicine. In the past decades, as a potential biomaterial, stimuli-responsive hydrogels have been a focus of attention for the inflammation treatment due to their excellent biocompatibility and design flexibility. Recently, thanks to the rapid development of nanotechnology and material science, more and more efforts have been made to develop safer, more personal and more effective hydrogels for the therapy of some frequent but tough inflammations such as sepsis, rheumatoid arthritis, osteoarthritis, periodontitis, and ulcerative colitis. Herein, from recent studies and articles, the conventional and emerging hydrogels in the delivery of anti-inflammatory drugs and the therapy for various inflammations are summarized. And their prospects of clinical translation and future development are also discussed in further detail.

Wireless Deep Brain Stimulation by Ultrasound-Responsive Molecular Piezoelectric Nanogenerators

Implantable neural stimulation devices are becoming prevalent in bioelectronic medicine for the precise treatment of various clinical diseases. Nevertheless, the limited lifespan and buckling size of the implanted devices remain significant obstacles for chronic clinical application. In this study, we developed an ultrasound-driven battery-free neurostimulator based on a high-performance mini-sized nanogenerator and demonstrated its successful application for the deep-brain-stimulation (DBS) therapy of Parkinson's disease in a rat model. This soft piezoelectric-triboelectric hybrid nanogenerators (PTNG) are made of porous thin-films of molecular piezoelectric materials, which have great advantages of facile, scalable, low-temperature, and flexible processing. Without any bucky accessory control circuits, the subcutaneously implanted soft PTNG can function as a wirelessly powered neurostimulator, allowing for the adjustment of stimulation parameters through external programmable ultrasound pulses. This DBS electroceutical application of energy-harvesting thin-film devices based on molecular piezoelectric materials provides valuable insight into the development of a soft high-performance bioelectronic device.

Porous Polymer Materials in Triboelectric Nanogenerators: A Review

Since the invention of the triboelectric nanogenerator (TENG), porous polymer materials (PPMs), with different geometries and topologies, have been utilized to enhance the output performance and expand the functionality of TENGs. In this review, the basic characteristics and preparation methods of various PPMs are introduced, along with their applications in TENGs on the basis of their roles as electrodes, triboelectric surfaces, and structural materials. According to the pore size and dimensionality, various types of TENGs that are built with hydrogels, aerogels, foams, and fibrous media are classified and their advantages and disadvantages are analyzed. To deepen the understanding of the future development trend, their intelligent and multifunctional applications in human-machine interfaces, smart wearable devices, and self-powering sensors are introduced. Finally, the future directions and challenges of PPMs in TENGs are explored to provide possible guidance on PPMs in various TENG-based intelligent devices and systems.

The Integration of Triboelectric Nanogenerators and Supercapacitors: The Key Role of Cellular Materials

The growing demand for sustainable and efficient energy harvesting and storage technologies has spurred interest in the integration of triboelectric nanogenerators (TENGs) with supercapacitors (SCs). This combination offers a promising solution for powering Internet of Things (IoT) devices and other low-power applications by utilizing ambient mechanical energy. Cellular materials, featuring unique structural characteristics such as high surface-to-volume ratios, mechanical compliance, and customizable properties, have emerged as essential components in this integration, enabling the improved performance and efficiency of TENG-SC systems. In this paper, we discuss the key role of cellular materials in enhancing TENG-SC systems' performance through their influence on contact area, mechanical compliance, weight, and energy absorption. We highlight the benefits of cellular materials, including increased charge generation, optimized energy conversion efficiency, and adaptability to various mechanical sources. Furthermore, we explore the potential for lightweight, low-cost, and customizable cellular materials to expand the applicability of TENG-SC systems in wearable and portable devices. Finally, we examine the dual effect of cellular materials' damping and energy absorption properties, emphasizing their potential to protect TENGs from damage and increase overall system efficiency. This comprehensive overview of the role of cellular materials in the integration of TENG-SC aims to provide insights into the development of next-generation sustainable energy harvesting and storage solutions for IoT and other low-power applications.

Non-Invasive Hybrid Ultrasound Stimulation of Visual Cortex In Vivo

The optic nerve is the second cranial nerve (CN II) that connects and transmits visual information between the retina and the brain. Severe damage to the optic nerve often leads to distorted vision, vision loss, and even blindness. Such damage can be caused by various types of degenerative diseases, such as glaucoma and traumatic optic neuropathy, and result in an impaired visual pathway. To date, researchers have not found a viable therapeutic method to restore the impaired visual pathway; however, in this paper, a newly synthesized model is proposed to bypass the damaged portion of the visual pathway and set up a direct connection between a stimulated visual input and the visual cortex (VC) using Low-frequency Ring-transducer Ultrasound Stimulation (LRUS). In this study, by utilizing and integrating various advanced ultrasonic and neurological technologies, the following advantages are achieved by the proposed LRUS model: 1. This is a non-invasive procedure that uses enhanced sound field intensity to overcome the loss of ultrasound signal due to the blockage of the skull. 2. The simulated visual signal generated by LRUS in the visual-cortex-elicited neuronal response in the visual cortex is comparable to light stimulation of the retina. The result was confirmed by a combination of real-time electrophysiology and fiber photometry. 3. VC showed a faster response rate under LRUS than light stimulation through the retina. These results suggest a potential non-invasive therapeutic method for restoring vision in optic-nerve-impaired patients using ultrasound stimulation (US).

Smart Triboelectric Nanogenerators Based on Stimulus-Response Materials: From Intelligent Applications to Self-Powered Systems

Smart responsive materials can react to external stimuli via a reversible mechanism and can be directly combined with a triboelectric nanogenerator (TENG) to deliver various intelligent applications, such as sensors, actuators, robots, artificial muscles, and controlled drug delivery. Not only that, mechanical energy in the reversible response of innovative materials can be scavenged and transformed into decipherable electrical signals. Because of the high dependence of amplitude and frequency on environmental stimuli, self-powered intelligent systems may be thus built and present an immediate response to stress, electrical current, temperature, magnetic field, or even chemical compounds. This review summarizes the recent research progress of smart TENGs based on stimulus-response materials. After briefly introducing the working principle of TENG, we discuss the implementation of smart materials in TENGs with a classification of several sub-groups: shape-memory alloy, piezoelectric materials, magneto-rheological, and electro-rheological materials. While we focus on their design strategy and function collaboration, applications in robots, clinical treatment, and sensors are described in detail to show the versatility and promising future of smart TNEGs. In the end, challenges and outlooks in this field are highlighted, with an aim to promote the integration of varied advanced intelligent technologies into compact, diverse functional packages in a self-powered mode.

Adaptive Triboelectric Nanogenerators for Long-Term Self-Treatment: A Review

Triboelectric nanogenerators (TENGs) were initially invented as an innovative energy-harvesting technology for scavenging mechanical energy from our bodies or the ambient environment. Through adaptive customization design, TENGs have also become a promising player in the self-powered wearable medical market for improving physical fitness and sustaining a healthy lifestyle. In addition to simultaneously harvesting our body's mechanical energy and actively detecting our physiological parameters and metabolic status, TENGs can also provide personalized medical treatment solutions in a self-powered modality. This review aims to cover the recent advances in TENG-based electronics in clinical applications, beginning from the basic working principles of TENGs and their general operation modes, continuing to the harvesting of bioenergy from the human body, and arriving at their adaptive design toward applications in chronic disease diagnosis and long-term clinical treatment. Considering the highly personalized usage scenarios, special attention is paid to customized modules that are based on TENGs and support complex medical treatments, where sustainability, biodegradability, compliance, and bio-friendliness may be critical for the operation of clinical systems. While this review provides a comprehensive understanding of TENG-based clinical devices that aims to reach a high level of technological readiness, the challenges and shortcomings of TENG-based clinical devices are also highlighted, with the expectation of providing a useful reference for the further development of such customized healthcare systems and the transfer of their technical capabilities into real-life patient care.

Responsive hydrogel microfibers for biomedical engineering

Responsive hydrogel microfibers can realize multiple controllable changes in shapes or properties under the stimulation of the surrounding environment, and are called as intelligent biomaterials. Recently, these responsive hydrogel microfibers have been proved to possess significant biomedical values, and remarkable progress has been achieved in biomedical engineering applications, including drug delivery, biosensors and clinical therapy, etc. In this review, the latest research progress and application prospects of responsive hydrogel microfibers in biomedical engineering are summarized. We first introduce the common preparation strategies of responsive hydrogel microfibers. Subsequently, the response characteristics and the biomedical applications of these materials are discussed. Finally, the present opportunities and challenges as well as the prospects for future development are critically analyzed.

Wirelessly Powered Electrical-Stimulation Based on Biodegradable 3D Piezoelectric Scaffolds Promotes the Spinal Cord Injury Repair

An electroactive scaffold integrated with noninvasive in vivo electrical-stimulation (ES) capability shows great promise in the repair and regeneration of damaged tissues. Developing high-performance piezoelectric biomaterials which can simultaneously serve as both a biodegradable tissue scaffold and controllable electrical stimulator remains a great challenge. Herein, we constructed a biodegradable high-performance 3D piezoelectric scaffold with ultrasound (US)-driven wireless ES capability, and demonstrated its successful application for the repair of spinal cord injuries in a rat model. The 3D multichannel piezoelectric scaffold was prepared by electrospinning of poly(lactic acid) (PLA) nanofibers incorporated with biodegradable high-performance piezoelectric potassium sodium niobate (K_0.5Na_0.5NbO₃, KNN) nanowires. With programmed US irradiation as a remote mechanical stimulus, the on-demand in vivo ES with an adjustable timeline, duration, and strength can be delivered by the 3D piezoelectric scaffold. Under proper US excitation, the 3D tissue scaffolds made of the piezoelectric composite nanofibers can accelerate the recovery of motor functions and enhance the repair of spinal cord injury. The immunohistofluorescence investigation indicated that the 3D piezoelectric scaffolds combined with the US-driven in vivo ES promoted neural stem cell differentiation and endogenous angiogenesis in the lesion. This work highlights the potential application of a biodegradable high-performance piezoelectric scaffold providing US-driven on-demand electrical cues for regenerative medicine.

Ultrasound Responsive Smart Implantable Hydrogels for Targeted Delivery of Drugs: Reviewing Current Practices

Over the last two decades, the process of delivering therapeutic drugs to a patient with a controlled release profile has been a significant focus of drug delivery research. Scientists have given tremendous attention to ultrasound-responsive hydrogels for several decades. These smart nanosystems are more applicable than other stimuli-responsive drug delivery vehicles (ie UV-, pH- and thermal-, responsive materials) because they enable more efficient targeted treatment via relatively non-invasive means. Ultrasound (US) is capable of safely transporting energy through opaque and complex media with minimal loss of energy. It is capable of being localized to smaller regions and coupled to systems operating at various time scales. However, the properties enabling the US to propagate effectively in materials also make it very difficult to transform acoustic energy into other forms that may be used. Recent research from a variety of domains has attempted to deal with this issue, proving that ultrasonic effects can be used to control chemical and physical systems with remarkable specificity. By obviating the need for multiple intravenous injections, implantable US responsive hydrogel systems can enhance the quality of life for patients who undergo treatment with a varied dosage regimen. Ideally, the ease of self-dosing in these systems would lead to increased patient compliance with a particular therapy as well. However, excessive literature has been reported based on implanted US responsive hydrogel in various fields, but there is no comprehensive review article showing the strategies to control drug delivery profile. So, this review was aimed at discussing the current strategies for controlling and targeting drug delivery profiles using implantable hydrogel systems.

Facile preparation of PVA hydrogels with adhesive, self-healing, antimicrobial, and on-demand removable capabilities for rapid hemostasis

Multifunctional and smart hydrogel-based hemostatic materials are of great significance in the field of medical care. In this paper, a facile method for the preparation of self-healing, adhesive and on-demand removable PBO hydrogels was established with a simple mixture of polyvinyl alcohol (PVA), borax and oligomeric procyanidin (OPC). In this hydrogel system, borax and OPC were used as dynamic crosslinkers to connect the PVA macromolecules through reversible borate ester bonds and hydrogen bonds, resulting in hydrogels that possess good self-healing and adhesive abilities. Furthermore, the PBO hydrogel displayed excellent antimicrobial activity against Escherichia coli and Staphylococcus aureus. In addition, thanks to the adhesive property of the hydrogel and the inherent hemostatic activity of OPC, this hydrogel showed rapid hemostasis performance as concluded from the in vivo experiments of mouse liver incision, tail amputation and femoral artery models. Benefitting from the fast degradation in water, this hydrogel could be easily removed on-demand within 10 min. Therefore, this well-designed PBO hydrogel offers an important prospect as a rapid hemostatic dressing.

Vagus nerve stimulation using a miniaturized wirelessly powered stimulator in pigs

Neuromodulation of peripheral nerves has been clinically used for a wide range of indications. Wireless and batteryless stimulators offer important capabilities such as no need for reoperation, and extended life compared to their wired counterparts. However, there are challenging trade-offs between the device size and its operating range, which can limit their use. This study aimed to examine the functionality of newly designed wirelessly powered and controlled implants in vagus nerve stimulation for pigs. The implant used near field inductive coupling at 13.56 MHz industrial, scientific, and medical band to harvest power from an external coil. The circular implant had a diameter of 13 mm and weighed 483 mg with cuff electrodes. The efficiency of the inductive link and robustness to distance and misalignment were optimized. As a result, the specific absorption rate was orders of magnitude lower than the safety limit, and the stimulation can be performed using only 0.1 W of external power. For the first time, wireless and batteryless VNS with more than 5 cm operation range was demonstrated in pigs. A total of 84 vagus nerve stimulations (10 s each) have been performed in three adult pigs. In a quantitative comparison of the effectiveness of VNS devices, the efficiency of systems on reducing heart rate was similar in both conventional (75%) and wireless (78.5%) systems. The pulse width and frequency of the stimulation were swept on both systems, and the response for physiological markers was drawn. The results were easily reproducible, and methods used in this study can serve as a basis for future wirelessly powered implants.

Characterization of Pannexin1, Connexin32, and Connexin43 in Spotted Sea Bass (Lateolabrax maculatus): They Are Important Neuro-Related Immune Response Genes Involved in Inflammation-Induced ATP Release

Many immunological diseases can be treated by regulating neurobehavior, in which extracellular ATP is a vital member of endogenous danger-associated molecular pattern signaling molecule that plays a crucial part in innate neuro-related immunity. It is actively released through pannexin (Panx) and connexin (Cx) hemichannels from activated or stressed cells during inflammation, injury, or apoptosis. In addition to participating in ATP release, Panxs and Cxs also have crucial immune functions. In this study, pannexin1, three connexin32 isoforms and connexin43 were identified and characterized in spotted sea bass (Lateolabrax maculatus), which were named LmPanx1, LmCx32.2, LmCx32.3, LmCx32.7, and LmCx43. Their similar topological structures were discovered by sequence analysis: a relatively unconserved C-terminal region and four highly conserved transmembrane (TM) domains, and so on. Each extracellular (ECL) region of Panx1 has two conserved cysteine residues. Unlike Panx1, each ECL region of Cx32 and Cx43 contains three conserved cysteine residues, forming two conserved motifs: CX6CX3C motif in ECL1 and CX4CX5C motif in ECL2. Furthermore, Panx1 and Cx43 share similar genomic organization and synteny with their counterparts in selected vertebrates. Cx32 and CX43 were located in the same locus in fish, but diverged into two loci from amphibian. Moreover, despite varying expression levels, the identified genes were constitutively expressed in all examined tissues. All genes were upregulated by PAMP [lipopolysaccharide and poly(I:C)] stimulation or bacterial infection in vivo and in vitro, but they were downregulated in the brain at 6 or 12 h after stimulation. Especially, the three LmCx32 isoforms and LmCx43 were upregulated by ATP stimulation in primary head kidney leukocytes; however, downregulation of LmCx32.3 and LmCx43 expression were noted at 12 h. Conversely, ATP treatment inhibited the expression of LmPanx1. Importantly, we showed that the spotted sea bass Panx1, Cx43, and Cx32 were localized on the cellular membrane and involved in inflammation-induced ATP release. Taken together, our results demonstrated that Panx1, Cx32, and Cx43 are important neuro-related immune response genes involved in inflammation-induced ATP release.

Development and Applications of Hydrogel-Based Triboelectric Nanogenerators: A Mini-Review

In recent years, with the appearance of the triboelectric nanogenerator (TENG), there has been a wave of research on small energy harvesting devices and self-powered wearable electronics. Hydrogels-as conductive materials with excellent tensile properties-have been widely focused on by researchers, which encouraged the development of the hydrogel-based TENGs (H-TENGs) that use the hydrogel as an electrode. Due to the great feasibility of adjusting the conductivity and mechanical property as well as the microstructure of the hydrogels, many H-TENGs with excellent performance have emerged, some of which are capable of excellent outputting ability with an output voltage of 992 V, and self-healing performance which can spontaneously heal within 1 min without any external stimuli. Although there are numerous studies on H-TENGs with excellent performance, a comprehensive review paper that systematically correlates hydrogels' properties to TENGs is still absent. Therefore, in this review, we aim to provide a panoramic overview of the working principle as well as the preparation strategies that significantly affect the properties of H-TENGs. We review hydrogel classification categories such as their network composition and their potential applications on sensing and energy harvesting, and in biomedical fields. Moreover, the challenges faced by the H-TENGs are also discussed, and relative future development of the H-TENGs are also provided to address them. The booming growth of H-TENGs not only broadens the applications of hydrogels into new areas, but also provides a novel alternative for the sustainable power sources.

Hydrogels as Soft Ionic Conductors in Flexible and Wearable Triboelectric Nanogenerators

Flexible triboelectric nanogenerators (TENGs) have attracted increasing interest since their advent in 2012. In comparison with other flexible electrodes, hydrogels possess transparency, stretchability, biocompatibility, and tunable ionic conductivity, which together provide great potential as current collectors in TENGs for wearable applications. The development of hydrogel-based TENGs (H-TENGs) is currently a burgeoning field but research efforts have lagged behind those of other common flexible TENGs. In order to spur research and development of this important area, a comprehensive review that summarizes recent advances and challenges of H-TENGs will be very useful to researchers and engineers in this emerging field. Herein, the advantages and types of hydrogels as soft ionic conductors in TENGs are presented, followed by detailed descriptions of the advanced functions, enhanced output performance, as well as flexible and wearable applications of H-TENGs. Finally, the challenges and prospects of H-TENGs are discussed.

New Era of Electroceuticals: Clinically Driven Smart Implantable Electronic Devices Moving towards Precision Therapy

In the name of electroceuticals, bioelectronic devices have transformed and become essential for dealing with all physiological responses. This significant advancement is attributable to its interdisciplinary nature from engineering and sciences and also the progress in micro and nanotechnologies. Undoubtedly, in the future, bioelectronics would lead in such a way that diagnosing and treating patients' diseases is more efficient. In this context, we have reviewed the current advancement of implantable medical electronics (electroceuticals) with their immense potential advantages. Specifically, the article discusses pacemakers, neural stimulation, artificial retinae, and vagus nerve stimulation, their micro/nanoscale features, and material aspects as value addition. Over the past years, most researchers have only focused on the electroceuticals metamorphically transforming from a concept to a device stage to positively impact the therapeutic outcomes. Herein, the article discusses the smart implants' development challenges and opportunities, electromagnetic field effects, and their potential consequences, which will be useful for developing a reliable and qualified smart electroceutical implant for targeted clinical use. Finally, this review article highlights the importance of wirelessly supplying the necessary power and wirelessly triggering functional electronic circuits with ultra-low power consumption and multi-functional advantages such as monitoring and treating the disease in real-time.