A Soft, Conductive External Stent Inhibits Intimal Hyperplasia in Vein Grafts by Electroporation and Mechanical Restriction

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.

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.

Nanocrystals for Deep-Tissue In Vivo Luminescence Imaging in the Near-Infrared Region

In vivo imaging technologies have emerged as a powerful tool for both fundamental research and clinical practice. In particular, luminescence imaging in the tissue-transparent near-infrared (NIR, 700-1700 nm) region offers tremendous potential for visualizing biological architectures and pathophysiological events in living subjects with deep tissue penetration and high imaging contrast owing to the reduced light-tissue interactions of absorption, scattering, and autofluorescence. The distinctive quantum effects of nanocrystals have been harnessed to achieve exceptional photophysical properties, establishing them as a promising category of luminescent probes. In this comprehensive review, the interactions between light and biological tissues, as well as the advantages of NIR light for in vivo luminescence imaging, are initially elaborated. Subsequently, we focus on achieving deep tissue penetration and improved imaging contrast by optimizing the performance of nanocrystal fluorophores. The ingenious design strategies of NIR nanocrystal probes are discussed, along with their respective biomedical applications in versatile in vivo luminescence imaging modalities. Finally, thought-provoking reflections on the challenges and prospects for future clinical translation of nanocrystal-based in vivo luminescence imaging in the NIR region are wisely provided.

Liquid metal-hydrogel composites for flexible electronics

As an emerging functional material, liquid metal-hydrogel composites exhibit excellent biosafety, high electrical conductivity, tunable mechanical properties and good adhesion, thus providing a unique platform for a wide range of flexible electronics applications such as wearable devices, medical devices, actuators, and energy conversion devices. Through different composite methods, liquid metals can be integrated into hydrogel matrices to form multifunctional composite material systems, which further expands the application range of hydrogels. In this paper, we provide a brief overview of the two materials: hydrogels and liquid metals, and discuss the synthesis method of liquid metal-hydrogel composites, focusing on the improvement of the performance of hydrogel materials by liquid metals. In addition, we summarize the research progress of liquid metal-hydrogel composites in the field of flexible electronics, pointing out the current challenges and future prospects of this material.

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.

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.

Advances in the development of biodegradable coronary stents: A translational perspective

Implantation of cardiovascular stents is an important therapeutic method to treat coronary artery diseases. Bare-metal and drug-eluting stents show promising clinical outcomes, however, their permanent presence may create complications. In recent years, numerous preclinical and clinical trials have evaluated the properties of bioresorbable stents, including polymer and magnesium-based stents. Three-dimensional (3D) printed-shape-memory polymeric materials enable the self-deployment of stents and provide a novel approach for individualized treatment. Novel bioresorbable metallic stents such as iron- and zinc-based stents have also been investigated and refined. However, the development of novel bioresorbable stents accompanied by clinical translation remains time-consuming and challenging. This review comprehensively summarizes the development of bioresorbable stents based on their preclinical/clinical trials and highlights translational research as well as novel technologies for stents (e.g., bioresorbable electronic stents integrated with biosensors). These findings are expected to inspire the design of novel stents and optimization approaches to improve the efficacy of treatments for cardiovascular diseases.

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Bioresorbable stents can overcome the limitations of non-degradable stents.

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3D printing of shape-memory polymeric stents can lead to better clinical outcomes.

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Advances in Mg-, Fe- and Zn-based stents from a translational perspective.

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Electronic stents integrated with biosensors can covey stent status in real time.

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Development in the assessment of stent performance in vivo.

A novel Nanocellulose-Gelatin-AS-IV external stent resists EndMT by activating autophagy to prevent restenosis of grafts

Vein grafts are widely used for coronary artery bypass grafting and hemodialysis access, but restenosis remains the "Achilles' heel" of these treatments. An extravascular stent is one wrapped around the vein graft and provides mechanical strength; it can buffer high arterial pressure and secondary vascular dilation of the vein to prevent restenosis. In this study, we developed a novel Nanocellulose-gelatin hydrogel, loaded with the drug Astragaloside IV (AS-IV) as an extravascular scaffold to investigate its ability to reduce restenosis. We found that the excellent physical and chemical properties of the drug AS-IV loaded Nanocellulose-gelatin hydrogel external stent limit graft vein expansion and make the stent biocompatible. We also found it can prevent restenosis by resisting endothelial-to-mesenchymal transition (EndMT) in vitro. It does so by activating autophagy, and AS-IV can enhance this effect both in vivo and in vitro. This study has added to existing research on the mechanism of extravascular stents in preventing restenosis of grafted veins. Furthermore, we have developed a novel extravascular stent for the prevention and treatment of restenosis. This will help optimize the clinical treatment plan of external stents and improve the prognosis in patients with vein grafts.

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The NC-Gelatin extravascular stent has suitable physicochemical properties to prevent restenosis of the grafted veins.

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The NC-Gelatin extravascular stent has excellent biocompatibility, which is critical for grafting veins.

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The NC-Gelatin extravascular stent prevents restenosis by activating autophagy against EndMT.

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AS-IV can enhance the effect of the stent to activate autophagy against EndMT.

Printable Metal-Polymer Conductors for Local Drug Delivery

Safe and effective local drug delivery is challenging due to complex physiological barriers that limit the entry of drugs. Here, we report the metal-polymer conductors (MPCs) for local drug delivery via iontophoresis or electroporation. The MPCs are stretchable, conductive, and biocompatible. The flexible MPCs of different geometries are used both on a dry, flat surface (skin) and a moist, curved surface (cornea) with conformability. Conformal integration with the tissues enables good mechanical/electrical properties and realizes application of electrical voltage to the target areas for local drug delivery. By iontophoresis and electroporation, the MPCs achieve efficient delivery of doxorubicin and siRNA, leading to tumor regression and inhibition of corneal neovascularization, respectively. Our work presents an efficient strategy to harness the power of the MPCs to broaden the scope of local drug delivery to dry and wet organs with different surface topography.

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.

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.

Flexible Electronic Catheter Based on Nanofibers for the In Vivo Elimination of Circulating Tumor Cells

Clearing circulating tumor cells (CTCs) that are closely related to cancer metastasis and recurrence in peripheral blood helps to reduce the probability of cancer recurrence and metastasis. However, conventional therapies aiming at killing CTCs always cause damage to normal blood cells, tissues, and organs. Here, we report a flexible electronic catheter that can capture and kill CTCs via irreversible electroporation (IRE) with high efficiency. The flexible electronic catheter is assembled from nanofibers (NFs) with liquid metal-polymer conductor (MPC) electrodes. The NFs were modified with an epithelial cellular adhesion molecule (EpCAM) antibody on the surface to improve specific biorecognition and cell adhesion. Whole-body blood can be screened by the catheter repeatedly, during which the EpCAM antibody on a nanofiber can enrich CTCs to the surface of the catheter. Taking advantage of the high specific surface area, the capture efficiency of NF-based catheters for CTCs is 25 times higher than previously reported cases. Furthermore, the number of nonspecifically captured WBCs is less than 10 per mm² areas of the catheter, compared to their original large number of 4-11 × 10⁶ mL^-1 of whole blood, showing good specificity of the flexible electronic catheter. The flexible and biocompatible MPC electrodes have a high killing efficiency of 100% for the captured CTCs in a rabbit model. No noticeable hematologic index and morphological changes of the vessels and major organs were observed, indicating that this electronic catheter had good biocompatibility. The present functional electronic catheter offers an alternative strategy for improving the efficiency of clinical cancer therapy.

Anticoagulant Hydrogel Tubes with Poly(ɛ-Caprolactone) Sheaths for Small-Diameter Vascular Grafts

Small-diameter vascular grafts (inner diameter < 6 mm) are useful in treating cardiovascular diseases. The off-the-shelf small-diameter vascular grafts for clinical applications remain a great limitation owing to their thrombogenicity or intimal hyperplasia. Herein, bilayer anticoagulant hydrogel tubes with poly(ε-caprolactone) (PCL) sheaths are prepared by freeze-thawing and electrospinning, which contain nanofibrillated cellulose (NFC)/poly(vinyl alcohol) (PVA)-heparin/poly-L-lysine nanoparticles tube as an inner layer and PCL sheath as an outer layer. The structure, anticoagulant property, and biocompatibility of the inner layer are studied. The effects of thickness of the outer layer on perfusion performance and mechanical property of hydrogel tubes with PCL sheaths (PCL-NFC/PVA-NPs tubes) are investigated. The effect of compliance of PCL-NFC/PVA-NPs tubes on their blood flow is studied by numerical simulation. The tissue compatibility and the patency of PCL-NFC/PVA-NPs tubes are evaluated by implantation in subcutaneous tissue of rats and carotid artery of rabbits. PCL-NFC/PVA-NPs tubes have prominent anticoagulation, sufficient burst pressure and good compliance similar to native arteries. PCL-NFC/PVA-NPs tubes facilitate infiltration of host cells and achieve active proliferation of recruited cells, which will be a promising candidate for small-diameter vascular grafts.

A Soft and Absorbable Temporary Epicardial Pacing Wire

Existing temporary epicardial pacing wires (TPWs) are rigid and non-absorbable, such that they can cause severe complications after cardiac surgery. Here, a soft and absorbable temporary epicardial pacing wire (saTPW) for effectively correcting abnormal heart rates in a rabbit model, such as bradycardia and ventricular premature beat, is developed. The saTPW exhibits excellent conductivity, flexibility, cycling stability (>100 000 cycles), and less inflammatory response during two-month subcutaneous implantation in a rat model. The saTPW which consists of poly(l-lactide-co-ε-caprolactone) and liquid metal, can degrade about 13% (mass loss) in the rats over a two-month subcutaneous implantation. It can be absorbed over time in the body. The cytocompatibility and absorbability avoid secondary injuries caused by remaining wires which are permanently left in the body. The saTPW will provide a great platform for diagnosis and treatments in cardiovascular diseases by delivering the physiological signal and applying electrical stimulation for therapy.