Toward Self-Control Systems for Neurogenic Underactive Bladder: A Triboelectric Nanogenerator Sensor Integrated with a Bistable Micro-Actuator

Self-Powered Hybrid Motion and Health Sensing System Based on Triboelectric Nanogenerators

Triboelectric nanogenerator (TENG) represents an effective approach for the conversion of mechanical energy into electrical energy and has been explored to combine multiple technologies in past years. Self-powered sensors are not only free from the constraints of mechanical energy in the environment but also capable of efficiently harvesting ambient energy to sustain continuous operation. In this review, the remarkable development of TENG-based human body sensing achieved in recent years is presented, with a specific focus on human health sensing solutions, such as body motion and physiological signal detection. The movements originating from different parts of the body, such as body, touch, sound, and eyes, are systematically classified, and a thorough review of sensor structures and materials is conducted. Physiological signal sensors are categorized into non-implantable and implantable biomedical sensors for discussion. Suggestions for future applications of TENG-based biomedical sensors are also indicated, highlighting the associated challenges.

Origami-Inspired Bionic Soft Robot Stomach with Self-Powered Sensing

The stomach is a vital organ in the human digestive system, and its digestive condition is critical to human health. The physical movement of the stomach during digestion is controlled by the circular and oblique muscles. Existing stomach simulators are unable to realistically reproduce the physical movement of the stomach. Due to the complexity of gastric motility, it is challenging to simulate and sense gastric motility. This study proposes for the first time a bionic soft robotic stomach (BSRS) with an integrated drive and sensing structure inspired by origami and self-powered sensing technology. This soft stomach (SS) can realistically simulate and sense the movements of various parts of the human stomach in real-time. The contraction force and contraction rate of the BSRS are investigated with different viscosity contents, and the experimental values are similar to the physiological range (maximum contraction force is 3.2 N, and maximum contraction rate is 0.8). This paper provides an experimental basis for the study of gastric digestive medicine and food science by simulating the peristaltic motion of the BSRS according to the human stomach and by combining the triboelectric nanogenerator (TENG) sensing technology to monitor the motion of the BSRS in real-time.

Flexible self-powered bioelectronics enables personalized health management from diagnosis to therapy

Flexible self-powered bioelectronics (FSPBs), incorporating flexible electronic features in biomedical applications, have revolutionized the human-machine interface since they hold the potential to offer natural and seamless human interactions while overcoming the limitations of battery-dependent power sources. Furthermore, as biosensors or actuators, FSPBs can dynamically monitor physiological signals to reveal real-time health abnormalities and provide timely and precise treatments. Therefore, FSPBs are increasingly shaping the landscape of health monitoring and disease treatment, weaving a sophisticated and personalized bond between humans and health management. Here, we examine the recent advanced progress of FSPBs in developing working mechanisms, design strategies, and structural configurations toward personalized health management, emphasizing its role in clinical medical scenarios from biophysical/biochemical sensors for sensing diagnosis to robust/biodegradable actuators for intervention therapy. Future perspectives on the challenges and opportunities in emerging multifunctional FSPBs for the next-generation health management systems are also forecasted.

Catheter-Free Urodynamics Testing: Current Insights and Clinical Potential

Lower urinary tract dysfunction not only interferes with the health-related quality of life of patients but may also lead to acute kidney injury and infections. To assess the bladder, urodynamic studies (UDS) have been implemented but the use of catheters leads to discomfort for the patient. Catheter-free long-term UDS would be useful and a potential solution could be ambulatory wireless devices that communicate via telemetry. Such sensors can detect pressure or volume. Numerous types of potential catheter-free sensors have been proposed for bladder monitoring. Despite substantial innovation in the manufacturing of implantable biomedical electronic systems, such sensors have remained at the laboratory stage due to a number of critical challenges. These challenges primarily concern hermeticity and biocompatibility, sensitivity and artifacts, drift, telemetry, and energy management. Having overcome these challenges, catheter-free ambulatory urodynamic monitoring could combine a synchronized intravesical pressure sensor with a volume analyzer but only the steps of cystometry and volume measurement are currently sufficiently reproducible to simulate UDS results. The measurement of volume by infrared optical sensors, in the form of abdominal patches, appears to be promising and studies are underway to market a telemetric ambulatory urodynamic monitoring system that includes an intravesical pressure sensor. There has been considerable progress in wearable and conformable electronics on many fronts, and continued collaboration between engineers and urologists could quickly overcome current challenges. In addition, to the diagnosis of UDS, such sensors could be useful in the development of a long-term closed-loop neuromodulation system. In this review, we explore the various types of catheter-free bladder sensors, inherent challenges and solutions to overcome these challenges, and the clinical potential of such long-term implantable sensors.

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.

Soft Bioelectronics for Therapeutics

Soft bioelectronics play an increasingly crucial role in high-precision therapeutics due to their softness, biocompatibility, clinical accuracy, long-term stability, and patient-friendliness. In this review, we provide a comprehensive overview of the latest representative therapeutic applications of advanced soft bioelectronics, ranging from wearable therapeutics for skin wounds, diabetes, ophthalmic diseases, muscle disorders, and other diseases to implantable therapeutics against complex diseases, such as cardiac arrhythmias, cancer, neurological diseases, and others. We also highlight key challenges and opportunities for future clinical translation and commercialization of soft therapeutic bioelectronics toward personalized medicine.

Artificial intelligence enhanced sensors - enabling technologies to next-generation healthcare and biomedical platform

The fourth industrial revolution has led to the development and application of health monitoring sensors that are characterized by digitalization and intelligence. These sensors have extensive applications in medical care, personal health management, elderly care, sports, and other fields, providing people with more convenient and real-time health services. However, these sensors face limitations such as noise and drift, difficulty in extracting useful information from large amounts of data, and lack of feedback or control signals. The development of artificial intelligence has provided powerful tools and algorithms for data processing and analysis, enabling intelligent health monitoring, and achieving high-precision predictions and decisions. By integrating the Internet of Things, artificial intelligence, and health monitoring sensors, it becomes possible to realize a closed-loop system with the functions of real-time monitoring, data collection, online analysis, diagnosis, and treatment recommendations. This review focuses on the development of healthcare artificial sensors enhanced by intelligent technologies from the aspects of materials, device structure, system integration, and application scenarios. Specifically, this review first introduces the great advances in wearable sensors for monitoring respiration rate, heart rate, pulse, sweat, and tears; implantable sensors for cardiovascular care, nerve signal acquisition, and neurotransmitter monitoring; soft wearable electronics for precise therapy. Then, the recent advances in volatile organic compound detection are highlighted. Next, the current developments of human-machine interfaces, AI-enhanced multimode sensors, and AI-enhanced self-sustainable systems are reviewed. Last, a perspective on future directions for further research development is also provided. In summary, the fusion of artificial intelligence and artificial sensors will provide more intelligent, convenient, and secure services for next-generation healthcare and biomedical applications.

Wireless, Fully Implantable and Expandable Electronic System for Bidirectional Electrical Neuromodulation of the Urinary Bladder

Current standard clinical options for patients with detrusor underactivity (DUA) or underactive bladder─the inability to release urine naturally─include the use of medications, voiding techniques, and intermittent catheterization, for which the patient inserts a tube directly into the urethra to eliminate urine. Although those are life-saving techniques, there are still unfavorable side effects, including urinary tract infection (UTI), urethritis, irritation, and discomfort. Here, we report a wireless, fully implantable, and expandable electronic complex that enables elaborate management of abnormal bladder function via seamless integrations with the urinary bladder. Such electronics can not only record multiple physiological parameters simultaneously but also provide direct electrical stimulation based on a feedback control system. Uniform distribution of multiple stimulation electrodes via mesh-type geometry realizes low-impedance characteristics, which improves voiding/urination efficiency at the desired times. In vivo evaluations using live, free-moving animal models demonstrate system-level functionality.

Magnetic Bistability for a Wider Bandwidth in Vibro-Impact Triboelectric Energy Harvesters

Mechanical energy from vibrations is widespread in the ambient environment. It may be harvested efficiently using triboelectric generators. Nevertheless, a harvester's effectiveness is restricted because of the limited bandwidth. To this end, this paper presents a comprehensive theoretical and experimental investigation of a variable frequency energy harvester, which integrates a vibro-impact triboelectric-based harvester and magnetic nonlinearity to increase the operation bandwidth and improve the efficiency of conventional triboelectric harvesters. A cantilever beam with a tip magnet was aligned with another fixed magnet at the same polarity to induce a nonlinear magnetic repulsive force. A triboelectric harvester was integrated into the system by utilizing the lower surface of the tip magnet to serve as the top electrode of the harvester, while the bottom electrode with an attached polydimethylsiloxane insulator was placed underneath. Numerical simulations were performed to examine the impact of the potential wells formed by the magnets. The structure's static and dynamic behaviors at varying excitation levels, separation distance, and surface charge density are all discussed. In order to develop a variable frequency system with a wide bandwidth, the system's natural frequency varies by changing the distance between the two magnets to reduce or magnify the magnetic force to achieve monostable or bistable oscillations. When the system is excited by vibrations, the beams vibrate, which causes an impact between the triboelectric layers. An alternating electrical signal is generated from a periodic contact-separation motion between the harvester's electrodes. Our theoretical findings were experimentally validated. The findings of this study have the potential to pave the way for the development of an effective energy harvester that is capable of scavenging energy from ambient vibrations across a broad range of excitation frequencies. The frequency bandwidth was found to increase by 120% at threshold distance compared to the conventional energy harvester. Nonlinear impact-driven triboelectric energy harvesters can effectively broaden the operational frequency bandwidth and enhance the harvested energy.

Biocompatible and Long-Term Monitoring Strategies of Wearable, Ingestible and Implantable Biosensors: Reform the Next Generation Healthcare

Sensors enable the detection of physiological indicators and pathological markers to assist in the diagnosis, treatment, and long-term monitoring of diseases, in addition to playing an essential role in the observation and evaluation of physiological activities. The development of modern medical activities cannot be separated from the precise detection, reliable acquisition, and intelligent analysis of human body information. Therefore, sensors have become the core of new-generation health technologies along with the Internet of Things (IoTs) and artificial intelligence (AI). Previous research on the sensing of human information has conferred many superior properties on sensors, of which biocompatibility is one of the most important. Recently, biocompatible biosensors have developed rapidly to provide the possibility for the long-term and in-situ monitoring of physiological information. In this review, we summarize the ideal features and engineering realization strategies of three different types of biocompatible biosensors, including wearable, ingestible, and implantable sensors from the level of sensor designing and application. Additionally, the detection targets of the biosensors are further divided into vital life parameters (e.g., body temperature, heart rate, blood pressure, and respiratory rate), biochemical indicators, as well as physical and physiological parameters based on the clinical needs. In this review, starting from the emerging concept of next-generation diagnostics and healthcare technologies, we discuss how biocompatible sensors revolutionize the state-of-art healthcare system unprecedentedly, as well as the challenges and opportunities faced in the future development of biocompatible health sensors.

Future regenerative medicine developments and their therapeutic applications

Although the currently available pharmacological assays can cure most pathological disorders, they have limited therapeutic value in relieving certain disorders like myocardial infarct, peripheral vascular disease, amputated limbs, or organ failure (e.g. renal failure). Pilot studies to overcome such problems using regenerative medicine (RM) delivered promising data. Comprehensive investigations of RM in zebrafish or reptilians are necessary for better understanding. However, the precise mechanisms remain poorly understood despite the tremendous amount of data obtained using the zebrafish model investigating the exact mechanisms behind their regenerative capability. Indeed, understanding such mechanisms and their application to humans can save millions of lives from dying due to potentially life-threatening events. Recent studies have launched a revolution in replacing damaged human organs via different approaches in the last few decades. The newly established branch of medicine (known as Regenerative Medicine aims to enhance natural repair mechanisms. This can be done through the application of several advanced broad-spectrum technologies such as organ transplantation, tissue engineering, and application of Scaffolds technology (support vascularization using an extracellular matrix), stem cell therapy, miRNA treatment, development of 3D mini-organs (organoids), and the construction of artificial tissues using nanomedicine and 3D bio-printers. Moreover, in the next few decades, revolutionary approaches in regenerative medicine will be applied based on artificial intelligence and wireless data exchange, soft intelligence biomaterials, nanorobotics, and even living robotics capable of self-repair. The present work presents a comprehensive overview that summarizes the new and future advances in the field of RM.

Magnetic soft robotic bladder for assisted urination

The poor contractility of the detrusor muscle in underactive bladders (UABs) fails to increase the pressure inside the UAB, leading to strenuous and incomplete urination. However, existing therapeutic strategies by modulating/repairing detrusor muscles, e.g., neurostimulation and regenerative medicine, still have low efficacy and/or adverse effects. Here, we present an implantable magnetic soft robotic bladder (MRB) that can directly apply mechanical compression to the UAB to assist urination. Composed of a biocompatible elastomer composite with optimized magnetic domains, the MRB enables on-demand contraction of the UAB when actuated by magnetic fields. A representative MRB for a UAB in a porcine model is demonstrated, and MRB-assisted urination is validated by in situ computed tomography imaging after 14-day implantation. The urodynamic tests show a series of successful urination with a high pressure increase and fast urine flow. Our work paves the way for developing MRB to assist urination for humans with UABs.

Hydraulic Detrusor for Artificial Bladder Active Voiding

The gold standard treatment for bladder cancer is radical cystectomy that implies bladder removal coupled to urinary diversions. Despite the serious complications and the impossibility of controlled active voiding, bladder substitution with artificial systems is a challenge and cannot represent a real option, yet. In this article, we present hydraulic artificial detrusor prototypes to control and drive the voiding of an artificial bladder (AB). These prototypes rely on two actuator designs (origami and bellows) based either on negative or positive operating pressure, to be combined with an AB structure. Based on the bladder geometry and size, we optimized the actuators in terms of contraction/expansion performances, minimizing the liquid volume required for actuation and exploring different actuator arrangements to maximize the voiding efficiency. To operate the actuators, an ad hoc electrohydraulic circuit was developed for transferring liquid between the actuators and a reservoir, both of them intended to be implanted. The AB, actuators, and reservoir were fabricated with biocompatible flexible thermoplastic materials by a heat-sealing process. We assessed the voiding efficiency with benchtop experiments by varying the actuator type and arrangement at different simulated patient positions (horizontal, 45° tilted, and vertical) to identify the optimal configuration and actuation strategy. The most efficient solution relies on two bellows actuators anchored to the AB. This artificial detrusor design resulted in a voiding efficiency of about 99%, 99%, and 89%, in the vertical, 45° tilted, and horizontal positions, respectively. The relative voiding time was reduced by about 17, 24, and 55 s compared with the unactuated bladder.

Unveiling Evolutionary Path of Nanogenerator Technology: A Novel Method Based on Sentence-BERT

In recent years, nanogenerator technology has developed rapidly with the rise of cloud computing, artificial intelligence, and other fields. Therefore, the quick identification of the evolutionary path of nanogenerator technology from a large amount of data attracts much attention. It is of great significance in grasping technical trends and analyzing technical areas of interest. However, there are some limitations in previous studies. On the one hand, previous research on technological evolution has generally utilized bibliometrics, patent analysis, and citations between patents and papers, ignoring the rich semantic information contained therein; on the other hand, its evolution analysis perspective is single, and it is difficult to obtain accurate results. Therefore, this paper proposes a new framework based on the methods of Sentence-BERT and phrase mining, using multi-source data, such as papers and patents, to unveil the evolutionary path of nanogenerator technology. Firstly, using text vectorization, clustering algorithms, and the phrase mining method, current technical themes of significant interest to researchers can be obtained. Next, this paper correlates the multi-source fusion themes through semantic similarity calculation and demonstrates the multi-dimensional technology evolutionary path by using the “theme river map”. Finally, this paper presents an evolution analysis from the perspective of frontier research and technology research, so as to discover the development focus of nanogenerators and predict the future application prospects of nanogenerator technology.

Advanced Implantable Biomedical Devices Enabled by Triboelectric Nanogenerators

Implantable biomedical devices (IMDs) play essential roles in healthcare. Subject to the limited battery life, IMDs cannot achieve long-term in situ monitoring, diagnosis, and treatment. The proposal and rapid development of triboelectric nanogenerators free IMDs from the shackles of batteries and spawn a self-powered healthcare system. This review aims to overview the development of IMDs based on triboelectric nanogenerators, divided into self-powered biosensors, in vivo energy harvesting devices, and direct electrical stimulation therapy devices. Meanwhile, future challenges and opportunities are discussed according to the development requirements of current-level self-powered IMDs to enhance output performance, develop advanced triboelectric nanogenerators with multifunctional materials, and self-driven close-looped diagnosis and treatment systems.

Advances in Assistive Electronic Device Solutions for Urology

Recent technology advances have led urology to become one of the leading specialities to utilise novel electronic systems to manage urological ailments. Contemporary bladder management strategies such as urinary catheters can provide a solution but leave the user mentally and physically debilitated. The unique properties of modern electronic devices, i.e., flexibility, stretchability, and biocompatibility, have allowed a plethora of new technologies to emerge. Many novel electronic device solutions in urology have been developed for treating impaired bladder disorders. These disorders include overactive bladder (OAB), underactive bladder (UAB) and other-urinary-affecting disorders (OUAD). This paper reviews common causes and conservative treatment strategies for OAB, UAB and OUAD, discussing the challenges and drawbacks of such treatments. Subsequently, this paper gives insight into clinically approved and research-based electronic advances in urology. Advances in this area cover bladder-stimulation and -monitoring devices, robot-assistive surgery, and bladder and sphincter prosthesis. This study aims to introduce the latest advances in electronic solutions for urology, comparing their advantages and disadvantages, and concluding with open problems for future urological device solutions.

Thermoset Shape Memory Polymer Variable Stiffness 4D Robotic Catheters

Variable stiffness catheters are typically composed of an encapsulated core. The core is usually composed of a low melting point alloy (LMPA) or a thermoplastic polymer (TP). In both cases, there is a need to encapsulate the core with an elastic material. This imposes a limit to the volume of variable stiffness (VS) material and limits miniaturization. This paper proposes a new approach that relies on the use of thermosetting materials. The variable stiffness catheter (VSC) proposed in this work eliminates the necessity for an encapsulation layer and is made of a unique biocompatible thermoset polymer with an embedded heating system. This significantly reduces the final diameter, improves manufacturability, and increases safety in the event of complications. The device can be scaled to sub-millimeter dimensions, while maintaining a high stiffness change. In addition, integration into a magnetic actuation system allows for precise actuation of one or multiple tools.

A Motion Capturing and Energy Harvesting Hybridized Lower-Limb System for Rehabilitation and Sports Applications

Lower-limb motion monitoring is highly desired in various application scenarios ranging from rehabilitation to sports training. However, there still lacks a cost-effective, energy-saving, and computational complexity-reducing solution for this specific demand. Here, a motion capturing and energy harvesting hybridized lower-limb (MC-EH-HL) system with 3D printing is demonstrated. It enables low-frequency biomechanical energy harvesting with a sliding block-rail piezoelectric generator (S-PEG) and lower-limb motion sensing with a ratchet-based triboelectric nanogenerator (R-TENG). A unique S-PEG is proposed with particularly designed mechanical structures to convert lower-limb 3D motion into 1D linear sliding on the rail. On the one hand, high output power is achieved with the S-PEG working at a very low frequency, which realizes self-sustainable systems for wireless sensing under the Internet of Things framework. On the other hand, the R-TENG gives rise to digitalized triboelectric output, matching the rotation angles to the pulse numbers. Additional physical parameters can be estimated to enrich the sensory dimension. Accordingly, demonstrative rehabilitation, human-machine interfacing in virtual reality, and sports monitoring are presented. This developed hybridized system exhibits an economic and energy-efficient solution to support the need for lower-limb motion tracking in various scenarios, paving the way for self-sustainable multidimensional motion tracking systems in near future.

Development of Triboelectroceutical Fabrics for Potential Applications in Self-Sanitizing Personal Protective Equipment

Attachment of microbial bodies including the corona virus on the surface of personal protective equipment (PPE) is found to be potential threat of spreading infection. Here, we report the development of a triboelectroceutical fabric (TECF) consisting of commonly available materials, namely, nylon and silicone rubber (SR), for the fabrication of protective gloves on the nitrile platform as model wearable PPE. A small triboelectric device (2 cm × 2 cm) consisting of SR and nylon on nitrile can generate more than 20 V transient or 41 μW output power, which is capable of charging a capacitor up to 65 V in only ∼50 s. The importance of the present work relies on the TECF-led antimicrobial activity through the generation of an electric current in saline water. The fabrication of TECF-based functional prototype gloves can generate hypochlorite ions through the formation of electrolyzed water upon rubbing them with saline water. Further, computational modelling has been employed to reveal the optimum structure and mechanistic pathway of antimicrobial hypochlorite generation. Detailed antimicrobial assays have been performed to establish effectiveness of such TECF-based gloves to reduce the risk from life-threatening pathogen spreading. The present work provides the rationale to consider the studied TECF, or other materials with comparable properties, as a material of choice for the development of self-sanitizing PPE in the fight against microbial infections including COVID-19.

Triboelectric Nanogenerators for Therapeutic Electrical Stimulation

Current solutions developed for the purpose of in and on body (IOB) electrical stimulation (ES) lack autonomous qualities necessary for comfortable, practical, and self-dependent use. Consequently, recent focus has been placed on developing self-powered IOB therapeutic devices capable of generating therapeutic ES for human use. With the recent invention of the triboelectric nanogenerator (TENG), harnessing passive human biomechanical energy to develop self-powered systems has allowed for the introduction of novel therapeutic ES solutions. TENGs are especially effective at providing ES for IOB therapeutic systems given their bioconformability, low cost, simple manufacturability, and self-powering capabilities. Due to the key role of naturally induced electrical signals in many physiological functions, TENG-induced ES holds promise to provide a novel paradigm in therapeutic interventions. The aim here is to detail research on IOB TENG devices applied for ES-based therapy in the fields of regenerative medicine, neurology, rehabilitation, and pharmaceutical engineering. Furthermore, considering TENG-produced ES can be measured for sensing applications, this technology is paving the way to provide a fully autonomous personalized healthcare system, capable of IOB energy generation, sensing, and therapeutic intervention. Considering these grounds, it seems highly relevant to review TENG-ES research and applications, as they could constitute the foundation and future of personalized healthcare.

All in One, Self-Powered Bionic Artificial Nerve Based on a Triboelectric Nanogenerator

Sensory and nerve systems play important role in mediating the interactions with the world. The pursuit of neuromorphic computing has inspired innovations in artificial sensory and nervous systems. Here, an all-in-one, tailorable artificial perception, and transmission nerve (APTN) was developed for mimicking the biological sensory and nervous ability to detect and transmit the location information of mechanical stimulation. The APTN shows excellent reliability with a single triboelectric electrode for the detection of multiple pixels, by employing a gradient thickness dielectric layer and a grid surface structure. The sliding mode is used on the APTN to eliminate the amplitude influence of output signal, such as force, interlayer distance. By tailoring the geometry, an L-shaped APTN is demonstrated for the application of single-electrode bionic artificial nerve for 2D detection. In addition, an APTN based prosthetic arm is also fabricated to biomimetically identify and transmit the stimuli location signal to pattern the feedback. With features of low-cost, easy installation, and good flexibility, the APTN renders as a promising artificial sensory and nervous system for artificial intelligence, human-machine interface, and robotics applications.

Functional Fibers and Fabrics for Soft Robotics, Wearables, and Human-Robot Interface

Soft robotics inspired by the movement of living organisms, with excellent adaptability and accuracy for accomplishing tasks, are highly desirable for efficient operations and safe interactions with human. With the emerging wearable electronics, higher tactility and skin affinity are pursued for safe and user-friendly human-robot interactions. Fabrics interlocked by fibers perform traditional static functions such as warming, protection, and fashion. Recently, dynamic fibers and fabrics are favorable to deliver active stimulus responses such as sensing and actuating abilities for soft-robots and wearables. First, the responsive mechanisms of fiber/fabric actuators and their performances under various external stimuli are reviewed. Fiber/yarn-based artificial muscles for soft-robots manipulation and assistance in human motion are discussed, as well as smart clothes for improving human perception. Second, the geometric designs, fabrications, mechanisms, and functions of fibers/fabrics for sensing and energy harvesting from the human body and environments are summarized. Effective integration between the electronic components with garments, human skin, and living organisms is illustrated, presenting multifunctional platforms with self-powered potential for human-robot interactions and biomedicine. Lastly, the relationships between robotic/wearable fibers/fabrics and the external stimuli, together with the challenges and possible routes for revolutionizing the robotic fibers/fabrics and wearables in this new era are proposed.

Triboelectric Effect Enabled Self-Powered, Point-of-Care Diagnostics: Opportunities for Developing ASSURED and REASSURED Devices

The use of rapid point-of-care (PoC) diagnostics in conjunction with physiological signal monitoring has seen tremendous progress in their availability and uptake, particularly in low- and middle-income countries (LMICs). However, to truly overcome infrastructural and resource constraints, there is an urgent need for self-powered devices which can enable on-demand and/or continuous monitoring of patients. The past decade has seen the rapid rise of triboelectric nanogenerators (TENGs) as the choice for high-efficiency energy harvesting for developing self-powered systems as well as for use as sensors. This review provides an overview of the current state of the art of such wearable sensors and end-to-end solutions for physiological and biomarker monitoring. We further discuss the current constraints and bottlenecks of these devices and systems and provide an outlook on the development of TENG-enabled PoC/monitoring devices that could eventually meet criteria formulated specifically for use in LMICs.

Advances in triboelectric nanogenerators for biomedical sensing

Biomedical sensors have been essential in improving healthcare outcomes over the past 30 years, though limited power source access and user wearability restraints have prevented them from taking a constant and active biomedical sensing role in our daily lives. Triboelectric nanogenerators (TENGs) have demonstrated exceptional capabilities and versatility in delivering self-powered and wear-optimized biomedical sensors, and are paving the way for a novel platform technology able to fully integrate into the developing 5G/Internet-of-Things ecosystem. This novel paradigm of TENG-based biomedical sensors aspires to provide ubiquitous and omnipresent real-time biomedical sensing for us all. In this review, we cover the remarkable developments in TENG-based biomedical sensing which have arisen in the last octennium, focusing on both in-body and on-body biomedical sensing solutions. We begin by covering TENG as biomedical sensors in the most relevant, mortality-associated clinical fields of pneumology and cardiology, as well as other organ-related biomedical sensing abilities including ambulation. We also include an overview of ambient biomedical sensing as a field of growing interest in occupational health monitoring. Finally, we explore TENGs as power sources for third party biomedical sensors in a number of fields, and conclude our review by focusing on the future perspectives of TENG biomedical sensors, highlighting key areas of attention to fully translate TENG-based biomedical sensors into clinically and commercially viable digital and wireless consumer and health products.

Multifunctional Coating with Both Thermal Insulation and Antibacterial Properties Applied to Nickel-Titanium Alloy

BACKGROUND

With excellent shape memory and superelastic properties, shape memory alloy (SMA) is an ideal actuator, and it can form smart structure for different applications in medical field. However, SMA devices cause apparent thermal damage to the surrounding tissues when it works in vivo, making the application of smart structure that is composed of SMA actuator in vivo is greatly limited.

METHODS

In this paper, coating (APA) with PLA as the main body to limit the heat conduction, a multifunctional Ag nanoparticles (AgNPs)/polylactic acid (PLA)/Al2O3 was synthesized. The Al2O3 layer was formed by micro-arc oxidation (MAO) and AgNPs were synthesized by silver nitrate and ethylene glycol. Scanning electron microscopy, transmission electron microscope, and Fourier transform infrared spectra were applied to analyze the morphology and characterization of APA coating. The antimicrobial activity, thermal insulation activity, and biocompatibility of APA coating were furtherly explored and verified through animal experiments and immunohistochemistry.

RESULTS

With different particle sizes and concentrations of AgNPs, APA multi-functional films were successfully prepared. The Al2O3 layer was closely combined with SMA and formed a porous surface, so the PLA and AgNPs layers can firmly adhere to SMA, thus reducing the release of nickel ions in SMA. AgNPs gave APA coating excellent antibacterial activity and effectively inhibited the growth of Staphylococcus aureus. In addition, coupled with the low thermal conductivity of PLA and Al2O3, AgNPs were tightly anchored on the surface of PLA, which has high infrared reflectivity, making the APA coating obtain good thermal insulation performance.

CONCLUSION

We have successfully prepared the APA coating and obtained the optimum amount of AgNPs, which makes it have good thermal insulation performance, good antibacterial activity and good biocompatibility, which provides a new prospect for the application of SMA.

Machine Learning Glove Using Self-Powered Conductive Superhydrophobic Triboelectric Textile for Gesture Recognition in VR/AR Applications

The rapid progress of Internet of things (IoT) technology raises an imperative demand on human machine interfaces (HMIs) which provide a critical linkage between human and machines. Using a glove as an intuitive and low-cost HMI can expediently track the motions of human fingers, resulting in a straightforward communication media of human-machine interactions. When combining several triboelectric textile sensors and proper machine learning technique, it has great potential to realize complex gesture recognition with the minimalist-designed glove for the comprehensive control in both real and virtual space. However, humidity or sweat may negatively affect the triboelectric output as well as the textile itself. Hence, in this work, a facile carbon nanotubes/thermoplastic elastomer (CNTs/TPE) coating approach is investigated in detail to achieve superhydrophobicity of the triboelectric textile for performance improvement. With great energy harvesting and human motion sensing capabilities, the glove using the superhydrophobic textile realizes a low-cost and self-powered interface for gesture recognition. By leveraging machine learning technology, various gesture recognition tasks are done in real time by using gestures to achieve highly accurate virtual reality/augmented reality (VR/AR) controls including gun shooting, baseball pitching, and flower arrangement, with minimized effect from sweat during operation.

Emerging Implantable Energy Harvesters and Self-Powered Implantable Medical Electronics

Implantable energy harvesters (IEHs) are the crucial component for self-powered devices. By harvesting energy from organisms such as heartbeat, respiration, and chemical energy from the redox reaction of glucose, IEHs are utilized as the power source of implantable medical electronics. In this review, we summarize the IEHs and self-powered implantable medical electronics (SIMEs). The typical IEHs are nanogenerators, biofuel cells, electromagnetic generators, and transcutaneous energy harvesting devices that are based on ultrasonic or optical energy. A benefit from these technologies of energy harvesting in vivo, SIMEs emerged, including cardiac pacemakers, nerve/muscle stimulators, and physiological sensors. We provide perspectives on the challenges and potential solutions associated with IEHs and SIMEs. Beyond the energy issue, we highlight the implanted devices that show the therapeutic function in vivo.

Soft sensors for a sensing-actuation system with high bladder voiding efficiency

Sensing-actuation systems can assist a bladder with lost sensation and weak muscle control. Here, we advance the relevant technology by integrating a soft and thin capacitive sensor with a shape memory alloy-based actuator to achieve a high-performance closed-loop configuration. In our design, sensors capable of continuous bladder volume detection and actuators with strong emptying force have been used. This integration has previously hindered performance due to large bladder volume changes. Our solution integrates sensing-actuation elements that are bladder compatible but do not interfere with one another, achieving real-time bladder management. The system attains a highly desirable voiding target of 71 to 100% of a rat's bladder with a volume sensitivity of 0.7 μF/liter. Our system represents an efficient voiding solution that avoids overfilling and represents a technological solution to bladder impairment treatment, serving as a model for similar soft sensor-actuator integration with other organs.

Nanomaterial-Enabled Flexible and Stretchable Sensing Systems: Processing, Integration, and Applications

Nanomaterial-enabled flexible and stretchable electronics have seen tremendous progress in recent years, evolving from single sensors to integrated sensing systems. Compared with nanomaterial-enabled sensors with a single function, integration of multiple sensors is conducive to comprehensive monitoring of personal health and environment, intelligent human-machine interfaces, and realistic imitation of human skin in robotics and prosthetics. Integration of sensors with other functional components promotes real-world applications of the sensing systems. Here, an overview of the design and integration strategies and manufacturing techniques for such sensing systems is given. Then, representative nanomaterial-enabled flexible and stretchable sensing systems are presented. Following that, representative applications in personal health, fitness tracking, electronic skins, artificial nervous systems, and human-machine interactions are provided. To conclude, perspectives on the challenges and opportunities in this burgeoning field are considered.

Nanogenerator-Based Self-Powered Sensors for Wearable and Implantable Electronics

Wearable and implantable electronics (WIEs) are more and more important and attractive to the public, and they have had positive influences on all aspects of our lives. As a bridge between wearable electronics and their surrounding environment and users, sensors are core components of WIEs and determine the implementation of their many functions. Although the existing sensor technology has evolved to a very advanced level with the rapid progress of advanced materials and nanotechnology, most of them still need external power supply, like batteries, which could cause problems that are difficult to track, recycle, and miniaturize, as well as possible environmental pollution and health hazards. In the past decades, based upon piezoelectric, pyroelectric, and triboelectric effect, various kinds of nanogenerators (NGs) were proposed which are capable of responding to a variety of mechanical movements, such as breeze, body drive, muscle stretch, sound/ultrasound, noise, mechanical vibration, and blood flow, and they had been widely used as self-powered sensors and micro-nanoenergy and blue energy harvesters. This review focuses on the applications of self-powered generators as implantable and wearable sensors in health monitoring, biosensor, human-computer interaction, and other fields. The existing problems and future prospects are also discussed.

Amyloid-like protein aggregates combining antifouling with antibacterial activity

A new class of biopolymer coating based on amyloid-like protein aggregates is reported to combine both antifouling and antibacterial activity.

Recent progress of nanogenerators acting as biomedical sensors in vivo

Since the nanogenerator (NG) was invented in 2006, it has been successfully developed and utilized to harvest various forms of mechanical energy in vivo. The NGs promote the progress of self-powered biomedical devices. Moreover, NGs can also be used as sensors to detect a variety of important physiological signals, which brings us closer to real-time, high-fidelity monitoring of physical and pathological information. This paper summarizes the in vivo applications of NGs as biomedical sensors, including in cardiac sensors, respiration sensors, blood pressure sensors, gastrointestinal sensors and bladder sensors. However, there are still many challenges in using NGs as sensors in vivo. For example, how can we minimize and encapsulate the NGs, how can we increase the stability and reliability during long-term detection, and how can we establish a corresponding relationship between the NG's electrical output and the physiological signals. It is also critical to follow the medical principles more closely in the development of self-powered sensors in the future. We believe that the self-powered sensors would promote the development of the next-generation healthcare monitoring systems.

Investigation of Low-Current Direct Stimulation for Rehabilitation Treatment Related to Muscle Function Loss Using Self-Powered TENG System

Muscle function loss is characterized as abnormal or completely lost muscle capabilities, and it can result from neurological disorders or nerve injuries. The currently available clinical treatment is to electrically stimulate the diseased muscles. Here, a self-powered system of a stacked-layer triboelectric nanogenerator (TENG) and a multiple-channel epimysial electrode to directly stimulate muscles is demonstrated. Then, the two challenges regarding direct TENG muscle stimulation are further investigated. For the first challenge of improving low-current TENG stimulation efficiency, it is found that the optimum stimulation efficiency can be achieved by conducting a systematic mapping with a multiple-channel epimysial electrode. The second challenge is TENG stimulation stability. It is found that the force output generated by TENGs is more stable than using the conventional square wave stimulation and enveloped high frequency stimulation. With modelling and in vivo measurements, it is confirmed that the two factors that account for the stable stimulation using TENGs are the long pulse duration and low current amplitude. The current waveform of TENGs can effectively avoid synchronous motoneuron recruitment at the two stimulation electrodes to reduce force fluctuation. Here, after investigating these two challenges, it is believed that TENG direct muscle stimulation could be used for rehabilitative and therapeutic purpose of muscle function loss treatment.

Self-Powered Direct Muscle Stimulation Using a Triboelectric Nanogenerator (TENG) Integrated with a Flexible Multiple-Channel Intramuscular Electrode

Muscle function loss can result from multiple nervous system diseases including spinal cord injury (SCI), stroke, and multiple sclerosis (MS). Electrical muscle stimulation is clinically employed for rehabilitative and therapeutic purpose and typically requires mA-level stimulation current. Here, we report electrical muscle stimulation, which is directly powered by a stacked-layer triboelectric nanogenerator (TENG) through a flexible multiple-channel intramuscular electrode. This multiple-channel intramuscular electrode allows mapping of motoneurons that is sparsely distributed in the muscle tissue and thus enables high efficiency TENG muscle stimulation, although the short-circuit current of the TENG is only 35 μA. With a stimulation efficiency matrix, we find the electrical muscle stimulation efficiency is affected by two factors, namely, the electrode-motoneuron position, and the stimulation waveform polarity. To test whether it is a universal phenomenon for electrical stimulation, we then further investigate with the conventional square wave current stimulation and confirm that the stimulation efficiency is also affected by these two factors. Thus, we develop a self-powered direct muscle stimulation system with a TENG as power source and waveform generator, and a multiple-channel intramuscular electrode to allow motoneuron mapping for stimulation efficiency optimization. We believe such self-powered system could be potentially used for rehabilitative and therapeutic purpose to treat muscle function loss.

Triboelectric Self-Powered Wearable Flexible Patch as 3D Motion Control Interface for Robotic Manipulator

Triboelectric nanogenerators and sensors can be applied as human-machine interfaces to the next generation of intelligent and interactive products, where flexible tactile sensors exhibit great advantages for diversified applications such as robotic control. In this paper, we present a self-powered, flexible, triboelectric sensor (SFTS) patch for finger trajectory sensing and further apply the collected information for robotic control. This innovative sensor consists of flexible and environmentally friendly materials, i. e., starch-based hydrogel, polydimethylsiloxane (PDMS), and silicone rubber. The sensor patch can be divided into a two-dimensional (2D) SFTS for in-plane robotic movement control and a one-dimensional (1D) SFTS for out-of-plane robotic movement control. The 2D-SFTS is designed with a grid structure on top of the sensing surface to track the continuous sliding information on the fingertip, e. g., trajectory, velocity, and acceleration, with four circumjacent starch-based hydrogel PDMS elastomer electrodes. Combining the 2D-SFTS with the 1D-SFTS, three-dimensional (3D) spatial information can be generated and applied to control the 3D motion of a robotic manipulator, and the real-time demonstration is successfully realized. With the facile design and very low-cost materials, the proposed SFTS shows great potential for applications in robotics control, touch screens, and electronic skins.

Controlling Surface Charge Generated by Contact Electrification: Strategies and Applications

Contact electrification is the phenomenon in which charge is generated on the surfaces of materials after they come into contact. The surface charge generated has traditionally been known to cause a vast range of undesirable consequences in our lives and in industry; on the other hand, it can also give rise to many types of useful applications. In addition, there has been a lot of interest in recent years for fabricating devices and materials based on regulating a desired amount of surface charge. It is thus important to understand the general strategies for increasing, decreasing, or controlling the surface charge generated by contact electrification. Herein, the fundamental mechanisms for influencing the amount of charge generated, the methods used for implementing these mechanisms, and some of the recent interesting applications that require regulating the amount of surface charge generated by contact electrification, are briefly summarized.

Investigation of Position Sensing and Energy Harvesting of a Flexible Triboelectric Touch Pad

Triboelectric nanogenerator (TENG) is a promising technology because it can harvest energy from the environment to enable self-sustainable mobile and wearable electronic devices. In this work, we present a flexible touch pad capable of detecting the contact location of an object and generating substantial energy simultaneously based on the coupling of triboelectric effects and electrostatic induction. The touch pad consists of Polytetrafluoroethylene (PTFE) thin film, multiple Aluminum (Al) electrodes and Polyethylene terephthalate (PET) layers, which can be achieved through low cost, simplified and scalable fabrication process. Different from the conventional multi-pixel-based positioning sensor (i.e., large array of sensing elements and electrodes), the analogue method proposed here is used to implement the positioning function with only four electrodes. Position location can achieve a detecting resolution of as small as 1.3 mm (the size of locating layer is 7.5 cm × 7.5 cm). For the energy harvesting part, a multilayer structure is designed to provide higher current output. The open circuit voltage of the device is around 420 V and the short circuit current can reach up to 6.26 µA with current density of 0.25 µA/cm². The maximum output power obtained is approximately 10 mW, which is 0.4 mW/cm². The flexibility and significantly reduced number of electrodes enable the proposed touch pad to be readily integrated into portable electronic devices, such as intelligent robots, laptops, healthcare devices, and environmental surveys, etc.

A Self-Powered Six-Axis Tactile Sensor by Using Triboelectric Mechanism

Triboelectric nanogenerators (TENGs) are highly promising because they can scavenge energy from their working environment to sustainably power wearable/mobile electronics. In this work, we propose a novel and straightforward strategy for six-axis force detection and object controlling by using a self-powered sensor based on TENG. The self-powered sensor can be used in diversified tactile sensing and energy saving applications, which has been demonstrated to be able to detect normal force in the range of 0⁻18 N. Using the vector properties of external force, six-axis directions in three-dimensional (3D) space is detected. Additionally, it is fabricated with environmental friendly materials, i.e., galinstan and polydimethylsiloxane (PDMS), promoting its applications in more diversified situations. Because of the available and high output voltage as well as the low internal impedance, the self-powered sensor is readily compatible with commercial signal processing and management circuits. The device presented in this work shows robust structure and stable output performance, enabling itself as an ideal human machine interface in self-powered, batteryless, and electric energy saving applications.