Low-cost gastrointestinal manometry via silicone-liquid-metal pressure transducers resembling a quipu

Magnetic steering continuum robot for transluminal procedures with programmable shape and functionalities

Millimeter-scale soft continuum robots offer safety and adaptability in transluminal procedures due to their passive compliance, but this feature necessitates interactions with surrounding lumina, leading to potential medical risks and restricted mobility. Here, we introduce a millimeter-scale continuum robot, enabling apical extension while maintaining structural stability. Utilizing phase transition components, the robot executes cycles of tip-based elongation, steered accurately through programmable magnetic fields. Each motion cycle features a solid-like backbone for stability, and a liquid-like component for advancement, thereby enabling autonomous shaping without reliance on environmental interactions. Together with clinical imaging technologies, we demonstrate the capability of navigating through tortuous and fragile lumina to transport microsurgical tools. Once it reaches larger anatomical spaces such as stomach, it can morph into functional 3D structures that serve as surgical tools or sensing units, overcoming the constraints of initially narrow pathways. By leveraging this design paradigm, we anticipate enhanced safety, multi-functionality, and cooperative capabilities among millimeter-scale continuum robots, opening new avenues for transluminal robotic surgery.

Implantable Resistive Strain Sensor-Decorated Colloidal Crystal Hydrogel Catheter for Intestinal Tract Pressure Sensing

In the quest to develop advanced monitoring systems for intestinal peristaltic stress, this study introduces a groundbreaking approach inspired by nature's sensory networks. By the integration of novel materials and innovative manufacturing techniques, a multifunctional Janus hydrogel patch has been engineered. This unique patch not only demonstrates superior stress-sensing capabilities in the intricate intestinal environment but also enables adhesion to wet tissue surfaces. This achievement opens new avenues for real-time physiological monitoring and potential therapeutic interventions in the realm of gastrointestinal health.

Soft mechanical sensors for wearable and implantable applications

Wearable and implantable sensing of biomechanical signals such as pressure, strain, shear, and vibration can enable a multitude of human-integrated applications, including on-skin monitoring of vital signs, motion tracking, monitoring of internal organ condition, restoration of lost/impaired mechanoreception, among many others. The mechanical conformability of such sensors to the human skin and tissue is critical to enhancing their biocompatibility and sensing accuracy. As such, in the recent decade, significant efforts have been made in the development of soft mechanical sensors. To satisfy the requirements of different wearable and implantable applications, such sensors have been imparted with various additional properties to make them better suited for the varied contexts of human-integrated applications. In this review, focusing on the four major types of soft mechanical sensors for pressure, strain, shear, and vibration, we discussed the recent material and device design innovations for achieving several important properties, including flexibility and stretchability, bioresorbability and biodegradability, self-healing properties, breathability, transparency, wireless communication capabilities, and high-density integration. We then went on to discuss the current research state of the use of such novel soft mechanical sensors in wearable and implantable applications, based on which future research needs were further discussed. This article is categorized under: Diagnostic Tools > Biosensing Diagnostic Tools > Diagnostic Nanodevices Implantable Materials and Surgical Technologies > Nanomaterials and Implants.

Recent progress in multifunctional, reconfigurable, integrated liquid metal-based stretchable sensors and standalone systems

Possessing a unique combination of properties that are traditionally contradictory in other natural or synthetical materials, Ga-based liquid metals (LMs) exhibit low mechanical stiffness and flowability like a liquid, with good electrical and thermal conductivity like metal, as well as good biocompatibility and room-temperature phase transformation. These remarkable properties have paved the way for the development of novel reconfigurable or stretchable electronics and devices. Despite these outstanding properties, the easy oxidation, high surface tension, and low rheological viscosity of LMs have presented formidable challenges in high-resolution patterning. To address this challenge, various surface modifications or additives have been employed to tailor the oxidation state, viscosity, and patterning capability of LMs. One effective approach for LM patterning is breaking down LMs into microparticles known as liquid metal particles (LMPs). This facilitates LM patterning using conventional techniques such as stencil, screening, or inkjet printing. Judiciously formulated photo-curable LMP inks or the introduction of an adhesive seed layer combined with a modified lift-off process further provide the micrometer-level LM patterns. Incorporating porous and adhesive substrates in LM-based electronics allows direct interfacing with the skin for robust and long-term monitoring of physiological signals. Combined with self-healing polymers in the form of substrates or composites, LM-based electronics can provide mechanical-robust devices to heal after damage for working in harsh environments. This review provides the latest advances in LM-based composites, fabrication methods, and their novel and unique applications in stretchable or reconfigurable sensors and resulting integrated systems. It is believed that the advancements in LM-based material preparation and high-resolution techniques have opened up opportunities for customized designs of LM-based stretchable sensors, as well as multifunctional, reconfigurable, highly integrated, and even standalone systems.

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.

In-vivo integration of soft neural probes through high-resolution printing of liquid electronics on the cranium

Current soft neural probes are still operated by bulky, rigid electronics mounted to a body, which deteriorate the integrity of the device to biological systems and restrict the free behavior of a subject. We report a soft, conformable neural interface system that can monitor the single-unit activities of neurons with long-term stability. The system implements soft neural probes in the brain, and their subsidiary electronics which are directly printed on the cranial surface. The high-resolution printing of liquid metals forms soft neural probes with a cellular-scale diameter and adaptable lengths. Also, the printing of liquid metal-based circuits and interconnections along the curvature of the cranium enables the conformal integration of electronics to the body, and the cranial circuit delivers neural signals to a smartphone wirelessly. In the in-vivo studies using mice, the system demonstrates long-term recording (33 weeks) of neural activities in arbitrary brain regions. In T-maze behavioral tests, the system shows the behavior-induced activation of neurons in multiple brain regions.

Ultralow-cost piezoelectric sensor constructed by thermal compression bonding for long-term biomechanical signal monitoring in chronic mental disorders

Wearable bioelectronic devices, which circumvent issues related to the large size and high cost of clinical equipment, have emerged as powerful tools for the auxiliary diagnosis and long-term monitoring of chronic psychiatric diseases. Current devices often integrate multiple intricate and expensive devices to ensure accurate diagnosis. However, their high cost and complexity hinder widespread clinical application and long-term user compliance. Herein, we developed an ultralow-cost poly(vinylidene fluoride)/zinc oxide nanofiber film-based piezoelectric sensor in a thermal compression bonding process. Our piezoelectric sensor exhibits remarkable sensitivity (13.4 mV N-1), rapid response (8 ms), and exceptional stability over 2000 compression/release cycles, all at a negligibly low fabrication cost. We demonstrate that pulse wave, blink, and speech signals can be acquired by the sensor, proposing a single biomechanical modality to monitor multiple physiological traits associated with bipolar disorder. This ultralow-cost and mass-producible piezoelectric sensor paves the way for extensive long-term monitoring and immediate feedback for bipolar disorder management.

Liquid metal biomaterials: translational medicines, challenges and perspectives

Until now, significant healthcare challenges and growing urgent clinical requirements remain incompletely addressed by presently available biomedical materials. This is due to their inadequate mechanical compatibility, suboptimal physical and chemical properties, susceptibility to immune rejection, and concerns about long-term biological safety. As an alternative, liquid metal (LM) opens up a promising class of biomaterials with unique advantages like biocompatibility, flexibility, excellent electrical conductivity, and ease of functionalization. However, despite the unique advantages and successful explorations of LM in biomedical fields, widespread clinical translations and applications of LM-based medical products remain limited. This article summarizes the current status and future prospects of LM biomaterials, interprets their applications in healthcare, medical imaging, bone repair, nerve interface, and tumor therapy, etc. Opportunities to translate LM materials into medicine and obstacles encountered in practices are discussed. Following that, we outline a blueprint for LM clinics, emphasizing their potential in making new-generation artificial organs. Last, the core challenges of LM biomaterials in clinical translation, including bio-safety, material stability, and ethical concerns are also discussed. Overall, the current progress, translational medicine bottlenecks, and perspectives of LM biomaterials signify their immense potential to drive future medical breakthroughs and thus open up novel avenues for upcoming clinical practices.

Wireless, Smart Hemostasis Device with All-Soft Sensing System for Quantitative and Real-Time Pressure Evaluation

The properly applied pressure between the skin and hemostasis devices is an essential parameter for preventing bleeding and postoperative complications after a transradial procedure. However, this parameter is usually controlled based on the subjective judgment of doctors, which might cause insufficient hemostatic effect or thrombosis. Here this study develops a compact and wireless sensing system for continuously monitoring the pressure applied on the radial artery and wrist skin in clinical practice. A liquid metal (LM)-based all-soft pressure sensor is fabricated to enable conformal attachment between the device and skin even under large deformation conditions. The linear sensitivity of 0.007 kPa-1 among the wide pressure range of 0-100 kPa is achieved and the real-time detection data can be wirelessly transmitted to mobile clients as a reference pressure value. With these devices, detailed pressure data can be collected, analyzed, and stored for medical assistance as well as to improve surgery quality.

Spiral NeuroString: High-Density Soft Bioelectronic Fibers for Multimodal Sensing and Stimulation

Bioelectronic fibers hold promise for both research and clinical applications due to their compactness, ease of implantation, and ability to incorporate various functionalities such as sensing and stimulation. However, existing devices suffer from bulkiness, rigidity, limited functionality, and low density of active components. These limitations stem from the difficulty to incorporate many components on one-dimensional (1D) fiber devices due to the incompatibility of conventional microfabrication methods (e.g., photolithography) with curved, thin and long fiber structures. Herein, we introduce a fabrication approach, ‶spiral transformation″, to convert two-dimensional (2D) films containing microfabricated devices into 1D soft fibers. This approach allows for the creation of high density multimodal soft bioelectronic fibers, termed Spiral NeuroString (S-NeuroString), while enabling precise control over the longitudinal, angular, and radial positioning and distribution of the functional components. We show the utility of S-NeuroString for motility mapping, serotonin sensing, and tissue stimulation within the dynamic and soft gastrointestinal (GI) system, as well as for single-unit recordings in the brain. The described bioelectronic fibers hold great promises for next-generation multifunctional implantable electronics.

Rational Design of Conductive Pathways in Flexible Tactile Sensors via Indirect 3D-Printing of Liquid Metal for High-Precision Monitoring and Recognition

Highly sensitive and conformal sensors are essential for the implementation of human-machine interfaces, health monitoring, and rehabilitation prostheses. The proper adjustment of conductive pathways in the sensing materials is essential for their sensitive transduction of mechanical stimuli into electrical signals. However, the rational, precise, and wide-range control of electrical networks within traditional conductive composites is difficult due to the randomly distributed fillers. Herein, we adopt an indirect 3D-printing method to fabricate pressure sensors with various microchannels for liquid metal (LM) to form consistent and tunable conductive pathways. LM is highly conductive, fluidic, and incompressible at ambient conditions, which guarantees the reliable regulation and function of our pressure sensor. Additive manufacturing provides a facile way to construct complicated microchannels with different lengths, different orientations, cross-sectional sizes, depth-width ratios, and shapes, which can effectively modulate the sensitivity and the sensing range. Under the optimized structural configurations, our sensor achieves a high sensitivity of 1.139 kPa-1, a detection range of 0-68 kPa (loading process), and stability of over 5000 cycles, whose sensing performance is better than most microchannel-filled LM sensors. It can achieve high-accuracy monitoring of pulse, speaking and gestures, and exhibit a full recognition of objects under the assistance of machine learning. This work can provide new ideas on the design of conductive pathways in flexible electronics and expand the application of recyclable LM in human-machine interfaces.

Ultrasonic-Enabled Nondestructive and Substrate-Independent Liquid Metal Ink Sintering

Printing or patterning particle-based liquid metal (LM) ink is a good strategy to overcome poor wettability of LM for its circuits' preparation in flexible and printed electronics. Subsequently, a crucial step is to recover conductivity of LM circuits consisting of insulating LM micro/nano-particles. However, most widely used mechanical sintering methods based on hard contact such as pressing, may not be able to contact the LM patterns' whole surface conformally, leading to insufficient sintering in some areas. Hard contact may also break delicate shapes of the printed patterns. Hereby, an ultrasonic-assisted sintering strategy that can not only preserve original morphology of the LM circuits but also sinter circuits on various substrates of complex surface topography is proposed. The influencing factors of the ultrasonic sintering are investigated empirically and interpreted with theoretical understanding by simulation. LM circuits encapsulated inside soft elastomer are successfully sintered, proving feasibility in constructing stretchable or flexible electronics. By using water as energy transmission medium, remote sintering without any direct contact with substrate is achieved, which greatly protect LM circuits from mechanical damage. In virtue of such remote and non-contact manipulation manner, the ultrasonic sintering strategy would greatly advance the fabrication and application scenarios of LM electronics.

A Photothermally Enhanced Vancomycin-Coated Liquid Metal Antimicrobial Agent with Targeting Capability

The targeted antimicrobial efficacy of Vancomycin decreases significantly over time due to bacterial resistance, whereas Ga-based liquid metals, which are less prone to inducing bacterial resistance, face challenges in achieving targeted antimicrobial effects. To tackle these issues, a highly efficient antimicrobial agent with targeting properties has been developed by combining Ga-based liquid metals and Vancomycin. Moreover, the performance of this antimicrobial agent can be greatly enhanced through the use of near-infrared light. Microscopic observations reveal that Vancomycin can be effectively encapsulated on the surface of liquid metal, facilitated by the presence of the oxide layer. The resulting core–shell structured antimicrobial agent demonstrates notable targeted antimicrobial effects against S. aureus. Antibacterial tests indicate that Vancomycin effectively improves the antibacterial properties of pure liquid metal. Additionally, this study unveils the excellent photothermal conversion capabilities of liquid metal, enabling the antimicrobial agent exposed to 808nm near-infrared light to exhibit significantly strengthened bactericidal performance. In this scenario, the antimicrobial agent can achieve nearly 100% effectiveness. This work enriches the investigation of integrating Ga-based antimicrobial agents with traditional antibiotics, showcasing promising antibacterial effects and establishing the groundwork for subsequent clinical applications.

Wafer-patterned, permeable, and stretchable liquid metal microelectrodes for implantable bioelectronics with chronic biocompatibility

Implantable bioelectronics provide unprecedented opportunities for real-time and continuous monitoring of physiological signals of living bodies. Most bioelectronics adopt thin-film substrates such as polyimide and polydimethylsiloxane that exhibit high levels of flexibility and stretchability. However, the low permeability and relatively high modulus of these thin films hamper the long-term biocompatibility. In contrast, devices fabricated on porous substrates show the advantages of high permeability but suffer from low patterning density. Here, we report a wafer-scale patternable strategy for the high-resolution fabrication of supersoft, stretchable, and permeable liquid metal microelectrodes (μLMEs). We demonstrate 2-μm patterning capability, or an ultrahigh density of ~75,500 electrodes/cm2, of μLME arrays on a wafer-size (diameter, 100 mm) elastic fiber mat by photolithography. We implant the μLME array as a neural interface for high spatiotemporal mapping and intervention of electrocorticography signals of living rats. The implanted μLMEs have chronic biocompatibility over a period of eight months.

Technology Roadmap for Flexible Sensors

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

Wirelessly powered deformable electronic stent for noninvasive electrical stimulation of lower esophageal sphincter

Electrical stimulation is a promising method to modulate gastrointestinal disorders. However, conventional stimulators need invasive implantation and removal surgeries associated with risks of infection and secondary injuries. Here, we report a battery-free and deformable electronic esophageal stent for wireless stimulation of the lower esophageal sphincter in a noninvasive fashion. The stent consists of an elastic receiver antenna infilled with liquid metal (eutectic gallium-indium), a superelastic nitinol stent skeleton, and a stretchable pulse generator that jointly enables 150% axial elongation and 50% radial compression for transoral delivery through the narrow esophagus. The compliant stent adaptive to the dynamic environment of the esophagus can wirelessly harvest energy through deep tissue. Continuous electrical stimulations delivered by the stent in vivo using pig models significantly increase the pressure of the lower esophageal sphincter. The electronic stent provides a noninvasive platform for bioelectronic therapies in the gastrointestinal tract without the need for open surgery.

Conductive and elastic bottlebrush elastomers for ultrasoft electronics

Understanding biological systems and mimicking their functions require electronic tools that can interact with biological tissues with matched softness. These tools involve biointerfacing materials that should concurrently match the softness of biological tissue and exhibit suitable electrical conductivities for recording and reading bioelectronic signals. However, commonly employed intrinsically soft and stretchable materials usually contain solvents that limit stability for long-term use or possess low electronic conductivity. To date, an ultrasoft (i.e., Young's modulus <30 kPa), conductive, and solvent-free elastomer does not exist. Additionally, integrating such ultrasoft and conductive materials into electronic devices is poorly explored. This article reports a solvent-free, ultrasoft and conductive PDMS bottlebrush elastomer (BBE) composite with single-wall carbon nanotubes (SWCNTs) as conductive fillers. The conductive SWCNT/BBE with a filler concentration of 0.4 - 0.6 wt% reveals an ultralow Young's modulus (<11 kPa) and satisfactory conductivity (>2 S/m) as well as adhesion property. Furthermore, we fabricate ultrasoft electronics based on laser cutting and 3D printing of conductive and non-conductive BBEs and demonstrate their potential applications in wearable sensing, soft robotics, and electrophysiological recording.

Mucosa-interfacing electronics

The surface mucosa that lines many of our organs houses myriad biometric signals and, therefore, has great potential as a sensor-tissue interface for high-fidelity and long-term biosensing. However, progress is still nascent for mucosa-interfacing electronics owing to challenges with establishing robust sensor-tissue interfaces; device localization, retention and removal; and power and data transfer. This is in sharp contrast to the rapidly advancing field of skin-interfacing electronics, which are replacing traditional hospital visits with minimally invasive, real-time, continuous and untethered biosensing. This Review aims to bridge the gap between skin-interfacing electronics and mucosa-interfacing electronics systems through a comparison of the properties and functions of the skin and internal mucosal surfaces. The major physiological signals accessible through mucosa-lined organs are surveyed and design considerations for the next generation of mucosa-interfacing electronics are outlined based on state-of-the-art developments in bio-integrated electronics. With this Review, we aim to inspire hardware solutions that can serve as a foundation for developing personalized biosensing from the mucosa, a relatively uncharted field with great scientific and clinical potential.

Emerging Liquid Metal Biomaterials: From Design to Application

Liquid metals (LMs) as emerging biomaterials possess unique advantages including their favorable biosafety, high fluidity, and excellent electrical and thermal conductivities, thus providing a unique platform for a wide range of biomedical applications ranging from drug delivery, tumor therapy, and bioimaging to biosensors. The structural design and functionalization of LMs endow them with enhanced functions such as enhanced targeting ability and stimuli responsiveness, enabling them to achieve better and even multifunctional synergistic therapeutic effects. Herein, the advantages of LMs in biomedicine are presented. The design of LM-based biomaterials with different scales ranging from micro-/nanoscale to macroscale and various components is explored in-depth to promote the understanding of structure-property relationships, guiding their performance optimization and applications. Furthermore, the related advanced progress in the development of LM-based biomaterials in biomedicine is summarized. Current challenges and prospects of LMs in the biomedical field are also discussed.

Review of Flexible Wearable Sensor Devices for Biomedical Application

With the development of cross-fertilisation in various disciplines, flexible wearable sensing technologies have emerged, bringing together many disciplines, such as biomedicine, materials science, control science, and communication technology. Over the past few years, the development of multiple types of flexible wearable devices that are widely used for the detection of human physiological signals has proven that flexible wearable devices have strong biocompatibility and a great potential for further development. These include electronic skin patches, soft robots, bio-batteries, and personalised medical devices. In this review, we present an updated overview of emerging flexible wearable sensor devices for biomedical applications and a comprehensive summary of the research progress and potential of flexible sensors. First, we describe the selection and fabrication of flexible materials and their excellent electrochemical properties. We evaluate the mechanisms by which these sensor devices work, and then we categorise and compare the unique advantages of a variety of sensor devices from the perspective of in vitro and in vivo sensing, as well as some exciting applications in the human body. Finally, we summarise the opportunities and challenges in the field of flexible wearable devices.

Femtosecond Laser-Induced Supermetalphobicity for Design and Fabrication of Flexible Tactile Electronic Skin Sensor

Pursuing flexible tactile electronic skin sensors with superior comprehensive performances is highly desired in practical applications. However, current flexible tactile electronic skin sensors suffer insufficient flexibility and sensitivity, as well as high-cost and low-efficiency in fabrication, and are susceptible to contamination in sensing performances. Here, a highly sensitive all-flexible tactile sensor (AFTS) is presented with capacitive sensing that combines a double-side micropyramids dielectric layer and a liquid metal (LM) electrode. The design and fabrication of LM-based AFTS are based on supermetalphobicity induced by femtosecond laser. The supermetalphobic micropyramids lead to a high sensitivity up to 2.78 kPa^-1, an ultralow limit of detection of ∼3 Pa, a fast response time of 80 ms, and an excellent durability of cyclic load over 10 000 times. The used femtosecond laser enables programmable, high-efficiency, low-cost, and large-scale fabrication of supermetalphobic double-side micropyramids, which is difficult to implement using conventional techniques. Furthermore, the outer substrates are treated by a femtosecond laser, endowing the AFTS with excellent antifouling performance and stable sensing signals in the highly humid environment. Successful monitoring of human physiological and motion signals demonstrates the potential of our developed AFTS for wearable biomonitoring applications.

Mechanically Active Materials and Devices for Bio-Interfaced Pressure Sensors-A Review

Pressures generated by external forces or by internal body processes represent parameters of critical importance in diagnosing physiological health and in anticipating injuries. Examples span intracranial hypertension from traumatic brain injuries, high blood pressure from poor diet, pressure-induced skin ulcers from immobility, and edema from congestive heart failure. Pressures measured on the soft surfaces of vital organs or within internal cavities of the body can provide essential insights into patient status and progression. Challenges lie in the development of high-performance pressure sensors that can softly interface with biological tissues to enable safe monitoring for extended periods of time. This review focuses on recent advances in mechanically active materials and structural designs for classes of soft pressure sensors that have proven uses in these contexts. The discussions include applications of such sensors as implantable and wearable systems, with various unique capabilities in wireless continuous monitoring, minimally invasive deployment, natural degradation in biofluids, and/or multiplexed spatiotemporal mapping. A concluding section summarizes challenges and future opportunities for this growing field of materials and biomedical research.