Integrated Sensors for Soft Medical Robotics.

Minimally invasive procedures assisted by soft robots for surgery, diagnostics, and drug delivery have unprecedented benefits over traditional solutions from both patient and surgeon perspectives. However, the translation of such technology into commercialization remains challenging. The lack of perception abilities is one of the obstructive factors paramount for a safe, accurate and efficient robot-assisted intervention. Integrating different types of miniature sensors onto robotic end-effectors is a promising trend to compensate for the perceptual deficiencies in soft robots. For example, haptic feedback with force sensors helps surgeons to control the interaction force at the tool-tissue interface, impedance sensing of tissue electrical properties can be used for tumor detection. The last decade has witnessed significant progress in the development of multimodal sensors built on the advancement in engineering, material science and scalable micromachining technologies. This review article provides a snapshot on common types of integrated sensors for soft medical robots. It covers various sensing mechanisms, examples for practical and clinical applications, standard manufacturing processes, as well as insights on emerging engineering routes for the fabrication of novel and high-performing sensing devices.

Facile Fabrication of "Tacky", Stretchable, and Aligned Carbon Nanotube Sheet-Based Electronics for On-Skin Health Monitoring.

Point-of-care monitoring of physiological signals such as electrocardiogram, electromyogram, and electroencephalogram is essential for prompt disease diagnosis and quick treatment, which can be realized through advanced skin-worn electronics. However, it is still challenging to design an intimate and nonrestrictive skin-contact device for physiological measurements with high fidelity and artifact tolerance. This research presents a facile method using a "tacky" surface to produce a tight interface between the ACNT skin-like electronic and the skin. The method provides the skin-worn electronic with a stretchability of up to 70% strain, greater than that of most common epidermal electrodes. Low-density ACNT bundles facilitate the infiltration of adhesive and improve the conformal contact between the ACNT sheet and the skin, while dense ACNT bundles lessen this effect. The stretchability and conformal contact allow the ACNT sheet-based electronics to create a tight interface with the skin, which enables the high-fidelity measurement of physiological signals (the Pearson's coefficient of 0.98) and tolerance for motion artifacts. In addition, our method allows the use of degradable substrates to enable reusability and degradability of the electronics based on ACNT sheets, integrating "green" properties into on-skin electronics.

Mesoporous Metastable CuTe2 Semiconductor.

Binary metastable semiconductor materials offer exciting possibilities in the field of optoelectronics, such as photovoltaics, tunable photosensors, and detectors. However, understanding their properties and translating them into practical applications can sometimes be challenging, owing to their thermodynamic instability. Herein, we report a temperature-controlled crystallization technique involving electrochemical deposition to produce metastable CuTe2 thin films that can reliably function under ambient conditions. A series of in situ heating/cooling cycle tests from room temperature to 200 °C followed by spectral, morphological, and compound analyses (such as ultraviolet-visible light spectroscopy, X-ray diffraction (XRD) analysis, and X-ray photoelectron spectroscopy (XPS)) suggest that the seeding electrodes play a key role in the realization of the metastable phase in CuTe2 films. In particular, CuTe2 films deposited on Al electrodes exhibit superior crystallinity and long-term stability compared with those grown on a Au substrate. The XRD data of thermally annealed CuTe2 thin films deposited on Al show a markedly sharp peak, indicating significantly increased crystal-domain sizes. Our method can be used to achieve the metastable phase of CuTe2 with a bandgap of 1.67 eV and offers outstanding photoresponsivity under different illumination conditions.

A Smart, Textile-Driven, Soft Exosuit for Spinal Assistance.

Work-related musculoskeletal disorders (WMSDs) are often caused by repetitive lifting, making them a significant concern in occupational health. Although wearable assist devices have become the norm for mitigating the risk of back pain, most spinal assist devices still possess a partially rigid structure that impacts the user's comfort and flexibility. This paper addresses this issue by presenting a smart textile-actuated spine assistance robotic exosuit (SARE), which can conform to the back seamlessly without impeding the user's movement and is incredibly lightweight. To detect strain on the spine and to control the smart textile automatically, a soft knitting sensor that utilizes fluid pressure as a sensing element is used. Based on the soft knitting hydraulic sensor, the robotic exosuit can also feature the ability of monitoring and rectifying human posture. The SARE is validated experimentally with human subjects (N = 4). Through wearing the SARE in stoop lifting, the peak electromyography (EMG) signals of the lumbar erector spinae are reduced by 22.8% ± 12 for lifting 5 kg weights and 27.1% ± 14 in empty-handed conditions. Moreover, the integrated EMG decreased by 34.7% ± 11.8 for lifting 5 kg weights and 36% ± 13.3 in empty-handed conditions. In summary, the artificial muscle wearable device represents an anatomical solution to reduce the risk of muscle strain, metabolic energy cost and back pain associated with repetitive lifting tasks.

Enhanced Photovoltaic Effect in n-3C-SiC/p-Si Heterostructure Using a Temperature Gradient for Microsensors.

The development of fifth-generation (5G) communications and the Internet of Things (IoT) has created a need for high-performance sensing networks and sensors. Improving the sensitivity and reducing the energy consumption of these sensors can improve the performance of the sensing network and conserve energy. This paper reports a large enhancement of the photovoltaic effect in a 3C-SiC/Si heterostructure and the tunability of the photovoltage under the impact of a temperature gradient, which has the potential to increase the sensitivity and reduce the energy consumption of microsensors. To start with, cubic silicon carbide (3C-SiC) was grown on a silicon wafer, and a micro-3C-SiC/Si heterostructure device was then fabricated using standard photolithography. The result revealed that the sensor could either capture light energy, transform it into electrical energy for self-power purposes, or detect light with intensities of 1.6 and 4 mW/cm2. Under the impact of the temperature gradient induced by conduction heat transfer from a heater, the measured photovoltage was improved. This thermo-phototronic coupling enhanced the photovoltage up to 51% at a temperature gradient of 8.73 K and light intensity of 4 mW/cm2. Additionally, the enhancement can be tuned by controlling the direction of the temperature gradient and the temperature difference. These findings indicate the promise of the temperature gradient in SiC/Si heterostructures for developing high-performance temperature sensors and self-powered photodetectors.

Transparent Pneumatic Tactile Sensors for Soft Biomedical Robotics.

Palpation is a simple but effective method to distinguish tumors from healthy tissues. The development of miniaturized tactile sensors embedded on endoscopic or robotic devices is key to achieving precise palpation diagnosis and subsequent timely treatment. This paper reports on the fabrication and characterization of a novel tactile sensor with mechanical flexibility and optical transparency that can be easily mounted on soft surgical endoscopes and robotics. By utilizing the pneumatic sensing mechanism, the sensor offers a high sensitivity of 1.25 mbar and negligible hysteresis, enabling the detection of phantom tissues with different stiffnesses ranging from 0 to 2.5 MPa. Our configuration, combining pneumatic sensing and hydraulic actuating, also eliminates electrical wiring from the functional elements located at the robot end-effector, thereby enhancing the system safety. The optical transparency path in the sensors together with its mechanical sensing capability open interesting possibilities in the early detection of solid tumor as well as in the development of all-in-one soft surgical robots that can perform visual/mechanical feedback and optical therapy.

Charge-Reduced Particles via Self-Propelled Electrohydrodynamic Atomization for Drug Delivery Applications.

Electrohydrodynamic atomization (EHDA) provides unparalleled control over the size and production rate of particles from solution. However, conventional methods produce highly charged particles that are not appropriate for inhalation drug delivery. We present a self-propelled EHDA system to address this challenge, a promising one-step platform for generating and delivering charge-reduced particles. Our approach uses a sharp electrode to produce ion wind, which reduces the cumulative charge in the particles and transports them to a target in front of the nozzle. We effectively controlled the morphologies of polymer products created from poly(vinylidene fluoride) (PVDF) at various concentrations. Our technique has also been proven safe for bioapplications, as evidenced by the delivery of PVDF particles onto breast cancer cells. The combination of simultaneous particle production and charge reduction, along with its direct delivery capability, makes the self-propelled EHDA a versatile technique for drug delivery applications.

Advanced Soft Robotic System for In Situ 3D Bioprinting and Endoscopic Surgery.

Three-dimensional (3D) bioprinting technology offers great potential in the treatment of tissue and organ damage. Conventional approaches generally rely on a large form factor desktop bioprinter to create in vitro 3D living constructs before introducing them into the patient's body, which poses several drawbacks such as surface mismatches, structure damage, and high contamination along with tissue injury due to transport and large open-field surgery. In situ bioprinting inside a living body is a potentially transformational solution as the body serves as an excellent bioreactor. This work introduces a multifunctional and flexible in situ 3D bioprinter (F3DB), which features a high degree of freedom soft printing head integrated into a flexible robotic arm to deliver multilayered biomaterials to internal organs/tissues. The device has a master-slave architecture and is operated by a kinematic inversion model and learning-based controllers. The 3D printing capabilities with different patterns, surfaces, and on a colon phantom are also tested with different composite hydrogels and biomaterials. The F3DB capability to perform endoscopic surgery is further demonstrated with fresh porcine tissue. The new system is expected to bridge a gap in the field of in situ bioprinting and support the future development of advanced endoscopic surgical robots.

Flexible Nanoarchitectonics for Biosensing and Physiological Monitoring Applications.

Flexible and implantable electronics hold tremendous promises for advanced healthcare applications, especially for physiological neural recording and modulations. Key requirements in neural interfaces include miniature dimensions for spatial physiological mapping and low impedance for recognizing small biopotential signals. Herein, a bottom-up mesoporous formation technique and a top-down microlithography process are integrated to create flexible and low-impedance mesoporous gold (Au) electrodes for biosensing and bioimplant applications. The mesoporous architectures developed on a thin and soft polymeric substrate provide excellent mechanical flexibility and stable electrical characteristics capable of sustaining multiple bending cycles. The large surface areas formed within the mesoporous network allow for high current density transfer in standard electrolytes, highly suitable for biological sensing applications as demonstrated in glucose sensors with an excellent detection limit of 1.95 µm and high sensitivity of 6.1 mA cm-2  µM-1 , which is approximately six times higher than that of benchmarking flat/non-porous films. The low impedance of less than 1 kΩ at 1 kHz in the as-synthesized mesoporous electrodes, along with their mechanical flexibility and durability, offer peripheral nerve recording functionalities that are successfully demonstrated in vivo. These features highlight the new possibilities of our novel flexible nanoarchitectonics for neuronal recording and modulation applications.

Wide bandgap semiconductor nanomembranes as a long-term biointerface for flexible, implanted neuromodulator.

Electrical neuron stimulation holds promise for treating chronic neurological disorders, including spinal cord injury, epilepsy, and Parkinson's disease. The implementation of ultrathin, flexible electrodes that can offer noninvasive attachment to soft neural tissues is a breakthrough for timely, continuous, programable, and spatial stimulations. With strict flexibility requirements in neural implanted stimulations, the use of conventional thick and bulky packages is no longer applicable, posing major technical issues such as short device lifetime and long-term stability. We introduce herein a concept of long-lived flexible neural electrodes using silicon carbide (SiC) nanomembranes as a faradic interface and thermal oxide thin films as an electrical barrier layer. The SiC nanomembranes were developed using a chemical vapor deposition (CVD) process at the wafer level, and thermal oxide was grown using a high-quality wet oxidation technique. The proposed material developments are highly scalable and compatible with MEMS technologies, facilitating the mass production of long-lived implanted bioelectrodes. Our experimental results showed excellent stability of the SiC/silicon dioxide (SiO2) bioelectronic system that can potentially last for several decades with well-maintained electronic properties in biofluid environments. We demonstrated the capability of the proposed material system for peripheral nerve stimulation in an animal model, showing muscle contraction responses comparable to those of a standard non-implanted nerve stimulation device. The design concept, scalable fabrication approach, and multimodal functionalities of SiC/SiO2 flexible electronics offer an exciting possibility for fundamental neuroscience studies, as well as for neural stimulation-based therapies.

Integrated, Transparent Silicon Carbide Electronics and Sensors for Radio Frequency Biomedical Therapy.

The integration of micro- and nanoelectronics into or onto biomedical devices can facilitate advanced diagnostics and treatments of digestive disorders, cardiovascular diseases, and cancers. Recent developments in gastrointestinal endoscopy and balloon catheter technologies introduce promising paths for minimally invasive surgeries to treat these diseases. However, current therapeutic endoscopy systems fail to meet requirements in multifunctionality, biocompatibility, and safety, particularly when integrated with bioelectronic devices. Here, we report materials, device designs, and assembly schemes for transparent and stable cubic silicon carbide (3C-SiC)-based bioelectronic systems that facilitate tissue ablation, with the capability for integration onto the tips of endoscopes. The excellent optical transparency of SiC-on-glass (SoG) allows for direct observation of areas of interest, with superior electronic functionalities that enable multiple biological sensing and stimulation capabilities to assist in electrical-based ablation procedures. Experimental studies on phantom, vegetable, and animal tissues demonstrated relatively short treatment times and low electric field required for effective lesion removal using our SoG bioelectronic system. In vivo experiments on an animal model were conducted to explore the versatility of SoG electrodes for peripheral nerve stimulation, showing an exciting possibility for the therapy of neural disorders through electrical excitation. The multifunctional features of SoG integrated devices indicate their high potential for minimally invasive, cost-effective, and outcome-enhanced surgical tools, across a wide range of biomedical applications.

Smart textiles using fluid-driven artificial muscle fibers.

The marriage of textiles with artificial muscles to create smart textiles is attracting great attention from the scientific community and industry. Smart textiles offer many benefits including adaptive comfort and high conformity to objects while providing active actuation for desired motion and force. This paper introduces a new class of programmable smart textiles created from different methods of knitting, weaving, and sticking fluid-driven artificial muscle fibers. Mathematical models are developed to describe the elongation-force relationship of the knitting and weaving textile sheets, followed by experiments to validate the model effectiveness. The new smart textiles are highly flexible, conformable, and mechanically programmable, enabling multimodal motions and shape-shifting abilities for use in broader applications. Different prototypes of the smart textiles are created with experimental validations including various shape-changing instances such as elongation (up to 65%), area expansion (108%), radial expansion (25%), and bending motion. The concept of reconfiguring passive conventional fabrics into active structures for bio-inspired shape-morphing structures is also explored. The proposed smart textiles are expected to contribute to the progression of smart wearable devices, haptic systems, bio-inspired soft robotics, and wearable electronics.

Atherothrombosis-on-Chip: A Site-Specific Microfluidic Model for Thrombus Formation and Drug Discovery.

Atherothrombosis, an atherosclerotic plaque disruption condition with superimposed thrombosis, is the underlying cause of cardiovascular episodes. Herein, a unique design is presented to develop a microfluidic site-specific atherothrombosis-on-chip model, providing a universal platform for studying the crosstalk between blood cells and plaque components. The device consists of two interconnected microchannels, namely main and supporting channels: the former mimics the vessel geometry with different stenosis, and the latter introduces plaque components to the circulation simultaneously. The unique design allows the site-specific introduction of plaque components in stenosed channels ranging from 0% to above 50%, resulting in thrombosis, which has not been achieved previously. The device successfully explains the correlation between vessel geometry and thrombus formation phenomenon as well as the influence of shear rate on platelet aggregation, confirming the reliability and the effectiveness of the design. The device exhibits significant sensitivity to aspirin. In therapeutic doses (50 × 10-6 and 100 × 10-6 m), aspirin delays and prevents platelet adhesion, thereby reducing the thrombus area in a dose-dependent manner. Finally, the device is effectively employed in testing the targeted binding of the RGD (arginyl-glycyl-aspartic acid) labeled polymeric nanoparticles on the thrombus, extending the use of the device to examine targeted drug carriers.

Hydrogel Nanoarchitectonics: An Evolving Paradigm for Ultrasensitive Biosensing.

The integration of nanoarchitectonics and hydrogel into conventional biosensing platforms offers the opportunities to design physically and chemically controlled and optimized soft structures with superior biocompatibility, better immobilization of biomolecules, and specific and sensitive biosensor design. The physical and chemical properties of 3D hydrogel structures can be modified by integrating with nanostructures. Such modifications can enhance their responsiveness to mechanical, optical, thermal, magnetic, and electric stimuli, which in turn can enhance the practicality of biosensors in clinical settings. This review describes the synthesis and kinetics of gel networks and exploitation of nanostructure-integrated hydrogels in biosensing. With an emphasis on different integration strategies of hydrogel with nanostructures, this review highlights the importance of hydrogel nanostructures as one of the most favorable candidates for developing ultrasensitive biosensors. Moreover, hydrogel nanoarchitectonics are also portrayed as a promising candidate for fabricating next-generation robust biosensors.

Controllable high-performance liquid marble micromixer.

A liquid marble is a liquid droplet coated with a shell of microparticles. Liquid marbles have served as a unique microreactor for chemical reactions and cell culture. Mixing is an essential task for liquid marbles as a microreactor. However, the potential of liquid marble-based microreactors is significantly limited due to the lack of effective mixing strategies. Most mixing strategies used manual and contact-based actuation schemes. This paper reports the development of a manipulation scheme that induces fluid motion into a liquid marble, leading to enhanced mixing. By inducing rotation on a horizontal axis, we significantly increased the mixing rate by 27.6 times compared to a non-actuated liquid marble and reduced the reaction time by more than 10 times. The proposed method provides a simple, continuous, precise, and controllable high-performance mixing strategy on a liquid marble platform.

Picomolar detection of carbohydrate-lectin interactions on piezoelectrically printed microcantilever array.

Recent advances in micro-electromechanical systems (MEMS) has allowed unprecedent perspectives for label-free detection (LFD) of biological and chemical analytes. Additionally, these LFD technologies offer the potential to design high resolution and high throughput sensing platforms, with the promise of further miniaturization. However, the immobilization of biomolecules onto inorganic surfaces without impacting their sensing abilities is crucial for designing these LFD technologies. Currently, covalent functionalization of self-assembled monolayers (SAMs) present promising pathways for improving assay sensitivity, reproducibility, surface stability and proximity of binding sites to the sensor surface. Herein, we investigate the use of chemical vapor deposition of 3-(glycidyloxypropyl)-trimethoxysilane (GOPTS) as a versatile SAM for the covalent functionalization of a SiO2 microcantilever array (MCA) for carbohydrate-lectin interactions with picogram sensitivity. Additionally, we demonstrate glycan immobilization to MCA is feasible using traditional piezoelectric microarray printer technology. Given the complexity of the glycome, the ability to spot samples in a high-throughput manner establishes our MCA as robust, label-free, and scalable means to analyze carbohydrate-protein interactions These findings demonstrate that GOPTS SAMs provide a suitable biofunctionalization route for MEMS and provides the proof of principle that can be extended to various LFD technologies toward a truly high-throughput and high-resolution platform.

Plasma-Induced Nanocrystalline Domain Engineering and Surface Passivation in Mesoporous Chalcogenide Semiconductor Thin Films.

The synthesis of highly crystalline mesoporous materials is key to realizing high-performance chemical and biological sensors and optoelectronics. However, minimizing surface oxidation and enhancing the domain size without affecting the porous nanoarchitecture are daunting challenges. Herein, we report a hybrid technique that combines bottom-up electrochemical growth with top-down plasma treatment to produce mesoporous semiconductors with large crystalline domain sizes and excellent surface passivation. By passivating unsaturated bonds without incorporating any chemical or physical layers, these films show better stability and enhancement in the optoelectronic properties of mesoporous copper telluride (CuTe) with different pore diameters. These results provide exciting opportunities for the development of long-term, stable, and high-performance mesoporous semiconductor materials for future technologies.

Engineering Stress in Thin Films: An Innovative Pathway Toward 3D Micro and Nanosystems.

Transformation of conventional 2D platforms into unusual 3D configurations provides exciting opportunities for sensors, electronics, optical devices, and biological systems. Engineering material properties or controlling and modulating stresses in thin films to pop-up 3D structures out of standard planar surfaces has been a highly active research topic over the last decade. Implementation of 3D micro and nanoarchitectures enables unprecedented functionalities including multiplexed, monolithic mechanical sensors, vertical integration of electronics components, and recording of neuron activities in 3D organoids. This paper provides an overview on stress engineering approaches to developing 3D functional microsystems. The paper systematically presents the origin of stresses generated in thin films and methods to transform a 2D design into an out-of-plane configuration. Different types of 3D micro and nanostructures, along with their applications in several areas are discussed. The paper concludes with current technical challenges and potential approaches and applications of this fast-growing research direction.

Advances in ultrasensitive piezoresistive sensors: from conventional to flexible and stretchable applications.

The piezoresistive effect has been a dominant mechanical sensing principle that has been widely employed in a range of sensing applications. This transducing concept still receives great attention because of the huge demand for developing small, low-cost, and high-performance sensing devices. Many researchers have extensively explored new methods to enhance the piezoresistive effect and to make sensors more and more sensitive. Many interesting phenomena and mechanisms to enhance the sensitivity have been discovered. Numerous review papers on the piezoresistive effect have been published; however, there is no comprehensive review article that thoroughly analyses methods and approaches to enhance the piezoresistive effect. This paper comprehensively reviews and presents all the advanced enhancement methods ranging from the quantum physical effect and new materials to nanoscopic and macroscopic structures, and from conventional rigid to flexible, stretchable and wearable applications. In addition, the paper summarises results recently achieved on applying the above-mentioned innovative sensing enhancement techniques in making extremely sensitive piezoresistive transducers.

Piezoresistive Effect with a Gauge Factor of 18 000 in a Semiconductor Heterojunction Modulated by Bonded Light-Emitting Diodes.

Giant piezoresistive effect enables the development of ultrasensitive sensing devices to address the increasing demands from hi-tech applications such as space exploration and self-driving cars. The discovery of the giant piezoresistive effect by optoelectronic coupling leads to a new strategy for enhancing the sensitivity of mechanical sensors, particularly with light from light-emitting diodes (LEDs). This paper reports on the piezoresistive effect in a 3C-SiC/Si heterostructure with a bonded LED that can reach a gauge factor (GF) as high as 18 000. This value represents an approximately 1000 times improvement compared to the configuration without a bonded LED. This GF is one of the highest GFs reported to date for the piezoresistive effect in semiconductors. The generation of carrier concentration gradient in the top thin 3C-SiC film under illumination from the LED coupling with the tuning current contributes to the modulation of the piezoresistive effect in a 3C-SiC/Si heterojunction. In addition, the feasibility of using different types of LEDs as the tools for modulating the piezoresistive effect is investigated by evaluating lateral photovoltage and photocurrent under LED's illumination. The generated lateral photovoltage and photocurrent are as high as 14 mV and 47.2 µA, respectively. Recent technologies for direct bonding of micro-LEDs on a Si-based device and the discovery reported here may have a significant impact on mechanical sensors.