Materials and Structural Designs toward Motion Artifact-Free Bioelectronics.

Bioelectronics encompassing electronic components and circuits for accessing human information play a vital role in real-time and continuous monitoring of biophysiological signals of electrophysiology, mechanical physiology, and electrochemical physiology. However, mechanical noise, particularly motion artifacts, poses a significant challenge in accurately detecting and analyzing target signals. While software-based "postprocessing" methods and signal filtering techniques have been widely employed, challenges such as signal distortion, major requirement of accurate models for classification, power consumption, and data delay inevitably persist. This review presents an overview of noise reduction strategies in bioelectronics, focusing on reducing motion artifacts and improving the signal-to-noise ratio through hardware-based approaches such as "preprocessing". One of the main stress-avoiding strategies is reducing elastic mechanical energies applied to bioelectronics to prevent stress-induced motion artifacts. Various approaches including strain-compliance, strain-resistance, and stress-damping techniques using unique materials and structures have been explored. Future research should optimize materials and structure designs, establish stable processes and measurement methods, and develop techniques for selectively separating and processing overlapping noises. Ultimately, these advancements will contribute to the development of more reliable and effective bioelectronics for healthcare monitoring and diagnostics.

Bionic artificial skin with a fully implantable wireless tactile sensory system for wound healing and restoring skin tactile function.

Tactile function is essential for human life as it enables us to recognize texture and respond to external stimuli, including potential threats with sharp objects that may result in punctures or lacerations. Severe skin damage caused by severe burns, skin cancer, chemical accidents, and industrial accidents damage the structure of the skin tissue as well as the nerve system, resulting in permanent tactile sensory dysfunction, which significantly impacts an individual's daily life. Here, we introduce a fully-implantable wireless powered tactile sensory system embedded artificial skin (WTSA), with stable operation, to restore permanently damaged tactile function and promote wound healing for regenerating severely damaged skin. The fabricated WTSA facilitates (i) replacement of severely damaged tactile sensory with broad biocompatibility, (ii) promoting of skin wound healing and regeneration through collagen and fibrin-based artificial skin (CFAS), and (iii) minimization of foreign body reaction via hydrogel coating on neural interface electrodes. Furthermore, the WTSA shows a stable operation as a sensory system as evidenced by the quantitative analysis of leg movement angle and electromyogram (EMG) signals in response to varying intensities of applied pressures.

Development of AI-Based Diagnostic Algorithm for Nasal Bone Fracture Using Deep Learning.

Facial bone fractures are relatively common, with the nasal bone the most frequently fractured facial bone. Computed tomography is the gold standard for diagnosing such fractures. Most nasal bone fractures can be treated using a closed reduction. However, delayed diagnosis may cause nasal deformity or other complications that are difficult and expensive to treat. In this study, the authors developed an algorithm for diagnosing nasal fractures by learning computed tomography images of facial bones with artificial intelligence through deep learning. A significant concordance with human doctors' reading results of 100% sensitivity and 77% specificity was achieved. Herein, the authors report the results of a pilot study on the first stage of developing an algorithm for analyzing fractures in the facial bone.

Salvage percutaneous transluminal angioplasty of the superficial femoral artery in the diabetic foot with deteriorating limb ischemia.

INTRODUCTION: PAD frequently co-occurs with diabetes, often leading to chronic nonhealing wounds. Foot gangrene and amputation are common outcomes of untreated CLI. CASE REPORT: A 67-year-old male with diabetes and deteriorating limb ischemia following surgical stress underwent successful surgical repair after emergency PTA of the SFA for extensive heel necrosis. After surgical debridement of necrotic heel tissue, the ABI on the affected side suddenly reduced to 0.36, but it improved to 1.06 at 4 weeks following stenting angioplasty, allowing the subsequent flap surgery to repair the heel defect. At the 1-year follow-up visit, the patient exhibited durable heel coverage and the restoration of weightbearing function. No signs or symptoms indicative of restenosis were evident in the blood vessel treated with stent angioplasty. CONCLUSION: This case highlights the importance of proper evaluation of critical ischemic conditions and the need for prompt endovascular interventions in preserving the at-risk diabetic foot.

Early-Stage Pilomatricoma with Cystic Features: A Case Report and Literature Review.

A conventional pilomatricoma presents as an asymptomatic, firm, subcutaneous nodule, commonly in the head, neck, and extremities of the paediatric population. However, its variants show diverse clinical features, which often pose a diagnostic challenge to clinicians. We recently treated an unusual case of pilomatricoma with cystic features in the upper chest of a 9-year-old girl, which manifested as a single solid tumour floating in a serous-filled sac formed by thick fibrous tissue. Herein, we present novel clinicopathological features of an early-stage pilomatricoma that should be clinically differentiated from a cutaneous abscess.

Masson Tumor of the Heel Fat Pad.

ABSTRACT: Intravascular papillary endothelial hyperplasia (Masson tumor) is an uncommon benign vascular lesion characterized by a reactive proliferation of endothelial cells. This lesion commonly occurs in the head, neck, and upper extremities. Although it can be found anywhere in the body, the lesion has never affected the heel fat pad. This report presents a rare case of Masson tumor of the heel fat pad to facilitate the recognition of this uncommon lesion and also suggests other conditions to be considered when diagnosing heel lesions.

Solvent-Assisted Filling of Liquid Metal and Its Selective Dewetting for the Multilayered 3D Interconnect in Stretchable Electronics.

As stretchable electronics are rapidly developing and becoming complex, the requirement for stretchable, multilayered, and large-area printed circuit boards (PCBs) is emerging. This demands a stretchable electrode and its vertical interconnect access (via) for 3-dimensional (3D) connectivity between layers. Here, we demonstrate solvent-assisted liquid metal (LM) filling into the submicrometer channel (∼400 nm), including via-hole filling and selective dewetting of LM. We provide the theoretical background of solvent-assisted LM filling and selective dewetting and reveal the osmotic pressure arising from anomalous mass transport phenomena, case II diffusion, which drives negative pressure, the spontaneous pulling of LM into the open channel. Also, we suggest design criteria for the geometry and dimension of LM interconnects to obtain structural stability without dewetting, based on the theoretical and computational background. We demonstrate a simple stretchable near-field communication (NFC) device including transferred micrometer-size light-emitting diodes (LEDs) with only 230 µm to the stretchable liquid metal PCB, without any soldering process. The device operates stably under repetitive stretching and releasing (∼50% uniaxial strain) due to the stable connection through the LM via between the upper and lower layers. Finally, we propose a concept for modular-type stretchable electronics, based on the cohesive liquid nature of LM. As a building block, the functional module can be easily removed from a mainframe, and replaced by another functional module, to suit user demand.

Implantable micro-scale LED device guided photodynamic therapy to potentiate antitumor immunity with mild visible light.

BACKGROUND: Photodynamic therapy (PDT) is a promising strategy to promote antitumor immunity by inducing immunogenic cell death (ICD) in tumor cells. However, practical PDT uses an intense visible light owing to the shallow penetration depth of the light, resulting in immunosuppression at the tumor tissues. METHODS: Herein, we propose an implantable micro-scale light-emitting diode device (micro-LED) guided PDT that enables the on-demand light activation of photosensitizers deep in the body to potentiate antitumor immunity with mild visible light. RESULTS: The micro-LED is prepared by stacking one to four micro-scale LEDs (100 µm) on a needle-shape photonic device, which can be directly implanted into the core part of the tumor tissue. The photonic device with four LEDs efficiently elicits sufficient light output powers without thermal degradation and promotes reactive oxygen species (ROS) from a photosensitizer (verteporfin; VPF). After the intravenous injection of VPF in colon tumor-bearing mice, the tumor tissues are irradiated with optimal light intensity using an implanted micro-LED. While tumor tissues under intense visible light causes immunosuppression by severe inflammatory responses and regulatory T cell activation, mild visible light elicits potent ICD in tumor cells, which promotes dendritic cell (DC) maturation and T cell activation. The enhanced therapeutic efficacy and antitumor immunity by micro-LED guided PDT with mild visible light are assessed in colon tumor models. Finally, micro-LED guided PDT in combination with immune checkpoint blockade leads to 100% complete tumor regression and also establishes systemic immunological memory to prevent the recurrence of tumors. CONCLUSION: Collectively, this study demonstrates that micro-LED guided PDT with mild visible light is a promising strategy for cancer immunotherapy.

Cuticular pad-inspired selective frequency damper for nearly dynamic noise-free bioelectronics.

Bioelectronics needs to continuously monitor mechanical and electrophysiological signals for patients. However, the signals always include artifacts by patients' unexpected movement (such as walking and respiration under approximately 30 hertz). The current method to remove them is a signal process that uses a bandpass filter, which may cause signal loss. We present an unconventional bandpass filter material-viscoelastic gelatin-chitosan hydrogel damper, inspired by the viscoelastic cuticular pad in a spider-to remove dynamic mechanical noise artifacts selectively. The hydrogel exhibits frequency-dependent phase transition that results in a rubbery state that damps low-frequency noise and a glassy state that transmits the desired high-frequency signals. It serves as an adaptable passfilter that enables the acquisition of high-quality signals from patients while minimizing signal process for advanced bioelectronics.

Stretchable, Patch-Type Calorie-Expenditure Measurement Device Based on Pop-Up Shaped Nanoscale Crack-Based Sensor.

Demands for precise health information tracking techniques are increasing, especially for daily dietry requirements to prevent obesity, diabetes, etc. Many commercially available sensors that detect dynamic motions of the body lack accuracy, while novel strain sensors at the research level mostly lack the capability to analyze measurements in real life conditions. Here, a stretchable, patch-type calorie expenditure measurement system is demonstrated that integrates an ultrasensitive crack-based strain sensor and Bluetooth-enabled wireless communication circuit to offer both accurate measurements and practical diagnosis of motion. The crack-based strain gauge transformed into a pop-up-shaped structure provides reliable measurements and broad range of strain (≈100%). Combined with the stretchable analysis circuit, the skin attachable tool translates variation of the knee flexion angle into calorie expenditure amount, using relative resistance change (R/R0 ) data from the flexible sensor. As signals from the knee joint angular movement translates velocity and walking/running behavior, the total amount of calorie expenditure is accurately analyzed. Finally, theoretical, experimental, and simulation analysis of signal stability, dynamic noises, and calorie expenditure calculation obtained from the device during exercise are demonstrated. For further applications, the devices are expected to be used in broader range of dynamic motion of the body for diagnosis of abnormalities and for rehabilitation.

Controllable Configuration of Sensing Band in a Pressure Sensor by Lenticular Pattern Deformation on Designated Electrodes.

Resistive-type pressure sensor, which are mainly utilized in industry, are easy to manufacture and are not significantly affected by external electromagnetic fields, unlike capacitive type. However, the produce signal is not linear, and it is also difficult to measure a wide range of pressures using such a sensor. Therefore, before being utilized, the extracted nonlinear data from them need to be processed by. A resistive sensor that is capable of measuring a wide range of pressure of up to 4 MPa with constant linearity is presented. Moreover it can selectively control the sensing pressure band, or act as an on/off switch, without the need for any additional computer processing.

A semi-permanent and durable nanoscale-crack-based sensor by on-demand healing.

Although sensitivity and durability are desirable in a sensor, both of them cannot be easily achieved. Site-specific and effective signal acquisition on the limited area of a sensor inevitably allows fatigue accumulation and contamination. For example, an ultrasensitive nanoscale-crack-based sensor for detecting a mechanical stimulus with tremendous sensitivity (a gauge factor greater than 2000 under 2% strain), yet limited durability (up to a few thousand stretching cycles in tensile tests) has been presented previously. Herein, we suggest a simple yet robust nanoscale-crack-based sensor that achieves remarkable durability through the use of a self-healable polymer. The self-healable polymer helps the crack gap recover and maintain high stability for 1 million cycles under 2% strain. Moreover, site-specific recovery with infrared light irradiation was demonstrated with monolithic arrayed sensors. The proposed strategy provides a unique solution to achieving highly enhanced durability and high mechanosensitivity, which are typically incompatible.

Cellular behavior controlled by bio-inspired and geometry-tunable nanohairs.

A cicada wing has a biocidal feature of rupturing the membrane of cells, while the cactus spine can transmit a water drop to the stem of the plant. Both of these properties have evolved from their respective unique structures. Here, we endeavor to develop geometry-controllable nanohairs that mimic the cicada's wing-like vertical hairs and the cactus spine-like stooped hairs, and to quantitatively characterize the cell migration behavior of the hairy structures. It was found that the neuroblastoma cells are highly sensitive to the variation of surfaces: flat, vertical, and stooped nanohairs (100 nm diameter and 900 nm height). The cells on the vertical hairs showed significantly decreased proliferation. It was found that the behavior of cells cultured on stooped nanohairs is strongly influenced by the direction of the stooped pattern of hairs when we quantitatively measured the migration of cells on flat, vertical, and stooped structures. However, the cells on the flat structures showed random movement and the cells on the vertical nanohairs restricted the nanohair movement. Cells on the stooped structure showed higher forward migration preference compared to that of the other structures. Furthermore, we found that these cellular behaviors on the different patterns of nanohairs were affected by intracellular actin flament change. Consistent with these results, the vertical and stooped structures can facilitate the control of cell viability and guide directional migration for biomedical applications such as organogenesis.

Surface energy-tunable iso decyl acrylate based molds for low pressure-nanoimprint lithography.

We presented surface energy-tunable nanoscale molds for unconventional lithography. The mold is highly robust, transparent, has a minimized haze, does not contain additives, and is a non-fluorinated isodecyl acrylate and trimethylolpropane triacrylate based polymer. By changing the mixing ratio of the polymer components, the cross-linking density, mechanical modulus, and surface energy (crucial factors in low pressure ((1-2) × 105 N m-2) low pressure-nanoimprint lithography (LP-NIL)), can be controlled. To verify these properties of the molds, we also characterized the surface energy by measuring the contact angles and calculating the work of adhesion among the wafer, polymer film, and mold for successful demolding in nanoscale structures. Moreover, the molds showed high optical clarity and precisely tunable mechanical and surface properties, capable of replicating sub-100 nm patterns by thermal LP-NIL and UV-NIL.

Dramatically Enhanced Mechanosensitivity and Signal-to-Noise Ratio of Nanoscale Crack-Based Sensors: Effect of Crack Depth.

The sensitivity of a nanoscale crack-based sensor is enhanced markedly by modulating the crack depth. The crack-depth-propagated sensor exhibits ≈16 000 gauge factor at 2% strain and a superior signal-to-noise ratio of ≈35, which facilitates detection of target signals for voice-pattern recognition.