Advanced Energy Harvesters and Energy Storage for Powering Wearable and Implantable Medical Devices.

Wearable and implantable active medical devices (WIMDs) are transformative solutions for improving healthcare, offering continuous health monitoring, early disease detection, targeted treatments, personalized medicine, and connected health capabilities. Commercialized WIMDs use primary or rechargeable batteries to power their sensing, actuation, stimulation, and communication functions, and periodic battery replacements of implanted active medical devices pose major risks of surgical infections or inconvenience to users. Addressing the energy source challenge is critical for meeting the growing demand of the WIMD market that is reaching valuations in the tens of billions of dollars. This review critically assesses the recent advances in energy harvesting and storage technologies that can potentially eliminate the need for battery replacements. With a key focus on advanced materials that can enable energy harvesters to meet the energy needs of WIMDs, this review examines the crucial roles of advanced materials in improving the efficiencies of energy harvesters, wireless charging, and energy storage devices. This review concludes by highlighting the key challenges and opportunities in advanced materials necessary to achieve the vision of self-powered wearable and implantable active medical devices, eliminating the risks associated with surgical battery replacement and the inconvenience of frequent manual recharging.

Advances in Wearable Piezoelectric Sensors for Hazardous Workplace Environments.

Recent advances in wearable energy harvesting technology as solutions to occupational health and safety programs are presented. Workers are often exposed to harmful conditions-especially in the mining and construction industries-where chronic health issues can emerge over time. While wearable sensors technology can aid in early detection and long-term exposure tracking, powering them and the associated risks are often an impediment for their widespread use, such as the need for frequent charging and battery safety. Repetitive vibration exposure is one such hazard, e.g., whole body vibration, yet it can also provide parasitic energy that can be harvested to power wearable sensors and overcome the battery limitations. This review can critically analyze the vibration effect on workers' health, the limitations of currently available devices, explore new options for powering different personal protective equipment devices, and discuss opportunities and directions for future research. The recent progress in self-powered vibration sensors and systems from the perspective of the underlying materials, applications, and fabrication techniques is reviewed. Lastly, the challenges and perspectives are discussed for reference to the researchers who are interested in self-powered vibration sensors.

Artificial Muscles and Soft Robotic Devices for Treatment of End-Stage Heart Failure.

Medical soft robotics constitutes a rapidly developing field in the treatment of cardiovascular diseases, with a promising future for millions of patients suffering from heart failure worldwide. Herein, the present state and future direction of artificial muscle-based soft robotic biomedical devices in supporting the inotropic function of the heart are reviewed, focusing on the emerging electrothermally artificial heart muscles (AHMs). Artificial muscle powered soft robotic devices can mimic the action of complex biological systems such as heart compression and twisting. These artificial muscles possess the ability to undergo complex deformations, aiding cardiac function while maintaining a limited weight and use of space. Two very promising candidates for artificial muscles are electrothermally actuated AHMs and biohybrid actuators using living cells or tissue embedded with artificial structures. Electrothermally actuated AHMs have demonstrated superior force generation while creating the prospect for fully soft robotic actuated ventricular assist devices. This review will critically analyze the limitations of currently available devices and discuss opportunities and directions for future research. Last, the properties of the cardiac muscle are reviewed and compared with those of different materials suitable for mechanical cardiac compression.

Magnetic, Electrical, and Physical Properties Evolution in Fe3O4 Nanofiller Reinforced Aluminium Matrix Composite Produced by Powder Metallurgy Method.

An investigation into the addition of different weight percentages of Fe3O4 nanoparticles to find the optimum wt.% and its effect on the microstructure, thermal, magnetic, and electrical properties of aluminum matrix composite was conducted using the powder metallurgy method. The purpose of this research was to develop magnetic properties in aluminum. Based on the obtained results, the value of density, hardness, and saturation magnetization (Ms) from 2.33 g/cm3, 43 HV and 2.49 emu/g for Al-10 Fe3O4 reached a maximum value of 3.29 g/cm3, 47 HV and 13.06 emu/g for the Al-35 Fe3O4 which showed an improvement of 41.2%, 9.3%, and 424.5%, respectively. The maximum and minimum coercivity (Hc) was 231.87 G for Al-10 Fe3O4 and 142.34 G for Al-35 Fe3O4. Moreover, the thermal conductivity and electrical resistivity at a high weight percentage (35wt.%) were 159 w/mK, 9.9 × 10-4 Ω·m, and the highest compressive strength was 133 Mpa.

3D-Printed Coaxial Hydrogel Patches with Mussel-Inspired Elements for Prolonged Release of Gemcitabine.

With the aim of fabricating drug-loaded implantable patches, a 3D printing technique was employed to produce novel coaxial hydrogel patches. The core-section of these patches contained a dopamine-modified methacrylated alginate hydrogel loaded with a chemotherapeutic drug (Gemcitabine), while their shell section was solely comprised of a methacrylated alginate hydrogel. Subsequently, these patches were further modified with CaCO3 cross linker and a polylactic acid (PLA) coating to facilitate prolonged release of the drug. Consequently, the results showed that addition of CaCO3 to the formula enhanced the mechanical properties of the patches and significantly reduced their swelling ratio as compared to that for patches without CaCO3. Furthermore, addition of PLA coating to CaCO3-containing patches has further reduced their swelling ratio, which then significantly slowed down the release of Gemcitabine, to a point where 4-layered patches could release the drug over a period of 7 days in vitro. Remarkably, it was shown that 3-layered and 4-layered Gemcitabine loaded patches were successful in inhibiting pancreatic cancer cell growth for a period of 14 days when tested in vitro. Lastly, in vivo experiments showed that gemcitabine-loaded 4-layered patches were capable of reducing the tumor growth rate and caused no severe toxicity when tested in mice. Altogether, 3D printed hydrogel patches might be used as biocompatible implants for local delivery of drugs to diseased site, to either shrink the tumor or to prevent the tumor recurrence after resection.

Dynamic Mechanical and Creep Behaviour of Meltspun PVDF Nanocomposite Fibers.

Piezoelectric fibers have an important role in wearable technology as energy generators and sensors. A series of hybrid nanocomposite piezoelectric fibers of polyinylidene fluoride (PVDF) loaded with barium-titanium oxide (BT) and reduced graphene oxide (rGO) were prepared via the melt spinning method. Our previous studies show that high-performance fibers with 84% of the electroactive ß-phase in the PVDF generated a peak output voltage up to 1.3 V and a power density of 3 W kg-1. Herein, the dynamic mechanical and creep behavior of these fibers were investigated to evaluate their durability and piezoelectric performance. Dynamic mechanical analysis (DMA) was used to provide phenomenological information regarding the viscoelastic properties of the fibers in the longitudinal direction. DSC and SEM were employed to characterize the crystalline structure of the samples. The storage modulus and the loss tangent increased by increasing the frequency over the temperature range (-50 to 150 °C) for all of the fibers. The storage modulus of the PVDF/rGO nanocomposite fibers had a higher value (7.5 GPa) in comparison with other fibers. The creep and creep recovery behavior of the PVDF/nanofillers in the nanocomposite fibers have been explored in the linear viscoelastic region at three different temperatures (10-130 °C). In the PVDF/rGO nanocomposite fibers, strong sheet/matrix interfacial interaction restricted the mobility of the polymer chains, which led to a higher modulus at temperatures 60 and 130 °C.

Dual high-stroke and high-work capacity artificial muscles inspired by DNA supercoiling.

Powering miniature robots using actuating materials that mimic skeletal muscle is attractive because conventional mechanical drive systems cannot be readily downsized. However, muscle is not the only mechanically active system in nature, and the thousandfold contraction of eukaryotic DNA into the cell nucleus suggests an alternative mechanism for high-stroke artificial muscles. Our analysis reveals that the compaction of DNA generates a mass-normalized mechanical work output exceeding that of skeletal muscle, and this result inspired the development of composite double-helix fibers that reversibly convert twist to DNA-like plectonemic or solenoidal supercoils by simple swelling and deswelling. Our modeling-optimized twisted fibers give contraction strokes as high as 90% with a maximum gravimetric work 36 times higher than skeletal muscle. We found that our supercoiling coiled fibers simultaneously provide high stroke and high work capacity, which is rare in other artificial muscles.

Bending Analysis of Polymer-Based Flexible Antennas for Wearable, General IoT Applications: A Review.

Flexible substrates have become essential in order to provide increased flexibility in wearable sensors, including polymers, plastic, paper, textiles and fabrics. This study is to comprehensively summarize the bending capabilities of flexible polymer substrate for general Internet of Things (IoTs) applications. The basic premise is to investigate the flexibility and bending ability of polymer materials as well as their tendency to withstand deformation. We start by providing a chronological order of flexible materials which have been used during the last few decades. In the future, the IoT is expected to support a diverse set of technologies to enable new applications through wireless connectivity. For wearable IoTs, flexibility and bending capabilities of materials are required. This paper provides an overview of some abundantly used polymer substrates and compares their physical, electrical and mechanical properties. It also studies the bending effects on the radiation performance of antenna designs that use polymer substrates. Moreover, we explore a selection of flexible materials for flexible antennas in IoT applications, namely Polyimides (PI), Polyethylene Terephthalate (PET), Polydimethylsiloxane (PDMS), Polytetrafluoroethylene (PTFE), Rogers RT/Duroid and Liquid Crystal Polymer (LCP). The study includes a complete analysis of bending and folding effects on the radiation characteristics such as S-parameters, resonant frequency deviation and the impedance mismatch with feedline of the flexible polymer substrate microstrip antennas. These flexible polymer substrates are useful for future wearable devices and general IoT applications.

Unipolar stroke, electroosmotic pump carbon nanotube yarn muscles.

Success in making artificial muscles that are faster and more powerful and that provide larger strokes would expand their applications. Electrochemical carbon nanotube yarn muscles are of special interest because of their relatively high energy conversion efficiencies. However, they are bipolar, meaning that they do not monotonically expand or contract over the available potential range. This limits muscle stroke and work capacity. Here, we describe unipolar stroke carbon nanotube yarn muscles in which muscle stroke changes between extreme potentials are additive and muscle stroke substantially increases with increasing potential scan rate. The normal decrease in stroke with increasing scan rate is overwhelmed by a notable increase in effective ion size. Enhanced muscle strokes, contractile work-per-cycle, contractile power densities, and energy conversion efficiencies are obtained for unipolar muscles.

Triaxial Carbon Nanotube/Conducting Polymer Wet-Spun Fibers Supercapacitors for Wearable Electronics.

The ubiquity of wearables, coupled with the increasing demand for power, presents a unique opportunity for nanostructured fiber-based mobile energy storage systems. When designing wearable electronic textiles, there is a need for mechanically flexible, low-cost and light-weight components. To meet this demand, we have developed an all-in-one fiber supercapacitor with a total thickness of less than 100 µm using a novel facile coaxial wet-spinning approach followed by a fiber wrapping step. The formed triaxial fiber nanostructure consisted of an inner poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) core coated with an ionically conducting chitosan sheath, subsequently wrapped with a carbon nanotube (CNT) fiber. The resulting supercapacitor is highly flexible, delivers a maximum energy density 5.83 Wh kg-1 and an extremely high power of 1399 W kg-1 along with remarkable cyclic stability and specific capacitance. This asymmetric all-in-one fiber supercapacitor may pave the way to a future generation of wearable energy storage devices.

Nanofibers-Based Piezoelectric Energy Harvester for Self-Powered Wearable Technologies.

The demands for wearable technologies continue to grow and novel approaches for powering these devices are being enabled by the advent of new energy materials and novel manufacturing strategies. In addition, decreasing the energy consumption of portable electronic devices has created a huge demand for the development of cost-effective and environment friendly alternate energy sources. Energy harvesting materials including piezoelectric polymer with its special properties make this demand possible. Herein, we develop a flexible and lightweight nanogenerator package based on polyvinyledene fluoride (PVDF)/LiCl electrospun nanofibers. The piezoelectric performance of the developed nanogenator is investigated to evaluate effect of the thickness of the as-spun mat on the output voltage using a vibration and impact test. It is found that the output voltage increases from 1.3 V to 5 V by adding LiCl as additive into the spinning solution compared with pure PVDF. The prepared PVDF/LiCl nanogenerator is able to generate voltage and current output of 3 V and 0.5 µA with a power density output of 0.3 µW cm-2 at the frequency of 200 Hz. It is found also that the developed nanogenerator can be utilized as a sensor to measure temperature changes from 30 °C to 90 °C under static pressure. The developed electrospun temperature sensor showed sensitivity of 0.16%/°C under 100 Pa pressure and 0.06%/°C under 220 Pa pressure. The obtained results suggested the developed energy harvesting textiles have promising applications for various wearable self-powered electrical devices and systems.

Advances in Wearable Sensors: Signalling the Provenance of Garments Using Radio Frequency Watermarks.

There is a significant nascent market for ethically produced products with enormous commercial potential around the world. A reliable method to signal the provenance of products is therefore critical for industry, given that competition based on price is not a viable strategy. The ability to trace and signal ethical treatment of animals is also of significant value to textiles manufactures. The efficacy of such a method can be measured with respect to the cost of implementation, scalability, and the difficulty of counterfeiting. The key to traceability is to win the trust of the consumer about the veracity of this information. Wearable sensors make it possible to monitor and improve the management of traceability and/or provenance. In this paper, we introduce a method for signalling the provenance of garments using radio frequency watermarks. The proposed model consists of two levels of authentication that are easy to use by legitimate vendors, but extremely difficult to imitate or hack, because the watermark is built-in and based on the radiation signature of electroactive materials.

Dual Delivery of Gemcitabine and Paclitaxel by Wet-Spun Coaxial Fibers Induces Pancreatic Ductal Adenocarcinoma Cell Death, Reduces Tumor Volume, and Sensitizes Cells to Radiation.

Pancreatic ductal adenocarcinoma (PDAC) has a dismal prognosis, with surgical resection of the tumor in conjunction with systemic chemotherapy the only potential curative therapy. Up to 80% of diagnosed cases are deemed unresectable, prompting the need for alternative treatment approaches. Herein, coaxial polymeric fibers loaded with two chemotherapeutic agents, gemcitabine (Gem) and paclitaxel (Ptx), are fabricated to investigate the effect of local drug delivery on PDAC cell growth in vitro and in vivo. A wet-spinning fabrication method to form a coaxial fiber with a polycaprolactone shell and alginate core loaded with Ptx and Gem, respectively, is used. In vitro, Gem+Ptx fibers display significant cytotoxicity as well as radiosensitizing properties toward PDAC cell lines greater than the equivalent free drugs, which may be attributed to a radiosensitizing effect of the polymers. In vivo studies assessing Gem+Ptx fiber efficacy found that Gem+Ptx fibers reduce tumor volume in a xenograft mouse model of PDAC. Importantly, no difference in mouse weight, circulating cytokines, or liver function is observed in mice treated with Gem+Ptx fibers compared to the empty fiber controls confirming the safety of the implant approach. With further development, Gem+Ptx fibers can improve the treatment of unresectable PDAC in the future.

Coaxial mussel-inspired biofibers: making of a robust and efficacious depot for cancer drug delivery.

Biopolymer-based hydrogels have emerged as promising platforms for drug delivery systems (DDSs) due to their inherent biocompatibility, tunable physical properties and controllable degradability. Yet, drug release in majority of these systems is solely contingent on diffusion of drug molecules through the hydrogel, which often leads to burst release of drugs from these systems. Herein, inspired by the chemistry of mussel adhesive proteins, a new generation of coaxial hydrogel fibers was developed that could simultaneously exert both affinity and diffusion control over the release of chemotherapeutic drugs. Specifically, dopamine-modified alginate hydrogel along with chemotherapeutic drugs (doxorubicin or gemcitabine) was used as the main core component to confer affinity-controlled release, while a methacrylated-alginate hydrogel was used as the shell composition to provide the controlled diffusion barrier. It was shown that our coaxial mussel-inspired biofibers yielded biocompatible hydrogel fibers (as indicated by comprehensive in vitro and in vivo experiments) with favourable properties including controlled swelling, and enhanced mechanical properties, when compared against single fibers made from unmodified alginate. Notably, it was observed that these coaxial fibers were capable of releasing the two drugs in a slower manner, when compared to single fibers made from pure alginate, which was partly attributed to stronger interactions of drugs with dopamine-modified alginate (the core element of coaxial fibers) as observed from zeta-potential measurements. It was further shown that these drug-loaded coaxial fibers had optimal anticancer activity both in vitro and in vivo using various pancreatic cancer cell lines. Most remarkably, drug loaded coaxial fibers, particularly doxorubicin-containing fibers, had higher anticancer effect in vivo compared to systemic injection of equivalent dosage of the drugs. Altogether, these biocompatible and robust hydrogel fibers may be further used as neoadjuvant or adjuvant therapies for controlled delivery of chemotherapeutic drugs locally to the tumor sites.

Electrically Conducting Hydrogel Graphene Nanocomposite Biofibers for Biomedical Applications.

Conductive biomaterials have recently gained much attention, specifically owing to their application for electrical stimulation of electrically excitable cells. Herein, flexible, electrically conducting, robust fibers composed of both an alginate biopolymer and graphene components have been produced using a wet-spinning process. These nanocomposite fibers showed better mechanical, electrical, and electrochemical properties than did single fibers that were made solely from alginate. Furthermore, with the aim of evaluating the response of biological entities to these novel nanocomposite biofibers, in vitro studies were carried out using C2C12 myoblast cell lines. The obtained results from in vitro studies indicated that the developed electrically conducting biofibers are biocompatible to living cells. The developed hybrid conductive biofibers are likely to find applications as 3D scaffolding materials for tissue engineering applications.

Wet-Spun Trojan Horse Cell Constructs for Engineering Muscle.

Engineering of 3D regenerative skeletal muscle tissue constructs (skMTCs) using hydrogels containing muscle precursor cells (MPCs) is of potential benefit for repairing Volumetric Muscle Loss (VML) arising from trauma (e.g., road/industrial accident, war injury) or for restoration of functional muscle mass in disease (e.g., Muscular Dystrophy, muscle atrophy). Additive Biofabrication (AdBiofab) technologies make possible fabrication of 3D regenerative skMTCs that can be tailored to specific delivery requirements of VML or functional muscle restoration. Whilst 3D printing is useful for printing constructs of many tissue types, the necessity of a balanced compromise between cell type, required construct size and material/fabrication process cyto-compatibility can make the choice of 3D printing a secondary alternative to other biofabrication methods such as wet-spinning. Alternatively, wet-spinning is more amenable to formation of fibers rather than (small) layered 3D-Printed constructs. This study describes the fabrication of biosynthetic alginate fibers containing MPCs and their use for delivery of dystrophin-expressing cells to dystrophic muscle in the mdx mouse model of Duchenne Muscular Dystrophy (DMD) compared to poly(DL-lactic-co-glycolic acid) copolymer (PLA:PLGA) topically-seeded with myoblasts. In addition, this study introduces a novel method by which to create 3D layered wet-spun alginate skMTCs for bulk mass delivery of MPCs to VML lesions. As such, this work introduces the concept of "Trojan Horse" Fiber MTCs (TH-fMTCs) and 3d Mesh-MTCs (TH-mMTCs) for delivery of regenerative MPCs to diseased and damaged muscle, respectively.

Fabrication of Aligned Biomimetic Gellan Gum-Chitosan Microstructures through 3D Printed Microfluidic Channels and Multiple In Situ Cross-Linking Mechanisms.

In this study we use a combination of ionic- and photo-cross-linking to develop a fabrication method for producing biocompatible microstructures using a methacrylated gellan gum (a polyanion) and chitosan (a polycation) in addition to lithium phenyl-2,4,6-trimethylbenzoylphosphinate (LAP) as the photoinitiator. This work involves the development of a low-cost, portable 3D bioprinter and a customized extrusion mechanism for controlled introduction of the materials through a 3D printed microfluidic nozzle, before being cross-linked in situ to form robust microstructure bundles. The formed microstructures yielded a diameter of less than 1 µm and a tensile strength range of ∼1 MPa. This study is the first to explore and achieve GGMA:CHT microstructure fabrication by means of controlled in-line compaction and photo-cross-linking through 3D printed microfluidic channels.

Self-Healing Hydrogels: The Next Paradigm Shift in Tissue Engineering?

Given their durability and long-term stability, self-healable hydrogels have, in the past few years, emerged as promising replacements for the many brittle hydrogels currently being used in preclinical or clinical trials. To this end, the incompatibility between hydrogel toughness and rapid self-healing remains unaddressed, and therefore most of the self-healable hydrogels still face serious challenges within the dynamic and mechanically demanding environment of human organs/tissues. Furthermore, depending on the target tissue, the self-healing hydrogels must comply with a wide range of properties including electrical, biological, and mechanical. Notably, the incorporation of nanomaterials into double-network hydrogels is showing great promise as a feasible way to generate self-healable hydrogels with the above-mentioned attributes. Here, the recent progress in the development of multifunctional and self-healable hydrogels for various tissue engineering applications is discussed in detail. Their potential applications within the rapidly expanding areas of bioelectronic hydrogels, cyborganics, and soft robotics are further highlighted.

Sheath-run artificial muscles.

Although guest-filled carbon nanotube yarns provide record performance as torsional and tensile artificial muscles, they are expensive, and only part of the muscle effectively contributes to actuation. We describe a muscle type that provides higher performance, in which the guest that drives actuation is a sheath on a twisted or coiled core that can be an inexpensive yarn. This change from guest-filled to sheath-run artificial muscles increases the maximum work capacity by factors of 1.70 to 2.15 for tensile muscles driven electrothermally or by vapor absorption. A sheath-run electrochemical muscle generates 1.98 watts per gram of average contractile power-40 times that for human muscle and 9.0 times that of the highest power alternative electrochemical muscle. Theory predicts the observed performance advantages of sheath-run muscles.

Sulfated polysaccharide-based scaffolds for orthopaedic tissue engineering.

Given their native-like biological properties, high growth factor retention capacity and porous nature, sulfated-polysaccharide-based scaffolds hold great promise for a number of tissue engineering applications. Specifically, as they mimic important properties of tissues such as bone and cartilage they are ideal for orthopaedic tissue engineering. Their biomimicry properties encompass important cell-binding motifs, native-like mechanical properties, designated sites for bone mineralisation and strong growth factor binding and signaling capacity. Even so, scientists in the field have just recently begun to utilise them as building blocks for tissue engineering scaffolds. Most of these efforts have so far been directed towards in vitro studies, and for these reasons the clinical gap is still substantial. With this review paper, we have tried to highlight some of the important chemical, physical and biological features of sulfated-polysaccharides in relation to their chondrogenic and osteogenic inducing capacity. Additionally, their usage in various in vivo model systems is discussed. The clinical studies reviewed herein paint a promising picture heralding a brave new world for orthopaedic tissue engineering.