John A. Rogers

Stable mounting is a central requirement for skin-interfaced wearable biomedical devices, because accurate and long-term measurements with clinical utility typically demand intimate contact with the skin, whereas practical use also requires gentle removal to minimize skin irritation and damage. Existing mounting strategies often struggle to satisfy these competing requirements simultaneously, especially under prolonged wear or in the presence of sweat and moisture. Suction-based mounting has recently emerged as a promising alternative because it can provide strong, reversible, and adhesive-free attachment, yet its underlying mechanics remain insufficiently understood. Here, we establish analytical models for the deformation and force of suction cups in a fully explicit form, covering both the cone suction cup and an optimized ring suction cup design. Unlike previous approaches that rely on indirect quantities such as the pressure difference and contact radius, which are not available before experiments and therefore cannot serve as controllable design variables, the present framework yields direct relations between suction performance and geometry parameters, material properties, and loading conditions, including the maximum push down displacement and the subsequent pull up displacement. The resulting formulas agree closely with accurate numerical solutions and lead to compact scaling laws that clearly identify how geometry and material parameters govern suction performance. These results provide a quantitative and physically transparent foundation for the design of suction-based mounting strategies in wearable devices.

Feet provide essential sensory input, supporting body awareness for safe movement. The impairment of plantar sensation, arising in conditions such as stroke and spinal cord injury, has a major impact on mobility, balance, and quality of life. Substituting the sensation of plantar pressure to another area on the body with intact somatosensory abilities requires capabilities for fast, programmable delivery of haptic feedback. Here, we introduce a wireless network of skin-conformable, multimodal haptic arrays that deliver high-density thermal and vibrotactile patterns anywhere on the body. Central to this approach is a hybrid motor unit that independently controls thermal and mechanical stimulation, enabling 128 degrees of freedom across 64 addressable nodes. Electromechanical characterization establishes precise, simultaneous, and safe modulation of both modalities. Psychophysical experiments demonstrate reliable spatial discrimination of colocated heat and vibration. These haptic arrays form the receivers in a sensory substitution system that delivers patterns of vibrotactile stimulation to mirror the distribution of pressure recorded from an insole-based array of pressure sensors. Exploratory case studies in individuals with spinal cord injury and stroke demonstrate feasibility and suggest improved performance during standing balance and walking tests. Altogether, this work highlights the potential of information-rich cutaneous interfaces to substitute plantar sensation, expanding the scope of somatosensory engagement for rehabilitation, entertainment, and education.

Recently developed methods for transforming 2D patterns of thin-film materials into 3D mesostructures create many interesting opportunities in microsystems design. A growing area of interest is in multifunctional thermal, electrical, chemical, and optical interfaces to biological tissues, particularly 3D multicellular, millimeter-scale constructs, such as spheroids, assembloids, and organoids. Herein, examples of 3D mechanical interfaces are presented, in which thin ribbons of parylene-C form the basis of transparent, highly compliant frameworks that can be reversibly opened and closed to capture, envelop, and mechanically restrain fragile 3D tissues in a gentle, nondestructive manner, for precise measurements of viscoelastic properties using techniques in nanoindentation. Finite element analysis serves as a design tool to guide selection of geometries and material parameters for shape-matching 3D architectures tailored to organoids of interest. These computational approaches also quantitate all aspects of deformations during the processes of opening and closing the structures and of forces imparted by them onto the surfaces of enclosed soft tissues. Studies of cerebral organoids by nanoindentation show effective Young's moduli in the range from 1.5 to 2.5 kPa depending on the age of the organoid. This collection of results suggests broad utility of compliant 3D mesostructures in noninvasive mechanical measurements of millimeter-scale, soft biological tissues.

Recent advances in the development of in-body bioelectronic systems are providing new opportunities for the clinical management of various diseases and disorders. These emerging technologies are tailored to specific organs and are beginning to blend both diagnostic sensing and therapeutic actuation. The aim of these systems is to seamlessly integrate with the physiological environment, as illustrated by the diverse device strategies discussed throughout this article. Next generation modalities, such as optogenetics combining gene therapy with devices for photostimulation, are gaining popularity and offer advantages over existing therapeutic strategies. In this perspective, we explore the current state of technological developments, key challenges in the field and potential pathways for translating these innovations into clinical practice.

ABSTRACT Conventional strategies for the management of acute pain have significant limitations. Pharmaceutical approaches carry risks for addiction and misuse. Standard implantable devices require secondary surgeries for removal and physical tethers to external systems for power and control. Recent work on bioresorbable electrical stimulators overcomes certain of these drawbacks, but existing versions still depend on transcutaneous leads. Here, we introduce a platform that employs thermal mechanisms for nerve block to bypass some of these limitations. The system integrates both a Joule heating element and a resistive temperature sensor in a soft cuff structure as a nerve interface, in which most of the materials are bioresorbable over a clinically relevant timeframe. This design enables precise control of nerve temperature within a safe range (≤45°C) for effective nerve block through a feedback‐guided strategy that continuously monitors temperature and adjusts current in real time. Options for wireless power delivery eliminate the need for external interfaces. Small animal model studies confirm the reversible and non‐invasive operation of this system. The results demonstrate effective suppression of compound nerve action potentials in response to thermal stimulation, with recovery of nerve conduction upon cooling. These findings highlight the potential of this platform as a safe and effective solution to acute pain management.

Synthesizing perceivable artificial neural inputs independent of typical sensory channels remains a fundamental challenge in developing next-generation brain−machine interfaces. Establishing a minimally invasive, wirelessly effective and miniaturized platform with long-term stability is crucial for creating research methods and clinically meaningful biointerfaces capable of mediating artificial perceptual feedback. Here we demonstrate a miniaturized, fully implantable transcranial optogenetic neural stimulator designed to generate artificial perceptions by patterning large cortical ensembles wirelessly in real time. Experimentally validated numerical simulations characterized light and heat propagation, whereas neuronal responses were assessed by in vivo electrophysiology and molecular methods. Cue discrimination during operant learning demonstrated the wireless genesis of artificial percepts sensed by mice, where spatial distance across large cortical networks and sequential order-based analyses of discrimination predicted performance. These conceptual and technical advances expand understanding of artificially patterned neural activity and its perception by the brain to guide the evolution of next-generation all-optical brain−machine communication. This work presents a fully implantable wireless optogenetic device that delivers spatiotemporally patterned cortical stimulation through the skull and generates artificial perception in mice.

Extended reality (XR) is an emerging field that connects the physical and digital worlds, enabling communication that transcends time and space. Commercial XR devices have been developed to support such experiences, but they are limited to specific sensations, mainly vibrational cues. Furthermore, these devices are realized mainly in rigid form factors, requiring external controllers or equipment, which hinders intuitive interaction and causes a mismatch with natural body movements. In this regard, skin-integrated human-machine interfaces with wearable electronics have played an important role in intuitive and immersive interaction in the XR environment, facilitating highly authentic sensory reconstruction and perception. Novel innovations in materials and structural design have enabled a wider range of sensory modalities and miniaturization, overcoming the limitations of conventional rigid XR systems. In this article, we thoroughly review human perception mechanisms to replicate hyper-realistic sensations. Then, we deal with the design and functionality for sensory feedback and input, specifically tailored for XR applications. In addition, we discuss precise system-level integration for untethered XR devices, alongside the role of artificial intelligence in real-time processing and rapid sensation conversion through predictive algorithms. Finally, we introduce promising XR applications and conclude with the challenges and prospects of future XR technologies.

Smart Healthcare Photonic Nanomaterials and Devices This artwork illustrates smart healthcare photonic nanomaterials, wearable and implantable devices for diagnostic, therapeutic and theranostic applications via neuro-immune cross-talks. In this Special Issue, Molly M. Stevens, John A. Rogers, and Sei Kwang Hahn emphasize light-emitting/responsive platforms that enable precise sensing and intervention, spanning imperceptible wearables and conformal implants, and frames opportunities and challenges on the path to the integrated digital photomedicine.

OBJECTIVES: Inappropriately treated pain can have deleterious outcomes in infants. Current tools rely on intermittent, subjective observation requiring specialised paediatric skills. This study aimed to diagnose infant pain through continuous monitoring with wireless sensors using Neonatal Pain and Agitation Sedation Scale (NPASS)-derived Clinical Sensor Pain Scale (CSPS) and Automated SPS (ASPS). METHODS: Clinically stable neonatal intensive care unit infants undergoing phlebotomy were recorded with wireless sensors and video, capturing vital signs, extremity movement and vocalisations. Clinicians and non-clinicians scored the sensor data with CSPS and videos with NPASS; ASPS was applied to the sensor data. Median scores were compared, inter-rater reliability assessed with intraclass correlation coefficients (ICC) and cross-scale comparisons performed using Wilcoxon signed-rank and Kruskal-Wallis tests. RESULTS: CSPS and ASPS closely aligned with NPASS scores, supporting their validity for continuous infant pain assessment. In 32 infants, the median CSPS score was 3 (IQR 2, 5), with excellent reliability (ICC, 95% CI 92 to 97), high internal consistency (Cronbach's α=0.99) and 95% absolute agreement, comparable to NPASS (p=0.95). Clinician and non-clinician scores were more consistent using CSPS than NPASS. ASPS also performed well, with a median score of 3 (IQR 1, 5), yielding results similar to CSPS (p=0.94) and NPASS (p=0.56). CONCLUSIONS: Wireless biosensors enabled objective monitoring of infant pain. CSPS and ASPS showed validity and reliability for diagnosing acute procedural pain, and feasibility for clinical use. Findings support the development of automated, real-time tools to reduce subjectivity and improve infant pain management, with the potential to advance treatment models and outcomes.

Soft Electronics A Lorentz-force-driven, liquid metal–embedded surface delivers rapid, reversible 3D shape morphing for precise low-velocity flow control. With minimal power, it modulates near-wall flows in real time, offering versatile, programmable actuation for small UAVs, bio-inspired aerodynamics, and environmental sensing—bridging soft electronics with advanced fluid dynamics. More details can be found in the Research Article by Donghyun You, Leonardo P. Chamorro, Xinchen Ni, John A. Rogers, and co-workers (DOI: 10.1002/aisy.202500457).

The authors declare no conflict of interest.

Long-term implantable bioelectronic systems, serving as human–machine interfaces or advanced surgical tools, offer a powerful means for direct information transmission between biological tissues and external computers, for innovative applications such as muscle– exoskeleton integration, neuromodulation and chronic disease management

The implementation of clinical needs and feedback throughout the development cycle of wearable health-monitoring technology is key to success. Close collaboration with all stakeholders involved will speed clinical translation to the market.

Historic and ongoing efforts in ecology and environmental science have highlighted the pressing need to monitor the health, sustainability and productivity of global and local ecosystems. Interest in these areas reflects a need both to determine the suitability of environments to support human activity (settlement, agriculture and industry) and to evaluate the impacts of such anthropogenic action. Of interest are chemical, biological and physical factors that reduce ecosystem viability owing to human intervention. Evaluating these factors and their impact on global health, ecological stability and resource availability demands improvements to existing environmental sensing technologies. Current methods to quantify chemical pollutants, biological factors and deleterious physical conditions affecting target ecosystems suffer from lack of automation and narrow spatiotemporal range. Recent advances in materials science, chemistry, electronics and robotics offer solutions to this problem. A vision emerges for fully autonomous, networked and ecoresorbable sensing systems that can be deployed over large aerial, terrestrial and aquatic environments. This Review describes ongoing efforts in these areas, focusing on materials advances supporting the accurate quantification of environmental factors with apparatus that accommodates full or partial device resorption. Discussion begins with an overview of hazards affecting global ecosystems, followed by a description of existing detection methods to quantify their severity. We proceed with an exploration of existing and developing technologies affecting sensor dispersion, motility, communication and power. Finally, we describe exciting recent efforts in the development of environmentally degradable materials that could prove beneficial in the realization of massively distributed (millions of individual sensors) transient sensor networks. Accurate, spatiotemporally resolved monitoring of environments and ecosystems serves as the starting point to both identify and remedy natural or anthropogenic environmental hazards. This Review covers materials science advances supporting a new paradigm in environmental sensing: distributed networks of sensing elements capable of system-level profiling with the possibility of harmless environmental resorption after a predetermined recording period.

Miniaturized implantable optoelectronic technologies for in vivo biomedical applications are gaining interest, but require strict thermal management for safe operation. Here, we introduce a comprehensive framework combining analytical solutions and numerical modeling to estimate and manage thermal effects of optoelectronic devices. We propose Green's functions to analytically solve temperature distributions in tissue from a point source with coupled thermal-optical power, capturing the influence of critical tissue properties and spatiotemporal parameters. Integrating the Green's function derives temperature distributions for sources with definable geometry. Numerical modeling defines scaling factors to account for variations in radiation patterns and material designs, enabling direct performance comparisons across systems. Guided by this framework, iterative optimization of a filamentary optogenetic probe for deep brain stimulation significantly reduces thermal loads while preserving typical behaviors in freely moving mice. Experimental validation through in vitro and in vivo characterization demonstrates scalable strategies to overcome thermal challenges in advanced bio-optoelectronic systems.

“In the 1960s, when the first NICUs opened, premature infants had a 95% chance of dying. Today, they have a 95% chance of survival” – Dr. Rahul K. Parikh, a pediatrician from California, published in August 2012 in the New York Times [1]. This incredible shift in survival can be considered a great example of the conquest of modern neonatal medicine. Among many technological advancements, the ability to continuously monitor vital signs such as heart rate and respiratory rate, was followed by closed loop body temperature (T) control, blood pressure assessment, and finally by continuous and non-invasive monitoring of oxygen saturation. Monitoring of these vital signs was paramount for the assessment of well-being and detection of pathophysiological states in tiny patients, allowing for adjustments or initiation of treatments or interventions that are lifesaving.There is no question that neonatal technology has advanced tremendously over the last 60 years and parents have become very approving of this. In the book From Surviving to Thriving, Fabiana Bacchini, the mother of a twin baby boy born at 27 weeks, wrote: “I was able to watch in happiness and gratitude, all the technology that exists to keep these tiny beings alive.” Later, it also became clear that, despite the important role of technology, it can also cause fear and anxiety for parents. Fabiana mentioned that the first time she entered the NICU “I did not see a baby, I saw wires, monitors and a breathing machine” [2].Indeed, current technology for vital signs monitoring uses several skin sensors connected to the bedside monitors by wires and cables. In most patients, raw signals, average values and trends of heart rate, respiratory rate, temperature, and oxygen saturation are continuously displayed. However, this system carries some challenges for patients, parents, and healthcare professionals (HCP) as the multiple wires can tangle around the infant body, restrict the patient’s movement, and cause discomfort or pressure sore. Hence, regular care involves frequent removal, reapplication, and readjustments of the sensors, which may harm the fragile neonatal skin, cause pain, and/or interrupt resting or sleeping. For parents, not much information is available on what are their perspectives on these vital signs monitoring systems. Some small surveys have reported that the presence of multiple wires and cables can cause intimidation and additional stress, acting as a barrier to skin-to-skin contact for fear of disconnecting the sensors or wires, or interfering with regular monitoring [3‒5]. This technology may also increase HCP’s workload as wires and cables may touch contaminated surfaces or become soiled with urine, blood or stools, increasing the risks of nosocomial infections [3, 6, 7]. Consequently, nurses must constantly inspect, sanitize, reposition, or replace components of the system.Neonatal intensive care units manage a diversity of health problems with variable degrees of severity and patient maturation. To develop a wireless system that can be used during the first days of life in a 400 g extremely preterm infant born at 22–23 weeks of gestation and a 4-kilo term infant born with perinatal asphyxia is a real challenge. Furthermore, there are some more stable infants that are just feeding and growing, or infants with chronic problems that require prolonged hospitalizations. Noticeably, the needs of these populations are different, creating challenges for the development of new vital signs monitoring systems. As an example, an extremely preterm infant in the first days of life spends most of the time quiet, sleeping inside the incubator, and has very sensitive skin that can easily be damaged by skin adhesives and sensors. In these cases, non-contact technologies may play a very important role, at least for the monitoring of heart rate and respiratory rate. This is not the case with more stable and mature infants that are active, and where parents can constantly hold and promote kangaroo care (KC). Therefore, the adoption of new monitoring technologies needs to consider those different needs, be very familiar with the technology advantages and limitations, and develop protocols and proper training for all healthcare providers involved.Although wired vital sign monitors are the standard, they are frequently cited as obstacles to key aspects of family-integrated care and routine clinical practice. Wireless vital sign monitoring technologies are increasingly being explored as a potential solution to these issues. However, there is limited research available which quantitatively or qualitatively examines how key NICU stakeholders such as parents and HCPs, perceive the current monitoring system and these wireless innovations.The small number of existing studies have highlighted that the wires and sensors used in current systems interfere with skin-to-skin contact and KC, limit parents’ ability to hold or touch their infants, and contribute to a highly technical environment that many find overwhelming. Survey and interview studies consistently show that parents perceive the wires as intimidating and as contributing to their anxiety [3, 8‒10]. HCPs also express widespread concerns with the current systems, especially regarding the physical clutter created by wires, challenges with positioning and handling of infants, risk of pressure sores from adhesives, and the frequency of false alarms [8, 11‒13].These concerns have led to growing interest in wireless monitoring as a possible solution. While research on parent and HCP in this area is very limited, all existing studies show optimism toward the adoption of wireless technology. Parents have generally responded positively, citing benefits such as reduced anxiety, possible easier interaction with their infant, improved KC, and enhanced infant comfort. However, there are some apprehensions related to signal reliability, sensor size and appearance, battery duration, and potential risks such as radiation exposure [3, 8, 14, 15]. Similarly, HCPs have voiced strong support for wireless monitoring, highlighting its potential to reduce handling difficulties, decrease false alarms, and improve comfort for both infants and families [3, 8, 11, 12]. Importantly, they also emphasize areas of concern, including reliability, safety related to radiation, and costs [8, 12]. In particular, the absence of economic feasibility studies is a significant gap in the current literature.Overall, the available evidence indicates that wireless monitoring is a promising advancement, with support from key stakeholder groups in the NICU. The shift away from wired systems could improve key aspects of neonatal care, particularly KC and parental engagement, while also addressing some of the frustrations voiced by HCPs. However, to address these challenges, and ensure new technologies will be adopted by NICU staff and parents, concerns around reliability, safety, and cost must be addressed through careful user-centered design, and rigorous research including clinical evaluation. Future research should prioritize that wireless systems not only meet regulatory and clinical standards but are also feasible and acceptable for daily use in the NICU.A large number of small studies have investigated the use of non-contact vital sign monitoring in the NICU. Most studies used a single-device system and monitored respiratory or heart rate using offline analysis. The following technologies have been tested: red, green, blue cameras, infrared cameras, monochrome cameras, depth cameras, and radar, primarily for respiratory rate and heart rate monitoring [16‒22]. Non-contact sensors are typically placed at the head or foot of the infant’s incubator or crib. In some cases, the sensor cannot collect data through the plexiglass and may require either an open incubator or a small opening to maintain a clear line of sight. Depending on the technology and algorithms used, a defined Region of Interest within the sensor’s visual field may be designated for vital sign extraction.These studies generally featured small sample sizes and short recording durations of <1 h [17, 19, 21]. Nearly all exclusively focused on accuracy by comparing novel non-contact methods to a reference measurement using the Bland-Altman method. Analyses of heart rate and respiratory rate using this method revealed low bias and moderately acceptable 95% limits of agreement. Feasibility outcomes were rarely explored and measured using metrics such as the amount of usable data or processing times. No studies explored outcomes related to safety, although this can be expected as these monitoring methods pose no threat to the fragile neonatal skin.While these technologies show promising preliminary results, several concerns remain. First, feasibility concerns remain as most devices rely on an uninterrupted clear view of the infant. How it would perform in situations where the infant is moving, clothed, or receiving care needs to be better clarified. Additionally, a systematic review of non-contact technologies applied the QUADAS-2 assessment and revealed several areas of concerns regarding risk of bias and applicability due to lack of clear inclusion and exclusion criteria and small sample sizes [23]. Furthermore, many studies lacked key basic descriptors of the population, such as age and weight, making it difficult to ensure a representative range of NICU patients such as those requiring respiratory support or in incubators were included in the research. Additionally, some studies provided incomplete descriptions of reference measurements, only naming them as “standard” or “routine” monitoring, limiting the ability to determine the risk of bias. Unfortunately, most non-contact studies lack a conflict-of interest statement.Ultimately, non-contact technologies may represent an appealing monitoring solution for some of the most vulnerable infants in the NICU, such as extremely premature infants with extremely fragile skin. This research area is rapidly growing as non-contact studies often utilize commercially available cameras and present low research risks for patients. However, concerns regarding the ability to perform reliably for prolonged periods in a real NICU environment and across a range of patients require further exploration and validation.Studies focusing on wearable devices provide slightly more detailed information regarding participant selection criteria and larger sample sizes. Emerging classes of wireless sensors in the form of soft, flexible, skin-like (“epidermal”) platforms have the potential to redefine practices for monitoring in the NICU, with additional possibilities for use in the home. Recent work at Northwestern University shows that a pair of devices of this type, each of which gently and non-invasively adheres to the fragile skin of a premature neonate, is capable of capturing complete, clinical grade vital signs information without any wires or cables [24, 25]. These devices include distributed flexible electronic components with stretchable interconnects; all embedded in strategic layouts within medical-grade silicone encapsulating structures. The designs optimize for conformal interfaces to the skin at relevant anatomical locations. In pilot studies on patients in NICU settings, these technologies achieved high accuracy and fidelity similar to those of traditional wired monitors. Extensions enabled by additional sensors allow for precise measurements of body sounds, relevant to cardiac and respiratory monitoring, with additional capabilities in tracking gastrointestinal activity [26]. Specifically, high-bandwidth microphones and accelerometers yield seismocardiograms, lung sounds, bowel motility, and even the spectral and temporal features of crying and other forms of vocalization. In this way, these advanced technologies can not only capture vital signs and physiological signals but also an array of important biophysical metrics of health status, beyond those addressed with conventional NICU hardware.Commercial translation is also gaining momentum. As an example, Sibel Health (Sibel Health, USA) has secured successive FDA 510(k) clearances since 2021 for its ANNE® One sensor platform, a pair of chest and foot patches to continuously monitor heart rate, respiratory rate, skin and core temperatures, oxygen saturation and biomarkers. It is also noteworthy that ANNE One® is currently under investigation in NICU at Montreal Children’s Hospital with the aim of create a wireless NICU. Meanwhile, other emerging technologies, focusing on more specific modalities, include Bambi Belt (Bambi Medical, the Netherlands) and Boppli® (PyrAmes, USA) for monitoring ECG/EMG and blood pressure, respectively [27‒29].Collectively, efforts with wireless technologies signal a paradigm shift to transform neonatal care with fewer risks and burdens, and to improve clinical workflow and patient safety. With continued refinement and real-world validation, wireless multimodal sensors are poised to enhance monitoring precision, promote a patient-centric environment, and ultimately give our most vulnerable patients a gentler start to life (Fig. 1). With that, a wireless NICU became a much closer to reality than just fiction.We thank the Research Institute of McGill University Health Center for the support of the Smart Hospital Project.John Rogers and Ja Uk are co-founders and unpaid consultants of a company with products for wireless health monitoring. Eva Senechal and Guilherme Sant’Anna have no conflicts of interest to declare.The Montreal Children’s Foundation has provided funding for the Smart Hospital Project.G.S., J.R., H.U.C., and E.S. all contributed equally to the original writing and reviewing of this editorial.

Analytical solutions of diffusion theory for light propagation in turbid media are essential for optical diagnostics and therapeutic applications, including cerebral oximetry, hemodynamic monitoring, and photostimulation. While existing solutions work reasonably well for collimated light sources-lasers and optical fibers-analytical solutions for LEDs remain missing, despite the growing use of LEDs in wearable and implantable bioelectronics. We present a method to solve the diffusion theory and derive analytical solutions for two biomedically relevant configurations: 1) surface-mounted LEDs on semi-infinite media (e.g., wearable devices) and 2) embedded LEDs in infinite media (e.g., implantable devices). Beyond a distance of 4 times the scattering length of the medium to the LED source, our analytical solutions are reasonably accurate, within 6% error for 1) and 3% for 2). This represents significant improvements over existing analytical solutions, characterized by 26% and 15% error, respectively. Using our analytical solutions, we derive tissue optical properties ([Formula: see text] and [Formula: see text]) from diffuse reflectance results with <7% error, and we determine the irradiance threshold for photostimulation, aligned with experimental optogenetic activation data. Our analytical solutions are readily adaptable to various biomedical applications, offering a rigorous theoretical foundation for next-generation LED-based bioelectronics, to enable more accurate optical diagnostics and therapies in clinical applications.

Sweat parameters such as volume and chloride concentration may offer invaluable clinical insights for people with CF (PwCF). Pilocarpine-induced sweat collection for chloridometry measurement is the gold standard for a CF diagnosis, but this technique is cumbersome and not suitable for remote settings or repeat measurements. We have previously reported the utility of a skin-interfaced microfluidic device (CF Patch) in conjunction with a smartphone image processing platform that enables real-time measurement of sweating rates and sodium chloride loss in laboratory and remote settings. Here, we conducted clinical studies assessing the accuracy of the CF Patch compared to chloridometry when using pilocarpine to induce sweat. We also tested the feasibility and accuracy of exercise-induced sweat chloride measurements in PwCF and healthy volunteers (HV). In the laboratory, using either pilocarpine or exercise to induce sweat, the CF Patch demonstrated strong correlations with sweat chloride measured by pilocarpine-induced chloridometry. In remote settings, exercise-induced sweat chlorides measured using the CF patch were strongly correlated with in-laboratory exercise-induced CF patch sweat chlorides in HV but had a weaker correlation in PwCF. For PwCF on CFTR modulators, there was greater day-to-day variability in sweat chloride compared to HV, which highlights the limitations of assessing CFTR modulator efficacy and pharmacodynamics based on a single in-laboratory chloridometry measurement. Moreover, these findings demonstrate that the CF Patch is suitable as a remote management device capable of measuring serial sweat chloride concentrations and offers the potential of monitoring the efficacy of CF medication regimens but should not replace pilocarpine-based chloridometry for making a CF diagnosis.

Plastic microparticles, a form of microparticles commonly referred to as microplastics (MP), have been the focus of increasing interest for understanding potential human and ecological impacts, including the development of health-based benchmark values. This systematic review critically evaluates 24 mammalian studies reporting reproductive and developmental outcomes, a disproportionately focused research area, with a particular focus on methodological rigor and risk of bias. Fit-for-purpose aspects of selection, performance, and attrition bias were integrated into the critical appraisal to better understand the potential bias studies may have across these domains. All studies received a tier III rating based on the National Toxicology Program's Office of Health Assessment and Translation framework, indicating a high risk of bias and insufficient reliability for risk assessment. Key issues identified across the body of evidence include poor exposure characterization, inadequate outcome assessment, lack of validated test guidelines, and failure to account for critical reproductive parameters such as estrous cycle monitoring and sperm analysis standards. Additionally, discrepancies in the particle characterization and homogeneity of the test material limit comparability and reproducibility across studies. This work highlights the current limitations in the body of evidence in terms of internal and construct validity, which preclude any conclusions on MP-related reproductive toxicity, and details a path forward for investigators to consider in future research.

Active flow control has gained substantial interest due to the ubiquitous role of fluids in engineering systems and applications and its potential to enhance aero‐, hydro‐, and hemodynamic system performance. This study presents an active flow control strategy employing a programmable shape‐morphing system actuated by Lorentz forces in liquid metal‐embedded microfluidics. The proposed system enables rapid, reversible, and three‐dimensional deformations of a thin elastomeric membrane without the need for external flow sources or high‐voltage inputs. The platform is evaluated for its capacity to induce distinct motions at various incoming velocities, revealing significant effects on momentum change. The study integrates advanced experimental techniques, reduced‐order modeling, and state‐of‐the‐art numerical methods to validate the system's versatility and performance. The findings highlight the potential of this soft actuating system to enhance flow control strategies, with potential applications ranging from improving the aerodynamics of bio‐inspired flying sensors to mimicking natural locomotion mechanisms in low‐velocity regimes. Further exploration of material innovations is crucial to expanding the system's capabilities and impact on specific flow control applications.

Abstract Acute Compartment Syndrome (ACS) is a serious medical condition that arises from increased pressure within osteofascial compartments, leading to impaired blood flow and potential tissue damage. Early and accurate diagnosis is critical for preventing permanent damage. Current methods rely largely on qualitative assessments with limited accuracy, and those that exploit invasive pressure measurements often prove inadequate. Herein, a soft materials‐based multimodal sensor probe is introduced, as well as the mechanical and thermal influences to monitor intra‐compartmental pressure, tissue oxygen saturation (StO 2 ), and blood flow simultaneously at a common location within an affected compartment. The system integrates three sensors into a thin, flexible probe capable of real‐time, wireless data transmission. The device allows for continuous monitoring with high reproducibility and sensitivity, to enhance diagnostic accuracy relative to current clinical practice, with the potential to early diagnosis of an acute compartment syndrome that requires fasciotomies. Large animal model studies, including short‐ and intermediate‐term reliability assessments, highlight the key engineering features. The results reveal expected inverse relationships between pressure, StO 2 , and flow rate under simulated compartment syndrome conditions. This multimodal approach enhances diagnostic precision, offers real‐time insights, and promises to yield improved outcomes through a comprehensive, quantitative diagnosis of compartment syndrome.

Abstract Emerging classes of wearable microfluidic sensors of eccrine sweat enable non‐invasive and real‐time monitoring of health status in applications that range from sports to worker safety, environmental exposures, and medical care. Opportunities for improving the performance of these systems include those in colorimetric detection of biochemical species with high accuracy across a wide dynamic range, in efficient collection of sweat and local measurements of sweat loss across a broad spectrum of sweat rates, and in an expanded set of biomarker targets. This paper introduces concepts in 3D microfluidic structures, surface chemistry, interface design, and colorimetric chemical reagents that address these opportunities. Demonstrations involve accurate quantification of sweat rate and total loss over a wide range, as well as precise colorimetric sensing of chloride, xanthine, and creatinine, as biomarkers associated with electrolyte balance, purine metabolism, and kidney function, respectively. Benchtop evaluations confirm high sensitivity and reproducibility, while on‐body trials illustrate reliable biomarker tracking in response to dietary intake and physiological activity. These ideas and chemistries expand the possibilities in sweat‐based diagnostic strategies, in strategies that have the potential to align with established, high‐volume manufacturing practices for commercial production.

The increasing demand for continuous, comprehensive physiological information captured by skin-interfaced wireless sensors is hindered by their relatively high-power consumption and the associated patient discomfort that can follow from the use of high capacity batteries. This paper presents an adaptive electronics platform and a tri-modal energy harvesting approach to reduce the need for battery power. Specifically, the schemes focus on sensors that involve light in their operation, through use of (i) photometric methods, where ambient light contributes directly to the measurement process, (ii) multijunction photovoltaic cells, where ambient light powers operation and/or charges an integrated battery, and (iii) photoluminescent packaging, where ambient light activates light-emitting species to enhance the first two schemes. Additional features of interest are in (i) in-sensor computational approaches that decrease the bandwidth and thus the energy consumption in wireless data communication and (ii) radio frequency power transfer for battery charging. These ideas have utility across broad other classes of wearable devices as well as small, portable electronic gadgetry.

Accurate identification of sleep stages and disorders is crucial for maintaining health, preventing chronic conditions, and improving diagnosis and treatment. Direct respiratory measurements, as key biomarkers, are missing in traditional wrist- or finger-worn wearables, which thus limit their precision in detection of sleep stages and sleep disorders. By contrast, this work introduces a simple, multimodal, skin-integrated, energy-efficient mechanoacoustic sensor capable of synchronized cardiac and respiratory measurements. The mechanical design enhances sensitivity and durability, enabling continuous, wireless monitoring of essential vital signs (respiration rate, heart rate and corresponding variability, temperature) and various physical activities. Systematic physiology-based analytics involving explainable machine learning allows both precise sleep characterization and transparent tracking of each factor's contribution, demonstrating the dominance of respiration, as validated through a diverse range of human subjects, both healthy and with sleep disorders. This methodology enables cost-effective, clinical-quality sleep tracking with minimal user effort, suitable for home and clinical use.

Wireless bioresorbable electrical stimulators have broad potential as therapeutic implants. Such devices operate for a clinically relevant duration and then harmlessly dissolve, eliminating the need for surgical removal. A representative application is in treating peripheral nerve injuries through targeted stimulation at either proximal or distal sites, with operation for up to one week. This report introduces enhanced devices with additional capabilities: (1) simultaneous stimulation of both proximal and distal sites, and (2) robust operation for as long as several months, all achieved with materials that naturally resorb by hydrolysis in surrounding biofluids. Systematic investigations of the materials and design aspects highlight the key features that enable dual stimulation and with enhanced stability. Animal model studies illustrate beneficial effects in promoting peripheral nerve regeneration, as quantified by increased total muscle and muscle fiber cross-sectional area and compound muscle action potentials. These findings expand the clinical applications of bioresorbable stimulators, particularly for long-term nerve regeneration and continuous neuromodulation-based monitoring. Wireless bioresorbable stimulators are promising therapeutic implants that naturally dissolve after use. Here, the authors developed a device that operates for months and enables simultaneous multi-site stimulation, preventing early muscle atrophy and accelerating reinnervation in nerve injury models.

Continuous kinematic biofeedback during exercise interventions can lead to improved therapeutic outcomes in hand and wrist rehabilitation. Conventional methods for measuring joint kinematics typically allow only static measurements performed by specially trained therapists. This paper introduces skin-conformal, wearable wireless systems designed to continuously and accurately capture the angles of target joints, specifically in hand and wrist. Supported by a computer vision-based calibration protocol run on a smart device, these magnetometer-based standalone systems provide patients and clinicians with continuous, real-time data on joint angles and ranges of motion through an intuitive graphical interface. Human trials in healthy volunteers demonstrate the accuracy and precision of the electrogoniometry system, as well as its compatibility with simulated hand therapy. We have also demonstrated the electrogoniometry system is suitable for tracking complex and rapid movements and for deployment during occupational tasks where it could serve as a biofeedback device to warn against excessive and clinically contraindicated motion. Real-time joint motion feedback during exercise interventions can enhance hand and wrist rehabilitation. Here, the authors introduce electrogoniometry systems that accurately monitor target joint angles in fingers and wrists in real-time for use in medical and physical activity settings.

PURPOSE: Hand physiotherapy after surgery has been shown to accelerate recovery of joint range of motion (ROM). Our group has designed a wireless, wearable goniometer to allow patients to independently and continuously measure the angle of their proximal interphalangeal (PIP) joint during home therapy exercises. Research has demonstrated that biofeedback during physiotherapy is effective, engaging, and can lead to improved outcomes. Our hope is that the ability to see real-time feedback of joint position during therapy will encourage patients to work harder, complete more exercises, and get the most benefit from their therapy programs. The purpose of this study was to assess the accuracy and feasibility for the use of this novel device during hand physiotherapy. METHODS: Volunteers were fitted with the wearable device about their right PIPJ, which was then actively flexed and extended through its complete range of motion under live fluoroscopy (lateral projection). Paired angular measurements were derived from the wearable device and fluoroscopic images, and this was then repeated for the left PIPJ. Separately, patients donned the wearable device and were guided through four to five positions of progressive flexion. Paired angular measurements were derived from the wearable device and a handheld goniometer operated by a certified hand therapist (CHT). Next, volunteers were guided through a simulated home exercise program (HEP) (composite fist, PIP blocking, blocked extension) by a CHT while the device measured PIPJ angle in real time. The bilateral index, middle, and small fingers were tested in each subject. Bland-Altman plots were used to visualize correspondence between the device measurement and the fluoroscopic or handheld goniometer measurements. Means were compared using a paired t-test. RESULTS: Six volunteers (12 fingers, 259 paired data points) were included in the fluoroscopy portion of the study. Mean difference between device and fluoroscopic measurement was 0.9o (SD = 2.2o, 95% CI = 0.7o - 1.2o), with errors ranging from -4.7o to +5.6o. Nine volunteers (27 fingers, 212 paired data-points) were included in the handheld goniometer portion of the study. Mean difference between device and handheld goniometer measurement was 0.6o (SD = 5.2o, 95% CI = -0.1o - 1.3o), with errors ranging from -13.1o to 12.9o. The device successfully tracked PIPJ angle in real time during a simulated HEP for all fingers tested. CONCLUSION: The wearable goniometer device is acceptably precise and accurate. It can track PIPJ angle during a simulated HEP and is a feasible method of providing biofeedback.

Global access to quality healthcare remains one of the most pressing issues for modern society. Despite advances in wearable and point-of-care biomedical devices, the dissemination of these technologies to resource-limited populations remains challenging, partially due to limitations imposed by cost. One of the largest cost drivers in the adoption of wearable devices for electrophysiological (ExG) monitoring, for instance, is the consumable overhead (electrolytes, adhesives, and electrodes) necessary to support patient use. Herein, we report the development and optimization of ultralow-cost (<0.03 USD per electrode), stable, and resource-available ExG electrolytes fabricated from agricultural byproducts widely available in local settings, thereby negating the dependency on importation. We show that composite hydrogels can be prepared from a variety of starch precursors via a facile one-pot sol–gel method to yield ionically conductive, mechanically compliant gel electrolytes. We further demonstrate that food starch materials for these purposes are resistant to dehydration and, when coupled with a wireless recording platform, can facilitate long-term (8 h) signal recording without significant loss in signal quality. Together, these characteristics mark starch-based electrolytes as possible alternatives to commercial formulations for skin-interfaced measurement electrodes, compatible with mobile sensing apparatus in resource-limited settings with cost, sustainability, and supply chain advantages without sacrificing clinical performance.