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Here, an H\u207a\u2010exchange strategy is reported that markedly enhances the sensing performance of sodium titanate (Na\n                    <jats:sub>2<\/jats:sub>\n                    Ti\n                    <jats:sub>3<\/jats:sub>\n                    O\n                    <jats:sub>7<\/jats:sub>\n                    , NTO) by introducing abundant surface hydroxyl groups and tuning conduction pathways. In H\u207a\u2010exchanged NTO (H\u2010NTO), hydroxyl groups act as selective adsorption sites for formaldehyde, while formaldehyde adsorption simultaneously suppresses surface\u2010proton and internal\u2010electron conduction by increasing the activation energy for proton hopping and generating electron\u2010trapping states. This dual modulation effectively eliminates cross\u2010sensitivity to other VOCs (e.g., methanol), enabling H\u2010NTO to achieve an ultralow detection limit of 2 ppb, a wide dynamic range up to 100\u00a0ppm, and stable operation over two months\u2014contrasting with the negligible response of pristine NTO. To demonstrate practical utility, we developed a handheld H\u2010NTO prototype for wireless indoor air\u2010quality monitoring and non\u2010invasive breath\u2010based breast cancer screening. Coupled with machine learning, the system achieved high diagnostic accuracy, establishing H\u207a\u2010exchange as a powerful route toward next\u2010generation intelligent formaldehyde sensors.\n                  <\/jats:p>","DOI":"10.1002\/advs.202518324","type":"journal-article","created":{"date-parts":[[2025,12,9]],"date-time":"2025-12-09T03:46:08Z","timestamp":1765251968000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["H\u207a Exchange\u2010Driven ppb\u2010Level and High\u2010Selective Formaldehyde Detection at Room Temperature for Environmental and Clinical Applications"],"prefix":"10.1002","volume":"13","author":[{"given":"Lubing","family":"Cai","sequence":"first","affiliation":[{"name":"Department of Chemistry College of Sciences Northeastern University  Shenyang Liaoning 110819 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