Capacitive epidermal electronics for electrically safe, long-term electrophysiological measurements

Mobile and Wireless Technologies in Health Behavior and the Potential for Intensively Adaptive Interventions

Recent advances in mobile and wireless technologies have made real-time assessments of health behaviors and their influences possible with minimal respondent burden. These tech-enabled real-time assessments provide the basis for intensively adaptive interventions (IAIs). Evidence of such studies that adjust interventions based on real-time inputs is beginning to emerge. Although IAIs are promising, the development of intensively adaptive algorithms generate new research questions, and the intensive longitudinal data produced by IAIs require new methodologies and analytic approaches. Research considerations and future directions for IAIs in health behavior research are provided.

Scalable Microfabrication Procedures for Adhesive-Integrated Flexible and Stretchable Electronic Sensors

New classes of ultrathin flexible and stretchable devices have changed the way modern electronics are designed to interact with their target systems. Though more and more novel technologies surface and steer the way we think about future electronics, there exists an unmet need in regards to optimizing the fabrication procedures for these devices so that large-scale industrial translation is realistic. This article presents an unconventional approach for facile microfabrication and processing of adhesive-peeled (AP) flexible sensors. By assembling AP sensors on a weakly-adhering substrate in an inverted fashion, we demonstrate a procedure with 50% reduced end-to-end processing time that achieves greater levels of fabrication yield. The methodology is used to demonstrate the fabrication of electrical and mechanical flexible and stretchable AP sensors that are peeled-off their carrier substrates by consumer adhesives. In using this approach, we outline the manner by which adhesion is maintained and buckling is reduced for gold film processing on polydimethylsiloxane substrates. In addition, we demonstrate the compatibility of our methodology with large-scale post-processing using a roll-to-roll approach.

Fabrication and Characterization of a Conformal Skin-like Electronic System for Quantitative, Cutaneous Wound Management

Recent advances in the development of electronic technologies and biomedical devices offer opportunities for non-invasive, quantitative assessment of cutaneous wound healing on the skin. Existing methods, however, still rely on visual inspections through various microscopic tools and devices that normally include high-cost, sophisticated systems and require well trained personnel for operation and data analysis. Here, we describe methods and protocols to fabricate a conformal, skin-like electronics system that enables conformal lamination to the skin surface near the wound tissues, which provides recording of high fidelity electrical signals such as skin temperature and thermal conductivity. The methods of device fabrication provide details of step-by-step preparation of the microelectronic system that is completely enclosed with elastomeric silicone materials to offer electrical isolation. The experimental study presents multifunctional, biocompatible, waterproof, reusable, and flexible/stretchable characteristics of the device for clinical applications. Protocols of clinical testing provide an overview and sequential process of cleaning, testing setup, system operation, and data acquisition with the skin-like electronics, gently mounted on hypersensitive, cutaneous wound and contralateral tissues on patients.

Breathable and Stretchable Temperature Sensors Inspired by Skin

Flexible electronics attached to skin for healthcare, such as epidermal electronics, has to struggle with biocompatibility and adapt to specified environment of skin with respect to breath and perspiration. Here, we report a strategy for biocompatible flexible temperature sensors, inspired by skin, possessing the excellent permeability of air and high quality of water-proof by using semipermeable film with porous structures as substrate. We attach such temperature sensors to underarm and forearm to measure the axillary temperature and body surface temperature respectively. The volunteer wears such sensors for 24 hours with two times of shower and the in vitro test shows no sign of maceration or stimulation to the skin. Especially, precise temperature changes on skin surface caused by flowing air and water dropping are also measured to validate the accuracy and dynamical response. The results show that the biocompatible temperature sensor is soft and breathable on the human skin and has the excellent accuracy compared to mercury thermometer. This demonstrates the possibility and feasibility of fully using the sensors in long term body temperature sensing for medical use as well as sensing function of artificial skin for robots or prosthesis.

Biodegradable elastomers and silicon nanomembranes/nanoribbons for stretchable, transient electronics, and biosensors

Transient electronics represents an emerging class of technology that exploits materials and/or device constructs that are capable of physically disappearing or disintegrating in a controlled manner at programmed rates or times. Inorganic semiconductor nanomaterials such as silicon nanomembranes/nanoribbons provide attractive choices for active elements in transistors, diodes and other essential components of overall systems that dissolve completely by hydrolysis in biofluids or groundwater. We describe here materials, mechanics, and design layouts to achieve this type of technology in stretchable configurations with biodegradable elastomers for substrate/encapsulation layers. Experimental and theoretical results illuminate the mechanical properties under large strain deformation. Circuit characterization of complementary metal-oxide-semiconductor inverters and individual transistors under various levels of applied loads validates the design strategies. Examples of biosensors demonstrate possibilities for stretchable, transient devices in biomedical applications.

Soft, curved electrode systems capable of integration on the auricle as a persistent brain-computer interface

Recent advances in electrodes for noninvasive recording of electroencephalograms expand opportunities collecting such data for diagnosis of neurological disorders and brain-computer interfaces. Existing technologies, however, cannot be used effectively in continuous, uninterrupted modes for more than a few days due to irritation and irreversible degradation in the electrical and mechanical properties of the skin interface. Here we introduce a soft, foldable collection of electrodes in open, fractal mesh geometries that can mount directly and chronically on the complex surface topology of the auricle and the mastoid, to provide high-fidelity and long-term capture of electroencephalograms in ways that avoid any significant thermal, electrical, or mechanical loading of the skin. Experimental and computational studies establish the fundamental aspects of the bending and stretching mechanics that enable this type of intimate integration on the highly irregular and textured surfaces of the auricle. Cell level tests and thermal imaging studies establish the biocompatibility and wearability of such systems, with examples of high-quality measurements over periods of 2 wk with devices that remain mounted throughout daily activities including vigorous exercise, swimming, sleeping, and bathing. Demonstrations include a text speller with a steady-state visually evoked potential-based brain-computer interface and elicitation of an event-related potential (P300 wave).

Toward flexible and wearable human-interactive health-monitoring devices

This Progress Report introduces flexible wearable health-monitoring devices that interact with a person by detecting from and stimulating the body. Interactive health-monitoring devices should be highly flexible and attach to the body without awareness like a bandage. This type of wearable health-monitoring device will realize a new class of electronics, which will be applicable not only to health monitoring, but also to other electrical devices. However, to realize wearable health-monitoring devices, many obstacles must be overcome to economically form the active electrical components on a flexible substrate using macroscale fabrication processes. In particular, health-monitoring sensors and curing functions need to be integrated. Here recent developments and advancements toward flexible health-monitoring devices are presented, including conceptual designs of human-interactive devices.

Wearable silver nanowire dry electrodes for electrophysiological sensing

We present wearable dry electrodes made of silver nanowires for long-term electrophysiological sensing such as electrocardiography and electromyography.

A high-density nanowire electrode on paper for biomedical applications

Different types of nanowires made from platinum, nickel and copper are fabricated and patterned with microscale resolution on paper substrates and employed for biomedical applications.

Multifunctional skin-like electronics for quantitative, clinical monitoring of cutaneous wound healing

Non-invasive, biomedical devices have the potential to provide important, quantitative data for the assessment of skin diseases and wound healing. Traditional methods either rely on qualitative visual and tactile judgments of a professional and/or data obtained using instrumentation with forms that do not readily allow intimate integration with sensitive skin near a wound site. Here, an electronic sensor platform that can softly and reversibly laminate perilesionally at wounds to provide highly accurate, quantitative data of relevance to the management of surgical wound healing is reported. Clinical studies on patients using thermal sensors and actuators in fractal layouts provide precise time-dependent mapping of temperature and thermal conductivity of the skin near the wounds. Analytical and simulation results establish the fundamentals of the sensing modalities, the mechanics of the system, and strategies for optimized design. The use of this type of "epidermal" electronics system in a realistic clinical setting with human subjects establishes a set of practical procedures in disinfection, reuse, and protocols for quantitative measurement. The results have the potential to address important unmet needs in chronic wound management.

A novel electrocardiogram parameterization algorithm and its application in myocardial infarction detection

The electrocardiogram (ECG) is a biophysical electric signal generated by the heart muscle, and is one of the major measurements of how well a heart functions. Automatic ECG analysis algorithms usually extract the geometric or frequency-domain features of the ECG signals and have already significantly facilitated automatic ECG-based cardiac disease diagnosis. We propose a novel ECG feature by fitting a given ECG signal with a 20th order polynomial function, defined as PolyECG-S. The PolyECG-S feature is almost identical to the fitted ECG curve, measured by the Akaike information criterion (AIC), and achieved a 94.4% accuracy in detecting the Myocardial Infarction (MI) on the test dataset. Currently ST segment elongation is one of the major ways to detect MI (ST-elevation myocardial infarction, STEMI). However, many ECG signals have weak or even undetectable ST segments. Since PolyECG-S does not rely on the information of ST waves, it can be used as a complementary MI detection algorithm with the STEMI strategy. Overall, our results suggest that the PolyECG-S feature may satisfactorily reconstruct the fitted ECG curve, and is complementary to the existing ECG features for automatic cardiac function analysis.

Self-adhesive epidermal carbon nanotube electronics for tether-free long-term continuous recording of biosignals

The long-term, continuous, inconspicuous, and noiseless monitoring of bioelectrical signals is critical to the early diagnosis of disease and monitoring health and wellbeing. However, it is a major challenge to record the bioelectrical signals of patients going about their daily lives because of the difficulties of integrating skin-like conducting materials, the measuring system, and medical technologies in a single platform. In this study, we developed a thin epidermis-like electronics that is capable of repeated self-adhesion onto skin, integration with commercial electronic components through soldering, and conformal contact without serious motion artifacts. Using well-mixed carbon nanotubes and adhesive polydimethylsiloxane, we fabricated an epidermal carbon nanotube electronics which maintains excellent conformal contact even within wrinkles in skin, and can be used to record electrocardiogram signals robustly. The electrode is biocompatible and can even be operated in water, which means patients can live normal lives despite wearing a complicated recording system.