Continuous wireless pressure monitoring and mapping with ultra-small passive sensors for health monitoring and critical care

A Self-Powered Sensor Mimicking Slow- and Fast-Adapting Cutaneous Mechanoreceptors

Highly efficient human skin systems transmit fast adaptive (FA) and slow adaptive (SA) pulses selectively or consolidatively to the brain for a variety of external stimuli. The integrated analysis of these signals determines how humans perceive external physical stimuli. Here, a self-powered mechanoreceptor sensor based on an artificial ion-channel system combined with a piezoelectric film is presented, which can simultaneously implement FA and SA pulses like human skin. This device detects stimuli with high sensitivity and broad frequency band without external power. For the feasibility study, various stimuli are measured or detected. Vital signs such as the heart rate and ballistocardiogram can be measured simultaneously in real time. Also, a variety of stimuli such as the mechanical stress, surface roughness, and contact by a moving object can be distinguished and detected. This opens new scientific fields to realize the somatic cutaneous sensor of the real skin. Moreover, this new sensing scheme inspired by natural sensing structures is able to mimic the five senses of living creatures.

Recent Advances in Wearable Transdermal Delivery Systems

Wearable transdermal delivery systems have recently received tremendous attention due to their noninvasive, convenient, and prolonged administration of pharmacological agents. Here, the material prospects, fabrication processes, and drug-release mechanisms of these types of therapeutic delivery systems are critically reviewed. The latest progress in the development of multifunctional wearable devices capable of closed-loop sensation and drug delivery is also discussed. This survey reveals that wearable transdermal delivery has already made an impact in diverse healthcare applications, while several grand challenges remain.

Noncontact Heartbeat and Respiration Monitoring Based on a Hollow Microstructured Self-Powered Pressure Sensor

Advances in mobile networks and low-power electronics have driven smart mobile medical devices at a tremendous pace, evoking increased interest in household healthcare, especially for those with cardiovascular or respiratory disease. Thus, flexible battery-free pressure sensors, with great potential for monitoring respiration and heartbeat in a smart way, are urgently demanded. However, traditional flexible battery-free pressure sensors for subtle physiological signal detecting are mostly tightly adhered onto the skin instead of working under the pressure of body weight in a noncontact mode, as the low sensitivity in the high-pressure region can hardly meet the demands. Moreover, a hollow microstructure (HM) with higher deformation than solid microstructures and great potential for improving the pressure sensitivity of self-powered sensors has never been investigated. Here, for the first time, we demonstrated a noncontact heartbeat and respiration monitoring system based on a flexible HM-enhanced self-powered pressure sensor, which possesses the advantages of low cost, a high dynamic-pressure sensitivity of 18.98 V·kPa^-1, and a wide working range of 40 kPa simultaneously. Specific superiority of physiological detection under a high pressure is also observed. Continuous reliable heartbeat and respiration information is successfully detected in a noncontact mode and transmitted to a mobile phone.

Fabrications and Performance of Wireless LC Pressure Sensors through LTCC Technology

This paper presents a kind of passive wireless pressure sensor comprised of a planar spiral inductor and a cavity parallel plate capacitor fabricated through low-temperature co-fired ceramic (LTCC) technology. The LTCC material with a low Young's modulus of ~65 GPa prepared by our laboratory was used to obtain high sensitivity. A three-step lamination process was applied to construct a high quality cavity structure without using any sacrificial materials. The effects of the thickness of the sensing membranes on the sensitivity and detection range of the pressure sensors were investigated. The sensor with a 148 μm sensing membrane showed the highest sensitivity of 3.76 kHz/kPa, and the sensor with a 432 μm sensing membrane presented a high detection limit of 2660 kPa. The tunable sensitivity and detection limit of the wireless pressure sensors can meet the requirements of different scenes.

A Highly Stretchable Nanofiber-Based Electronic Skin with Pressure-, Strain-, and Flexion-Sensitive Properties for Health and Motion Monitoring

The development of flexible and stretchable electronic skins that can mimic the complex characteristics of natural skin is of great value for applications in human motion detection, healthcare, speech recognition, and robotics. In this work, we propose an efficient and low-cost fabrication strategy to construct a highly sensitive and stretchable electronic skin that enables the detection of dynamic and static pressure, strain, and flexion based on an elastic graphene oxide (GO)-doped polyurethane (PU) nanofiber membrane with an ultrathin conductive poly(3,4-ethylenedioxythiophene) (PEDOT) coating layer. The three-dimensional porous elastic GO-doped PU@PEDOT composite nanofibrous substrate and the continuous self-assembled conductive pathway in the nanofiber-based electronic skin offer more contact sites, a larger deformation space, and a reversible capacity for pressure and strain sensing, which provide multimodal mechanical sensing capabilities with high sensitivity and a wide sensing range. The nanofiber-based electronic skin sensor demonstrates a high pressure sensitivity (up to 20.6 kPa^-1), a broad sensing range (1 Pa to 20 kPa), excellent cycling stability and repeatability (over 10,000 cycles), and a high strain sensitivity over a wide range (up to approximately 550%). We confirmed the applicability of the nanofiber-based electronic skin to pulse monitoring, expression, voice recognition, and the full range of human motion, demonstrating its potential use in wearable human-health monitoring systems.

Extending the Limits of Wireless Power Transfer to Miniaturized Implantable Electronic Devices

Implantable electronic devices have been evolving at an astonishing pace, due to the development of fabrication techniques and consequent miniaturization, and a higher efficiency of sensors, actuators, processors and packaging. Implantable devices, with sensing, communication, actuation, and wireless power are of high demand, as they pave the way for new applications and therapies. Long-term and reliable powering of such devices has been a challenge since they were first introduced. This paper presents a review of representative state of the art implantable electronic devices, with wireless power capabilities, ranging from inductive coupling to ultrasounds. The different power transmission mechanisms are compared, to show that, without new methodologies, the power that can be safely transmitted to an implant is reaching its limit. Consequently, a new approach, capable of multiplying the available power inside a brain phantom for the same specific absorption rate (SAR) value, is proposed. In this paper, a setup was implemented to quadruple the power available in the implant, without breaking the SAR limits. A brain phantom was used for concept verification, with both simulation and measurement data.

An All-Silk-Derived Dual-Mode E-skin for Simultaneous Temperature-Pressure Detection

Flexible skin-mimicking electronics are highly desired for development of smart human-machine interfaces and wearable human-health monitors. Human skins are able to simultaneously detect different information, such as touch, friction, temperature, and humidity. However, due to the mutual interferences of sensors with different functions, it is still a big challenge to fabricate multifunctional electronic skins (E-skins). Herein, a combo temperature-pressure E-skin is reported through assembling a temperature sensor and a strain sensor in both of which flexible and transparent silk-nanofiber-derived carbon fiber membranes (SilkCFM) are used as the active material. The temperature sensor presents high temperature sensitivity of 0.81% per centigrade. The strain sensor shows an extremely high sensitivity with a gauge factor of ∼8350 at 50% strain, enabling the detection of subtle pressure stimuli that induce local strain. Importantly, the structure of the SilkCFM in each sensor is designed to be passive to other stimuli, enabling the integrated E-skin to precisely detect temperature and pressure at the same time. It is demonstrated that the E-skin can detect and distinguish exhaling, finger pressing, and spatial distribution of temperature and pressure, which cannot be realized using single mode sensors. The remarkable performance of the silk-based combo temperature-pressure sensor, together with its green and large-scalable fabrication process, promising its applications in human-machine interfaces and soft electronics.

Infrared Energy Harvesting in Millimeter-Scale GaAs Photovoltaics

The design and characterization of mm-scale GaAs photovoltaic cells are presented and demonstrate highly efficient energy harvesting in the near infrared. Device performance is improved dramatically by optimization of the device structure for the near-infrared spectral region and improving surface and sidewall passivation with ammonium sulfide treatment and subsequent silicon nitride deposition. The power conversion efficiency of a 6.4 mm2 cell under 660 nW/mm2 NIR illumination at 850 nm is greater than 30 %, which is higher than commercial crystalline silicon solar cells under similar illumination conditions. Critical performance limiting factors of sub-mm scale GaAs photovoltaic cells are addressed and compared to theoretical calculations.

Lab-on-Skin: A Review of Flexible and Stretchable Electronics for Wearable Health Monitoring

Skin is the largest organ of the human body, and it offers a diagnostic interface rich with vital biological signals from the inner organs, blood vessels, muscles, and dermis/epidermis. Soft, flexible, and stretchable electronic devices provide a novel platform to interface with soft tissues for robotic feedback and control, regenerative medicine, and continuous health monitoring. Here, we introduce the term "lab-on-skin" to describe a set of electronic devices that have physical properties, such as thickness, thermal mass, elastic modulus, and water-vapor permeability, which resemble those of the skin. These devices can conformally laminate on the epidermis to mitigate motion artifacts and mismatches in mechanical properties created by conventional, rigid electronics while simultaneously providing accurate, non-invasive, long-term, and continuous health monitoring. Recent progress in the design and fabrication of soft sensors with more advanced capabilities and enhanced reliability suggest an impending translation of these devices from the research lab to clinical environments. Regarding these advances, the first part of this manuscript reviews materials, design strategies, and powering systems used in soft electronics. Next, the paper provides an overview of applications of these devices in cardiology, dermatology, electrophysiology, and sweat diagnostics, with an emphasis on how these systems may replace conventional clinical tools. The review concludes with an outlook on current challenges and opportunities for future research directions in wearable health monitoring.

Flexible Sensors for Pressure Therapy: Effect of Substrate Curvature and Stiffness on Sensor Performance

Flexible pressure sensors are increasingly being used in medical and non-medical applications, and particularly in innovative health monitoring. Their efficacy in medical applications such as compression therapy depends on the accuracy and repeatability of their output, which in turn depend on factors such as sensor type, shape, pressure range, and conformability of the sensor to the body surface. Numerous researchers have examined the effects of sensor type and shape, but little information is available on the effect of human body parameters such as support surfaces' curvature and the stiffness of soft tissues on pressure sensing performance. We investigated the effects of body parameters on the performance of pressure sensors using a custom-made human-leg-like test setup. Pressure sensing parameters such as accuracy, drift and repeatability were determined in both static (eight hours continuous pressure) and dynamic (10 cycles of pressure application of 30 s duration) testing conditions. The testing was performed with a focus on compression therapy application for venous leg ulcer treatments, and was conducted in a low-pressure range of 20-70 mmHg. Commercially available sensors manufactured by Peratech and Sensitronics were used under various loading conditions to determine the influence of stiffness and curvature. Flat rigid, flat soft silicone and three cylindrical silicone surfaces of radii of curvature of 3.5 cm, 5.5 cm and 6.5 cm were used as substrates under the sensors. The Peratech sensor averaged 94% accuracy for both static and dynamic measurements on all substrates; the Sensitronics sensor averaged 88% accuracy. The Peratech sensor displayed moderate variations and the Sensitronics sensor large variations in output pressure readings depending on the underlying test surface, both of which were reduced markedly by individual pressure calibration for surface type. Sensor choice and need for calibration to surface type are important considerations for their application in healthcare monitoring.

Wireless Biological Electronic Sensors

The development of wireless biological electronic sensors could open up significant advances for both fundamental studies and practical applications in a variety of areas, including medical diagnosis, environmental monitoring, and defense applications. One of the major challenges in the development of wireless bioelectronic sensors is the successful integration of biosensing units and wireless signal transducers. In recent years, there are a few types of wireless communication systems that have been integrated with biosensing systems to construct wireless bioelectronic sensors. To successfully construct wireless biological electronic sensors, there are several interesting questions: What types of biosensing transducers can be used in wireless bioelectronic sensors? What types of wireless systems can be integrated with biosensing transducers to construct wireless bioelectronic sensors? How are the electrical sensing signals generated and transmitted? This review will highlight the early attempts to address these questions in the development of wireless biological electronic sensors.

Self-Powered Real-Time Arterial Pulse Monitoring Using Ultrathin Epidermal Piezoelectric Sensors

Continuous monitoring of an arterial pulse using a pressure sensor attached on the epidermis is an important technology for detecting the early onset of cardiovascular disease and assessing personal health status. Conventional pulse sensors have the capability of detecting human biosignals, but have significant drawbacks of power consumption issues that limit sustainable operation of wearable medical devices. Here, a self-powered piezoelectric pulse sensor is demonstrated to enable in vivo measurement of radial/carotid pulse signals in near-surface arteries. The inorganic piezoelectric sensor on an ultrathin plastic achieves conformal contact with the complex texture of the rugged skin, which allows to respond to the tiny pulse changes arising on the surface of epidermis. Experimental studies provide characteristics of the sensor with a sensitivity (≈0.018 kPa^-1 ), response time (≈60 ms), and good mechanical stability. Wireless transmission of detected arterial pressure signals to a smart phone demonstrates the possibility of self-powered and real-time pulse monitoring system.

Wearable Microfluidic Diaphragm Pressure Sensor for Health and Tactile Touch Monitoring

Flexible pressure sensors have many potential applications in wearable electronics, robotics, health monitoring, and more. In particular, liquid-metal-based sensors are especially promising as they can undergo strains of over 200% without failure. However, current liquid-metal-based strain sensors are incapable of resolving small pressure changes in the few kPa range, making them unsuitable for applications such as heart-rate monitoring, which require a much lower pressure detection resolution. In this paper, a microfluidic tactile diaphragm pressure sensor based on embedded Galinstan microchannels (70 µm width × 70 µm height) capable of resolving sub-50 Pa changes in pressure with sub-100 Pa detection limits and a response time of 90 ms is demonstrated. An embedded equivalent Wheatstone bridge circuit makes the most of tangential and radial strain fields, leading to high sensitivities of a 0.0835 kPa^-1 change in output voltage. The Wheatstone bridge also provides temperature self-compensation, allowing for operation in the range of 20-50 °C. As examples of potential applications, a polydimethylsiloxane (PDMS) wristband with an embedded microfluidic diaphragm pressure sensor capable of real-time pulse monitoring and a PDMS glove with multiple embedded sensors to provide comprehensive tactile feedback of a human hand when touching or holding objects are demonstrated.

A Novel Intracranial Pressure Readout Circuit for Passive Wireless LC Sensor

We present a wide frequency range, low cost, wireless intracranial pressure monitoring system, which includes an implantable passive sensor and an external reader. The passive sensor consists of two spiral coils and transduces the pressure change to a resonant frequency shift. The external portable reader reads out the sensor's resonant frequency over a wide frequency range (35 MHz-2.7 GHz). We propose a novel circuit topology, which tracks the system's impedance and phase change at a high frequency with low-cost components. This circuit is very simple and reliable. A prototype has been developed, and measurement results demonstrate that the device achieves a suitable measurement distance (>2 cm), sufficient sample frequency (>6 Hz), fine resolution, and good measurement accuracy for medical practice. Responsivity of this prototype is 0.92 MHz/mmHg and resolution is 0.028 mmHg. COMSOL specific absorption rate simulation proves that this system is safe. Considerations to improve the device performance have been discussed, which include the size of antenna, the power radiation, the Analog-to-digital converter (ADC) choice, and the signal processing algorithm.

On-skin liquid metal inertial sensor

A wireless on-skin inertial sensor based on free-moving liquid metal is introduced. The inertial sensor comprises a eutectic gallium-indium (eGaIn) droplet that modulates the capacitance between two electrodes. The capacitive output of the sensor is connected to a planar coil to form an LC resonator whose resonant frequency can be read out wirelessly. Liquid metal electrodes and the coil are fabricated on a 20 μm thick silicone membrane, which can stretch up to 600%, using spray-deposition of eGaIn. The moving droplet is encapsulated on the opposite side of the membrane using spray-deposition of Dragon Skin 10 silicone. The output characteristics, electrical simulations of the capacitance, and dynamic characteristics of the sensor are shown. The sensor is used for measuring tilt angles and recording arm gestures.

Passive and Space-Discriminative Ionic Sensors Based on Durable Nanocomposite Electrodes toward Sign Language Recognition

This work developed an ionic sensor for human motion monitoring by employing durable H-reduced graphene oxide (RGO)/carbon nanotubes (CNTs)/Ag electrodes and an ionic polymer interlayer. The sensor functions as a result of unbalanced ion transport and accumulation between two electrodes stimulated by applied deformation. The networking structure and stable electrodes provide convenient ion-transport channels and a large ion accumulation space, resulting in a sensitivity of 2.6 mV in the strain range below 1% and high stability over 6000 bending cycles. Ionic sensors are of intense interest motivated by detecting human activities, which usually associate with a large strain or deformation change. More importantly, direction identification and spatial deformation recognition are feasible in this research, which is beneficial for the detection of complex multidimensional activities. Here, an integrated smart glove with several sensors mounted on the hand joints displays a distinguished ability in the complex geometry of hand configurations. Based on its superior performance, the potential applications of this passive ionic sensor in sign language recognition and human-computer interaction are demonstrated.

Passive, wireless transduction of electrochemical impedance across thin-film microfabricated coils using reflected impedance

A new method of wirelessly transducing electrochemical impedance without integrated circuits or discrete electrical components was developed and characterized. The resonant frequency and impedance magnitude at resonance of a planar inductive coil is affected by the load on a secondary coil terminating in sensing electrodes exposed to solution (reflected impedance), allowing the transduction of the high-frequency electrochemical impedance between the two electrodes. Biocompatible, flexible secondary coils with sensing electrodes made from gold and Parylene C were microfabricated and the reflected impedance in response to phosphate-buffered saline solutions of varying concentrations was characterized. Both the resonant frequency and impedance at resonance were highly sensitive to changes in solution conductivity at the secondary electrodes, and the effects of vertical separation, lateral misalignment, and temperature changes were also characterized. Two applications of reflected impedance in biomedical sensors for hydrocephalus shunts and glucose sensing are discussed.

Inductive passive sensor for intraparenchymal and intraventricular monitoring of intracranial pressure

Accurate measurement of intracranial hypertension is crucial for the management of elevated intracranial pressure (ICP). Catheter-based intraventricular ICP measurement is regarded as the gold standard for accurate ICP monitoring. However, this method is invasive, time-limited, and associated with complications. In this paper, we propose an implantable passive sensor that could be used for continuous intraparenchymal and intraventricular ICP monitoring. Moreover, the sensor can be placed simultaneously along with a cerebrospinal fluid shunt system in order to monitor its function. The sensor consists of a flexible coil which is connected to a miniature pressure sensor via an 8-cm long, ultra-thin coaxial cable. An external orthogonal-coil RF probe communicates with the sensor to detect pressure variation. The performance of the sensor was evaluated in an in vitro model for intraparenchymal and intraventricular ICP monitoring. The findings from this study demonstrate proof-of-concept of intraparenchymal and intraventricular ICP measurement using inductive passive pressure sensors.

Smart Sensor Systems for Wearable Electronic Devices

Wearable human interaction devices are technologies with various applications for improving human comfort, convenience and security and for monitoring health conditions. Healthcare monitoring includes caring for the welfare of every person, which includes early diagnosis of diseases, real-time monitoring of the effects of treatment, therapy, and the general monitoring of the conditions of people's health. As a result, wearable electronic devices are receiving greater attention because of their facile interaction with the human body, such as monitoring heart rate, wrist pulse, motion, blood pressure, intraocular pressure, and other health-related conditions. In this paper, various smart sensors and wireless systems are reviewed, the current state of research related to such systems is reported, and their detection mechanisms are compared. Our focus was limited to wearable and attachable sensors. Section 1 presents the various smart sensors. In Section 2, we describe multiplexed sensors that can monitor several physiological signals simultaneously. Section 3 provides a discussion about short-range wireless systems including bluetooth, near field communication (NFC), and resonance antenna systems for wearable electronic devices.

Invasive and noninvasive means of measuring intracranial pressure: a review

Measurement of intracranial pressure (ICP) can be invaluable in the management of critically ill patients. Cerebrospinal fluid is produced by the choroid plexus in the brain ventricles (a set of communicating chambers), after which it circulates through the different ventricles and exits into the subarachnoid space around the brain, where it is reabsorbed into the venous system. If the fluid does not drain out of the brain or get reabsorbed, the ICP increases, which may lead to brain damage or death. ICP elevation accompanied by dilatation of the cerebral ventricles is termed hydrocephalus, whereas ICP elevation accompanied by normal or small ventricles is termed idiopathic intracranial hypertension.

OBJECTIVE

We performed a comprehensive literature review on how to measure ICP invasively and noninvasively.

APPROACH

This review discusses the advantages and disadvantages of current invasive and noninvasive approaches.

MAIN RESULTS

Invasive methods remain the most accurate at measuring ICP, but they are prone to a variety of complications including infection, hemorrhage and neurological deficits. Ventricular catheters remain the gold standard but also carry the highest risk of complications, including difficult or incorrect placement. Direct telemetric intraparenchymal ICP monitoring devices are a good alternative. Noninvasive methods for measuring and evaluating ICP have been developed and classified in five broad categories, but have not been reliable enough to use on a routine basis. These methods include the fluid dynamic, ophthalmic, otic, and electrophysiologic methods, as well as magnetic resonance imaging, transcranial Doppler ultrasonography (TCD), cerebral blood flow velocity, near-infrared spectroscopy, transcranial time-of-flight, spontaneous venous pulsations, venous ophthalmodynamometry, optical coherence tomography of retina, optic nerve sheath diameter (ONSD) assessment, pupillometry constriction, sensing tympanic membrane displacement, analyzing otoacoustic emissions/acoustic measure, transcranial acoustic signals, visual-evoked potentials, electroencephalography, skull vibrations, brain tissue resonance and the jugular vein.

SIGNIFICANCE

This review provides a current perspective of invasive and noninvasive ICP measurements, along with a sense of their relative strengths, drawbacks and areas for further improvement. At present, none of the noninvasive methods demonstrates sufficient accuracy and ease of use while allowing continuous monitoring in routine clinical use. However, they provide a realizable ICP measurement in specific patients especially when invasive monitoring is contraindicated or unavailable. Among all noninvasive ICP measurement methods, ONSD and TCD are attractive and may be useful in selected settings though they cannot be used as invasive ICP measurement substitutes. For a sufficiently accurate and universal continuous ICP monitoring method/device, future research and developments are needed to integrate further refinements of the existing methods, combine telemetric sensors and/or technologies, and validate large numbers of clinical studies on relevant patient populations.

Single-Subject Studies in Translational Nutrition Research

There is a great deal of interest in personalized, individualized, or precision interventions for disease and health-risk mitigation. This is as true of nutrition-based intervention and prevention strategies as it is for pharmacotherapies and pharmaceutical-oriented prevention strategies. Essentially, technological breakthroughs have enabled researchers to probe an individual's unique genetic, biochemical, physiological, behavioral, and exposure profile, allowing them to identify very specific and often nuanced factors that an individual might possess, which may make it more or less likely that he or she responds favorably to a particular intervention (e.g., nutrient supplementation) or disease prevention strategy (e.g., specific diet). However, as compelling and intuitive as personalized nutrition might be in the current era in which data-intensive biomedical characterization of individuals is possible, appropriately and objectively vetting personalized nutrition strategies is not trivial and requires novel study designs and data analytical methods. These designs and methods must consider a very integrated use of the multiple contemporary biomedical assays and technologies that motivate them, which adds to their complexity. Single-subject or N-of-1 trials can be used to assess the utility of personalized interventions and, in addition, can be crafted in such a way as to accommodate the necessarily integrated use of many emerging biomedical technologies and assays. In this review, we consider the motivation, design, and implementation of N-of-1 trials in translational nutrition research that are meant to assess the utility of personalized nutritional strategies. We provide a number of example studies, discuss appropriate analytical methods given the complex data they generate and require, and consider how such studies could leverage integration of various biomarker assays and clinical end points. Importantly, we also consider the development of strategies and algorithms for matching nutritional needs to individual biomedical profiles and the issues surrounding them. Finally, we discuss the limitations of personalized nutrition studies, possible extensions of N-of-1 nutritional intervention studies, and areas of future research.

Passive Wearable Skin Patch Sensor Measures Limb Hemodynamics Based on Electromagnetic Resonance

OBJECTIVE

The objectives of this study were to design and develop an open-circuit electromagnetic resonant skin patch sensor, characterize the fluid volume and resonant frequency relationship, and investigate the sensor's ability to measure limb hemodynamics and pulse volume waveform features.

METHODS

The skin patch was designed from an open-circuit electromagnetic resonant sensor comprised of a single baseline trace of copper configured into a square planar spiral which had a self-resonating response when excited by an external radio frequency sweep. Using a human arm phantom with a realistic vascular network, the sensor's performance to measure limb hemodynamics was evaluated.

RESULTS

The sensor was able to measure pulsatile blood flow which registered as shifts in the sensor's resonant frequencies. The time-varying waveform pattern of the resonant frequency displayed a systolic upstroke, a systolic peak, a dicrotic notch, and a diastolic down stroke. The resonant frequency waveform features and peak systolic time were validated against ultrasound pulse wave Doppler. A statistical correlation analysis revealed a strong correlation () between the resonant sensor peak systolic time and the pulse wave Doppler peak systolic time.

CONCLUSION

The sensor was able to detect pulsatile flow, identify hemodynamic waveform features, and measure heart rate with 98% accuracy.

SIGNIFICANCE

The open-circuit resonant sensor design leverages the architecture of a thin planar spiral which is passive (does not require batteries), robust and lightweight (does not have electrical components or electrical connections), and may be able to wirelessly monitor cardiovascular health and limb hemodynamics.

Effect of temperature variation on remote pressure readout in wirelessly powered intracranial pressure monitoring system

An implantable pressure monitoring system is a compelling approach to home monitoring of intracranial pressure in the long term. In our approach, an on-body unit powers a cranially concealed system where a piezoresistive element senses the pressure. A data transmission unit built in the same platform emits a signal at a pressure dependent frequency through a miniature far field antenna. In this work, we focus on assessing the impact of variable temperature on the pressure readout at an off-body unit through in-vitro experiments.

Flexible Sensing Electronics for Wearable/Attachable Health Monitoring

Wearable or attachable health monitoring smart systems are considered to be the next generation of personal portable devices for remote medicine practices. Smart flexible sensing electronics are components crucial in endowing health monitoring systems with the capability of real-time tracking of physiological signals. These signals are closely associated with body conditions, such as heart rate, wrist pulse, body temperature, blood/intraocular pressure and blood/sweat bio-information. Monitoring such physiological signals provides a convenient and non-invasive way for disease diagnoses and health assessments. This Review summarizes the recent progress of flexible sensing electronics for their use in wearable/attachable health monitoring systems. Meanwhile, we present an overview of different materials and configurations for flexible sensors, including piezo-resistive, piezo-electrical, capacitive, and field effect transistor based devices, and analyze the working principles in monitoring physiological signals. In addition, the future perspectives of wearable healthcare systems and the technical demands on their commercialization are briefly discussed.

Wearable smart sensor systems integrated on soft contact lenses for wireless ocular diagnostics

Wearable contact lenses which can monitor physiological parameters have attracted substantial interests due to the capability of direct detection of biomarkers contained in body fluids. However, previously reported contact lens sensors can only monitor a single analyte at a time. Furthermore, such ocular contact lenses generally obstruct the field of vision of the subject. Here, we developed a multifunctional contact lens sensor that alleviates some of these limitations since it was developed on an actual ocular contact lens. It was also designed to monitor glucose within tears, as well as intraocular pressure using the resistance and capacitance of the electronic device. Furthermore, in-vivo and in-vitro tests using a live rabbit and bovine eyeball demonstrated its reliable operation. Our developed contact lens sensor can measure the glucose level in tear fluid and intraocular pressure simultaneously but yet independently based on different electrical responses.

Evidence of an application of a variable MEMS capacitive sensor for detecting shunt occlusions

A sensor was tested subdural and in vitro, simulating a supine infant with a ventricular-peritoneal shunt and controlled occlusions. The variable MEMS capacitive device is able to detect and forecast blockages, similar to early detection procedures in cancer patients. For example, with gradual occlusion development over a year, the method forecasts a danger over one month ahead of blockage. The method also distinguishes between ventricular and peritoneal occlusions. Because the sensor provides quantitative data on the dynamics of the cerebrospinal fluid, it can help test new therapies and work toward understanding hydrocephalus as well as idiopathic normal pressure hydrocephalus. The sensor appears to be a substantial advance in treating brain injuries treated with shunts and has the potential to bring significant impact in a clinical setting.

Electronic Skin with Multifunction Sensors Based on Thermosensation

A multifunctional electronic skin (e-skin) with multimodal sensing capabilities of perceiving mechanical and thermal stimuli, discriminating matter type, and sensing wind is developed using the thermosensation of a platinum ribbon array, whose temperature varies with conductive or convective heat transfer toward the surroundings. Pressure is perceived by a porous elastomer covering on the heated platinum ribbon, which bears mechanical-thermal conversion to allow high integration with other sensors.

Stretchable electronic skin based on silver nanowire composite fiber electrodes for sensing pressure, proximity, and multidirectional strain

Electronic skin (E-skin) has been attracting great research interest and effort due to its potential applications in wearable health monitoring, smart prosthetics, robot skins and so on. To expand its applications, two key challenges lie in the realization of device stretchability, and independent sensing of pressure and multidirectional lateral strain. Here we made a combination of rational device structure and artfully engineered sensing materials to fulfill the mentioned demands. The as-prepared E-skin took a simple orthogonal configuration to enable both capacitive mode for pressure sensing and resistive mode for multidirectional strain sensing, independently. Pre-cracked silver nanowire based fibers with helical microstructures were utilized as basic electrodes to endow the E-skin with intrinsic stretchability and strain sensing capability. Through dielectric layer optimization, the pressure sensing sensitivity was greatly enhanced, with a detection limit of 1.5 Pa. For application demonstrations, we utilized the E-skin as both flat and curved platforms for pressure mapping, and also as human motion sensors, such as palm and thumb bending.

A microscale optical implant for continuous in vivo monitoring of intraocular pressure

Intraocular pressure (IOP) is a key clinical parameter in glaucoma management. However, despite the potential utility of daily measurements of IOP in the context of disease management, the necessary tools are currently lacking, and IOP is typically measured only a few times a year. Here we report on a microscale implantable sensor that could provide convenient, accurate, on-demand IOP monitoring in the home environment. When excited by broadband near-infrared (NIR) light from a tungsten bulb, the sensor's optical cavity reflects a pressure-dependent resonance signature that can be converted to IOP. NIR light is minimally absorbed by tissue and is not perceived visually. The sensor's nanodot-enhanced cavity allows for a 3-5 cm readout distance with an average accuracy of 0.29 mm Hg over the range of 0-40 mm Hg. Sensors were mounted onto intraocular lenses or silicone haptics and secured inside the anterior chamber in New Zealand white rabbits. Implanted sensors provided continuous in vivo tracking of short-term transient IOP elevations and provided continuous measurements of IOP for up to 4.5 months.

Development of a flexible and stretchable tactile sensor array with two different structures for robotic hand application

A flexible capacitance sensors array for robot hand application which could be used for objects distinction.

Tribotronic Transistor Array as an Active Tactile Sensing System

Large-scale tactile sensor arrays are of great importance in flexible electronics, human-robot interaction, and medical monitoring. In this paper, a flexible 10 × 10 tribotronic transistor array (TTA) is developed as an active tactile sensing system by incorporating field-effect transistor units and triboelectric nanogenerators into a polyimide substrate. The drain-source current of each tribotronic transistor can be individually modulated by the corresponding external contact, which has induced a local electrostatic potential to act as the conventional gate voltage. By scaling down the pixel size from 5 × 5 to 0.5 × 0.5 mm², the sensitivities of single pixels are systematically investigated. The pixels of the TTA show excellent durability, independence, and synchronicity, which are suitable for applications in real-time tactile sensing, motion monitoring, and spatial mapping. The integrated tribotronics provides an unconventional route to realize an active tactile sensing system, with prospective applications in wearable electronics, human-machine interfaces, fingerprint identification, and so on.

Wireless, Room Temperature Volatile Organic Compound Sensor Based on Polypyrrole Nanoparticle Immobilized Ultrahigh Frequency Radio Frequency Identification Tag

Due to rapid advances in technology which have contributed to the development of portable equipment, highly sensitive and selective sensor technology is in demand. In particular, many approaches to the modification of wireless sensor systems have been studied. Wireless systems have many advantages, including unobtrusive installation, high nodal densities, low cost, and potential commercial applications. In this study, we fabricated radio frequency identification (RFID)-based wireless sensor systems using carboxyl group functionalized polypyrrole (C-PPy) nanoparticles (NPs). The C-PPy NPs were synthesized via chemical oxidation copolymerization, and then their electrical and chemical properties were characterized by a variety of methods. The sensor system was composed of an RFID reader antenna and a sensor tag made from a commercially available ultrahigh frequency RFID tag coated with C-PPy NPs. The C-PPy NPs were covalently bonded to the tag to form a passive sensor. This type of sensor can be produced at a very low cost and exhibits ultrahigh sensitivity to ammonia, detecting concentrations as low as 0.1 ppm. These sensors operated wirelessly and maintained their sensing performance as they were deformed by bending and twisting. Due to their flexibility, these sensors may be used in wearable technologies for sensing gases.

An Angstrom-sensitive, differential MEMS capacitor for monitoring the milliliter dynamics of fluids

A device, with MEMS sensors at its core, has been fabricated and tested for measuring low fluid pressure and slow flow rates. The motivation was to measure clinically relevant ranges of slow-moving fluids in living systems, such as the cerebrospinal fluid in the brain. For potential clinical utility, the device can be read transcutaneously by inductive coupling to MEMS capacitive sensors in circuits with resonance frequencies in the MHz range. Signal shifts for flow rates in the range of 0-42 mL/h and differential pressure levels between 0.1 and 2 kPa have been measured, because the sensitivity in the capacitance gap measurement is about 1 Å. The sensors have been used successfully to monitor simulated cerebrospinal fluid dynamics. The device does not utilize any internal power, since it is powered externally via the inductive coupling.

Self-Powered, One-Stop, and Multifunctional Implantable Triboelectric Active Sensor for Real-Time Biomedical Monitoring

Operation time of implantable electronic devices is largely constrained by the lifetime of batteries, which have to be replaced periodically by surgical procedures once exhausted, causing physical and mental suffering to patients and increasing healthcare costs. Besides the efficient scavenging of the mechanical energy of internal organs, this study proposes a self-powered, flexible, and one-stop implantable triboelectric active sensor (iTEAS) that can provide continuous monitoring of multiple physiological and pathological signs. As demonstrated in human-scale animals, the device can monitor heart rates, reaching an accuracy of ∼99%. Cardiac arrhythmias such as atrial fibrillation and ventricular premature contraction can be detected in real-time. Furthermore, a novel method of monitoring respiratory rates and phases is established by analyzing variations of the output peaks of the iTEAS. Blood pressure can be independently estimated and the velocity of blood flow calculated with the aid of a separate arterial pressure catheter. With the core-shell packaging strategy, monitoring functionality remains excellent during 72 h after closure of the chest. The in vivo biocompatibility of the device is examined after 2 weeks of implantation, proving suitability for practical use. As a multifunctional biomedical monitor that is exempt from needing an external power supply, the proposed iTEAS holds great potential in the future of the healthcare industry.

Pursuing prosthetic electronic skin

Skin plays an important role in mediating our interactions with the world. Recreating the properties of skin using electronic devices could have profound implications for prosthetics and medicine. The pursuit of artificial skin has inspired innovations in materials to imitate skin's unique characteristics, including mechanical durability and stretchability, biodegradability, and the ability to measure a diversity of complex sensations over large areas. New materials and fabrication strategies are being developed to make mechanically compliant and multifunctional skin-like electronics, and improve brain/machine interfaces that enable transmission of the skin's signals into the body. This Review will cover materials and devices designed for mimicking the skin's ability to sense and generate biomimetic signals.

Dual-channel NIR activatable theranostic prodrug for in vivo spatiotemporal tracking thiol-triggered chemotherapy

Real-time tracking for where (W), when (W), and how (H) prodrugs are delivered and activated in vivo is a great challenge for prodrug development. Disulfide linkage-based prodrugs as well as their delivery systems have been studied extensively, but the WWH question in spatial and temporal (spatiotemporal) precision remains unanswered. Herein, we present a novel prodrug of camptothecin (CPT) linked to a near-infrared (NIR) cyanine dye via a disulfide linkage (Cy-S-CPT). The cleavage of the disulfide bond in Cy-S-CPT by endogenous glutathione (GSH) can activate the anti-cancer drug CPT and induce a remarkable fluorescence shift from 825 to 650 nm, thereby providing dual fluorescent channels to real-time track the prodrug biodistribution and activation in vivo. Impressively, the dual-channel NIR fluorescence bioimaging exhibits the pervasive drug distribution, i.e., the biodistribution of the intact prodrug was traced at the 825 nm-NIR fluorescence channel, whereas the activated drug was tracked at the 650 nm red fluorescence channel. In this way, we can overcome the blind spot in the metabolism kinetics of prodrugs in a certain organ or tissue. As demonstrated, the prodrug prompts activation in all the organs, particularly in the liver after an intravenous injection, and achieves predominant accumulation and activation in tumors at 24 h post injection. Cy-S-CPT loaded in PEG-PLA nanoparticles display significantly improved therapeutic efficacy and low side effects with respect to the clinical used drug CPT-11. As a consequence, the NIR spatiotemporal bioimaging in vivo with dual fluorescence channels allows the prodrug release profile to be extracted precisely, particularly in visualizing drug-released information from complex biological systems such as mice, thereby providing a unique opportunity to take insight into the relationship between theranosis and pharmacokinetics.

Thiol-epoxy/maleimide ternary networks as softening substrates for flexible electronics

Softening microelectrode arrays, or flexible bioelectronic systems which can dynamically change modulus under the application of an external stimulus such as heat or electromagnetic radiation, have been of significant interest in the literature within the previous decade. Through their ability to actively soften in vivo, these devices have shown the capacity to attenuate the neuronal damage associated with insertion of rigid microelectrode arrays into soft tissue. Thiol-click substrates specifically have shown particularly impressive results for fabricating devices requiring small-scale, high-performance electronics for neural recording. However, previous attempts to engineer increasingly lower-modulus substrates for these devices have failed due to the fundamental chemistries' (the thioether linkage) flexibility. This failure has led to substrates without sufficient mechanical rigidity for penetrating soft tissue at physiological temperatures, or sufficient softening capacity to reduce the mechanical mismatch between soft tissue and implantable device. In this work, a ternary thiol-epoxy/maleimide network is investigated as a potential substrate materials space in which the degree of softening can be modulated without sacrificing the mechanical rigidity at physiological temperatures. Using these networks as platforms for the microfabrication of electrode arrays, example implantable intracortical microelectrode arrays are fabricated on both thiol-epoxy and thiol-epoxy/maleimide networks to demonstrate the insertion capacity of microelectrode arrays on the ternary polymer networks.

A Wireless Pressure Sensor Integrated with a Biodegradable Polymer Stent for Biomedical Applications

This paper describes the fabrication and characterization of a wireless pressure sensor for smart stent applications. The micromachined pressure sensor has an area of 3.13 × 3.16 mm² and is fabricated with a photosensitive SU-8 polymer. The wireless pressure sensor comprises a resonant circuit and can be used without the use of an internal power source. The capacitance variations caused by changes in the intravascular pressure shift the resonance frequency of the sensor. This change can be detected using an external antenna, thus enabling the measurement of the pressure changes inside a tube with a simple external circuit. The wireless pressure sensor is capable of measuring pressure from 0 mmHg to 230 mmHg, with a sensitivity of 0.043 MHz/mmHg. The biocompatibility of the pressure sensor was evaluated using cardiac cells isolated from neonatal rat ventricular myocytes. After inserting a metal stent integrated with the pressure sensor into a cardiovascular vessel of an animal, medical systems such as X-ray were employed to consistently monitor the condition of the blood vessel. No abnormality was found in the animal blood vessel for approximately one month. Furthermore, a biodegradable polymer (polycaprolactone) stent was fabricated with a 3D printer. The polymer stent exhibits better sensitivity degradation of the pressure sensor compared to the metal stent.

Flexible and Stretchable Physical Sensor Integrated Platforms for Wearable Human-Activity Monitoringand Personal Healthcare

Flexible and stretchable physical sensors that can measure and quantify electrical signals generated by human activities are attracting a great deal of attention as they have unique characteristics, such as ultrathinness, low modulus, light weight, high flexibility, and stretchability. These flexible and stretchable physical sensors conformally attached on the surface of organs or skin can provide a new opportunity for human-activity monitoring and personal healthcare. Consequently, in recent years there has been considerable research effort devoted to the development of flexible and stretchable physical sensors to fulfill the requirements of future technology, and much progress has been achieved. Here, the most recent developments of flexible and stretchable physical sensors are described, including temperature, pressure, and strain sensors, and flexible and stretchable sensor-integrated platforms. The latest successful examples of flexible and stretchable physical sensors for the detection of temperature, pressure, and strain, as well as their novel structures, technological innovations, and challenges, are reviewed first. In the next section, recent progress regarding sensor-integrated wearable platforms is overviewed in detail. Some of the latest achievements regarding self-powered sensor-integrated wearable platform technologies are also reviewed. Further research direction and challenges are also proposed to develop a fully sensor-integrated wearable platform for monitoring human activity and personal healthcare in the near future.

Wearable, wireless gas sensors using highly stretchable and transparent structures of nanowires and graphene

Herein, we report the fabrication of a highly stretchable, transparent gas sensor based on silver nanowire-graphene hybrid nanostructures. Due to its superb mechanical and optical characteristics, the fabricated sensor demonstrates outstanding and stable performances even under extreme mechanical deformation (stable until 20% of strain). The integration of a Bluetooth system or an inductive antenna enables the wireless operation of the sensor. In addition, the mechanical robustness of the materials allows the device to be transferred onto various nonplanar substrates, including a watch, a bicycle light, and the leaves of live plants, thereby achieving next-generation sensing electronics for the 'Internet of Things' area.

Stretchable and Multimodal All Graphene Electronic Skin

A transparent and stretchable all-graphene multifunctional electronic-skin sensor matrix is developed. Three different functional sensors are included in this matrix: humidity, thermal, and pressure sensors. These are judiciously integrated into a layer-by-layer geometry through a simple lamination process.

Biocompatible Pressure Sensing Skins for Minimally Invasive Surgical Instruments

This paper presents 800-μm thick, biocompatible sensing skins composed of arrays of pressure sensors. The arrays can be configured to conform to the surface of medical instruments so as to act as disposable sensing skins. In particular, the fabrication of cylindrical geometries is considered here for use on endoscopes. The sensing technology is based on polydimethylsiloxane synthetic silicone encapsulated microchannels filled with a biocompatible salt-saturated glycerol solution, functioning as the conductive medium. A multi-layer manufacturing approach is introduced that enables stacking sensing microchannels, mechanical stress concentration features, and electrical routing via flexcircuits in a thickness of less than 1 mm. The proposed approach is inexpensive and does not require clean room tools or techniques. The mechanical stress concentration features are implemented using a patterned copper layer that serves to improve sensing range and sensitivity. Sensor performance is demonstrated experimentally using a sensing skin mounted on a neuroendoscope insertion cannula and is shown to outperform previously developed non-biocompatible sensors.

Mobile technology and the digitization of healthcare

The convergence of science and technology in our dynamic digital era has resulted in the development of innovative digital health devices that allow easy and accurate characterization in health and disease. Technological advancements and the miniaturization of diagnostic instruments to modern smartphone-connected and mobile health (mHealth) devices such as the iECG, handheld ultrasound, and lab-on-a-chip technologies have led to increasing enthusiasm for patient care with promises to decrease healthcare costs and to improve outcomes. This 'hype' for mHealth has recently intersected with the 'real world' and is providing important insights into how patients and practitioners are utilizing digital health technologies. It is also raising important questions regarding the evidence supporting widespread device use. In this state-of-the-art review, we assess the current literature of mHealth and aim to provide a framework for the advances in mHealth by understanding the various device, patient, and clinical factors as they relate to digital health from device designs and patient engagement, to clinical workflow and device regulation. We also outline new strategies for generation and analysis of mHealth data at the individual and population-based levels.

Fingertip skin-inspired microstructured ferroelectric skins discriminate static/dynamic pressure and temperature stimuli

In human fingertips, the fingerprint patterns and interlocked epidermal-dermal microridges play a critical role in amplifying and transferring tactile signals to various mechanoreceptors, enabling spatiotemporal perception of various static and dynamic tactile signals. Inspired by the structure and functions of the human fingertip, we fabricated fingerprint-like patterns and interlocked microstructures in ferroelectric films, which can enhance the piezoelectric, pyroelectric, and piezoresistive sensing of static and dynamic mechanothermal signals. Our flexible and microstructured ferroelectric skins can detect and discriminate between multiple spatiotemporal tactile stimuli including static and dynamic pressure, vibration, and temperature with high sensitivities. As proof-of-concept demonstration, the sensors have been used for the simultaneous monitoring of pulse pressure and temperature of artery vessels, precise detection of acoustic sounds, and discrimination of various surface textures. Our microstructured ferroelectric skins may find applications in robotic skins, wearable sensors, and medical diagnostic devices.

Recent Progress in Electronic Skin

The skin is the largest organ of the human body and can sense pressure, temperature, and other complex environmental stimuli or conditions. The mimicry of human skin's sensory ability via electronics is a topic of innovative research that could find broad applications in robotics, artificial intelligence, and human-machine interfaces, all of which promote the development of electronic skin (e-skin). To imitate tactile sensing via e-skins, flexible and stretchable pressure sensor arrays are constructed based on different transduction mechanisms and structural designs. These arrays can map pressure with high resolution and rapid response beyond that of human perception. Multi-modal force sensing, temperature, and humidity detection, as well as self-healing abilities are also exploited for multi-functional e-skins. Other recent progress in this field includes the integration with high-density flexible circuits for signal processing, the combination with wireless technology for convenient sensing and energy/data transfer, and the development of self-powered e-skins. Future opportunities lie in the fabrication of highly intelligent e-skins that can sense and respond to variations in the external environment. The rapidly increasing innovations in this area will be important to the scientific community and to the future of human life.

Wireless Hydrogen Smart Sensor Based on Pt/Graphene-Immobilized Radio-Frequency Identification Tag

Hydrogen, a clean-burning fuel, is of key importance to various industrial applications, including fuel cells and the aerospace and automotive industries. However, hydrogen gas is odorless, colorless, and highly flammable; thus, appropriate safety protocol implementation and monitoring are essential. Highly sensitive hydrogen-gas leak detection and surveillance systems are needed; additionally, the ability to monitor large areas (e.g., cities) via wireless networks is becoming increasingly important. In this report, we introduce a radio frequency identification (RFID)-based wireless smart-sensor system, composed of a Pt-decorated reduced graphene oxide (Pt_rGO)-immobilized RFID sensor tag and an RFID-reader antenna-connected network analyzer to detect hydrogen gas. The Pt_rGOs, produced using a simple chemical reduction process, were immobilized on an antenna pattern in the sensor tag through spin coating. The resulting Pt_rGO-based RFID sensor tag exhibited a high sensitivity to hydrogen gas at unprecedentedly low concentrations (1 ppm), with wireless communication between the sensor tag and RFID-reader antenna. The wireless sensor tag demonstrated flexibility and a long lifetime due to the strong immobilization of Pt_rGOs on the substrate and battery-independent operation during hydrogen sensing, respectively.

Facile and Scalable Preparation of Solid Silver Nanoparticles (<10 nm) for Flexible Electronics

Metal conductive ink for flexible electroncs has exhibited a promising future recently. Here, an innovative strategy was reported to synthesize silver nanocolloid (2.5±0.5 nm) and separate solid silver nanoparticles (<10 nm) effectively. Specifically, silver nitrate (AgNO3) was used as a silver precursor, sodium borohydride (NaBH4) as a reducing agent, fatty acid (CnH2n+1COOH) as a dispersant agent, and ammonia (NH3·H2O) and hydrochloride (HCl) as a pH regulator and complexing agent in aqueous solution. The main mechanism is the solubility changes of fatty acid salts (CnH2n+1COO-NH4+) and fatty acid (CnH2n+1COOH) coated on the synthesized silver nanoparticles (NPs) in aqueous solution. This change determines the suspension and precipitation of silver NPs directly. The results show that when n in dispersant is 12 and molar ratio (C12H24O2/AgNO3) is 1.0, the separation yield of silver NPs is up to 94.8%. After sintering at 125 °C for 20 min, the as-prepared conductive silver nanoink (20 wt %) presents a satisfactory resistivity (as low as 6.6 μΩ·cm on the polyester-PET substrate), about 4 times the bulk silver. In addition, the efficacy of the as-prepared conductive ink was verified with the construction of a radio frequency antenna by inkjet printing and conductive character pattern (Fudan-Fudan) by direct wiring, showing excellent electrical performance.

Dissolution chemistry and biocompatibility of silicon- and germanium-based semiconductors for transient electronics

Semiconducting materials are central to the development of high-performance electronics that are capable of dissolving completely when immersed in aqueous solutions, groundwater, or biofluids, for applications in temporary biomedical implants, environmentally degradable sensors, and other systems. The results reported here include comprehensive studies of the dissolution by hydrolysis of polycrystalline silicon, amorphous silicon, silicon-germanium, and germanium in aqueous solutions of various pH values and temperatures. In vitro cellular toxicity evaluations demonstrate the biocompatibility of the materials and end products of dissolution, thereby supporting their potential for use in biodegradable electronics. A fully dissolvable thin-film solar cell illustrates the ability to integrate these semiconductors into functional systems.