Wearable and flexible electronics for continuous molecular monitoring

Can Wearable Sweat Lactate Sensors Contribute to Sports Physiology?

The rise of wearable sensors to measure lactate content in human sweat during sports activities has attracted the attention of physiologists given the potential of these “analytical tools” to provide real-time information. Beyond the assessment of the sensing technology per se, which, in fact, has not rigorously been validated yet in controlled conditions, there are many open questions about the true usefulness of such wearable sensors in real scenarios. On the one hand, the evidence for the origin of sweat lactate (e.g., via the sweat gland, derivation from blood, or other alternative mechanisms), its high concentration (1–25 mM or even higher) compared to levels in the blood, and the possible correlation between different biofluids (particularly blood) is rather contradictory and generates vivid debate in the field. On the other hand, it is important to point out that accurate detection of sweat lactate is highly dependent on the procedure used to collect and/or reach the fluid, and this can likely explain the large discrepancies reported in the literature. In brief, this paper provides our vision of the current state of the field and a thoughtful evaluation of the possible reasons for present controversies, together with an analysis of the impact of wearable sweat lactate sensors in the physiological context. Finally, although there is not yet overwhelming scientific evidence to provide an unequivocal answer to whether wearable sweat lactate sensors can contribute to sports physiology, we still understand the importance to bring this challenging question up-front to create awareness and guidance in the development, validation, and implementation of wearable sensors.

Flexible Biosensors Based on Colorimetry, Fluorescence, and Electrochemistry for Point-of-Care Testing

With the outbreak and pandemic of COVID-19, point-of-care testing (POCT) systems have been attracted much attention due to their significant advantages of small batches of samples, user-friendliness, easy-to-use and simple detection. Among them, flexible biosensors show practical significance as their outstanding properties in terms of flexibility, portability, and high efficiency, which provide great convenience for users. To construct highly functional flexible biosensors, abundant kinds of polymers substrates have been modified with sufficient properties to address certain needs. Paper-based biosensors gain considerable attention as well, owing to their foldability, lightweight and adaptability. The other important flexible biosensor employs textiles as substrate materials, which has a promising prospect in the area of intelligent wearable devices. In this feature article, we performed a comprehensive review about the applications of flexible biosensors based on the classification of substrate materials (polymers, paper and textiles), and illustrated the strategies to design effective and artificial sensing platforms, including colorimetry, fluorescence, and electrochemistry. It is demonstrated that flexible biosensors play a prominent role in medical diagnosis, prognosis, and healthcare.

Digital printing of selective and reversible ion optodes on fabrics: toward smart clothes for epidermal chemical sensing

While wearable chemical sensors often rely on electrochemical techniques, optical chemical sensors coupled with a smartphone or a miniaturized camera represent an attractive approach to the monitoring of sweat composition. In this paper, we modify real sports fabrics such as polyester-spandex fabrics with rational combinations of sensing chemicals including a pH indicator, an ion exchanger, and an ionophore via one-step inkjet printing. Highly selective and fully reversible pH optodes as well as Na⁺- and K⁺-selective optodes are obtained only when the most hydrophobic sensing chemicals are used (e.g., sodium ionophore VIII vs. sodium ionophore VI). These sensors exhibit large color-based responses that can be readily identified by naked eye or analyzed via an iPhone app. Their dynamic ranges well cover the physiological sweat concentrations of the analytes. Compared to most other sensors created on garments, our fabric-based optodes are cost-effective, mass-reproducible by the digital printing technology currently used in the textile industry, and do not significantly compromise the essential properties of fabrics such as flexibility, stretchability, wickability, and breathability.

Organic Bioelectronic Devices for Metabolite Sensing

Electrochemical detection of metabolites is essential for early diagnosis and continuous monitoring of a variety of health conditions. This review focuses on organic electronic material-based metabolite sensors and highlights their potential to tackle critical challenges associated with metabolite detection. We provide an overview of the distinct classes of organic electronic materials and biorecognition units used in metabolite sensors, explain the different detection strategies developed to date, and identify the advantages and drawbacks of each technology. We then benchmark state-of-the-art organic electronic metabolite sensors by categorizing them based on their application area (in vitro, body-interfaced, in vivo, and cell-interfaced). Finally, we share our perspective on using organic bioelectronic materials for metabolite sensing and address the current challenges for the devices and progress to come.

Wirelessly operated bioelectronic sutures for the monitoring of deep surgical wounds

Monitoring surgical wounds post-operatively is necessary to prevent infection, dehiscence and other complications. However, the monitoring of deep surgical sites is typically limited to indirect observations or to costly radiological investigations that often fail to detect complications before they become severe. Bioelectronic sensors could provide accurate and continuous monitoring from within the body, but the form factors of existing devices are not amenable to integration with sensitive wound tissues and to wireless data transmission. Here we show that multifilament surgical sutures functionalized with a conductive polymer and incorporating pledgets with capacitive sensors operated via radiofrequency identification can be used to monitor physicochemical states of deep surgical sites. We show in live pigs that the sutures can monitor wound integrity, gastric leakage and tissue micromotions, and in rodents that the healing outcomes are equivalent to those of medical-grade sutures. Battery-free wirelessly operated bioelectronic sutures may facilitate post-surgical monitoring in a wide range of interventions.

3D Temporary-Magnetized Soft Robotic Structures for Enhanced Energy Harvesting

The advent of functional materials offers tremendous potential in a broad variety of areas such as electronics, robotics, and energy devices. Magnetic materials are an attractive candidate that enable multifunctional devices with capabilities in both sensing and actuation. However, current magnetic devices, especially those with complex motion modalities, rely on permanently magnetized materials with complicated, non-uniform magnetization profiles. Here, based on magnetic materials with temporary-magnetization, a mechanically guided assembly process successfully converts laser-patterned 2D magnetic materials into judiciously engineered 3D structures, with dimensions and geometries ranging from mesoscale 3D filaments, to arrayed centimeter-scale 3D membranes. With tailorable mechanical properties and highly adjustable geometries, 3D soft structures can exhibit various tethered locomotions under the precise control of magnetic fields, including local deformation, unidirectional tilting, and omnidirectional rotation, and can serve as dynamic surfaces for further integration with other functional materials or devices. Examples demonstrated here focus on energy-harvesting systems, including 3D piezoelectric devices for noncontact conversion of mechanical energy and active motion sensing, as well as 3D solar tracking systems. The design strategy and resulting magnetic-controlled 3D soft structures hold great promise not only for enhanced energy harvesting, but also for multimodal sensing, robotic interfaces, and biomedical devices.

Corona-Enabled Electrostatic Printing for Ultra-fast Manufacturing of Binder-Free Multifunctional E-Skins

As essential components in intelligent systems, printed soft electronics (PSEs) are playing crucial roles in public health, national security, and economics. Innovations in printing technologies are required to promote the broad application of high-performance PSEs at a low cost. However, current printing techniques are still facing long-lasting challenges in addressing the conflict between printing speed and performance. To overcome this challenge, we developed a new corona-enabled electrostatic printing (CEP) technique for ultra-fast (milliseconds) roll-to-roll (R2R) manufacturing of binder-free multifunctional e-skins. The printing capability and controllability of CEP were investigated through parametric studies and microstructure observation. The electric field generation, material transfer, and particle amount and size selecting mechanisms were numerically and experimentally studied. CEP-printed graphene e-skins were demonstrated to possess an outstanding strain sensing performance. The binder-free feature of the CEP-assembled networks enables them to provide pressure sensitivity as low as 2.5 Pa and capability to detect acoustic signals of hundreds of hertz in frequency. Furthermore, the CEP technique was utilized to pattern different types of functional materials (e.g., graphene and thermochromic polymers) onto different substrates (e.g., tape and textile). Overall, this study demonstrated that CEP can be a novel contactless and ultra-fast manufacturing platform compatible with the R2R process for fabricating high-performance, scalable, and low-cost soft electronics.

Self-Powered Smart Arm Training Band Sensor Based on Extremely Stretchable Hydrogel Conductors

The development of elastic electronic technology has promoted the application of triboelectric nanogenerators (TENGs) in flexible wearable electronics. However, most of the flexible electronics cannot achieve the requirements of being extremely stretchable, transparent, and highly conductive at the same time. Herein, we report a TENG constructed using a double-network polymer ionic conductor sodium alginate/zinc sulfate/poly acrylic-acrylamide (SA-Zn) hydrogel, which exhibited outstanding stretchability (>10,000%), high transparency (>95%), and good conductivity (0.34 S·m^-1). The SA-Zn hydrogel TENG (SH-TENG) could harvest energy from typical human movements, such as bending, stretching, and twisting, which could light up 234 green commercial LEDs easily. Additionally, the SH-TENG can be used to prepare a self-powered smart training band sensor for monitoring arm stretching motion. This work may provide an innovative platform for accessing the next generation of sustainable wearable and sports monitoring electronics.

Non-invasive wearable chemical sensors in real-life applications

Over the past decade, non-invasive wearable chemical sensors have gained tremendous attention in the field of personal health monitoring and medical diagnosis. These sensors provide non-invasive, real-time, and continuous monitoring of targeted biomarkers with more simplicity than the conventional diagnostic approaches. This review primarily describes the substrate materials used for sensor fabrication, sample collection and handling, and analytical detection techniques that are utilized to detect biomarkers in different biofluids. Common substrates including paper, textile, and hydrogel for wearable sensor fabrication are discussed. Principles and applications of colorimetric and electrochemical detection in wearable chemical sensors are illustrated. Data transmission systems enabling wireless communication between the sensor and output devices are also discussed. Finally, examples of different designs of wearable chemical sensors including tattoos, garments, and accessories are shown. Successful development of non-invasive wearable chemical sensors will effectively help users to manage their personal health, predict the potential diseases, and eventually improve the overall quality of life.

Why gender is relevant to materials science and engineering

For historical reasons science today has substantially more evidence for males and men than for females and women, which means that quality of research and innovation outcomes may often be worse for women than for men. I explore how the gender dimension-a term used to mean effects of biological (sex) and/or socio-cultural (gender) characteristics-fits into new materials research and engineering and especially in nano-materials applications. Horizon Europe expects that grant proposals should include explanation if gender dimension is relevant to the project's objectives. This paper shows that often the answer should be yes it is.

E-Skin: The Dawn of a New Era of On-Body Monitoring Systems

Real-time "on-body" monitoring of human physiological signals through wearable systems developed on flexible substrates (e-skin) is the next target in human health control and prevention, while an alternative to bulky diagnostic devices routinely used in clinics. The present work summarizes the recent trends in the development of e-skin systems. Firstly, we revised the material development for e-skin systems. Secondly, aspects related to fabrication techniques were presented. Next, the main applications of e-skin systems in monitoring, such as temperature, pulse, and other bio-electric signals related to health status, were analyzed. Finally, aspects regarding the power supply and signal processing were discussed. The special features of e-skin as identified contribute clearly to the developing potential as in situ diagnostic tool for further implementation in clinical practice at patient personal levels.

Temporal profiling of cytokines in passively expressed sweat for detection of infection using wearable device

This work presents the viability of passive eccrine sweat as a functional biofluid toward tracking the human body's inflammatory response. Cytokines are biomarkers that orchestrate the manifestation and progression of an infection/inflammatory event. Hence, noninvasive, real-time monitoring of cytokines can be pivotal in assessing the progression of infection/inflammatory event, which may be feasible through monitoring of host immune markers in eccrine sweat. This work is the first experimental proof demonstrating the ability to detect inflammation/infection such as fever, FLU directly from passively expressed sweat in human subjects using a wearable "SWEATSENSER" device. The developed SWEATSENSER device demonstrates stable, real-time monitoring of inflammatory cytokines in passive sweat. An accuracy of >90% and specificity >95% was achieved using SWEATSENSER for a panel of cytokines (interleukin-6, interleukin-8, interleukin-10, and tumor necrosis factor-α) over an analytical range of 0.2-200 pg mL-1. The SWEATSENSER demonstrated a correlation of Pearson's r > 0.98 for the study biomarkers in a cohort of 26 subjects when correlated with standard reference method. Comparable IL-8 levels (2-15 pg mL-1) between systemic circulation (serum) and eccrine sweat through clinical studies in a cohort of 15 subjects, and the ability to distinguish healthy and sick (infection) cohort using inflammatory cytokines in sweat provides pioneering evidence of the SWEATSENSER technology for noninvasive tracking of host immune response biomarkers. Such a wearable device can offer significant strides in improving prognosis and provide personalized therapeutic treatment for several inflammatory/infectious diseases.

Wearable Glucose Monitoring and Implantable Drug Delivery Systems for Diabetes Management

The global cost of diabetes care exceeds $1 trillion each year with more than $327 billion being spent in the United States alone. Despite some of the advances in diabetes care including continuous glucose monitoring systems and insulin pumps, the technology associated with managing diabetes has largely remained unchanged over the past several decades. With the rise of wearable electronics and novel functional materials, the field is well-poised for the next generation of closed-loop diabetes care. Wearable glucose sensors implanted within diverse platforms including skin or on-tooth tattoos, skin-mounted patches, eyeglasses, contact lenses, fabrics, mouthguards, and pacifiers have enabled noninvasive, unobtrusive, and real-time analysis of glucose excursions in ambulatory care settings. These wearable glucose sensors can be integrated with implantable drug delivery systems, including an insulin pump, glucose responsive insulin release implant, and islets transplantation, to form self-regulating closed-loop systems. This review article encompasses the emerging trends and latest innovations of wearable glucose monitoring and implantable insulin delivery technologies for diabetes management with a focus on their advanced materials and construction. Perspectives on the current unmet challenges of these strategies are also discussed to motivate future technological development toward improved patient care in diabetes management.

Programmable receptors enable bacterial biosensors to detect pathological biomarkers in clinical samples

Bacterial biosensors, or bactosensors, are promising agents for medical and environmental diagnostics. However, the lack of scalable frameworks to systematically program ligand detection limits their applications. Here we show how novel, clinically relevant sensing modalities can be introduced into bactosensors in a modular fashion. To do so, we have leveraged a synthetic receptor platform, termed EMeRALD (Engineered Modularized Receptors Activated via Ligand-induced Dimerization) which supports the modular assembly of sensing modules onto a high-performance, generic signaling scaffold controlling gene expression in E. coli. We apply EMeRALD to detect bile salts, a biomarker of liver dysfunction, by repurposing sensing modules from enteropathogenic Vibrio species. We improve the sensitivity and lower the limit-of-detection of the sensing module by directed evolution. We then engineer a colorimetric bactosensor detecting pathological bile salt levels in serum from patients having undergone liver transplant, providing an output detectable by the naked-eye. The EMeRALD technology enables functional exploration of natural sensing modules and rapid engineering of synthetic receptors for diagnostics, environmental monitoring, and control of therapeutic microbes.

Energy Autonomous Sweat-Based Wearable Systems

The continuous operation of wearable electronics demands reliable sources of energy, currently met through Li-ion batteries and various energy harvesters. These solutions are being used out of necessity despite potential safety issues and unsustainable environmental impact. Safe and sustainable energy sources can boost the use of wearables systems in diverse applications such as health monitoring, prosthetics, and sports. In this regard, sweat- and sweat-equivalent-based studies have attracted tremendous attention through the demonstration of energy-generating biofuel cells, promising power densities as high as 3.5 mW cm-2 , storage using sweat-electrolyte-based supercapacitors with energy and power densities of 1.36 Wh kg-1 and 329.70 W kg-1 , respectively, and sweat-activated batteries with an impressive energy density of 67 Ah kg-1 . A combination of these energy generating, and storage devices can lead to fully energy-autonomous wearables capable of providing sustainable power in the µW to mW range, which is sufficient to operate both sensing and communication devices. Here, a comprehensive review covering these advances, addressing future challenges and potential solutions related to fully energy-autonomous wearables is presented, with emphasis on sweat-based energy storage and energy generation elements along with sweat-based sensors as applications.

Soft Wearable Healthcare Materials and Devices

In spite of advances in electronics and internet technologies, current healthcare remains hospital-centred. Disruptive technologies are required to translate state-of-art wearable devices into next-generation patient-centered diagnosis and therapy. In this review, recent advances in the emerging field of soft wearable materials and devices are summarized. A prerequisite for such future healthcare devices is the need of novel materials to be mechanically compliant, electrically conductive, and biologically compatible. It is begun with an overview of the two viable design strategies reported in the literatures, which is followed by description of state-of-the-art wearable healthcare devices for monitoring physical, electrophysiological, chemical, and biological signals. Self-powered wearable bioenergy devices are also covered and sensing systems, as well as feedback-controlled wearable closed-loop biodiagnostic and therapy systems. Finally, it is concluded with an overall summary and future perspective.

State of Sweat: Emerging Wearable Systems for Real-Time, Noninvasive Sweat Sensing and Analytics

Skin-interfaced wearable systems with integrated colorimetric assays, microfluidic channels, and electrochemical sensors offer powerful capabilities for noninvasive, real-time sweat analysis. This Perspective details recent progress in the development and translation of novel wearable sensors for personalized assessment of sweat dynamics and biomarkers, with precise sampling and real-time analysis. Sensor accuracy, system ruggedness, and large-scale deployment in remote environments represent key opportunity areas, enabling broad deployment in the context of field studies, clinical trials, and recent commercialization. On-body measurements in these contexts show good agreement compared to conventional laboratory-based sweat analysis approaches. These device demonstrations highlight the utility of biochemical sensing platforms for personalized assessment of performance, wellness, and health across a broad range of applications.

Smart Fibers and Textiles for Personal Health Management

Fibers and textiles play key roles in the development and day-to-day activities of human society. Innovations related to flexible electronics-smart fibers and textiles with sensing, thermal regulation, and energy management capabilities-have drawn great interest from both academic and industrial communities. Smart fibers and textiles are anticipated to revolutionize personal health management due to their manifold features and capabilities, providing the foundation for many intelligent wearables. In this Perspective, we provide a brief overview of recent advances in the design and fabrication of smart fibers and textiles for health management applications, focusing primarily on those with sensing, thermal regulation, and energy management functions. We describe the existing challenges and opportunities and propose future development directions.

Flexible and Conductive Bioelectrodes Based on Chitosan-Carbon Black Membranes: Towards the Development of Wearable Bioelectrodes

Wearable sensors for non-invasive monitoring constitute a growing technology in many industrial fields, such as clinical or sport monitoring. However, one of the main challenges in wearable sensing is the development of bioelectrodes via the use of flexible and stretchable materials capable of maintaining conductive and biocompatible properties simultaneously. In this study, chitosan-carbon black (CH-CB) membranes have been synthesized using a straightforward and versatile strategy and characterized in terms of their composition and their electrical and mechanical properties. In this sense, CH-CB membranes showed good conductivity and mechanical resistance thanks to the presence of carbon black, which decreases the insulating behavior of chitosan, while flexibility and biocompatibility are maintained due to the dual composition of the membrane. Thus, flexible and biocompatible conductive bioelectrodes have been developed by the combined use of CH and CB without the use of toxic reagents, extra energy input, or long reaction times. The membranes were modified using the enzymes Glucose Oxidase and Laccase in order to develop flexible and biocompatible bioelectrodes for enzymatic glucose biofuel cells (BFCs) and glucose detection. A BFC assembled using the flexible bioelectrodes developed was able to deliver 15 µW cm^-2, using just 1 mM glucose as biofuel, and up to 21.3 µW·cm^-2 with higher glucose concentration. Additionally, the suitability of the CH-CB membranes to be used as a glucose sensor in a linear range from 100 to 600 µM with a limit of detection (LOD) of 76 µM has been proven. Such demonstrations for energy harvesting and sensing capabilities of the developed membrane pave the way for their use in wearable sensing and energy harvesting technologies in the clinical field due to their good mechanical, electrical, and biocompatible properties.

Hidden Markov model-based heartbeat detector using electrocardiogram and arterial pressure signals

The automatic detection of a heartbeat is commonly performed by detecting the QRS complex in the electrocardiogram (ECG), however, various noise sources and missing data can jeopardize the reliability of the ECG. Therefore, there is a growing interest in combining the information from many physiological signals to accurately detect heartbeats. To this end, hidden Markov models (HMMs) are used in this work to jointly exploit the information from ECG, arterial blood pressure (ABP) and pulmonary arterial pressure (PAP) signals in order to conceive a heartbeat detector. After preprocessing the physiological signals, a sliding window is used to extract an observation sequence to be passed through two HMMs (previously trained on a training dataset) in order to obtain the log-likelihoods of observation and signals a detection if the difference of log-likelihoods exceeds an adaptive threshold. Several HMM-based heartbeat detectors were conceived to exploit the information from the ECG, ABP and PAP signals from the MIT-BIH Arrhythmia, PhysioNet Computing in Cardiology Challenge 2014, and MGH/MF Waveform databases. A grid search methodology was used to optimize the duration of the observation sequence and a multiplicative factor to form the adaptive threshold. Using the optimal parameters found on a training database through 10-fold cross-validation, sensitivity and positive predictivity above 99% were obtained on the MIT-BIH Arrhythmia and PhysioNet Computing in Cardiology Challenge 2014 databases, while they are above 95% in the MGH/MF waveform database using ECG and ABP signals. Our detector approach showed detection performances comparable with the literature in the three databases.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13534-021-00192-x.

Functionalization Strategies of PEDOT and PEDOT:PSS Films for Organic Bioelectronics Applications

Organic bioelectronics involves the connection of organic semiconductors with living organisms, organs, tissues, cells, membranes, proteins, and even small molecules. In recent years, this field has received great interest due to the development of all kinds of devices architectures, enabling the detection of several relevant biomarkers, the stimulation and sensing of cells and tissues, and the recording of electrophysiological signals, among others. In this review, we discuss recent functionalization approaches for PEDOT and PEDOT:PSS films with the aim of integrating biomolecules for the fabrication of bioelectronics platforms. As the choice of the strategy is determined by the conducting polymer synthesis method, initially PEDOT and PEDOT:PSS films preparation methods are presented. Later, a wide variety of PEDOT functionalization approaches are discussed, together with bioconjugation techniques to develop efficient organic-biological interfaces. Finally, and by making use of these approaches, the fabrication of different platforms towards organic bioelectronics devices is reviewed.

Recent progress for silver nanowires conducting film for flexible electronics

Silver nanowires (AgNWs), as one-dimensional nanometallic materials, have attracted wide attention due to the excellent electrical conductivity, transparency and flexibility, especially in flexible and stretchable electronics. However, the microscopic discontinuities require AgNWs be attached to some carrier for practical applications. Relative to the preparation method, how to integrate AgNWs into the flexible matrix is particularly important. In recent years, plenty of papers have been published on the preparation of conductors based on AgNWs, including printing techniques, coating techniques, vacuum filtration techniques, template-assisted assembly techniques, electrospinning techniques and gelating techniques. The aim of this review is to discuss different assembly method of AgNW-based conducting film and their advantages.

GRAPHIC ABSTRACT

Conducting films based on silver nanowires (AgNWs) have been reviewed with a focus on their assembly and their advantages.

Wearable Biosensors for Non-Invasive Sweat Diagnostics

Recent advances in microfluidics, microelectronics, and electrochemical sensing methods have steered the way for the development of novel and potential wearable biosensors for healthcare monitoring. Wearable bioelectronics has received tremendous attention worldwide due to its great a potential for predictive medical modeling and allowing for personalized point-of-care-testing (POCT). They possess many appealing characteristics, for example, lightweight, flexibility, good stretchability, conformability, and low cost. These characteristics make wearable bioelectronics a promising platform for personalized devices. In this paper, we review recent progress in flexible and wearable sensors for non-invasive biomonitoring using sweat as the bio-fluid. Real-time and molecular-level monitoring of personal health states can be achieved with sweat-based or perspiration-based wearable biosensors. The suitability of sweat and its potential in healthcare monitoring, sweat extraction, and the challenges encountered in sweat-based analysis are summarized. The paper also discusses challenges that still hinder the full-fledged development of sweat-based wearables and presents the areas of future research.

Inorganic Perovskite Quantum Dot-Based Strain Sensors for Data Storage and In-Sensor Computing

Although remarkable improvement has been achieved in stretchable strain sensors, challenges still exist in aspects including intelligent sensing, simultaneous data processing, and scalable fabrication techniques. In this work, a strain-sensitive device is presented by fabricating a CsPbBr₃ quantum dots (QDs) floating-gate field-effect transistor (FET) sensing array on thin polyimide (PI) films. The FET exhibits an excellent on/off ratio (>10³) and a large memory window (>2 V). With the introduction of CsPbBr₃ QDs as the trapping layer, an additional UV response is obtained because of the photogenerated charge carriers that significantly enhance the source-drain current (I_DS) of the device. At each electrical state, the I_DS varies with the strains and the sensing range is from compressive +12.5% to tensile -10.8%. Excellent data retainability and mechanical durability demonstrate the high quality and reliability of the fabricated sensors. Furthermore, synapse functions including long-term potentiation (LTP), long-term depression (LTD), etc., are emulated at the device level. Linearity factor changes of LTP/LTD in different sensing scenarios demonstrate the reliability of the device and further confirm the different sensing mechanisms with/without UV illumination. Our results exhibit the potential of transistor-based devices for multifunctional intelligent sensing.

Flexible triphase enzyme electrode based on hydrophobic porous PVDF membrane for high-performance bioassays

Flexible bioassays based on oxidase-catalyzed and electrocatalytic cascade reactions have been widely reported. However, the fluctuant oxygen level and high anodic potential restricts the detection accuracy. To overcome these challenges, we report here a flexible triphase enzyme electrode by assembling an oxidase enzyme layer and Pt electrocatalysts onto a carbon nanotube film/porous polyvinylidene fluoride hydrophobic substrate. Such a flexible enzyme electrode has an air-liquid-solid triphase reaction zone where oxygen level is air phase dependent (constant and sufficient high), which stabilized the oxidase kinetics and enabled the cathodic measurement of enzymatic product H₂O₂ with minimum interferents caused from oxygen level fluctuation and many oxidizable species in analyte solution. Furthermore, the flexible triphase enzyme electrode exhibited good mechanical stability even after being bent over 600 times and an excellent air permeability, which are crucial to wearable devices that require long-term skin contact.

Low dimensional materials for glucose sensing

Biosensors are essential components for effective healthcare management. Since biological processes occur on molecular scales, nanomaterials and nanosensors intrinsically provide the most appropriate landscapes for developing biosensors. Low-dimensional materials have the advantage of offering high surface areas, increased reactivity and unique physicochemical properties for efficient and selective biosensing. So far, nanomaterials and nanodevices have offered significant prospects for glucose sensing. Targeted glucose biosensing using such low-dimensional materials enables much more effective monitoring of blood glucose levels, thus providing significantly better predictive diabetes diagnostics and management. In this review, recent advances in using low dimensional materials for sensing glucose are summarized. Sensing fundamentals are discussed, as well as invasive, minimally-invasive and non-invasive sensing methods. The effects of morphological characteristics and size-dependent properties of low dimensional materials are explored for glucose sensing, and the key performance parameters such as selectivity, stability and sensitivity are also discussed. Finally, the challenges and future opportunities that low dimensional materials can offer for glucose sensing are outlined.

Dual Network Sponge for Compressible Lithium-Ion Batteries

Compressible energy devices have received increasing attention with the rapid development of flexible electronics and wearable devices due to their size adaptability and functional stability. However, it is hard to simultaneously achieve satisfactory energy density and mechanical stability for electrodes. Here an open-porous dual network sponge (DNS) with two networks of highly conductive carbon nanotubes and Li⁺ -intercalating TiO₂ -B nanowires is synthesized and employed as compressible lithium ion battery electrodes. All 1D components inside the DNS mutually penetrate with each other to form two physically distinct but functionally coupling networks, endowing DNS excellent compressibility and stability. A prototype compressible lithium-ion battery (C-LIB) is also demonstrated, in which the DNS exhibits a specific capacity of >238 mAh g^-1 under static 50% strain, and further in situ measurements show that under 1000 times of cyclic strains, DNS can charge and discharge normally maintaining a high capacity of 240 mAh g^-1 and exhibits robustness to fast strain rates up to 500% min^-1 . The dual network structure can be extended to design high-performance compliant electrodes that are promising to serve in future compressible and deformable electronics and energy systems.

Bio-inspired fractal textile device for rapid sweat collection and monitoring

In this study, a new design concept in sweat collection was developed to achieve rapid and intact sweat sampling for analytical purposes. Textiles with fast water wicking properties were first selected and laser engraved into tree-like bifurcating channels for sweat collection. The fractal framework of the bifurcating textile channels was theoretically derived to minimize the flow resistance for fast sweat absorption. The optimized collector with designed fractal geometry exhibited thorough coverage of emerging droplets without overflow. Great collection efficiency was achieved with a short induction time (<1 minute after perspiration begins) and a maximum sweat collection flux up to 4.0 μL cm-2 min-1 without leakage. After being combined with printed sensors and microchips, the assembled sweat collection/sensing device can simultaneously provide measurements of salt concentration and sweat rate for wireless hydration state monitoring. The collection/sensing system also exhibited fast response times to abrupt changes in sweat rates or concentrations and thus can be used to detect instant physical conditions in exercise. Finally, field tests were performed to demonstrate the reliability and practicality of the device in real-time sweat monitoring under vigorous activities.

Bioresorbable Photonics: Materials, Devices and Applications

Bio-photonic devices that utilize the interaction between light and biological substances have been emerging as an important tool for clinical diagnosis and/or therapy. At the same time, implanted biodegradable photonic devices can be disintegrated and resorbed after a predefined operational period, thus avoiding the risk and cost associated with the secondary surgical extraction. In this paper, the recent progress on biodegradable photonics is reviewed, with a focus on material strategies, device architectures and their biomedical applications. We begin with a brief introduction of biodegradable photonics, followed by the material strategies for constructing biodegradable photonic devices. Then, various types of biodegradable photonic devices with different functionalities are described. After that, several demonstration examples for applications in intracranial pressure monitoring, biochemical sensing and drug delivery are presented, revealing the great potential of biodegradable photonics in the monitoring of human health status and the treatment of human diseases. We then conclude with the summary of this field, as well as current challenges and possible future directions.

Stretchable and Superwettable Colorimetric Sensing Patch for Epidermal Collection and Analysis of Sweat

Stretchable and wearable sensors allow intimate integration with the human body for health and fitness monitoring. In addition to the acquisition of various physical parameters, quantitative analysis of chemical biomarkers present in sweat may provide vital insights into the physiological state of an individual. A widely investigated system utilizes electrochemical techniques for continuous monitoring of these biomarkers. The required supporting electronics and batteries are often challenging to form a deformable system. In this study, an intrinsically stretchable sensing patch is developed with compliant mechanical properties for conformal attachment to the skin and reliable collection of sweat. In these patches, superhydrophilic colorimetric assays consisting of thermoplastic polyurethane nanofiber textiles decorated with silica nanoparticles are assembled over a styrene-ethylene-butylene-styrene-based superhydrophobic substrate, thereby generating a large wettability contrast to efficiently concentrate the sweat. The system supports multiplexed colorimetric analysis of sweat to quantify pH and ion concentrations with images acquired using smartphones, in which the influence of ambient lighting conditions is largely compensated with a set of reference color markers. Successful demonstrations of in situ analysis of sweat after physical exercises effectively illustrate the practical suitability of the sensing patch, which is attractive for advanced health monitoring, clinical diagnostics, and competitive sports.

Non-toxic near-infrared light-emitting diodes

Harnessing cost-efficient printable semiconductor materials as near-infrared (NIR) emitters in light-emitting diodes (LEDs) is extremely attractive for sensing and diagnostics, telecommunications, and biomedical sciences. However, the most efficient NIR LEDs suitable for printable electronics rely on emissive materials containing precious transition metal ions (such as platinum), which have triggered concerns about their poor biocompatibility and sustainability. Here, we review and highlight the latest progress in NIR LEDs based on non-toxic and low-cost functional materials suitable for solution-processing deposition. Different approaches to achieve NIR emission from organic and hybrid materials are discussed, with particular focus on fluorescent and exciplex-forming host-guest systems, thermally activated delayed fluorescent molecules, aggregation-induced emission fluorophores, as well as lead-free perovskites. Alternative strategies leveraging photonic microcavity effects and surface plasmon resonances to enhance the emission of such materials in the NIR are also presented. Finally, an outlook for critical challenges and opportunities of non-toxic NIR LEDs is provided.

Microneedle-Based Potentiometric Sensing System for Continuous Monitoring of Multiple Electrolytes in Skin Interstitial Fluids

Electrolytes play a pivotal role in regulating cardiovascular functions, hydration, and muscle activation. The current standards for monitoring electrolytes involve periodic sampling of blood and measurements using laboratory techniques, which are often uncomfortable/inconvenient to the subjects and add considerable expense to the management of their underlying disease conditions. The wide range of electrolytes in skin interstitial fluids (ISFs) and their correlations with those in plasma create exciting opportunities for applications such as electrolyte and circadian metabolism monitoring. However, it has been challenging to monitor these electrolytes in the skin ISFs. In this study, we report a minimally invasive microneedle-based potentiometric sensing system for multiplexed and continuous monitoring of Na⁺ and K⁺ in the skin ISFs. The potentiometric sensing system consists of a miniaturized stainless-steel hollow microneedle to prevent sensor delamination and a set of modified microneedle electrodes for multiplex monitoring. We demonstrate the measurement of Na⁺ and K⁺ in artificial ISFs with a fast response time, excellent reversibility and repeatability, adequate selectivity, and negligible potential interferences upon the addition of a physiologically relevant concentration of metabolites, dietary biomarkers, and nutrients. In addition, the sensor maintains the sensitivity after multiple insertions into the chicken skin model. Furthermore, the measurements in artificial ISFs using calibrated sensors confirm the accurate measurements of physiological electrolytes in artificial ISFs. Finally, the skin-mimicking phantom gel and chicken skin model experiments demonstrate the sensor's potential for minimally invasive monitoring of electrolytes in skin ISFs. The developed sensor platform can be adapted for a wide range of other applications, including real-time monitoring of nutrients, metabolites, and proteins.

Catalytic effects of magnetic and conductive nanoparticles on immobilized glucose oxidase in skin sensors

Wearable skin sensors is a promising technology for real-time health care monitoring. They are of particular interest for monitoring glucose in diabetic patients. The concentration of glucose in sweat can be more than two orders of magnitude lower than in blood. In consequence, the scientific and technological efforts are focused in developing new concepts to enhance the sensitivity, decrease the limit of detection (LOD) and reduce the response time (RT) of glucose skin sensors. This work explores the effect of adsorbed superparamagnetic magnetite nanoparticles (MNPs) and conductive nanoparticles (CNPs) on carbon nanotube substrates (CNTs) used to immobilize glucose oxidase enzyme in the working electrode of skin sensors. MNPs and CNPs are made of magnetite and gold, respectively. The performance of the sensors was tested in standard buffer solution, artificial sweat, fresh sweat and on the skin of a healthy volunteer during an exercise session. In the case of artificial sweat, the presence of MNPs accelerated the RT from 7 to 5 s at the expense of increasing the LOD from 0.017 to 0.022 mM with slight increase of the sensitivity from 4.90 to 5.09μAm M^-1cm^-2. The presence of CNPs greatly accelerated the RT from 7 to 2 s and lowered the LOD from 0.017 to 0.014 mM at the expense of a great diminution of the sensitivity from 4.90 to 4.09μAm M^-1cm^-2. These effects were explained mechanistically by analyzing the changes in the concentration of free oxygen and electrons promoted by MNPs and CNPs in the CNTs and its consequences on the the glucose oxidation process.

Paper-based wearable electronics

Skin-interfaced wearable electronics can find a broad spectrum of applications in healthcare, human-machine interface, robotics, and others. The state-of-the-art wearable electronics usually suffer from costly and complex fabrication procedures and nonbiodegradable polymer substrates. Paper, comprising entangled micro- or nano-scale cellulose fibers, is compatible with scalable fabrication techniques and emerges as a sustainable, inexpensive, disposable, and biocompatible substrate for wearable electronics. Given various attractive properties (e.g., breathability, flexibility, biocompatibility, and biodegradability) and rich tunability of surface chemistry and porous structures, paper offers many exciting opportunities for wearable electronics. In this review, we first introduce the intriguing properties of paper-based wearable electronics and strategies for cellulose modifications to satisfy specific demands. We then overview the applications of paper-based devices in biosensing, energy storage and generation, optoelectronics, soft actuators, and several others. Finally, we discuss some challenges that need to be addressed before practical uses and wide implementation of paper-based wearable electronics.

SP, N. M, Barik AK, Pai KM, Unnikrishnan VK, George SD, Kartha VB, Chidangil S. Photonics of human saliva: potential optical methods for the screening of abnormal health conditions and infections

Human saliva can be treated as a pool of biological markers able to reflect on the state of personal health. Recent years have witnessed an increase in the use of optical devices for the analysis of body fluids. Several groups have carried out studies investigating the potential of saliva as a non-invasive and reliable clinical specimen for use in medical diagnostics. This brief review aims to highlight the optical technologies, mainly surface plasmon resonance (SPR), Raman, and Fourier transform infrared (FTIR) spectroscopy, which are being used for the probing of saliva for diverse biomedical applications. Advances in bio photonics offer the promise of unambiguous, objective and fast detection of abnormal health conditions and viral infections (such as COVID-19) from the analysis of saliva.

Energy-efficient IoT based improved health monitoring system for sports persons

Nowadays, wearable technology and the Internet of Things (IoT) are transforming the healthcare sector by refining the way how devices, applications, and people connect and interact with each other. IoT applications in sports are tremendously useful to monitor health and reduce the risk factor. The battery life of wearable and accurate monitoring has been considered a significant challenge in sports medicine. Hence, in this paper, Energy Efficient IoT based Improved Health Monitoring system (EEIoT-IHMS) has been proposed for accurate and continuous sports person’s health monitoring system. This paper determines the optimal set of clusters based on sensor features, in which power usage has been minimized by duty cycling with optimized prediction accuracy. The experimental results demonstrate that the proposed (EEIoT-IHMS) enhances accuracy ratio, improves battery life, and reduces energy consumption compared to other popular methods.

Novel Conformal Skin Patch with Embedded Thin-Film Electrodes for Early Detection of Extravasation

Extravasation is a complication of intravenous (IV) cannulation in which vesicant drugs leak from a vein into the surrounding subcutaneous tissue. The severity of extravasation depends on the type, concentration, and volume of drugs that accumulate in the subcutaneous tissue. Rapid detection of extravasation can facilitate prompt medical intervention, minimizing tissue damage, and preventing adverse events. In this study, we present two portable sensor patches, namely gold- and carbon-based sensing patches, for early detection of extravasation. The gold-based sensor patch detected extravasated fluid of volume as low as 2 mL in in vivo animal models and human clinical trials; the patch exhibited a resistance change of 41%. The carbon-based sensor patch exhibited a resistance change of 51% for 2 mL of extravasated fluid, and fabrication throughput and cost-effectiveness are superior for this patch compared with the gold-based sensing patch.

A review on nanostructured thin films on flexible substrates: links between strains and magnetic properties

This paper provides a topical review of work on systems based on magnetic nanostructured thin films on polymer substrates. This topic has indeed experienced a significant growth in the last ten years. Several studies show a strong potential of these systems for a number of applications requiring functionalities on non-planar surfaces. However, the deformations necessary for this type of applications are likely to modify their magnetic properties, and the relationships between strain fields, potential damages and functional properties must be well understood. This review focuses both on the development of techniques dedicated to this research, on the synthesis of the experimental results obtained over the last ten years and on the perspectives related to stretchable or flexible magnetoelectric systems. In particular, the article focuses on the links between magnetic behavior and the strain field developing during the whole history of these systems (elaboration, reversible and irreversible loading).

Stretchable wideband dipole antennas and rectennas for RF energy harvesting

The ultimate application of bio-integrated, stretchable electronics hinges on the indispensable modules of stretchable wireless data transmission and power supplies. While radiofrequency (RF) antennas and rectennas could enable wireless communication and RF energy harvesting in the far-field, their performance deteriorates because of the frequency detuning from mechanical deformations. Here, stretchable wideband antennas and rectennas are introduced to robustly operate and combine received RF power over their wideband upon mechanical deformations. Devices with stretchable wideband antennas and rectennas create application opportunities such as self-powered systems, remote monitoring of the environment, and clean energy. A comprehensive set of manufacturing schemes, device components, and theoretical design tools for the stretchable wideband antennas and rectennas is reported. A stretchable wideband rectenna integrated with various functional sensing modules and its demonstration with enhanced effective rectenna efficiency over the state-of-the-art by 10-100 times illustrates a system-level example of this technology.

A flexible multiplexed immunosensor for point-of-care in situ wound monitoring

Chronic wounds arise from interruption of normal healing due to many potential pathophysiological factors. Monitoring these multivariate factors can provide personalized diagnostic information for wound management, but current sensing technologies use complex laboratory tests or track a limited number of wound parameters. We report a flexible biosensing platform for multiplexed profiling of the wound microenvironment, inflammation, and infection state at the point of care. This platform integrates a sensor array for measuring inflammatory mediators [tumor necrosis factor-α, interleukin-6 (IL-6), IL-8, and transforming growth factor-β1], microbial burden (Staphylococcus aureus), and physicochemical parameters (temperature and pH) with a microfluidic wound exudate collector and flexible electronics for wireless, smartphone-based data readout. We demonstrate in situ multiplexed monitoring in a mouse wound model and also profile wound exudates from patients with venous leg ulcers. This technology may facilitate more timely and personalized wound management to improve chronic wound healing outcomes.

Small-volume detection: platform developments for clinically-relevant applications

Biochemical analysis of human body fluids is a frequent and fruitful strategy for disease diagnosis. Point-of-care (POC) diagnostics offers the tantalizing possibility of providing rapid diagnostic results in non-laboratory settings. Successful diagnostic testing using body fluids has been reported on in the literature; however, small-volume detection devices, which offer remarkable advantages such as portability, inexpensiveness, capacity for mass production, and tiny sample volume requirements have not been thoroughly discussed. Here, we review progress in this research field, with a focus on developments since 2015. In this review article, we provide a summary of articles that have detailed the development of small-volume detection strategies using clinical samples over the course of the last 5 years. Topics covered include small-volume detection strategies in ophthalmology, dermatology or plastic surgery, otolaryngology, and cerebrospinal fluid analysis. In ophthalmology, advances in technology could be applied to examine tear or anterior chamber (AC) fluid for glucose, lactoferrin, interferon, or VEGF. These approaches could impact detection and care for diseases including diabetic mellitus, dry-eye disease, and age-related maculopathy. Early detection and easy monitoring are critical approaches for improving overall care and outcome. In dermatology or plastic surgery, small-volume detection strategies have been applied for passive or interactive wound dressing, wound healing monitoring, and blister fluid analysis for autoimmune disease diagnosis. In otolaryngology, the analysis of nasal secretions and mucosa could be used to differentiate between allergic responses and infectious diseases. Cerebrospinal fluid analysis could be applied in neurodegenerative diseases, central neural system infection and tumor diagnosis. Other small-volume fluids that have been analyzed for diagnostic and monitoring purposes include semen and cervico-vaginal fluids. We include more details regarding each of these fluids, associated collection and detection devices, and approaches in our review.

Optical glucose biosensor built-in disposable strips and wearable electronic devices

On-demand screening, real-time monitoring and rapid diagnosis of ubiquitous diseases, such as diabetes, at early stages are indispensable in personalised treatment. Emerging impacts of nano/microscale materials on optical and portable biosensor strips and devices have become increasingly important in the remarkable development of sensitive visualisation (i.e. visible inspection by the human eye) assays, low-cost analyses and personalised home testing of patients with diabetes. With the increasing public attention regarding the self-monitoring of diabetes, the development of visual readout, easy-to-use and wearable biosensors has gained considerable interest. Our comprehensive review bridges the practical assessment gap between optical bio-visualisation assays, disposable test strips, sensor array designs and full integration into flexible skin-based or contact lens devices with the on-site wireless signal transmission of glucose detection in physiological fluids. To date, the fully modulated integration of nano/microscale optical biosensors into wearable electronic devices, such as smartphones, is critical to prolong periods of indoor and outdoor clinical diagnostics. Focus should be given to the improvements of invasive, wireless and portable sensing technologies to improve the applicability and reliability of screen display, continuous monitoring, dynamic data visualisation, online acquisition and self and in-home healthcare management of patients with diabetes.

Wearable Sensors and Systems for Wound Healing-Related pH and Temperature Detection

Wound healing is a complex tissue regeneration process involving many changes in multiple physiological parameters. The pH and temperature of a wound site have long been recognized as important biomarkers for assessing wound healing status. For effective wound management, wound dressings integrated with wearable sensors and systems used for continuous monitoring of pH and temperature have received much attention in recent years. Herein, recent advances in the development of wearable pH and temperature sensors and systems based on different sensing mechanisms for wound status monitoring and treatment are comprehensively summarized. Challenges in the areas of sensing performance, infection identification threshold, large-area 3-dimensional detection, and long-term reliable monitoring in current wearable sensors/systems and emerging solutions are emphasized, providing critical insights into the development of wearable sensors and systems for wound healing monitoring and management.

Flexible electrochemical biosensors for healthcare monitoring

As the interest in wearable devices has increased recently, increasing biosensor flexibility has begun to attract considerable attention. Among the various types of biosensors, electrochemical biosensors are uniquely suited for the development of such flexible biosensors due to their many advantages, including their fast response, inherent miniaturization, convenient operation, and portability. Therefore, many studies on flexible electrochemical biosensors have been conducted in recent years to achieve non-invasive and real-time monitoring of body fluids such as tears, sweat, and saliva. To achieve this, various substrates, novel nanomaterials, and detection techniques have been utilized to develop conductive flexible platforms that can be applied to create flexible electrochemical biosensors. In this review, we discussed recently reported flexible electrochemical biosensors and divided them into specific categories including materials for flexible substrate, fabrication techniques for flexible biosensor development, and recently developed flexible electrochemical biosensors to externally monitor target molecules, thereby providing a means to noninvasively examine cells and body fluid samples. In conclusion, this review will discuss the materials, methods, recent studies, and perspectives on flexible electrochemical biosensors for healthcare monitoring and wearable biosensing systems.

Advances in airborne microorganisms detection using biosensors: A critical review

Humanity has been facing the threat of a variety of infectious diseases. Airborne microorganisms can cause airborne infectious diseases, which spread rapidly and extensively, causing huge losses to human society on a global scale. In recent years, the detection technology for airborne microorganisms has developed rapidly; it can be roughly divided into biochemical, immune, and molecular technologies. However, these technologies still have some shortcomings; they are time-consuming and have low sensitivity and poor stability. Most of them need to be used in the ideal environment of a laboratory, which limits their applications. A biosensor is a device that converts biological signals into detectable signals. As an interdisciplinary field, biosensors have successfully introduced a variety of technologies for bio-detection. Given their fast analysis speed, high sensitivity, good portability, strong specificity, and low cost, biosensors have been widely used in environmental monitoring, medical research, food and agricultural safety, military medicine and other fields. In recent years, the performance of biosensors has greatly improved, becoming a promising technology for airborne microorganism detection. This review introduces the detection principle of biosensors from the three aspects of component identification, energy conversion principle, and signal amplification. It also summarizes its research and application in airborne microorganism detection. The new progress and future development trend of the biosensor detection of airborne microorganisms are analyzed.

Structurally coloured contact lens sensor for point-of-care ophthalmic health monitoring

Point-of-care (POC) diagnosis is of great significance in offering precise and personalized treatment for patients with eye diseases. Contact lenses, as a kind of popular wearable device on the eye, provide a suitable platform for the integration of biosensors for the POC diagnosis of eye diseases. However, existing contact lens sensors usually involve complex electronics and circuits, the manufacturing of which is complicated and signal readout requires additional instruments. To realize the instrument-free detection of pathologically relevant signals of eye diseases, we successfully established a structurally coloured contact lens sensor with a tunable colour in this investigation, which can directly report changes in moisture and pressure that are critical signs for xerophthalmia and glaucoma diagnosis, respectively, by altering colours. Importantly, this structurally coloured contact lens sensor is made solely from a biocompatible hydrogel, without the addition of any chemical pigments, therefore exhibiting superior biosafety and wearing comfort for wearable applications. With both excellent biocompatibility and sensing capabilities, this structurally coloured contact lens sensors thus holds great promise for instrument-free ophthalmic health monitoring, which will benefit a large proportion of the population that have a high risk of eye disease.