Scaling Metal-Elastomer Composites toward Stretchable Multi-Helical Conductive Paths for Robust Responsive Wearable Health Devices

E-Skin and Its Advanced Applications in Ubiquitous Health Monitoring

E-skin is a bionic device with flexible and intelligent sensing ability that can mimic the touch, temperature, pressure, and other sensing functions of human skin. Because of its flexibility, breathability, biocompatibility, and other characteristics, it is widely used in health management, personalized medicine, disease prevention, and other pan-health fields. With the proposal of new sensing principles, the development of advanced functional materials, the development of microfabrication technology, and the integration of artificial intelligence and algorithms, e-skin has developed rapidly. This paper focuses on the characteristics, fundamentals, new principles, key technologies, and their specific applications in health management, exercise monitoring, emotion and heart monitoring, etc. that advanced e-skin needs to have in the healthcare field. In addition, its significance in infant and child care, elderly care, and assistive devices for the disabled is analyzed. Finally, the current challenges and future directions of the field are discussed. It is expected that this review will generate great interest and inspiration for the development and improvement of novel e-skins and advanced health monitoring systems.

Toward an AI Era: Advances in Electronic Skins

Electronic skins (e-skins) have seen intense research and rapid development in the past two decades. To mimic the capabilities of human skin, a multitude of flexible/stretchable sensors that detect physiological and environmental signals have been designed and integrated into functional systems. Recently, researchers have increasingly deployed machine learning and other artificial intelligence (AI) technologies to mimic the human neural system for the processing and analysis of sensory data collected by e-skins. Integrating AI has the potential to enable advanced applications in robotics, healthcare, and human-machine interfaces but also presents challenges such as data diversity and AI model robustness. In this review, we first summarize the functions and features of e-skins, followed by feature extraction of sensory data and different AI models. Next, we discuss the utilization of AI in the design of e-skin sensors and address the key topic of AI implementation in data processing and analysis of e-skins to accomplish a range of different tasks. Subsequently, we explore hardware-layer in-skin intelligence before concluding with an analysis of the challenges and opportunities in the various aspects of AI-enabled e-skins.

Materials, Structure, and Interface of Stretchable Interconnects for Wearable Bioelectronics

Since wearable technologies for telemedicine have emerged to tackle global health concerns, the demand for well-attested wearable healthcare devices with high user comfort also arises. Skin-wearables for health monitoring require mechanical flexibility and stretchability for not only high compatibility with the skin's dynamic nature but also a robust collection of fine health signals from within. Stretchable electrical interconnects, which determine the device's overall integrity, are one of the fundamental units being understated in wearable bioelectronics. In this review, a broad class of materials and engineering methodologies recently researched and developed are presented, and their respective attributes, limitations, and opportunities in designing stretchable interconnects for wearable bioelectronics are offered. Specifically, the electrical and mechanical characteristics of various materials (metals, polymers, carbons, and their composites) are highlighted, along with their compatibility with diverse geometric configurations. Detailed insights into fabrication techniques that are compatible with soft substrates are also provided. Importantly, successful examples of establishing reliable interfacial connections between soft and rigid elements using novel interconnects are reviewed. Lastly, some perspectives and prospects of remaining research challenges and potential pathways for practical utilization of interconnects in wearables are laid out.

Electronic Skin for Health Monitoring Systems: Properties, Functions, and Applications

Electronic skin (e-skin), a skin-like wearable electronic device, holds great promise in the fields of telemedicine and personalized healthcare because of its good flexibility, biocompatibility, skin conformability, and sensing performance. E-skin can monitor various health indicators of the human body in real time and over the long term, including physical indicators (exercise, respiration, blood pressure, etc.) and chemical indicators (saliva, sweat, urine, etc.). In recent years, the development of various materials, analysis, and manufacturing technologies has promoted significant development of e-skin, laying the foundation for the application of next-generation wearable medical technologies and devices. Herein, the properties required for e-skin health monitoring devices to achieve long-term and precise monitoring and summarize several detectable indicators in the health monitoring field are discussed. Subsequently, the applications of integrated e-skin health monitoring systems are reviewed. Finally, current challenges and future development directions in this field are discussed. This review is expected to generate great interest and inspiration for the development and improvement of e-skin and health monitoring systems.

Flexible Copper Films Modification via Spontaneous Reduction of Aryldiazonium Gold Salts: Unraveling Surface Properties and Energy Profile

In this study, we report the modification of flexible copper films via the spontaneous reduction of aryldiazonium gold salts [X-4-C6H4N≡N]AuCl4 (X═COOH, NO2). The electroless modification involves dipping of flexible copper films in the aryldiazonium gold solutions for a few seconds, under ambient conditions, followed by a washing step with deionized water to obtain a mechanically robust gold-aryl coating. The chemical composition, morphology, electronic structure, and optical properties of the gold-aryl layer and the flexibility of the modified copper films are supported by the results from X-ray photoelectron spectroscopy (XPS), electrochemistry, contact angle, scanning electron microscopy (SEM), and ultraviolet photoelectron spectroscopy (UPS). XPS surface analysis showed metallic gold in addition to C-C, C-O/C-N, and C═O functional groups from the grafted aryls. Cu 2p showed metallic copper as a major component and a small amount of Cu(II) ions. Wettability studies showed that Au-COOH@Cu increased the contact angle of the bare copper films from 68.0 ± 0.7° to 82.0° ± 0.7°, while Au-NO2@Cu increased the contact angle to 134.0° ± 0.3°. UPS energy profile analysis of [HOOC-4-C6H4N≡N]AuCl4 (valence band maximum = 1.91 eV) exhibited greater reducibility than [O2N-4-C6H4N≡N]AuCl4 (valence band maximum = 2.91 eV). The lower ionization potential of [HOOC-4-C6H4N≡N]AuCl4 (IP = 4.33 eV) enhanced the reactivity upon copper film contact, potentially inducing efficient energy level alignment, compared with [O2N-4-C6H4N≡N]AuCl4 (IP = 5.62 eV). UPS results were further supported by electrochemistry investigation which revealed that [HOOC-4-C6H4N≡N]AuCl4 is easily reducible compared with [O2N-4-C6H4N≡N]AuCl4. The findings presented here hold significant implications for developing flexible copper films and pave the way for future advancements in electronic material modification for industrial applications.

Stretchable Electronics with Strain-Resistive Performance

Stretchable electronics have attracted tremendous attention amongst academic and industrial communities due to their prospective applications in personal healthcare, human-activity monitoring, artificial skins, wearable displays, human-machine interfaces, etc. Other than mechanical robustness, stable performances under complex strains in these devices that are not for strain sensing are equally important for practical applications. Here, a comprehensive summarization of recent advances in stretchable electronics with strain-resistive performance is presented. First, detailed overviews of intrinsically strain-resistive stretchable materials, including conductors, semiconductors, and insulators, are given. Then, systematic representations of advanced structures, including helical, serpentine, meshy, wrinkled, and kirigami-based structures, for strain-resistive performance are summarized. Next, stretchable arrays and circuits with strain-resistive performance, that integrate multiple functionalities and enable complex behaviors, are introduced. This review presents a detailed overview of recent progress in stretchable electronics with strain-resistive performances and provides a guideline for the future development of stretchable electronics.

Highly Stretchable and Fluorescent Visualizable Thermoplastic Polyurethane/Tetraphenylethylene Plied Yarn Strain Sensor with Heterogeneous and Cracked Structure for Human Health Monitoring

Smart wearable technology has been more and more widely used in monitoring and prewarning of human health and safety, while flexible yarn-based strain sensors have attracted extensive research interest due to their ability to withstand greater external strain and their significant application potential in real-time monitoring of human motion and health signals. Although several strain sensors based on yarn structures have been reported, it remains challenging to strike a balance between high sensitivity and wide strain ranges. At the same time, visual signal sensing is expected to be used in strain sensors thanks to its intuitiveness. In this work, thermoplastic polyurethane (TPU) and tetraphenylethylene (TPE) were wet-spun to fabricate flexible fluorescent fibers used as the substrate of the sensor, followed by the drop addition of polydimethylsiloxane (PDMS) beads and curing to produce a heterogeneous structure, which were further twisted into a plied yarn. Finally, a visualizable flexible yarn strain sensor based on solidified liquid beads and crack structure was obtained by loading polydopamine (PDA) and polypyrrole (PPy) in situ. The sensor exhibited high sensitivity (the GF value was 58.9 at the strain range of 143-184%), a wide working strain range (0-184%), a low monitoring limit (<0.1%), a fast response (58.82 ms), reliable responses at different frequencies, and excellent cycle durability (over 2000 cycles). At the same time, the yarn strain sensor also had excellent photothermal characteristics and a fluorescence crack visualization effect. These attractive advantages enabled yarn strain sensors to accurately monitor various human activities, showing great application potential in health monitoring, personalized medical diagnosis, and other aspects.

Highly stable and strain-insensitive metal film conductors via manipulating strain distribution

Metal film-based stretchable conductors are essential elements of flexible electronics for wearable, biomedical, and robotic applications, which require strain-insensitive high conductivity over a wide strain range and excellent cyclic stability. However, they suffer from serious electrical failure under monotonic and cyclic tensile loading at a small strain due to the uncontrolled film cracking behavior. Here, we propose a novel in-plane crack control strategy of engineering hierarchical microstructures to achieve outstanding electromechanical performance via harnessing the strain distribution in metal films. The wrinkles delay the crack initiation at undercuts which should be the most vulnerable sites during the stretching process. The surface protrusions/grooves/undercuts inhibit the crack propagation because of the effective strain redistribution. In addition, hierarchical microstructures significantly improve cyclic stability due to the strong interfacial adhesion and stable crack patterns. The metal film-based conductors exhibit ultrahigh strain-insensitive conductivity (1.7 × 107 S m-1), negligible resistance change (ΔR/R0 = 0.007) over an ultra-wide strain range (>200%), and excellent cyclic strain durability (>15 000 cycles at 100% strain). A range of metal films was explored to establish the universality of this strategy, including ductile copper and silver, as well as brittle molybdenum and high entropy alloy. We demonstrate the strain-insensitive electrical functionality of a metal film-based conductor in a flexible light-emitting diode circuit.

Template-Free and Stretchable Conductive Fiber with a Built-In Helical Structure for Strain-Insensitive Signal Transmission

With the rapid development of intelligent electronic devices, conductive fibers have become very critical to signal transmission devices. However, metal-based rigid conductive wires, such as high-modulus copper and silver wires, are prone to signal failure owing to tensile breakage under large strain conditions. Therefore, strain-insensitive stretchable conductive fibers for signal transmission are critical for next-generation wearable devices. Herein, a stretchable conductive fiber with a built-in helical structure is constructed by a "speed discrepancy" fiber-coating strategy with mass scalable production (60 cm/min). Such a "speed discrepancy" strategy is the key mechanism to template-free fabricate a built-in helical structure of the stretchable conductive fiber. The resultant fiber exhibits high conductivity (873 S/cm), stable insensitive signal transmission with a high quality factor (47.4), and a low relative resistance change (∼6%) under large strain. The built-in helical structure inspired by loofah whiskers endows the fiber with excellent strain insensitivity, and it can withstand large strains. On the proof of concept, our fiber can be seamlessly knitted, woven, and braided into smart textiles as an ideal signal transmission device under large strains, which will undoubtedly promote the development of intelligent electronic textiles and next-generation wearable devices.

Stimuli-Triggered Multishape, Multimode, and Multistep Deformations Designed by Microfluidic 3D Droplet Printing

Elastomers generally possess low Young's modulus and high failure strain, which are widely used in soft robots and intelligent actuators. However, elastomers generally lack diverse functionalities, such as stimulated shape morphing, and a general strategy to implement these functionalities into elastomers is still challenging. Here, a microfluidic 3D droplet printing platform is developed to design composite elastomers architected with arrays of functional droplets. Functional droplets with controlled size, composition, position, and pattern are designed and implemented in the composite elastomers, imparting functional performances to the systems. The composited elastomers are sensitive to stimuli, such as solvent, temperature, and light, and are able to demonstrate multishape (bow- and S-shaped), multimode (gradual and sudden), and multistep (one- and two-step) deformations. Based on the unique properties of droplet-embedded composite elastomers, a variety of stimuli-responsive systems are developed, including designable numbers, biomimetic flowers, and soft robots, and a series of functional performances are achieved, presenting a facile platform to impart diverse functionalities into composite elastomers by microfluidic 3D droplet printing.