Nanomaterials-patterned flexible electrodes for wearable health monitoring: a review

The Need for Smart Materials in an Expanding Smart World: MXene-Based Wearable Electronics and Their Advantageous Applications

As a result of the transformation of inflexible electronic structures into flexible and stretchy devices, wearable electronics now provide great advantages in a variety of fields, including mobile healthcare sensing and monitoring, human-machine interfaces, portable energy storage and harvesting, and more. Because of their enriched surface functionalities, large surface area, and high electrical conductivity, transition metal nitrides and carbides (also known as MXenes) have recently come to be extensively considered as a group of functioning two-dimensional nanomaterials as well as exceptional fundamental elements for forming flexible electronics devices. This Review discusses the most recent advancements that have been made in the field of MXene-enabled flexible electronics for wearable electronics. The emphasis is placed on extensively established nonstructural features in order to highlight some MXene-enabled electrical devices that were constructed on a nanometric scale. These attributes include devices configured in three dimensions: printed materials, bioinspired structures, and textile and planar substrates. In addition, sample applications in electromagnetic interference (EMI) shielding, energy, healthcare, and humanoid control of machinery illustrate the exceptional development of these nanodevices. The increasing potential of MXene nanoparticles as a new area in next-generation wearable electronic technologies is projected in this Review. The design challenges associated with these electronic devices are also discussed, and possible solutions are presented.

Muscle-inspired anisotropic carboxymethyl cellulose-based double-network conductive hydrogels for flexible strain sensors

Conductive hydrogels are considered one of the most promising materials for preparing flexible sensors due to their flexible and extensible properties. However, conventional hydrogels' weak mechanical and isotropic properties are greatly limited in practical applications. Here, the internal structure of the hydrogel was regulated by pre-stretching synergistic ion crosslinking to construct a carboxymethyl cellulose-based double network-oriented hydrogel similar to muscle. The introduction of pre-stretching increased the tensile strength of the double-network hydrogel from 1.45 MPa to 4.32 MPa, and its light transmittance increased from 67.3 % to 84.5 %. In addition, the hydrogel's thermal stability and electrical conductivity were improved to a certain extent. Its good mechanical properties and conductive properties can be converted into stable electrical signal output during deformation. The carboxymethyl cellulose-based double network oriented hydrogels were further assembled as flexible substrates into flexible sensor devices. The hydrogel sensors can monitor simple joint movements as well as complex spatial movements, which makes them have potential application value in the research field of intelligent response electronic devices such as flexible wearables, intelligent strain sensing, and soft robots.

Printed dry electrode for neuromuscular electrical stimulation (NMES) for e-textile

Muscle atrophy is a well-known consequence of immobilization and critical illness, leading to prolonged rehabilitation and increased mortality. In this study, we develop a solution to preserve muscle mass using customized biocompatible neuromuscular electrical stimulation (NMES) device. Commercially available NMES solutions with gel-based electrodes often lead to skin irritation. We demonstrate the printing of conducting electrodes on a compressive stocking textile that can be used for more than seven days without observing any inflammation. This solution consists of a dry and biocompatible electrode directly integrated into the textile with good mechanical compatibility with skin (Young's modulus of 0.39 MPa). The surface roughness of the underlying substrate plays a significant role in obtaining good print quality. Electrochemical Impedance Spectroscopy (EIS) analysis showed that the printed electrode showed better performance than the commercial ones based on a matched interfacial performance and improved series resistance. Furthermore, we investigated our NMES solution in a hospital setting to evaluate its effectiveness on muscle atrophy, with promising results.

Biomedical Silicones: Leveraging Additive Strategies to Propel Modern Utility

Silicones have a long history of use in biomedical devices, with unique properties stemming from the siloxane (Si-O-Si) backbone that feature a high degree of flexibility and chemical stability. However, surface, rheological, mechanical, and electrical properties of silicones can limit their utility. Successful modification of silicones to address these limitations could lead to superior and new biomedical devices. Toward improving such properties, recent additive strategies have been leveraged to modify biomedical silicones and are highlighted herein.

Design and Fabrication of Embroidered Textile Strain Sensors: An Alternative to Stitch-Based Strain Sensors

Smart textile sensors have been gaining popularity as alternative methods for the continuous monitoring of human motion. Multiple methods of fabrication for these textile sensors have been proposed, but the simpler ones include stitching or embroidering the conductive thread onto an elastic fabric to create a strain sensor. Although multiple studies have demonstrated the efficacy of textile sensors using the stitching technique, there is almost little to no information regarding the fabrication of textile strain sensors using the embroidery method. In this paper, a design guide for the fabrication of an embroidered resistive textile strain sensor is presented. All of the required design steps are explained, as well as the different embroidery design parameters and their optimal values. Finally, three embroidered textile strain sensors were created using these design steps. These sensors are based on the principle of superposition and were fabricated using a stainless-steel conductive thread embroidered onto a polyester-rubber elastic knit structure. The three sensors demonstrated an average gauge factor of 1.88±0.51 over a 26% working range, low hysteresis (8.54±2.66%), and good repeatability after being pre-stretched over a certain number of stretching cycles.

Non-equilibrium spin-transport properties of Co/phosphorene/Co MTJ with non-collinear electrodes under mechanical bending

Monolayer phosphorene has outstanding mechanical flexibility, making it rather attractive in flexible spintronics that are based on 2D materials. Here, we report a first-principles study on non-equilibrium electronic-transport properties of the Co/phosphorene/Co magnetic tunnel junction (MTJ) with two α-Co electrodes. The magnetic moments of the two electrodes are considered in the parallel configuration (PC) and the anti-parallel configuration (APC). The tunneling current through the MTJ is investigated at a small bias from 0 to 40 mV when mechanical bending is applied on the MTJ with different central angle (θ) values. For both the PC and APC, the tunneling current increases evidently and monotonously with increasing mechanical bending for 25° < θ < 40°, as compared to that without bending, which is mainly due to the reduced tunnel barrier. In the PC, the spin-injection efficiency (SIE) of the current is largely increased at a small bias from 0 to 40 mV for 25° ≤ θ ≤ 30° with a maximum of 90%, while the SIE is overall increased under all mechanical bending angles for the APC. The tunnel magnetoresistance is decreased with an increasing bias voltage, which can be largely enhanced for θ ≥ 25°, especially at small bias. Our results indicate that the Co/phosphorene/Co MTJ has promising applications in flexible low-power spintronic devices.

Wound-Dressing-Based Antenna Inkjet-Printed Using Nanosilver Ink for Wireless Medical Monitoring

In this paper, we present a wound-dressing-based antenna fabricated via screen-printed and inkjet-printed technologies. To inkjet print a conductive film on wound dressing, it must be screen-printed, UV-curable-pasted, and hard-baked to provide appropriate surface wettability. Two passes were UV-curable-pasted and hard-baked at 100 °C for 2 h on the wound dressing to obtain 65° WCA for silver printing. The silver film was printed onto the wound dressing at room-tempature with 23 μm droplet spacing for three passes, then sintered at 120 °C for 1 h. By optimizing the inkjet printing conditions by modifying the surface morphologies and electrical properties, three-pass printed silver films with 3.15 μm thickness and 1.05 × 10⁷ S/m conductivity were obtained. The insertion losses at the resonant frequency (17 and 8.85 GHz) were -2.9 and -2.1 dB for the 5000 and 10,000 μm microstrip transmission lines, respectively. The material properties of wound dressing with the relative permittivity and loss-tangent of 3.15-3.25 and 0.04-0.05, respectively, were determined by two transmission line methods and used for antenna design. A quasi-Yagi antenna was designed and implemented on the wound-dressing with an antenna bandwidth of 3.2-4.6 GHz, maximal gain of 0.67 dBi, and 42% radiation efficiency. The bending effects parallel and perpendicular to the dipole direction of three fixtures were also examined. The gain decreased from 0.67 to -1.22 dBi and -0.44 dBi for a flat to curvature radius of 5 cm fixture after parallel and perpendicular bending, respectively. Although the maximal gain was reduced with the bending radius, the directivity of the radiation pattern remained unchanged. The feasibility of a wound-dressing antenna demonstrates that inkjet-printed technology enables fast fabrication with low cost and environmental friendliness. Additionally, inkjet-printed technology can be combined with sensing technology to realize remote medical monitoring, such as with smart bandages, for assessment of chronic wound status or basic physical conditions.

Fabrication of Textile-Based Dry Electrode and Analysis of Its Surface EMG Signal for Applying Smart Wear

Ag/AgCl hydrogel electrodes, which are wet electrodes, are generally used to acquire bio-signals non-invasively. Research concerning dry electrodes is ongoing due to the following limitations of wet electrodes: (1) skin irritation and disease when attached for a long time; (2) poor adhesion due to sweat; and (3) considerable cost due to disposable use. Accordingly, electrodes in film, embroidery, and knit forms were manufactured from conductive sheets and conductive yarns, which are typical textile-type dry electrode materials, using different manufacturing methods and conditions. The prepared electrodes were conducted to measure the morphology, surface resistance, skin-electrode impedance, EMG signal acquisition, and analysis. The conductive sheet type electrode exhibited a similar skin-impedance, noise, and muscle activation signal amplitude to the Ag/AgCl gel electrode due to the excellent adhesion and shape stabilization. Embroidery electrodes were manufactured based on two-dimension lock stitch (Em_LS) and three-dimension moss-stitch (Em_MS). More stable EMG signal acquisition than Em_LS was possible when manufactured with Em_MS. The knit electrode was manufactured with the typical structures of plain, purl, and interlock. Although it was possible to acquire EMG signals, considerable noise was generated as the shape and size of the electrodes were changed due to the stretch characteristics of the knit structure. Finally, the applicability of the textile-type dry electrode was confirmed by combining it with a wearable device. More stable and accurate EMG signal acquirement will be possible through more precise parameter control in the future.

The era of nano-bionic: 2D materials for wearable and implantable body sensors

Nano-bionics have the potential of revolutionizing modern medicine. Among nano-bionic devices, body sensors allow to monitor in real-time the health of patients, to achieve personalized medicine, and even to restore or enhance human functions. The advent of two-dimensional (2D) materials is facilitating the manufacturing of miniaturized and ultrathin bioelectronics, that can be easily integrated in the human body. Their unique electronic properties allow to efficiently transduce physical and chemical stimuli into electric current. Their flexibility and nanometric thickness facilitate the adaption and adhesion to human body. The low opacity permits to obtain transparent devices. The good cellular adhesion and reduced cytotoxicity are advantageous for the integration of the devices in vivo. Herein we review the latest and more significant examples of 2D material-based sensors for health monitoring, describing their architectures, sensing mechanisms, advantages and, as well, the challenges and drawbacks that hampers their translation into commercial clinical devices.

Development of a textile based protein sensor for monitoring the healing progress of a wound

This article focuses on the design and fabrication of flexible textile-based protein sensors to be embedded in wound dressings. Chronic wounds require continuous monitoring to prevent further complications and to determine the best course of treatment in the case of infection. As proteins are essential for the progression of wound healing, they can be used as an indicator of wound status. Through measuring protein concentrations, the sensor can assess and monitor the wound condition continuously as a function of time. The protein sensor consists of electrodes that are directly screen printed using both silver and carbon composite inks on polyester nonwoven fabric which was deliberately selected as this is one of the common backing fabric types currently used in wound dressings. These sensors were experimentally evaluated and compared to each other by using albumin protein solution of pH 7. A comprehensive set of cyclic voltammetry measurements was used to determine the optimal sensor design the measurement of protein in solution. As a result, the best sensor design is comprised of silver conductive tracks but a carbon layer as the working and counter electrodes at the interface zone. This design prevents the formation of silver dioxide and protects the sensor from rapid decay, which allows for the recording of consecutive measurements using the same sensor. The chosen printed protein sensor was able to detect bovine serum albumin at concentrations ranging from 30 to 0.3 mg/mL with a sensitivity of \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$0.0026 \mu $$\end{document}0.0026μA/M. Further testing was performed to assess the sensor’s ability to identify BSA from other interferential substances usually present in wound fluids and the results show that it can be distinguishable.

Water Quality Carbon Nanotube-Based Sensors Technological Barriers and Late Research Trends: A Bibliometric Analysis

Water is the key element that defines and individualizes our planet. Relative to body weight, water represents 70% or more for the majority of all species on Earth. Taking care of water as a whole is equivalent with taking care of the entire biodiversity or the whole of humanity itself. Water quality is becoming an increasingly important component of terrestrial life, hence intensive work is being conducted to develop sensors for detecting contaminants and assessing water quality and characteristics. Our bibliometric analysis is focused on water quality sensors based on carbon nanotubes and highlights the most important objectives and achievements of researchers in recent years. Due to important measurement characteristics such as sensitivity and selectivity, or low detection limit and linearity, up to the ability to measure water properties, including detection of heavy metal content or the presence of persistent organic compounds, carbon nanotube (CNT) sensors, taking advantage of available nanotechnologies, are becoming increasingly attractive. The conducted bibliometric analysis creates a visual, more efficient keystones mapping. CNT sensors can be integrated into an inexpensive real-time monitoring data acquisition system as an alternative for classical expensive and time-consuming offline water quality monitoring. The conducted bibliometric analysis reveals all connections and maps all the results in this water quality CNT sensors research field and gives a perspective on the approached methods on this specific type of sensor. Finally, challenges related to integration of other trends that have been used and proven to be valuable in the field of other sensor types and capable to contribute to the development (and outlook) for future new configurations that will undoubtedly emerge are presented.

Advances in Soft and Dry Electrodes for Wearable Health Monitoring Devices

Electrophysiology signals are crucial health status indicators as they are related to all human activities. Current demands for mobile healthcare have driven considerable interest in developing skin-mounted electrodes for health monitoring. Silver-Silver chloride-based (Ag-/AgCl) wet electrodes, commonly used in conventional clinical practice, provide excellent signal quality, but cannot monitor long-term signals due to gel evaporation and skin irritation. Therefore, the focus has shifted to developing dry electrodes that can operate without gels and extra adhesives. Compared to conventional wet electrodes, dry ones offer various advantages in terms of ease of use, long-term stability, and biocompatibility. This review outlines a systematic summary of the latest research on high-performance soft and dry electrodes. In addition, we summarize recent developments in soft materials, biocompatible materials, manufacturing methods, strategies to promote physical adhesion, methods for higher breathability, and their applications in wearable biomedical devices. Finally, we discuss the developmental challenges and advantages of various dry electrodes, while suggesting research directions for future studies.

Nanostructured Carbons: towards Soft-Bioelectronics, Biosensing and Theraputic Applications

Recently, nanostructured carbon-based soft bioelectronics and biosensors have received tremendous attention due to their outstanding physical and chemical properties. The ultrahigh specific surface area, high flexibility, lightweight, high electrical conductivity, and biocompatibility of 1D and 2D nanocarbons, such as carbon nanotubes (CNT) and graphene, are advantageous for bioelectronics applications. These materials improve human life by delivering therapeutic advancements in gene, tumor, chemo, photothermal, immune, radio, and precision therapies. They are also utilized in biosensing platforms, including optical and electrochemical biosensors to detect cholesterol, glucose, pathogenic bacteria (e. g., coronavirus), and avian leucosis virus. This review summarizes the most recent advancements in bioelectronics and biosensors by exploiting the outstanding characteristics of nanocarbon materials. The synthesis and biocompatibility of nanocarbon materials are briefly discussed. In the following sections, applications of graphene and CNTs for different therapies and biosensing are elaborated. Finally, the key challenges and future perspectives of nanocarbon materials for biomedical applications are highlighted.

Carbon Nanotube Wearable Sensors for Health Diagnostics

This perspective article highlights a recent surge of interest in the application of textiles containing carbon nanotube (CNT) sensors for human health monitoring. Modern life puts more and more pressure on humans, which translates into an increased number of various health disorders. Unfortunately, this effect either decreases the quality of life or shortens it prematurely. A possible solution to this problem is to employ sensors to monitor various body functions and indicate an upcoming disease likelihood at its early stage. A broad spectrum of materials is currently under investigation for this purpose, some of which already entered the market. One of the most promising materials in this field are CNTs. They are flexible and of high electrical conductivity, which can be modulated upon several forms of stimulation. The article begins with an illustration of techniques for how wearable sensors can be built from them. Then, their application potential for tracking various health parameters is presented. Finally, the article ends with a summary of this field's progress and a vision of the key directions to domesticate this concept.