Highly stretchable potentiometric ion sensor based on surface strain redistributed fiber for sweat monitoring

What Exactly Can Bionic Strategies Achieve for Flexible Sensors?

Flexible sensors have attracted great attention in the field of wearable electronic devices due to their deformability, lightness, and versatility. However, property improvement remains a key challenge. Fortunately, natural organisms exhibit many unique response mechanisms to various stimuli, and the corresponding structures and compositions provide advanced design ideas for the development of flexible sensors. Therefore, this Review highlights recent advances in sensing performance and functional characteristics of flexible sensors from the perspective of bionics for the first time. First, the "twins" of bionics and flexible sensors are introduced. Second, the enhancements in electrical and mechanical performance through bionic strategies are summarized according to the prototypes of humans, plants, and animals. Third, the functional characteristics of bionic strategies for flexible sensors are discussed in detail, including self-healing, color-changing, tangential force, strain redistribution, and interfacial resistance. Finally, we summarize the challenges and development trends of bioinspired flexible sensors. This Review aims to deepen the understanding of bionic strategies and provide innovative ideas and references for the design and manufacture of next-generation flexible sensors.

Innovative Material-Based Wearable Non-Invasive Electrochemical Sweat Sensors towards Biomedical Applications

Sweat is an accessible biofluid that provides useful physiological information about the body's biomolecular state and systemic health. Wearable sensors possess various advantageous features, such as lightweight design, wireless connectivity, and compatibility with human skin, that make them suitable for continuous monitoring. Wearable electrochemical sweat sensors can diagnose diseases and monitor health conditions by detecting biomedical signal changes in sweat. This paper discusses the state-of-the-art research in the field of wearable sweat sensors and the materials used in their construction. It covers biomarkers present in sweat, sensing modalities, techniques for sweat collection, and ways to power these sensors. Innovative materials are categorized into three subcategories: sweat collection, sweat detection, and self-powering. These include substrates for sensor fabrication, analyte detection electrodes, absorbent patches, microfluidic devices, and self-powered devices. This paper concludes by forecasting future research trends and prospects in material-based wearable non-invasive sweat sensors.

Evaluation of a wearable fabric-based sensor for accurate sodium determination in sweat during exercise

INTRODUCTION

Newly developed wearable fabric sensors (WFS) can increase the ease and accuracy of sweat sodium measurements by performing simultaneous sampling and analysis on the body during exercise.

PURPOSE

Determine the accuracy of a WFS for measurement of sodium concentration in sweat.

METHODS

Subjects wore a WFS prototype and sweat collectors on their forearm during cycle ergometry. Subjects exercised at a moderate intensity (~ 65% heart rate reserve) for 30-60 min. Sweat samples were collected and analyzed using a commercial sweat sodium analyzer (SSA) every 10-15 min. WFS were adhered with an armband and connected to custom built electronics. Accuracy was determined by comparing predicted WFS concentration to the actual concentration from the commercial SSA and analyzed statistically using ANOVA and Bland-Altman plots.

RESULTS

A total of 19 subjects completed the study. The average sweat sodium concentration was 59 mM ± 22 mM from a SSA compared with 54 mM ± 22 mM from the WFS. Overall, the average accuracy of the WFS was 88% in comparison to the SSA with p = 0.45. A line of best fit comparing predicted versus actual sweat sodium concentration had a slope of 0.99, intercept of - 4.46, and an r2 of 0.90. Bland-Altman analysis showed the average concentration difference between the WFS and the SSA was 5.35 mM, with 99% of data points between ± 1.96 times the standard deviation.

CONCLUSION

The WFS accurately predicted sweat sodium concentration during moderate intensity cycle ergometry. With the need for precise assessment of sodium loss, especially during long duration exercise, this novel analysis method can benefit athletes and coaches. Further research involving longer duration and more intense exercise is warranted.

Large-Scale Wearable Textile-Based Sweat Sensor with High Sensitivity, Rapid Response, and Stable Electrochemical Performance

Textile-based sweat sensors display great potential to enhance wearable comfort and health monitoring; however, their widespread application is severely hindered by the intricate manufacturing process and electrochemical characteristics. To address this challenge, we combined both impregnation coating technology and conjugated electrospinning technology to develop an electro-assisted impregnation core-spinning technology (EAICST), which enables us to simply construct a sheath-core electrochemical sensing yarn (TPFV/CPP yarn) via coating PEDOT:PSS-coated carbon fibers (CPP) with polyurethane (TPU)/polyacrylonitrile (PAN)/poloxamer (F127)/valinomycin as shell. The TPFV/CPP yarn was sewn into the fabric and integrated with a sensor to achieve a detachable feature and efficiently monitor K+ levels in sweat. By introducing EAICST, a speed of 10 m/h can be realized in the continuous preparation of the TPFV/CPP yarn, while the interconnected pores in the yarn sheath enable it to quickly capture and diffuse sweat. Besides, the sensor exhibited excellent sensitivity (54.26 mV/decade), fast response (1.7 s), anti-interference, and long-term stability (5000 s or more). Especially, it also possesses favorable washability and wear resistance properties. Taken together, this study provides a crucial technical foundation for the development of advanced wearable devices designed for sweat analysis.

Porous Conductive Textiles for Wearable Electronics

Over the years, researchers have made significant strides in the development of novel flexible/stretchable and conductive materials, enabling the creation of cutting-edge electronic devices for wearable applications. Among these, porous conductive textiles (PCTs) have emerged as an ideal material platform for wearable electronics, owing to their light weight, flexibility, permeability, and wearing comfort. This Review aims to present a comprehensive overview of the progress and state of the art of utilizing PCTs for the design and fabrication of a wide variety of wearable electronic devices and their integrated wearable systems. To begin with, we elucidate how PCTs revolutionize the form factors of wearable electronics. We then discuss the preparation strategies of PCTs, in terms of the raw materials, fabrication processes, and key properties. Afterward, we provide detailed illustrations of how PCTs are used as basic building blocks to design and fabricate a wide variety of intrinsically flexible or stretchable devices, including sensors, actuators, therapeutic devices, energy-harvesting and storage devices, and displays. We further describe the techniques and strategies for wearable electronic systems either by hybridizing conventional off-the-shelf rigid electronic components with PCTs or by integrating multiple fibrous devices made of PCTs. Subsequently, we highlight some important wearable application scenarios in healthcare, sports and training, converging technologies, and professional specialists. At the end of the Review, we discuss the challenges and perspectives on future research directions and give overall conclusions. As the demand for more personalized and interconnected devices continues to grow, PCT-based wearables hold immense potential to redefine the landscape of wearable technology and reshape the way we live, work, and play.

Electrochemical sensing fibers for wearable health monitoring devices

Real-time monitoring of health conditions is an emerging strong issue in health care, internet information, and other strongly evolving areas. Wearable electronics are versatile platforms for non-invasive sensing. Among a variety of wearable device principles, fiber electronics represent cutting-edge development of flexible electronics. Enabled by electrochemical sensing, fiber electronics have found a wide range of applications, providing new opportunities for real-time monitoring of health conditions by daily wearing, and electrochemical fiber sensors as explored in the present report are a promising emerging field. In consideration of the key challenges and corresponding solutions for electrochemical sensing fibers, we offer here a timely and comprehensive review. We discuss the principles and advantages of electrochemical sensing fibers and fabrics. Our review also highlights the importance of electrochemical sensing fibers in the fabrication of "smart" fabric designs, focusing on strategies to address key issues in fiber-based electrochemical sensors, and we provide an overview of smart clothing systems and their cutting-edge applications in therapeutic care. Our report offers a comprehensive overview of current developments in electrochemical sensing fibers to researchers in the fields of wearables, flexible electronics, and electrochemical sensing, stimulating forthcoming development of next-generation "smart" fabrics-based electrochemical sensing.

Strain-insensitive and multiplexed potentiometric ion sensors via printed PMMA molecular layer

Wearable biomimetic electronics have aroused tremendous attention due to their capability to continuously detect and deliver real-time dynamic physiological signals pertaining to the wearer's environment. However, upon close contact with the human skins, a wearable sensor undergoes mechanical strain which inevitably degrades the electrical performance. To address this issue, we demonstrate a universal design approach for stretchable and multiplexed biosensors that can yield unaltered ion sensing performance under variable mechanical tensile strains, which is achieved by introducing a PMMA molecular layer between stretchable substrate and ion sensors. Such design demonstrates reliable multiplexed ion sensing capability and provides high sensitivity (>50 mV/decade), reliable selectivity, as well as wide working range (0.1-100 mM) for sodium, ammonium, potassium and calcium ions in complex sweat biomarkers. Via this introduced PMMA molecular layer, our sensor even exhibits 95 % electrical performance maintained up to 30 % tensile strain, whereas the mechanical tensile property is far superior to original sensor performance. Besides, the sensors were also utilized for real-time monitoring of ions in sweat to validate its biomedical electronics applications. This sensing platform can be easily extended to other biomimetic sensors to enable stable signal acquisition for biomedical 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.

Self-healing polymers through hydrogen-bond cross-linking: synthesis and electronic applications

Recently, polymers capable of repeatedly self-healing physical damage and restoring mechanical properties have attracted extensive attention. Among the various supramolecular chemistry, hydrogen-bonding (H-bonding) featuring reversibility, directionality and high per-volume concentration has become one of the most attractive directions for the development of self-healing polymers (SHPs). Herein, we review the recent advances in the design of high-performance SHPs based on different H-bonding types, for example, H-bonding motifs and excessive H-bonding. In particular, the effects of the structural design of SHPs on their mechanical performance and healing efficiency are discussed in detail. Moreover, we also summarize how to employ H-bonding-based SHPs for the preparation of self-healable electronic devices, focusing on promising topics, including energy harvesting devices, energy storage devices, and flexible sensing devices. Finally, the current challenges and possible strategies for the development of H-bonding-based SHPs and their smart electronic applications are highlighted.

A Review of the Carbon-Based Solid Transducing Layer for Ion-Selective Electrodes

As one of the key components of solid-contact ion-selective electrodes (SC-ISEs), the SC layer plays a crucial role in electrode performance. Carbon materials, known for their efficient ion-electron signal conversion, chemical stability, and low cost, are considered ideal materials for solid-state transducing layers. In this review, the application of different types of carbon materials in SC-ISEs (from 2007 to 2023) has been comprehensively summarized and discussed. Representative carbon-based materials for the fabrication of SC-ISEs have been systematically outlined, and the influence of the structural characteristics of carbon materials on achieving excellent performance has been emphasized. Finally, the persistent challenges and potential opportunities are also highlighted and discussed, aiming to inspire the design and fabrication of next-generation SC-ISEs with multifunctional composite carbon materials in the future.

Nucleic acid aptamer-based biosensors and their application in thrombin analysis

Thrombin is a multifunctional serine protease that plays an important role in coagulation and anticoagulation processes. Aptamers have been widely applied in biosensors due to their high specificity, low cost and good biocompatibility. This review summarizes recent advances in thrombin quantification using aptamer-based biosensors. The primary focus is optical sensors and electrochemical sensors, along with their applications in thrombin analysis and disease diagnosis.

Flexible Sweat Sensors: From Films to Textiles

Flexible sweat sensors have found widespread potential applications for long-term wear and tracking and real-time monitoring of human health. However, the main substrate currently used in common flexible sweat sensors is thin film, which has disadvantages such as poor air permeability and the need for additional wearables. In this Review, the recent progress of sweat sensors has been systematically summarized by the types of monitoring methods of sweat sensors. In addition, this Review introduces and compares the performance of sweat sensors based on thin film and textile substrates such as fiber/yarn. Finally, opportunities and suggestions for the development of flexible sweat sensors are presented by summarizing the integration methods of sensors and human body monitoring sites.

Flexible Textile-Based Sweat Sensors for Wearable Applications

The current physical health care system has gradually evolved into a form of virtual hospitals communicating with sensors, which can not only save time but can also diagnose a patient's physical condition in real time. Textile-based wearable sensors have recently been identified as detection platforms with high potential. They are developed for the real-time noninvasive detection of human physiological information to comprehensively analyze the health status of the human body. Sweat comprises various chemical compositions, which can be used as biomarkers to reflect the relevant information of the human physiology, thus providing references for health conditions. Combined together, textile-based sweat sensors are more flexible and comfortable than other conventional sensors, making them easily integrated into the wearable field. In this short review, the research progress of textile-based flexible sweat sensors was reviewed. Three mechanisms commonly used for textile-based sweat sensors were firstly contrasted with an introduction to their materials and preparation processes. The components of textile-based sweat sensors, which mainly consist of a sweat transportation channel and collector, a signal-selection unit, sensing elements and sensor integration and communication technologies, were reviewed. The applications of textile-based sweat sensors with different mechanisms were also presented. Finally, the existing problems and challenges of sweat sensors were summarized, which may contribute to promote their further development.

Advances in Medical Wearable Biosensors: Design, Fabrication and Materials Strategies in Healthcare Monitoring

In the past decade, wearable biosensors have radically changed our outlook on contemporary medical healthcare monitoring systems. These smart, multiplexed devices allow us to quantify dynamic biological signals in real time through highly sensitive, miniaturized sensing platforms, thereby decentralizing the concept of regular clinical check-ups and diagnosis towards more versatile, remote, and personalized healthcare monitoring. This paradigm shift in healthcare delivery can be attributed to the development of nanomaterials and improvements made to non-invasive biosignal detection systems alongside integrated approaches for multifaceted data acquisition and interpretation. The discovery of new biomarkers and the use of bioaffinity recognition elements like aptamers and peptide arrays combined with the use of newly developed, flexible, and conductive materials that interact with skin surfaces has led to the widespread application of biosensors in the biomedical field. This review focuses on the recent advances made in wearable technology for remote healthcare monitoring. It classifies their development and application in terms of electrochemical, mechanical, and optical modes of transduction and type of material used and discusses the shortcomings accompanying their large-scale fabrication and commercialization. A brief note on the most widely used materials and their improvements in wearable sensor development is outlined along with instructions for the future of medical wearables.

Smart Materials Enabled with Artificial Intelligence for Healthcare Wearables

Contemporary medicine suffers from many shortcomings in terms of successful disease diagnosis and treatment, both of which rely on detection capacity and timing. The lack of effective, reliable, and affordable detection and real‐time monitoring limits the affordability of timely diagnosis and treatment. A new frontier that overcomes these challenges relies on smart health monitoring systems that combine wearable sensors and an analytical modulus. This review presents the latest advances in smart materials for the development of multifunctional wearable sensors while providing a bird's eye‐view of their characteristics, functions, and applications. The review also presents the state‐of‐the‐art on wearables fitted with artificial intelligence (AI) and support systems for clinical decision in early detection and accurate diagnosis of disorders. The ongoing challenges and future prospects for providing personal healthcare with AI‐assisted support systems relating to clinical decisions are presented and discussed.

Fiber‐Shaped Electronic Devices

Textile electronics embedded in clothing represent an exciting new frontier for modern healthcare and communication systems. Fundamental to the development of these textile electronics is the development of the fibers forming the cloths into electronic devices. An electronic fiber must undergo diverse scrutiny for its selection for a multifunctional textile, viz., from the material selection to the device architecture, from the wearability to mechanical stresses, and from the environmental compatibility to the end‐use management. Herein, the performance requirements of fiber‐shaped electronics are reviewed considering the characteristics of single electronic fibers and their assemblies in smart clothing. Broadly, this article includes i) processing strategies of electronic fibers with required properties from precursor to material, ii) the state‐of‐art of current fiber‐shaped electronics emphasizing light‐emitting devices, solar cells, sensors, nanogenerators, supercapacitors storage, and chromatic devices, iii) mechanisms involved in the operation of the above devices, iv) limitations of the current materials and device manufacturing techniques to achieve the target performance, and v) the knowledge gap that must be minimized prior to their deployment. Lessons learned from this review with regard to the challenges and prospects for developing fiber‐shaped electronic components are presented as directions for future research on wearable electronics.

A thread-based wearable sweat nanobiosensor

Non-invasive wearable biosensors provide an efficient way of continuously quantifying a person's biochemical parameters, and are highly valuable for predicting human physiological status and flagging risks and illness. Commercial wearable sensors are available for tracking a user's physical activities, but few could monitor user's health conditions through sweat analysis. Electronic textile (e-textile) biosensors enable new applications in this scenario because of its high flexibility/wearability, low cost, high level of electronic integration, and unobtrusiveness. However, challenges in developing e-textile sweat biosensors remain in the production of textile-based biosensing materials, skin interfacing design, and embedded data acquisition/transmission. Here, we propose a novel wearable electrochemical sweat biosensor based on conductive threads decorated with zinc-oxide nanowires (ZnO NWs) and apply it to detecting lactate and sodium in perspiration during physical exercise. The sweat biosensor is fully integrated with signal readout and data communication circuits in a wearable headband and is capable of monitoring human sweat accurately and wirelessly. We achieved the detection of lactate and sodium in linear ranges of 0-25 mM and 0.1-100 mM and limits of detection of 3.61 mM and 0.16 mM, respectively, which cover the clinically-relevant ranges of lactate and sodium in human sweat. We demonstrated accurate lactate and sodium measurements in human sweat from a healthy volunteer, and the results are in good agreement with standard test results. We also conducted on-body measurements on the same human volunteer during exercise and confirmed the robustness of the signal readout during body movements and the excellent accuracy of the testing results.

Highly Concentrated, Conductive, Defect-free Graphene Ink for Screen-Printed Sensor Application

Ultrathin and defect-free graphene ink is prepared through a high-throughput fluid dynamics process, resulting in a high exfoliation yield (53.5%) and a high concentration (47.5 mg mL^-1). A screen-printed graphene conductor exhibits a high electrical conductivity of 1.49 × 10⁴ S m^-1 and good mechanical flexibility. An electrochemical sodium ion sensor based on graphene ink exhibits an excellent potentiometric sensing performance in a mechanically bent state. Real-time monitoring of sodium ion concentration in sweat is demonstrated. Conductive inks based on graphene materials have received significant attention for the fabrication of a wide range of printed and flexible devices. However, the application of graphene fillers is limited by their restricted mass production and the low concentration of their suspensions. In this study, a highly concentrated and conductive ink based on defect-free graphene was developed by a scalable fluid dynamics process. A high shear exfoliation and mixing process enabled the production of graphene at a high concentration of 47.5 mg mL^-1 for graphene ink. The screen-printed graphene conductor exhibits a high electrical conductivity of 1.49 × 10⁴ S m^-1 and maintains high conductivity under mechanical bending, compressing, and fatigue tests. Based on the as-prepared graphene ink, a printed electrochemical sodium ion (Na⁺) sensor that shows high potentiometric sensing performance was fabricated. Further, by integrating a wireless electronic module, a prototype Na⁺-sensing watch is demonstrated for the real-time monitoring of the sodium ion concentration in human sweat during the indoor exercise of a volunteer. The scalable and efficient procedure for the preparation of graphene ink presented in this work is very promising for the low-cost, reproducible, and large-scale printing of flexible and wearable electronic devices.

Applying Nanomaterials to Modern Biomedical Electrochemical Detection of Metabolites, Electrolytes, and Pathogens

Personal biosensors and bioelectronics have been demonstrated for use in out-of-clinic biomedical devices. Such modern devices have the potential to transform traditional clinical analysis into a new approach, allowing patients or users to screen their own health or warning of diseases. Researchers aim to explore the opportunities of easy-to-wear and easy-to-carry sensors that would empower users to detect biomarkers, electrolytes, or pathogens at home in a rapid and easy way. This mobility would open the door for early diagnosis and personalized healthcare management to a wide audience. In this review, we focus on the recent progress made in modern electrochemical sensors, which holds promising potential to support point-of-care technologies. Key original research articles covered in this review are mainly experimental reports published from 2018 to 2020. Strategies for the detection of metabolites, ions, and viruses are updated in this article. The relevant challenges and opportunities of applying nanomaterials to support the fabrication of new electrochemical biosensors are also discussed. Finally, perspectives regarding potential benefits and current challenges of the technology are included. The growing area of personal biosensors is expected to push their application closer to a new phase of biomedical advancement.

Wireless, Flexible, Ion-Selective Electrode System for Selective and Repeatable Detection of Sodium

Wireless, flexible, ion-selective electrodes (ISEs) are of great interest in the development of wearable health monitors and clinical systems. Existing film-based electrochemical sensors, however, still have practical limitations due to poor electrical contact and material–interfacial leakage. Here, we introduce a wireless, flexible film-based system with a highly selective, stable, and reliable sodium sensor. A flexible and hydrophobic composite with carbon black and soft elastomer serves as an ion-to-electron transducer offering cost efficiency, design simplicity, and long-term stability. The sensor package demonstrates repeatable analysis of selective sodium detection in saliva with good sensitivity (56.1 mV/decade), stability (0.53 mV/h), and selectivity coefficient of sodium against potassium (−3.0). The film ISEs have an additional membrane coating that provides reinforced stability for the sensor upon mechanical bending. Collectively, the comprehensive study of materials, surface chemistry, and sensor design in this work shows the potential of the wireless flexible sensor system for low-profile wearable applications.

Srivastava S. Wearable Skin Sensors and Their Challenges: A Review of Transdermal, Optical, and Mechanical Sensors

Wearable technology and mobile healthcare systems are both increasingly popular solutions to traditional healthcare due to their ease of implementation and cost-effectiveness for remote health monitoring. Recent advances in research, especially the miniaturization of sensors, have significantly contributed to commercializing the wearable technology. Most of the traditional commercially available sensors are either mechanical or optical, but nowadays transdermal microneedles are also being used for micro-sensing such as continuous glucose monitoring. However, there remain certain challenges that need to be addressed before the possibility of large-scale deployment. The biggest challenge faced by all these wearable sensors is our skin, which has an inherent property to resist and protect the body from the outside world. On the other hand, biosensing is not possible without overcoming this resistance. Consequently, understanding the skin structure and its response to different types of sensing is necessary to remove the scientific barriers that are hindering our ability to design more efficient and robust skin sensors. In this article, we review research reports related to three different biosensing modalities that are commonly used along with the challenges faced in their implementation for detection. We believe this review will be of significant use to researchers looking to solve existing problems within the ongoing research in wearable sensors.