Washable, Sewable, All-Carbon Electrodes and Signal Wires for Electronic Clothing

A Framework for Selecting and Assessing Wearable Sensors Deployed in Safety Critical Scenarios

Wearable sensors for psychophysiological monitoring are becoming increasingly mainstream in safety critical contexts. They offer a novel solution to capturing sub-optimal states and can help identify when workers in safety critical environments are suffering from states such as fatigue and stress. However, sensors can differ widely in their application, design, usability, and measurement and there is a lack of guidance on what should be prioritized or considered when selecting a sensor. The paper aims to highlight which concepts are important when creating or selecting a device regarding the optimization of both measurement and usability. Additionally, the paper discusses how design choices can enhance both the usability and measurement capabilities of wearable sensors. The hopes are that this paper will provide researchers and practitioners in human factors and related fields with a framework to help guide them in building and selecting wearable sensors that are well suited for deployment in safety critical contexts.

Carbon nanotube fibers with dynamic strength up to 14 GPa

High dynamic strength is of fundamental importance for fibrous materials that are used in high-strain rate environments. Carbon nanotube fibers are one of the most promising candidates. Using a strategy to optimize hierarchical structures, we fabricated carbon nanotube fibers with a dynamic strength of 14 gigapascals (GPa) and excellent energy absorption. The dynamic performance of the fibers is attributed to the simultaneous breakage of individual nanotubes and delocalization of impact energy that occurs during the high-strain rate loading process; these behaviors are due to improvements in interfacial interactions, nanotube alignment, and densification therein. This work presents an effective strategy to utilize the strength of individual carbon nanotubes at the macroscale and provides fresh mechanism insights.

Fully Screen-Printed and Gentle-to-Skin Wet ECG Electrodes with Compact Wireless Readout for Cardiac Diagnosis and Remote Monitoring

Recent advances in electrocardiogram (ECG) diagnosis and monitoring have triggered a demand for smart and wearable ECG electrodes and readout systems. Here, we report the development of a fully screen-printed gentle-to-skin wet ECG electrode integrated with a scaled-down printed circuit board (PCB) packaged inside a 3D-printed antenna-on-package (AoP). All three components of the wet ECG electrode (i.e., silver nanowire-based conductive part, electrode gel, and adhesive gel) are screen-printed on a flexible plastic substrate and only require 265 times less metal for the conductive part and 176 times less ECG electrode gel than the standard commercial wet ECG electrodes. In addition, our electrically small AoP achieved a maximum read range of 142 m and offers a 4 times larger wireless communication range than the typical commercial chip antenna. The adult volunteers' study results indicated that our system recorded ECG data that correlated well with data from a commercial ECG system and electrodes. Furthermore, in the context of a 12-lead ECG diagnostic system, the fully printed wet ECG electrodes demonstrated a performance similar to that of commercially available wet ECG electrodes while being gentle on the skin. This was confirmed through a blind review method by two cardiology consultants and one family medicine consultant, validating the consistency of the diagnostic information obtained from both electrodes. In conclusion, these findings highlight the potential of fully screen-printed wet ECG electrodes for both monitoring and diagnostic purposes. These electrodes could serve as potential candidates for clinical practice, and the screen-printing method has the capability to facilitate industrial mass production.

Well-defined in-textile photolithography towards permeable textile electronics

Textile-based wearable electronics have attracted intensive research interest due to their excellent flexibility and breathability inherent in the unique three-dimensional porous structures. However, one of the challenges lies in achieving highly conductive patterns with high precision and robustness without sacrificing the wearing comfort. Herein, we developed a universal and robust in-textile photolithography strategy for precise and uniform metal patterning on porous textile architectures. The as-fabricated metal patterns realized a high precision of sub-100 µm with desirable mechanical stability, washability, and permeability. Moreover, such controllable coating permeated inside the textile scaffold contributes to the significant performance enhancement of miniaturized devices and electronics integration through both sides of the textiles. As a proof-of-concept, a fully integrated in-textiles system for multiplexed sweat sensing was demonstrated. The proposed method opens up new possibilities for constructing multifunctional textile-based flexible electronics with reliable performance and wearing comfort.

A Sewing Approach to the Fabrication of Eco/bioresorbable Electronics

Eco/bioresorbable electronics represent an emerging class of technology defined by an ability to dissolve or otherwise harmlessly disappear in environmental or biological surroundings after a period of stable operation. The resulting devices provide unique capabilities as temporary biomedical implants, environmental sensors, and related systems. Recent publications report schemes to overcome challenges in fabrication that follow from the low thermostability and/or high chemical reactivity of the eco/bioresorbable constituent materials. Here, this work reports the use of high-speed sewing machines, as the basis for a high-throughput manufacturing technique that addresses many requirements for these applications, without the need for high temperatures or reactive solvents. Results demonstrate that a range of eco/bioresorbable metal wires and polymer threads can be embroidered into complex, user-defined conductive patterns on eco/bioresorbable substrates. Functional electronic components, such as stretchable interconnects and antennas are possible, along with fully integrated systems. Examples of the latter include wirelessly powered light-emitting diodes, radiofrequency identification tags, and temporary cardiac pacemakers. These advances add to a growing range of options in high-throughput, automated fabrication of eco/bioresorbable electronics.

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.

Clinical applications of smart wearable sensors

Smart wearable sensors are electronic devices worn on the body that collect, process, and transmit various physiological data. Compared to traditional devices, their advantages in terms of portability and comfort have made them increasingly important in the medical field. This review takes a unique clinical physician's standpoint, diverging from conventional sensor-type-based classifications, and provides a comprehensive overview of the diverse clinical applications of wearable sensors in recent years. In this review, we categorize these applications according to different diseases, encompassing skin diseases and injuries, cardiovascular diseases, abnormal human motion, as well as endocrine and metabolic disorders. Additionally, we discuss the challenges and perspectives hindering the development of sensors for clinical use, emphasizing the critical need for interdisciplinary collaboration between medical and engineering professionals. Overall, this review would serve as an important reference for the future direction of sensor devices in clinical use.

Biocompatible Material-Based Flexible Biosensors: From Materials Design to Wearable/Implantable Devices and Integrated Sensing Systems

Human beings have a greater need to pursue life and manage personal or family health in the context of the rapid growth of artificial intelligence, big data, the Internet of Things, and 5G/6G technologies. The application of micro biosensing devices is crucial in connecting technology and personalized medicine. Here, the progress and current status from biocompatible inorganic materials to organic materials and composites are reviewed and the material-to-device processing is described. Next, the operating principles of pressure, chemical, optical, and temperature sensors are dissected and the application of these flexible biosensors in wearable/implantable devices is discussed. Different biosensing systems acting in vivo and in vitro, including signal communication and energy supply are then illustrated. The potential of in-sensor computing for applications in sensing systems is also discussed. Finally, some essential needs for commercial translation are highlighted and future opportunities for flexible biosensors are considered.

Conductive Thread-Based Immunosensor for Pandemic Influenza A (H1N1) Virus Detection

Infectious agents such as viruses pose significant threats to human health, being transmitted via direct contact as well as airborne transmission without direct contact, thus requiring rapid detection to prevent the spread of infectious diseases. In this study, we developed a conductive thread-based immunosensor (CT-IS), a biosensor to easily detect the presence of airborne viruses. CT-IS utilizes an antibody that specifically recognizes the HA protein of the pandemic influenza A (pH1N1) virus, which is incorporated into the conductive thread. The antigen-antibody interaction results in increased strain on the conductive thread in the presence of the pH1N1 virus, resulting in increased electrical resistance of the CT-IS. We evaluated the performance of this sensor using the HA protein and the pH1N1 virus, in addition to samples from patients infected with the pH1N1 virus. We observed a significant change in resistance in the pH1N1-infected patient samples (positive: n = 11, negative: n = 9), whereas negligible change was observed in the control samples (patients not infected with the pH1N1 virus; negative). Hence, the CT-IS is a lightweight fiber-type sensor that can be used as a wearable biosensor by combining it with textiles, to detect the pH1N1 virus in a person's vicinity.

Graphene Interlocking Carbon Nanotubes for High-Strength and High-Conductivity Fibers

Carbon nanotubes (CNTs) are promising building blocks for the fabrication of novel fibers with structural and functional properties. However, the mechanical and electrical performances of carbon nanotube fibers (CNTFs) are far lower than the intrinsic properties of individual CNTs. Exploring methods for the controllable assembly and continuous preparation of high-performance CNTFs is still challenging. Herein, a graphene/chlorosulfonic acid-assisted wet-stretching method is developed to produce highly densified and well-aligned graphene/carbon nanotube fibers (G/CNTFs) with excellent mechanical and electrical performances. Graphene with small size and high quality can bridge the adjacent CNTs to avoid the interfacial slippage under deformation, which facilitates the formation of a robust architecture with abundant conductive pathways. Their ordered structure and enhanced interfacial interactions endow the fibers with both high strength (4.7 GPa) and high electrical conductivity (more than 2 × 10⁶ S/m). G/CNTF-based lightweight wires show good flexibility and knittability, and the high-performance fiber heaters exhibit ultrafast electrothermal response over 1000 °C/s and a low operation voltage of 3 V. This method paves the way for optimizing the microstructures and producing high-strength and high-conductivity CNTFs, which are promising candidates for the high-value fiber-based applications.

Characterization and Validation of Flexible Dry Electrodes for Wearable Integration

When long-term biosignal monitoring is required via surface electrodes, the use of conventional silver/silver chloride (Ag/AgCl) gelled electrodes may not be the best solution, as the gel in the electrodes tends to dry out over time. In this work, the electrical behaviour and performance of dry electrodes for biopotential monitoring was assessed. Three materials were investigated and compared against the gold-standard Ag/AgCl gelled electrodes. To characterize their electrical behaviour, the impedance response over the frequency was evaluated, as well as its signal to noise ratio. The electrodes' performance was evaluated by integrating them in a proven electrocardiogram (ECG) acquisition setup where an ECG signal was acquired simultaneously with a set of dry electrodes and a set of standard Ag/AgCl gelled electrodes as reference. The obtained results were morphologically compared using the Normalised Root Mean Squared Error (nRMSE) and the Cosine Similarity (CS). The findings of this work suggest that the use of dry electrodes for biopotential monitoring is a suitable replacement for the conventional Ag/AgCl gelled electrodes. The signal obtained with dry electrodes is comparable to the one obtained with the gold standard, with the advantage that these do not require the use of gel and can be easily integrated into fabric to facilitate their use in long-term monitoring scenarios.

Paintable Carbon Nanotube Coating-Based Textronics for Sustained Holter-Type Electrocardiography

A growing population suffering from or at high risk of developing cardiovascular diseases can benefit from rapid, precise, and readily available diagnostics. Textronics is an interdisciplinary approach for designing and manufacturing high-performance flexible electronics integrated with textiles for various applications, with electrocardiography (ECG) being the most convenient and most frequently used diagnostic technique for textronic solutions. The key challenges that still exist for textronics include expedient manufacturing, adaptation to human subjects, sustained operational stability for Holter-type data acquisition, reproducibility, and compatibility with existing solutions. The present study demonstrates conveniently paintable ECG electroconductive coatings on T-shirts woven from polyester or 70% polyamide and 30% polyester. The up to 600-μm-thick coatings encompass working electrodes of low resistivity 60 Ω sq^-1 sheathed in the insulated pathways-conjugable with a wireless, multichannel ECG recorder. Long (800 μm) multiwalled carbon nanotubes, with scalable reproducibility and purity (18 g per round of synthesis), constituted the electroactive components and were embedded into a commercially available screen-printing acrylic base. The resulting paint had a viscosity of 0.75 Pa·s at 56 s^-1 and 25 °C and was conveniently applied using a paintbrush, making this technique accessible to manufacturers. The amplified and nondigitally processed ECG signals were recorded under dry-skin conditions using a certified ECG recorder. The system enabled the collection of ECG signals from two channels, allowing the acquisition of cardiac electrical activity on six ECG leads with quality at par with medical diagnostics. Importantly, the Holter-type ECG allowed ambulatory recording for >24 h under various activities (sitting, sleeping, walking, and running) in three male participants. The ECG signal was stable for >5 cycles of washing, a level of stability not reported yet previously. The developed ECG-textronic application possesses acceptable and reproducible characteristics, making this technology a suitable candidate for further testing in clinical trials.

Advances in Emerging Photonic Memristive and Memristive-Like Devices

Possessing the merits of high efficiency, low consumption, and versatility, emerging photonic memristive and memristive-like devices exhibit an attractive future in constructing novel neuromorphic computing and miniaturized bionic electronic system. Recently, the potential of various emerging materials and structures for photonic memristive and memristive-like devices has attracted tremendous research efforts, generating various novel theories, mechanisms, and applications. Limited by the ambiguity of the mechanism and the reliability of the material, the development and commercialization of such devices are still rare and in their infancy. Therefore, a detailed and systematic review of photonic memristive and memristive-like devices is needed to further promote its development. In this review, the resistive switching mechanisms of photonic memristive and memristive-like devices are first elaborated. Then, a systematic investigation of the active materials, which induce a pivotal influence in the overall performance of photonic memristive and memristive-like devices, is highlighted and evaluated in various indicators. Finally, the recent advanced applications are summarized and discussed. In a word, it is believed that this review provides an extensive impact on many fields of photonic memristive and memristive-like devices, and lay a foundation for academic research and commercial applications.

Smart Electronic Textiles for Wearable Sensing and Display

Increasing demand of using everyday clothing in wearable sensing and display has synergistically advanced the field of electronic textiles, or e-textiles. A variety of types of e-textiles have been formed into stretchy fabrics in a manner that can maintain their intrinsic properties of stretchability, breathability, and wearability to fit comfortably across different sizes and shapes of the human body. These unique features have been leveraged to ensure accuracy in capturing physical, chemical, and electrophysiological signals from the skin under ambulatory conditions, while also displaying the sensing data or other immediate information in daily life. Here, we review the emerging trends and recent advances in e-textiles in wearable sensing and display, with a focus on their materials, constructions, and implementations. We also describe perspectives on the remaining challenges of e-textiles to guide future research directions toward wider adoption in practice.

Mxene reinforced supramolecular hydrogels with high strength, stretchability and reliable conductivity for sensitive strain sensors

Conductive hydrogels used as electronics have received much attention due to their great flexibility and stretchability. However, the fabrication of ideal conductive hydrogels fulfilling with excellent mechanical properties and outstanding sensitivity remains a great challenge until now. Moreover, high sensitivity and broad linearity range are pivotal for the feasibility and accuracy of hydrogel sensors. In this study, a conductive supramolecular hydrogel was engineered by directly mixing the aqueous dispersion of MXene with the precursor of N-acryloyl glycinamide (NAGA) monomer and then rapidly photo cross-linked by UV irradiation. The resultant PNAGA/MXene hydrogel-sensors exhibited high mechanical strength (4.8 MPa), great stretchability (630%), and excellent durability. The conductive hydrogel-based sensor presented excellent conductivity (17.3 S·m^-1 ) and a wide scope of linear dependence of sensitivity on strain (0-125%, gauge factor = 2.05). It displayed reliable detection of various motions, including repeated subtle movements and large strain. It was also showed good degradation in vitro and antifouling capability. This work may provide a simple and promising platform for engineering conductive supramolecular hydrogels with integrated high performance aiming for smart wearable electronics, electronic skin, soft robots, and human-machine interfacing. This article is protected by copyright. All rights reserved.

Transformation of Health and Social Care Systems-An Interdisciplinary Approach Toward a Foundational Architecture

Objective

For realizing pervasive and ubiquitous health and social care services in a safe and high quality as well as efficient and effective way, health and social care systems have to meet new organizational, methodological, and technological paradigms. The resulting ecosystems are highly complex, highly distributed, and highly dynamic, following inter-organizational and even international approaches. Even though based on international, but domain-specific models and standards, achieving interoperability between such systems integrating multiple domains managed by multiple disciplines and their individually skilled actors is cumbersome.

Methods

Using the abstract presentation of any system by the universal type theory as well as universal logics and combining the resulting Barendregt Cube with parameters and the engineering approach of cognitive theories, systems theory, and good modeling best practices, this study argues for a generic reference architecture model moderating between the different perspectives and disciplines involved provide on that system. To represent architectural elements consistently, an aligned system of ontologies is used.

Results

The system-oriented, architecture-centric, and ontology-based generic reference model allows for re-engineering the existing and emerging knowledge representations, models, and standards, also considering the real-world business processes and the related development process of supporting IT systems for the sake of comprehensive systems integration and interoperability. The solution enables the analysis, design, and implementation of dynamic, interoperable multi-domain systems without requesting continuous revision of existing specifications.

Electronic Textiles for Wearable Point-of-Care Systems

Traditional public health systems are suffering from limited, delayed, and inefficient medical services, especially when confronted with the pandemic and the aging population. Fusing traditional textiles with diagnostic, therapeutic, and protective medical devices can unlock electronic textiles (e-textiles) as point-of-care platform technologies on the human body, continuously monitoring vital signs and implementing round-the-clock treatment protocols in close proximity to the patient. This review comprehensively summarizes the research advances on e-textiles for wearable point-of-care systems. We start with a brief introduction to emphasize the significance of e-textiles in the current healthcare system. Then, we describe textile sensors for diagnosis, textile therapeutic devices for medical treatment, and textile protective devices for prevention, by highlighting their working mechanisms, representative materials, and clinical application scenarios. Afterward, we detail e-textiles' connection technologies as the gateway for real-time data transmission and processing in the context of 5G technologies and Internet of Things. Finally, we provide new insights into the remaining challenges and future directions in the field of e-textiles. Fueled by advances in chemistry and materials science, textile-based diagnostic devices, therapeutic devices, protective medical devices, and communication units are expected to interact synergistically to construct intelligent, wearable point-of-care textile platforms, ultimately illuminating the future of healthcare system in the Internet of Things era.