An All-in-One, Bioderived, Air-Permeable, and Sweat-Stable MXene Epidermal Electrode for Muscle Theranostics

Ultrathin Self-Healing Nanofibrous Membrane with a Hierarchical Confined Structure for Biomimetic Epidermal Electrodes

Integrating self-healing capabilities into epidermal electrodes is crucial to improving their reliability and longevity. Self-healing nanofibrous materials are considered an ideal candidate for constructing ultrathin, long-lasting wearable epidermal electrodes due to their lightweight and high breathability. However, due to the strong interaction between fibers, self-healing nanofiber membranes cannot exist stably. Therefore, the development of self-healing and breathable nanofibrous epidermal electrodes still remains a major challenge. Here, a hierarchical confinement strategy that combines molecular and spatial confinement to overcome supramolecular hydrogen bonding between self-healing nanofibers is reported, and an ultrathin self-healing nanofibrous epidermal electrode with a neural net-like structure is developed. It can achieve real-time monitoring of electrophysiological signals through long-term conformal attachment to skin or plants and has no adverse effects on skin health or plant growth. Given the almost imperceptible nature of epidermal electrodes to users and plants, it lays the foundation for the development of biocompatible, self-healing, wearable, flexible electronics.

Flexible electronics for cardiovascular monitoring on complex physiological skins

Cardiovascular diseases (CVDs) pose a significant global health threat, responsible for a considerable portion of worldwide mortality. Flexible electronics enable continuous, noninvasive, real-time, and portable monitoring, providing an ideal platform for personalized healthcare. Nevertheless, challenges persist in sustaining stable adherence across diverse and intricate skin environments, hindering further advancement toward clinical applications. Strategies such as structural design and chemical modification can significantly enhance the environmental adaptability and monitoring performance of flexible electronics. This review delineates processing techniques, including structural design and chemical modification, to mitigate signal interference from sebaceous skin, motion artifacts from the skin in motion, and infection risks from fragile skin, thereby enabling the accurate monitoring of key cardiovascular indicators in complex physiological environments. Moreover, it delves into the potential for the strategic development and improvement of flexible electronics to ensure their alignment with complex physiological environment requirements, facilitating their transition to clinical applications.

Breathable, Adhesive, and Biomimetic Skin-Like Super Tattoo

Electronic tattoo, capable of imperceivably acquiring bio-electrical signals from the body, is broadly applied in healthcare and human-machine interface. Tattoo substrate, the foundation of electronic tattoo, is expected to be mechanically mimetic to skin, adhesive, and breathable, and yet remains highly challenging to achieve. Herein, the study mimics human skin and design a breathable, adhesive, and mechanically skin-like super tattoo substrate based on an ultra-thin film (≈2 µm). Similar to skin, super tattoo demonstrates strain-adaptive stiffening properties with high tear energy (5.4 kJ·m-2) and toughness (1.3 MJ·m-3). Superior to skin, it exhibits high adhesion, ionic conductivity, and permeability. A variety of conductive electrodes can be processed on it, showing the universality toward an ideal platform for electronic tattoo with stable and low contact impedance. Super tattoo-based electrodes can imperceivably and accurately monitor weak electromyography (EMG) of swallowing on the junction, providing effective guidance for rehabilitation training of dysphagia.

Synergistic Strategies of Biomolecular Transport Technologies in Transdermal Healthcare Systems

Transdermal healthcare systems have gained significant attention for their painless and convenient drug administration, as well as their ability to detect biomarkers promptly. However, the skin barrier limits the candidates of biomolecules that can be transported, and reliance on simple diffusion poses a bottleneck for personalized diagnosis and treatment. Consequently, recent advancements in transdermal transport technologies have evolved toward active methods based on external energy sources. Multiple combinations of these technologies have also shown promise for increasing therapeutic effectiveness and diagnostic accuracy as delivery efficiency is maximized. Furthermore, wearable healthcare platforms are being developed in diverse aspects for patient convenience, safety, and on-demand treatment. Herein, a comprehensive overview of active transdermal delivery technologies is provided, highlighting the combination-based diagnostics, therapeutics, and theragnostics, along with the latest trends in platform advancements. This offers insights into the potential applications of next-generation wearable transdermal medical devices for personalized autonomous healthcare.

Bioinspired Robust Gas-Permeable On-Skin Electronics: Armor-Designed Nanoporous Flash Graphene Assembly Enhancing Mechanical Resilience

Soft on-skin electrodes play an important role in wearable technologies, requiring attributes such as wearing comfort, high conductivity, and gas permeability. However, conventional fabrication methods often compromise simplicity, cost-effectiveness, or mechanical resilience. In this study, a mechanically robust and gas-permeable on-skin electrode is presented that incorporates Flash Graphene (FG) integrated with a bioinspired armor design. FG, synthesized through Flash Joule Heating process, offers a small-sized and turbostratic arrangement that is ideal for the assembly of a conductive network with nanopore structures. Screen-printing is used to embed the FG assembly into the framework of polypropylene melt-blown nonwoven fabrics (PPMF), forming a soft on-skin electrode with low sheet resistance (125.2 ± 4.7 Ω/□) and high gas permeability (≈10.08 mg cm⁻2 h⁻¹). The "armor" framework ensures enduring mechanical stability through adhesion, washability, and 10,000 cycles of mechanical contact friction tests. Demonstrating capabilities in electrocardiogram (ECG) and electromyogram (EMG) monitoring, along with serving as a self-powered triboelectric sensor, the FG/PPMF electrode holds promise for scalable, high-performance flexible sensing applications, thereby enriching the landscape of integrated wearable technologies.

Multichannel microneedle dry electrode patches for minimally invasive transdermal recording of electrophysiological signals

The collection of multiple-channel electrophysiological signals enables a comprehensive understanding of the spatial distribution and temporal features of electrophysiological activities. This approach can help to distinguish the traits and patterns of different ailments to enhance diagnostic accuracy. Microneedle array electrodes, which can penetrate skin without pain, can lessen the impedance between the electrodes and skin; however, current microneedle methods are limited to single channels and cannot achieve multichannel collection in small areas. Here, a multichannel (32 channels) microneedle dry electrode patch device was developed via a dimensionality reduction fabrication and integration approach and supported by a self-developed circuit system to record weak electrophysiological signals, including electroencephalography (EEG), electrocardiogram (ECG), and electromyography (EMG) signals. The microneedles reduced the electrode-skin contact impedance by penetrating the nonconducting stratum corneum in a painless way. The multichannel microneedle array (MMA) enabled painless transdermal recording of multichannel electrophysiological signals from the subcutaneous space, with high temporal and spatial resolution, reaching the level of a single microneedle in terms of signal precision. The MMA demonstrated the detection of the spatial distribution of ECG, EMG and EEG signals in live rabbit models, and the microneedle electrode (MNE) achieved better signal quality in the transcutaneous detection of EEG signals than did the conventional flat dry electrode array. This work offers a promising opportunity to develop advanced tools for neural interface technology and electrophysiological recording.

Architectural design and affecting factors of MXene-based textronics for real-world application

Today, textile-based wearable electronic devices (textronics) have been developed by taking advantage of nanotechnology and textile substrates. Textile substrates offer flexibility, air permeability, breathability, and wearability, whereas, using nanomaterials offers numerous functional properties, like electrical conductivity, hydrophobicity, touch sensitivity, self-healing properties, joule heating properties, and many more. For these reasons, textronics have been extensively used in many applications. Recently, new emerging two-dimensional (2D) transition metal carbide and nitride, known as MXene, nanomaterials have been highly considered for developing textronics because the surface functional groups and hydrophilicity of MXene nanoflakes allow the facile fabrication of MXene-based textronics. In addition, MXene nanosheets possess excellent electroconductivity and mechanical properties as well as large surface area, which also give numerous opportunities to develop novel functional MXene/textile-based wearable electronic devices. Therefore, this review summarizes the recent advancements in the architectural design of MXene-based textronics, like fiber, yarn, and fabric. Regarding the fabrication of MXene/textile composites, numerous factors affect the functional properties (e.g. fabric structure, MXene size, etc.). All the crucial affecting parameters, which should be chosen carefully during the fabrication process, are critically discussed here. Next, the recent applications of MXene-based textronics in supercapacitors, thermotherapy, and sensors are elaborately delineated. Finally, the existing challenges and future scopes associated with the development of MXene-based textronics are presented.

E-Tattoos: Toward Functional but Imperceptible Interfacing with Human Skin

The human body continuously emits physiological and psychological information from head to toe. Wearable electronics capable of noninvasively and accurately digitizing this information without compromising user comfort or mobility have the potential to revolutionize telemedicine, mobile health, and both human-machine or human-metaverse interactions. However, state-of-the-art wearable electronics face limitations regarding wearability and functionality due to the mechanical incompatibility between conventional rigid, planar electronics and soft, curvy human skin surfaces. E-Tattoos, a unique type of wearable electronics, are defined by their ultrathin and skin-soft characteristics, which enable noninvasive and comfortable lamination on human skin surfaces without causing obstruction or even mechanical perception. This review article offers an exhaustive exploration of e-tattoos, accounting for their materials, structures, manufacturing processes, properties, functionalities, applications, and remaining challenges. We begin by summarizing the properties of human skin and their effects on signal transmission across the e-tattoo-skin interface. Following this is a discussion of the materials, structural designs, manufacturing, and skin attachment processes of e-tattoos. We classify e-tattoo functionalities into electrical, mechanical, optical, thermal, and chemical sensing, as well as wound healing and other treatments. After discussing energy harvesting and storage capabilities, we outline strategies for the system integration of wireless e-tattoos. In the end, we offer personal perspectives on the remaining challenges and future opportunities in the field.

Multilayer Perceptron Algorithm-Assisted Flexible Piezoresistive PDMS/Chitosan/cMWCNT Sponge Pressure Sensor for Sedentary Healthcare Monitoring

Recently, the health problems faced by sedentary workers have received increasing attention. In this study, a pressure sensor based on a poly(dimethylsiloxane) (PDMS)/carboxylated chitosan (CCS)/carboxylated multiwalled carbon nanotube (cMWCNT) sponge was prepared to realize a portable, sensitive, comfortable, and noninvasive healthcare monitoring system for sedentary workers. The proposed piezoresistive pressure sensor exhibited exceptional sensing performances with high sensitivity (147.74 kPa-1), an ultrawide detection range (22 Pa to 1.42 MPa), and reliable stability (over 3000 cycles). Furthermore, the obtained sensor displayed superior capability in detecting various human motion signals. Based on the 4 × 4 sensing array and multilayer perceptron (MLP) algorithm model, a smart cushion was developed to recognize five types of sitting postures and supply timely reminders to sedentary workers. The piezoresistive sponge pressure sensor proposed in this study reveals promising potential in the fields of wearable electronics, healthcare monitoring, and human-machine interface applications.

An Ultra-Thin MXene Film for Multimodal Sensing of Neuroelectrical Signals with Artifacts Removal

Neuroelectrical signals transmitted onto the skin tend to decay to an extremely weak level, making them highly susceptible to interference from the environment and body movement. Meanwhile, for comprehensively understanding cognitive nerve conduction, multimodal sensing of neural signals, such as magnetic resonance imaging (MRI) and functional near-infrared spectroscopy (fNIRS), is highly required. Previous metal or polymer conductors cannot either provide a seamless on-skin feature for accurate sensing of neuroelectrical signals or be compatible with multimodal imaging techniques without opto- and magnet- artifacts. Herein, a ≈20 nm thick MXene film that is able to simultaneously detect electrophysiological signals and perform imaging by MRI and fNIRS with high fidelity is reported. The ultrathin film is made of crosslinked Ti3 C2 Tx film via poly (3,4-ethylene dioxythiophene): polystyrene sulfonate (PEDOT: PSS), showing a record high electroconductivity and transparency combination (11 000 S cm-1 @89%). Among them, PEDOT: PSS not only plays a cross-linking role to stabilize MXene film but also shortens the interlayer distance for effective charge transfer and high transparency. Thus, it can achieve a low interfacial impedance with skin or neural surfaces for accurate recording of electrophysiological signals with low motion artifacts. Besides, the high transparency originating from the ultrathin feature leads to good compatibility with fNIRS and MRI without optical and magnetic artifacts, enabling multimodal cognitive neural monitoring during prolonged use.

Synergetic Monitoring of both Physiological Pressure and Epidermal Biopotential Based on a Simplified on-Skin-Printed Sensor Modality

Flexible electronic sensors show great potential for health monitoring but are usually limited to single sensing functionality. To enrich their functions, complicated device configurations, sophisticated material systems, and preparation processes are typically involved, obstructing their large-scale deployment and widespread application. Herein, to achieve a good balance between simplicity and multifunctionality, a new paradigm of sensor modality for both mechanical sensing and bioelectrical sensing is presented based on a single material system and a simple solution processing approach. The whole multifunctional sensors are constructed with a pair of highly conductive ultrathin electrodes (WPU/MXene-1) and an elastic micro-structured mechanical sensing layer (WPU/MXene-2), with the human skin serving as the substrate for the whole sensors. The resultant sensors show high pressure sensitivity and low skin-electrode interfacial impedance, enabling to synergetically monitor both physiological pressure (e.g., arterial pulse signals) and epidermal bioelectrical signals (including electrocardiograph and electromyography). The universality and extensibility of this methodology to construct multifunctional sensors with different material systems are also verified. This simplified sensor modality with enhanced multifunctionality provides a novel design concept to construct future smart wearables for health monitoring and medical diagnosis.

Soft Bioelectronics for Therapeutics

Soft bioelectronics play an increasingly crucial role in high-precision therapeutics due to their softness, biocompatibility, clinical accuracy, long-term stability, and patient-friendliness. In this review, we provide a comprehensive overview of the latest representative therapeutic applications of advanced soft bioelectronics, ranging from wearable therapeutics for skin wounds, diabetes, ophthalmic diseases, muscle disorders, and other diseases to implantable therapeutics against complex diseases, such as cardiac arrhythmias, cancer, neurological diseases, and others. We also highlight key challenges and opportunities for future clinical translation and commercialization of soft therapeutic bioelectronics toward personalized medicine.

Ti3C2Tx MXene-Based Multifunctional Tactile Sensors for Precisely Detecting and Distinguishing Temperature and Pressure Stimuli

Although skin-like sensors that can simultaneously detect various physical stimuli are of fair importance in cutting-edge human-machine interaction, robotic, and healthcare applications, they still face challenges in facile, scalable, and cost-effective production using conventional active materials. The emerging two-dimensional transition metal carbide, Ti3C2Tx MXene, integrated with favorable thermoelectric properties, metallic-like conductivity, and a hydrophilic surface, is promising for solving these problems. Herein, skin-like multifunctional sensors are designed to precisely detect and distinguish temperature and pressure stimuli without cross-talk by decorating elastic and porous substrates with MXene sheets. Because the combination of the thermoelectric and conductive MXene with the thermally insulating, elastic, and porous substrate integrates efficient Seebeck and piezoresistive effects, the resultant sensor exhibits not only an ultralow detection limit (0.05 K), high signal-to-noise ratio, and excellent cycling stability for temperature detection but also high sensitivity, fast response time, and outstanding durability for pressure detection. Based on the impressive dual-mode sensing properties and independent temperature and pressure detections, a multimode input terminal and an electronic skin are created, exhibiting great potential in robotic and human-machine interaction applications. This work provides a scalable fabrication of multifunctional tactile sensors for precisely detecting and distinguishing temperature and pressure stimuli.

Recent Progress of Biomaterials-Based Epidermal Electronics for Healthcare Monitoring and Human-Machine Interaction

Epidermal electronics offer an important platform for various on-skin applications including electrophysiological signals monitoring and human-machine interactions (HMI), due to their unique advantages of intrinsic softness and conformal interfaces with skin. The widely used nondegradable synthetic materials may produce massive electronic waste to the ecosystem and bring safety issues to human skin. However, biomaterials extracted from nature are promising to act as a substitute material for the construction of epidermal electronics, owing to their diverse characteristics of biocompatibility, biodegradability, sustainability, low cost and natural abundance. Therefore, the development of natural biomaterials holds great prospects for advancement of high-performance sustainable epidermal electronics. Here, we review the recent development on different types of biomaterials including proteins and polysaccharides for multifunctional epidermal electronics. Subsequently, the applications of biomaterials-based epidermal electronics in electrophysiological monitoring and HMI are discussed, respectively. Finally, the development situation and future prospects of biomaterials-based epidermal electronics are summarized. We expect that this review can provide some inspirations for the development of future, sustainable, biomaterials-based epidermal electronics.

Latest advances on MXenes in biomedical research and health care

The unique combination of physical and chemical properties of MXenes has propelled a growing number of applications in biomedicine and healthcare. The expanding library of MXenes with tunable properties is paving the way for high-performance, application-specific MXene-based sensing and therapeutic platforms. In this article, we highlight the emerging biomedical applications of MXenes with specific emphasis on bioelectronics, biosensors, tissue engineering, and therapeutics. We present examples of MXenes and their composites enabling novel technological platforms and therapeutic strategies, and elucidate potential avenues for further developments. Finally, we discuss the materials, manufacturing, and regulatory challenges that need to be synergistically addressed for the clinical translation of MXene-based biomedical technologies.

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