Stretchable Biofuel Cells as Wearable Textile-based Self-Powered Sensors

From Lab to Life: Self-Powered Sweat Sensors and Their Future in Personal Health Monitoring

The rapid development of wearable sweat sensors has demonstrated their potential for continuous, non-invasive disease diagnosis and health monitoring. Emerging energy harvesters capable of converting various environmental energy sources-biomechanical, thermal, biochemical, and solar-into electrical energy are revolutionizing power solutions for wearable devices. Based on self-powered technology, the integration of the energy harvesters with wearable sweat sensors can drive the device for biosensing, signal processing, and data transmission. As a result, self-powered sweat sensors are able to operate continuously without external power or charging, greatly facilitating the development of wearable electronics and personalized healthcare. This review focuses on the recent advances in self-powered sweat sensors for personalized healthcare, covering sweat sensors, energy harvesters, energy management, and applications. The review begins with the foundations of wearable sweat sensors, providing an overview of their detection methods, materials, and wearable devices. Then, the working mechanism, structure, and a characteristic of different types of energy harvesters are discussed. The features and challenges of different energy harvesters in energy supply and energy management of sweat sensors are emphasized. The review concludes with a look at the future prospects of self-powered sweat sensors, outlining the trajectory of the field and its potential to flourish.

A Simple and Sensitive Wearable SERS Sensor Utilizing Plasmonic-Active Gold Nanostars

Wearable sweat sensors hold great potential for offering detailed health insights by monitoring various biomarkers present in sweat, such as glucose, lactate, uric acid, and urea, in real time. However, most previously reported sensors, primarily based on electrochemical technology, are limited to monitoring only a single analyte at a given time. This study introduces a simple, sensitive, wearable patch based on surface-enhanced Raman spectroscopy (SERS), integrated with highly plasmonically active sharp-branched gold nanostars (GNS) for the simultaneous detection of three sweat biomarkers: lactate, urea, and glucose. We have fabricated the GNS on commercially available adhesive tape, resulting in achieving a low-cost, flexible, and adhesive wearable SERS patch. The limits of detection for lactate, urea, and glucose were achieved at 0.7, 0.6, and 0.7 μM, respectively, which are significantly lower than the clinically relevant concentrations of these biomarkers in sweat. We further evaluated the performance of our wearable SERS patch during outdoor activities, including sitting, walking, and running. To evaluate its overall effectiveness, we simultaneously measured the concentrations of lactate, urea, and glucose during these activities. Overall, our simple, sensitive wearable SERS sensor represents a significant breakthrough by enabling the simultaneous detection of lactate, urea, and glucose present in sweat, marking a major step toward future applications in autonomous and noninvasive personalized healthcare monitoring at home.

Self-powered biosensing sutures for real-time wound monitoring

Effective wound management has the potential to reduce both the duration and cost of wound healing. However, traditional methods often rely on direct observation or complex and expensive biological testing to monitor and evaluate the invasive damage caused by wound healing, which can be time-consuming. Biosensors offer the advantage of precise and real-time monitoring, but existing devices are not suitable for integration with sensitive wound tissue due to their external dimensions. Here, we have designed a self-powered biosensing suture (SPBS) based on biofuel cells to accurately monitor glucose concentration at the wound site and promote wound healing. The anode of the SPBS consists of carbon nanotubes-modified carbon fibers, tetrathiafulvalene (TTF), and glucose oxidase (GOx), while the cathode is composed of Ag2O and carbon nanotubes modified nanotubes modified carbon fibers. It was observed that SPBS exhibited excellent physical and chemical stability in vitro. Regardless of different bending degrees or pH values, the maximum power density of SPBS remained above 92%, which is conducive to long-term dynamic evaluation. Furthermore, the voltage generated by SPBS reflects blood glucose concentration, and measurements at wound sites are consistent with those obtained using a commercially available blood glucose meter. SPBS achieves the healing effect of traditional medical sutures after complete healing within 14 days. It offers valuable insights for intelligent devices dedicated to real-time wound monitoring.

Fibres-threads of intelligence-enable a new generation of wearable systems

Fabrics represent a unique platform for seamlessly integrating electronics into everyday experiences. The advancements in functionalizing fabrics at both the single fibre level and within constructed fabrics have fundamentally altered their utility. The revolution in materials, structures, and functionality at the fibre level enables intimate and imperceptible integration, rapidly transforming fibres and fabrics into next-generation wearable devices and systems. In this review, we explore recent scientific and technological breakthroughs in smart fibre-enabled fabrics. We examine common challenges and bottlenecks in fibre materials, physics, chemistry, fabrication strategies, and applications that shape the future of wearable electronics. We propose a closed-loop smart fibre-enabled fabric ecosystem encompassing proactive sensing, interactive communication, data storage and processing, real-time feedback, and energy storage and harvesting, intended to tackle significant challenges in wearable technology. Finally, we envision computing fabrics as sophisticated wearable platforms with system-level attributes for data management, machine learning, artificial intelligence, and closed-loop intelligent networks.

Approaches of wearable and implantable biosensor towards of developing in precision medicine

In the relentless pursuit of precision medicine, the intersection of cutting-edge technology and healthcare has given rise to a transformative era. At the forefront of this revolution stands the burgeoning field of wearable and implantable biosensors, promising a paradigm shift in how we monitor, analyze, and tailor medical interventions. As these miniature marvels seamlessly integrate with the human body, they weave a tapestry of real-time health data, offering unprecedented insights into individual physiological landscapes. This log embarks on a journey into the realm of wearable and implantable biosensors, where the convergence of biology and technology heralds a new dawn in personalized healthcare. Here, we explore the intricate web of innovations, challenges, and the immense potential these bioelectronics sentinels hold in sculpting the future of precision medicine.

Advances in Energy Harvesting Technologies for Wearable Devices

The development of wearable electronics is revolutionizing human health monitoring, intelligent robotics, and informatics. Yet the reliance on traditional batteries limits their wearability, user comfort, and continuous use. Energy harvesting technologies offer a promising power solution by converting ambient energy from the human body or surrounding environment into electrical power. Despite their potential, current studies often focus on individual modules under specific conditions, which limits practical applicability in diverse real-world environments. Here, this review highlights the recent progress, potential, and technological challenges in energy harvesting technology and accompanying technologies to construct a practical powering module, including power management and energy storage devices for wearable device developments. Also, this paper offers perspectives on designing next-generation wearable soft electronics that enhance quality of life and foster broader adoption in various aspects of daily life.

Eye-Readable and Wearable Colorimetric Sensor Arrays for In Situ Monitoring of Volatile Organic Compounds

Wearable sensors utilize changes in color as a response to physiological stimuli, making them easily recognizable by the naked eye. These colorimetric wearable sensors offer benefits such as easy readability, rapid responsiveness, cost-effectiveness, and straightforward manufacturing techniques. However, their applications in detecting volatile organic compounds (VOCs) in situ have been limited due to the low concentration of complex VOCs and complicated external interferences. Aiming to address these challenges, we introduced readable and wearable colorimetric sensing arrays with a microchannel structure and highly gas-sensitive materials for in situ detection of complex VOCs. The highly gas-sensitive materials were designed by loading gas-sensitive dyes into the porous metal-organic frameworks and further depositing the composites on the electrospun nanofiber membrane. The colorimetric sensor arrays were fabricated using various gas-sensitive composites, including eight dye/MOF composites that respond to various VOCs and two Pd2+/dye/MOF composites that respond to ethylene. This enables the specific recognition of multiple characteristic VOCs. A microfluidic channel made of polydimethylsiloxane (PDMS) was integrated with different colorimetric elements to create a wearable sensor array. It was attached to the surface of fruits to collect and monitor VOCs using the DenseNet classification method. As a proof of concept, we demonstrated the feasibility of the wearable sensing system in monitoring the ripening process of fruits by continuously measuring the VOC emissions from the skin of the fruit.

Advancements in Bio-inspired Self-Powered Wireless Sensors: Materials, Mechanisms, and Biomedical Applications

The rapid maturation of smart city ecosystems is intimately linked to advances in the Internet of Things (IoT) and self-powered sensing technologies. Central to this evolution are battery-less sensors that are critical for applications such as continuous health monitoring through blood metabolites and vital signs, the recognition of human activity for behavioral analysis, and the operational enhancement of humanoid robots. The focus on biosensors that exploit the human body for energy-spanning wearable, attachable, and implantable variants has intensified, driven by their broad applicability in areas from underwater exploration to biomedical assays and earthquake monitoring. The heart of these sensors lies in their diverse energy harvesting mechanisms, including biofuel cells, and piezoelectric, triboelectric, and pyroelectric nanogenerators. Notwithstanding the wealth of research, the literature still lacks a holistic review that integrates the design challenges and implementation intricacies of such sensors. Our review seeks to fill this gap by thoroughly evaluating energy harvesting strategies from both material and structural perspectives and assessing their roles in powering an array of sensors for myriad uses. This exploration offers a comprehensive outlook on the state of self-powered sensing devices, tackling the nuances of their deployment and highlighting their potential to revolutionize data gathering in autonomous systems. The intent of this review is to chart the current landscape and future prospects, providing a pivotal reference point for ongoing research and innovation in self-powered wireless sensing technologies.

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.

Enzymatic biofuel cell: A potential power source for self-sustained smart textiles

Self-sustained smart textiles require a miniaturized and flexible power source, while the state-of-the-art lithium-ion battery cannot be seamlessly integrated into smart textiles. Enzymatic biofuel cells (EBFC), utilizing physiological glucose or lactate as fuels to convert chemical energy into electricity, are a potential alternative power source. In comparison to other proposed energy harvesters relying on solar and biomechanical energy, EBFCs feature several key properties, including continuous power generation, biocompatible interfaces without using toxic elements, simple configuration without extra packaging, and biodegradability. There is an urgent need to introduce EBFCs to the researchers working on smart textiles, who typically are not expert on bioelectrochemistry. This minireview first introduces the working principle of EBFC and then summarizes its recent progress on fibers, yarns, and textiles. It's expected that this review can help to bridge the knowledge gap and provide the community of smart textiles with information on both the strengths and limitations of EBFCs.

Research Progress in Enzyme Biofuel Cells Modified Using Nanomaterials and Their Implementation as Self-Powered Sensors

Enzyme biofuel cells (EBFCs) can convert chemical or biochemical energy in fuel into electrical energy, and therefore have received widespread attention. EBFCs have advantages that traditional fuel cells cannot match, such as a wide range of fuel sources, environmental friendliness, and mild reaction conditions. At present, research on EBFCs mainly focuses on two aspects: one is the use of nanomaterials with excellent properties to construct high-performance EBFCs, and the other is self-powered sensors based on EBFCs. This article reviews the applied nanomaterials based on the working principle of EBFCs, analyzes the design ideas of self-powered sensors based on enzyme biofuel cells, and looks forward to their future research directions and application prospects. This article also points out the key properties of nanomaterials in EBFCs, such as electronic conductivity, biocompatibility, and catalytic activity. And the research on EBFCs is classified according to different research goals, such as improving battery efficiency, expanding the fuel range, and achieving self-powered sensors.

Advancements in wearable technology for monitoring lactate levels using lactate oxidase enzyme and free enzyme as analytical approaches: A review

Lactate is a metabolite that holds significant importance in human healthcare, biotechnology, and the food industry. The need for lactate monitoring has led to the development of various devices for measuring lactate concentration. Traditional laboratory methods, which involve extracting blood samples through invasive techniques such as needles, are costly, time-consuming, and require in-person sampling. To overcome these limitations, new technologies for lactate monitoring have emerged. Wearable biosensors are a promising approach that offers non-invasiveness, low cost, and short response times. They can be easily attached to the skin and provide continuous monitoring. In this review, we evaluate different types of wearable biosensors for lactate monitoring using lactate oxidase enzyme as biological recognition element and free enzyme systems.

A Dual-Functional MXene-Based Bioanode for Wearable Self-Charging Biosupercapacitors

As a reliable energy-supply platform for wearable electronics, biosupercapacitors combine the characteristics of biofuel cells and supercapacitors to harvest and store the energy from human's sweat. However, the bulky preparation process and deep embedding of enzyme active sites in bioelectrodes usually limit the energy-harvesting process, retarding the practical power-supply sceneries especially during the complicated in vivo motion. Herein, a MXene/single-walled carbon nanotube/lactate oxidase hierarchical structure as the dual-functional bioanode is designed, which can not only provide a superior 3D catalytic microenvironment for enzyme accommodation to harvest energy from sweat, but also offers sufficient capacitance to store energy via the electrical double-layer capacitor. A wearable biosupercapacitor is fabricated in the "island-bridge" structure with a composite bioanode, active carbon/Pt cathode, polyacrylamide hydrogel substrate, and liquid metal conductor. The device exhibits an open-circuit voltage of 0.48 V and the high power density of 220.9 µW cm-2 at 0.5 mA cm-2 . The compact conformal adhesion with skin is successfully maintained under stretching/bending conditions. After repeatedly stretching the devices, there is no significant power attenuation in pulsed output. The unique bioelectrode structure and attractive energy harvesting/storing properties demonstrate the promising potential of this biosupercapacitor as a micro self-powered platform of wearable electronics.

Biofluid-Activated Biofuel Cells, Batteries, and Supercapacitors: A Comprehensive Review

Recent developments in wearable and implanted devices have resulted in numerous, unprecedented capabilities that generate increasingly detailed information about a user's health or provide targeted therapy. However, options for powering such systems remain limited to conventional batteries which are large and have toxic components and as such are not suitable for close integration with the human body. This work provides an in-depth overview of biofluid-activated electrochemical energy devices, an emerging class of energy sources judiciously designed for biomedical applications. These unconventional energy devices are composed of biocompatible materials that harness the inherent chemistries of various biofluids to produce useable electrical energy. This work covers examples of such biofluid-activated energy devices in the form of biofuel cells, batteries, and supercapacitors. Advances in materials, design engineering, and biotechnology that form the basis for high-performance, biofluid-activated energy devices are discussed. Innovations in hybrid manufacturing and heterogeneous integration of device components to maximize power output are also included. Finally, key challenges and future scopes of this nascent field are provided.

3D Printed Conformal Strain and Humidity Sensors for Human Motion Prediction and Health Monitoring via Machine Learning

Wearable sensors have garnered considerable attention due to their flexibility and lightweight characteristics in the realm of healthcare applications. However, developing robust wearable sensors with facile fabrication and good conformity remains a challenge. In this study, a conductive graphene nanoplate-carbon nanotube (GC) ink is synthesized for multi jet fusion (MJF) printing. The layer-by-layer fabrication process of MJF not only improves the mechanical and flame-retardant properties of the printed GC sensor but also bolsters its robustness and sensitivity. The direction of sensor bending significantly impacts the relative resistance changes, allowing for precise investigations of joint motions in the human body, such as those of the fingers, wrists, elbows, necks, and knees. Furthermore, the data of resistance changes collected by the GC sensor are utilized to train a support vector machine with a 95.83% accuracy rate for predicting human motions. Due to its stable humidity sensitivity, the sensor also demonstrates excellent performance in monitoring human breath and predicting breath modes (normal, fast, and deep breath), thereby expanding its potential applications in healthcare. This work opens up new avenues for using MJF-printed wearable sensors for a variety of healthcare applications.

Fully Autonomous Active Self-Powered Point-of-Care Devices: The Challenges and Opportunities

Quick and effective point-of-care (POC) devices have the chance to revolutionize healthcare in developed and developing countries since they can operate anywhere the patient is, with the possibility of obtaining and sending the results to the doctor without delay. In recent years, significant efforts have focused on developing new POC systems that can screen for biomarkers continuously and non-invasively in body fluids to prevent, diagnose, and manage diseases. However, one of the critical challenges left to address is how to power them effectively and sufficiently. In developing countries and rural and remote areas, where there are usually no well-established electricity grids or nearby medical facilities, and using batteries is unreliable or not cost-effective, alternative power sources are the most challenging issue for stand-alone and self-sustained POC devices. Here, we provide an overview of the techniques for used self-powering POC devices, where the sample is used to detect and simultaneously generate energy to power the system. Likewise, this paper introduced the state-of-the-art with a review of different research projects, patents, and commercial products for self-powered POCs from the mid-2010s until present day.

A Miniaturized, Battery-Free, Wireless Wound Monitor That Predicts Wound Closure Rate Early

Diabetic foot ulcers are chronic wounds that affect millions and increase the risk of amputation and mortality, highlighting the critical need for their early detection. Recent demonstrations of wearable sensors enable real-time wound assessment, but they rely on bulky electronics, making them difficult to interface with wounds. Herein, a miniaturized, wireless, battery-free wound monitor that measures lactate in real-time and seamlessly integrates with bandages for conformal attachment to the wound bed is introduced. Lactate is selected due to its multifaceted role in initiating healing. Studies in healthy and diabetic mice reveal distinct lactate profiles for normal and impaired healing wounds. A mathematical model based on the sensor data predicts wound closure rate within the first 3 days post-injury with ≈76% accuracy, which increases to ≈83% when pH is included. These studies underscore the significance of monitoring biomarkers during the inflammation phase, which can offer several benefits, including short-term use of wound monitors and their easy removal, resulting in lower risks of injury and infection at the wound site. Improvements in prediction accuracy can be achieved by designing mathematical models that build on multiple wound parameters such as pro-inflammatory and metabolic markers. Achieving this goal will require designing multi-analyte wound monitors.

Growing recyclable and healable piezoelectric composites in 3D printed bioinspired structure for protective wearable sensor

Bionic multifunctional structural materials that are lightweight, strong, and perceptible have shown great promise in sports, medicine, and aerospace applications. However, smart monitoring devices with integrated mechanical protection and piezoelectric induction are limited. Herein, we report a strategy to grow the recyclable and healable piezoelectric Rochelle salt crystals in 3D-printed cuttlebone-inspired structures to form a new composite for reinforcement smart monitoring devices. In addition to its remarkable mechanical and piezoelectric performance, the growth mechanisms, the recyclability, the sensitivity, and repairability of the 3D-printed Rochelle salt cuttlebone composite were studied. Furthermore, the versatility of composite has been explored and applied as smart sensor armor for football players and fall alarm knee pads, focusing on incorporated mechanical reinforcement and electrical self-sensing capabilities with data collection of the magnitude and distribution of impact forces, which offers new ideas for the design of next-generation smart monitoring electronics in sports, military, aerospace, and biomedical engineering.

Advanced Textile-Based Wearable Biosensors for Healthcare Monitoring

With the innovation of wearable technology and the rapid development of biosensors, wearable biosensors based on flexible textile materials have become a hot topic. Such textile-based wearable biosensors promote the development of health monitoring, motion detection and medical management, and they have become an important support tool for human healthcare monitoring. Textile-based wearable biosensors not only non-invasively monitor various physiological indicators of the human body in real time, but they also provide accurate feedback of individual health information. This review examines the recent research progress of fabric-based wearable biosensors. Moreover, materials, detection principles and fabrication methods for textile-based wearable biosensors are introduced. In addition, the applications of biosensors in monitoring vital signs and detecting body fluids are also presented. Finally, we also discuss several challenges faced by textile-based wearable biosensors and the direction of future development.

Flexible and Stretchable Organic Electrochemical Transistors for Physiological Sensing Devices

Flexible and stretchable bioelectronics provides a biocompatible interface between electronics and biological systems and has received tremendous attention for in situ monitoring of various biological systems. Considerable progress in organic electronics has made organic semiconductors, as well as other organic electronic materials, ideal candidates for developing wearable, implantable, and biocompatible electronic circuits due to their potential mechanical compliance and biocompatibility. Organic electrochemical transistors (OECTs), as an emerging class of organic electronic building blocks, exhibit significant advantages in biological sensing due to the ionic nature at the basis of the switching behavior, low driving voltage (<1 V), and high transconductance (in millisiemens range). During the past few years, significant progress in constructing flexible/stretchable OECTs (FSOECTs) for both biochemical and bioelectrical sensors has been reported. In this regard, to summarize major research accomplishments in this emerging field, this review first discusses structure and critical features of FSOECTs, including working principles, materials, and architectural engineering. Next, a wide spectrum of relevant physiological sensing applications, where FSOECTs are the key components, are summarized. Last, major challenges and opportunities for further advancing FSOECT physiological sensors are discussed.

The Evolving Role of Proteins in Wearable Sweat Biosensors

Sweat is an increasingly popular biological medium for fitness monitoring and clinical diagnostics. It contains an abundance of biological information and is available continuously and noninvasively. Sweat-sensing devices often employ proteins in various capacities to create skin-friendly matrices that accurately extract valuable and time-sensitive information from sweat. Proteins were first used in sensors as biorecognition elements in the form of enzymes and antibodies, which are now being tuned to operate at ranges relevant for sweat. In addition, a range of structural proteins, sometimes assembled in conjunction with polymers, can provide flexible and compatible matrices for skin sensors. Other proteins also naturally possess a range of functionalities─as adhesives, charge conductors, fluorescence emitters, and power generators─that can make them useful components in wearable devices. Here, we examine the four main components of wearable sweat sensors─the biorecognition element, the transducer, the scaffold, and the adhesive─and the roles that proteins have played so far, or promise to play in the future, in each component. On a case-by-case basis, we analyze the performance characteristics of existing protein-based devices, their applicable ranges of detection, their transduction mechanism and their mechanical properties. Thereby, we review and compare proteins that can readily be used in sweat sensors and others that will require further efforts to overcome design, stability or scalability challenges. Incorporating proteins in one or multiple components of sweat sensors could lead to the development and deployment of tunable, greener, and safer biosourced devices.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Screen-Printable Functional Nanomaterials for Flexible and Wearable Single-Enzyme-Based Energy-Harvesting and Self-Powered Biosensing Devices

Developing flexible bioelectronics is essential to the realization of artificial intelligence devices and biomedical applications, such as wearables, but their potential is limited by sustainable energy supply. An enzymatic biofuel cell (BFC) is promising for power supply, but its use is limited by the challenges of incorporating multiple enzymes and rigid platforms. This paper shows the first example of screen-printable nanocomposite inks engineered for a single-enzyme-based energy-harvesting device and a self-powered biosensor driven by glucose on bioanode and biocathode. The anode ink is modified with naphthoquinone and multiwalled carbon nanotubes (MWCNTs), whereas the cathode ink is modified with Prussian blue/MWCNT hybrid before immobilizing with glucose oxidase. The flexible bioanode and the biocathode consume glucose. This BFC yields an open circuit voltage of 0.45 V and a maximum power density of 266 μW cm-2. The wearable device coupled with a wireless portable system can convert chemical energy into electric energy and detect glucose in artificial sweat. The self-powered sensor can detect glucose concentrations up to 10 mM. Common interfering substances, including lactate, uric acid, ascorbic acid, and creatinine, have no effect on this self-powered biosensor. Additionally, the device can endure multiple mechanical deformations. New advances in ink development and flexible platforms enable a wide range of applications, including on-body electronics, self-sustainable applications, and smart fabrics.

A Systematic Review on the Advanced Techniques of Wearable Point-of-Care Devices and Their Futuristic Applications

Personalized point-of-care testing (POCT) devices, such as wearable sensors, enable quick access to health monitoring without the use of complex instruments. Wearable sensors are gaining popularity owing to their ability to offer regular and continuous monitoring of physiological data by dynamic, non-invasive assessments of biomarkers in biofluids such as tear, sweat, interstitial fluid and saliva. Current advancements have concentrated on the development of optical and electrochemical wearable sensors as well as advances in non-invasive measurements of biomarkers such as metabolites, hormones and microbes. For enhanced wearability and ease of operation, microfluidic sampling, multiple sensing, and portable systems have been incorporated with materials that are flexible. Although wearable sensors show promise and improved dependability, they still require more knowledge about interaction between the target sample concentrations in blood and non-invasive biofluids. In this review, we have described the importance of wearable sensors for POCT, their design and types of these devices. Following which, we emphasize on the current breakthroughs in the application of wearable sensors in the realm of wearable integrated POCT devices. Lastly, we discuss the present obstacles and forthcoming potentials including the use of Internet of Things (IoT) for offering self-healthcare using wearable POCT.

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.

Epidermal Wearable Biosensors for Monitoring Biomarkers of Chronic Disease in Sweat

Biological information detection technology is mainly used for the detection of physiological and biochemical parameters closely related to human tissues and organ lesions, such as biomarkers. This technology has important value in the clinical diagnosis and treatment of chronic diseases in their early stages. Wearable biosensors can be integrated with the Internet of Things and Big Data to realize the detection, transmission, storage, and comprehensive analysis of human physiological and biochemical information. This technology has extremely wide applications and considerable market prospects in frontier fields including personal health monitoring, chronic disease diagnosis and management, and home medical care. In this review, we systematically summarized the sweat biomarkers, introduced the sweat extraction and collection methods, and discussed the application and development of epidermal wearable biosensors for monitoring biomarkers in sweat in preclinical research in recent years. In addition, the current challenges and development prospects in this field were discussed.

Self-Powered Biosensors for Monitoring Human Physiological Changes

Human physiological signals have an important role in the guidance of human health or exercise training and can usually be divided into physical signals (electrical signals, blood pressure, temperature, etc.) and chemical signals (saliva, blood, tears, sweat). With the development and upgrading of biosensors, many sensors for monitoring human signals have appeared. These sensors are characterized by softness and stretching and are self-powered. This article summarizes the progress in self-powered biosensors in the past five years. Most of these biosensors are used as nanogenerators and biofuel batteries to obtain energy. A nanogenerator is a kind of generator that collects energy at the nanoscale. Due to its characteristics, it is very suitable for bioenergy harvesting and sensing of the human body. With the development of biological sensing devices, the combination of nanogenerators and classical sensors so that they can more accurately monitor the physiological state of the human body and provide energy for biosensor devices has played a great role in long-range medical care and sports health. A biofuel cell has a small volume and good biocompatibility. It is a device in which electrochemical reactions convert chemical energy into electrical energy and is mostly used for monitoring chemical signals. This review analyzes different classifications of human signals and different forms of biosensors (implanted and wearable) and summarizes the sources of self-powered biosensor devices. Self-powered biosensor devices based on nanogenerators and biofuel cells are also summarized and presented. Finally, some representative applications of self-powered biosensors based on nanogenerators are introduced.

Thermally Laminated Lighting Textile for Wearable Displays with High Durability

Textile-based light-emitting devices are attracting more and more attention because of their potential applications in smart clothing, human-computer interfaces, safety warnings, entertainment fashion, etc. However, simple and efficient manufacturing of luminescent devices on fabrics even clothing with excellent stretchability and washability remains challenging. Here, a solvent-free thermal lamination process combined with laser engraving has been proposed to fabricate electroluminescent (EL) devices on textiles. All the preprepared components, such as the bottom electrode, the EL layer, and the top transparent electrode, were thermally laminated on the surface of textiles employing thermoplastic polyurethane (TPU) as the binding matrix. The stretchability, luminance, and interface adhesion of the EL devices were systematically studied, showing excellent mechanical durability at high temperature, in humid environments, withstanding repeated machine washing, and resistant to various forms of physical damage. As a demonstration of potential application, textile-based EL devices were fabricated, which could display colored and pixelated patterns as well as dynamic images. The thermal lamination technology developed in this work can potentially enable people to DIY (do it yourself) fabricate light-emitting devices on clothing using daily tools, which could facilitate the widespread use of textile-based wearable displays.

Functional Fiber Materials to Smart Fiber Devices

The development of fiber materials has accompanied the evolution of human civilization for centuries. Recent advances in materials science and chemistry offered fibers new applications with various functions, including energy harvesting, energy storing, displaying, health monitoring and treating, and computing. The unique one-dimensional shape of fiber devices endows them advantages to work as human-interfaced electronics due to the small size, lightweight, flexibility, and feasibility for integration into large-scale textile systems. In this review, we first present a discussion of the basics of fiber materials and the design principles of fiber devices, followed by a comprehensive analysis on recently developed fiber devices. Finally, we provide the current challenges facing this field and give an outlook on future research directions. With novel fiber devices and new applications continuing to be discovered after two decades of research, we envision that new fiber devices could have an important impact on our life in the near future.

Miniaturized Microfluidic Electrochemical Biosensors Powered by Enzymatic Biofuel Cell

Electrochemical biosensors, in which enzymatic biofuel cells simultaneously work as energy power and signal generators, have become a research hotspot. They display the merits of power self-support, a simplified structure, in vivo operational feasibility, online and timely monitoring, etc. Since the concept of enzymatic biofuel cell-powered biosensors (EBFC-SPBs) was first proposed, its applications in health monitoring have scored tremendous achievements. However, the creation and practical application of portable EBFC-SPBs are still impeded by the difficulty in their miniaturization. In recent years, the booming microfluidic technology has powerfully pushed forward the progress made in miniaturized and portable EBFC-SPBs. This brief review recalls and summarizes the achievements and progress made in miniaturized EBFC-SPBs. In addition, we also discuss the advantages and challenges that microfluidic and screen-printing technologies provide to wearable and disposable EBFC-SPBs.

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.

Reliability of printed stretchable electronics based on nano/micro materials for practical applications

Recent decades have witnessed the booming development of stretchable electronics based on nano/micro composite inks. Printing is a scalable, low-cost, and high-efficiency fabrication tool to realize stretchable electronics through additive processes. However, compared with conventional flexible electronics, stretchable electronics need to experience more severe mechanical deformation which may cause destructive damage. Most of the reported works in this field mainly focus on how to achieve a high stretchability of nano/micro composite conductors or single working modules/devices, with limited attention given to the reliability for practical applications. In this minireview, we summarized the failure modes when printing stretchable electronics using nano/micro composite ink, including dysfunction of the stretchable interconnects, the stress-concentrated rigid-soft interfaces for hybrid electronics, the vulnerable vias upon stretching, thermal accumulation, and environmental instability of stretchable materials. Strategies for tackling these challenges to realize reliable performances are proposed and discussed. Our review provides an overview on the importance of reliable, printable, and stretchable electronics, which are the key enablers in propelling stretchable electronics from fancy demos to practical applications.

Wearable and flexible electrochemical sensors for sweat analysis: a review

Flexible wearable sweat sensors allow continuous, real-time, noninvasive detection of sweat analytes, provide insight into human physiology at the molecular level, and have received significant attention for their promising applications in personalized health monitoring. Electrochemical sensors are the best choice for wearable sweat sensors due to their high performance, low cost, miniaturization, and wide applicability. Recent developments in soft microfluidics, multiplexed biosensing, energy harvesting devices, and materials have advanced the compatibility of wearable electrochemical sweat-sensing platforms. In this review, we summarize the potential of sweat for medical detection and methods for sweat stimulation and collection. This paper provides an overview of the components of wearable sweat sensors and recent developments in materials and power supply technologies and highlights some typical sensing platforms for different types of analytes. Finally, the paper ends with a discussion of the challenges and a view of the prospective development of this exciting field.

What Is Left for Real-Life Lactate Monitoring? Current Advances in Electrochemical Lactate (Bio)Sensors for Agrifood and Biomedical Applications

Monitoring of lactate is spreading from the evident clinical environment, where its role as a biomarker is notorious, to the agrifood ambit as well. In the former, lactate concentration can serve as a useful indicator of several diseases (e.g., tumour development and lactic acidosis) and a relevant value in sports performance for athletes, among others. In the latter, the spotlight is placed on the food control, bringing to the table meaningful information such as decaying product detection and stress monitoring of species. No matter what purpose is involved, electrochemical (bio)sensors stand as a solid and suitable choice. However, for the time being, this statement seems to be true only for discrete measurements. The reality exposes that real and continuous lactate monitoring is still a troublesome goal. In this review, a critical overview of electrochemical lactate (bio)sensors for clinical and agrifood situations is performed. Additionally, the transduction possibilities and different sensor designs approaches are also discussed. The main aim is to reflect the current state of the art and to indicate relevant advances (and bottlenecks) to keep in mind for further development and the final achievement of this highly worthy objective.

Recent advancements in the field of flexible/wearable enzyme fuel cells

This review article focusses on new advances in the field of enzyme fuel cells (EFCs), especially, on flexible materials which can be used to make flexible EFCs for wearable devices, three-dimensional (3D) printed structures to prepare electrodes for EFCs and micro/nano electromechanical structures (MEMS/NEMS) to fabricate micro-EFCs. Particular attention is given to newly developed approaches to obtain efficient electrodes for harvesting energy via EFCs. This review article explains the various attributes of these recently developing technologies and their ability to mitigate the energy requirements of flexible/wearable bioelectronic devices. Besides discussing key milestones achieved, this perspective review article also emphasizes the main hurdles that are currently impeding the realization of flexible/wearable EFCs. We have also emphasized on the major hurdles related to the flexible materials required to fabricate wearable EFCs, suitable 3D printing techniques required, and MEMS and NEMS to fabricate micro-EFCs. In all the recently developed techniques, there are some common issues like stability, low power output, mechanical strength and flexibility. This review article also provides various routes to mitigate these issues. The main aim of this perspective article is to develop curiosity among the researchers of various fields to team up in order to address the huge challenges that restrict the real-world application of flexible/wearable EFCs. Such collaboration is important to harness the full potential of EFCs. It is requested to read this review article with supporting information to get the complete essence.

Engineering Self-Powered Electrochemical Sensors Using Analyzed Liquid Sample as the Sole Energy Source

Many healthcare and environmental monitoring devices use electrochemical techniques to detect and quantify analytes. With sensors progressively becoming smaller-particularly in point-of-care (POC) devices and wearable platforms-it creates the opportunity to operate them using less energy than their predecessors. In fact, they may require so little power that can be extracted from the analyzed fluids themselves, for example, blood or sweat in case of physiological sensors and sources like river water in the case of environmental monitoring. Self-powered electrochemical sensors (SPES) can generate a response by utilizing the available chemical species in the analyzed liquid sample. Though SPESs generate relatively low power, capable devices can be engineered by combining suitable reactions, miniaturized cell designs, and effective sensing approaches for deciphering analyte information. This review details various such sensing and engineering approaches adopted in different categories of SPES systems that solely use the power available in liquid sample for their operation. Specifically, the categories discussed in this review cover enzyme-based systems, battery-based systems, and ion-selective electrode-based systems. The review details the benefits and drawbacks with these approaches, as well as prospects of and challenges to accomplishing them.

Design and Testing of Autonomous Chargeable and Wearable Sweat/Ionic Liquid-Based Supercapacitors

This work demonstrates ionic liquid electrolyte-inscribed sweat-based dual electrolyte functioning supercapacitors capable of self-charging through sweat electrolyte function under a non-enzymatic route. The supercapacitor electrodes are fabricated from TREN (tris(2-aminoethyl)amine), poly-3,4-ethylenedioxythiophene, and a graphene oxide mixture with copper-mediated chelate, and this polymer-GO-metal chelate film can produce excellent energy harvest/storage performance from a sweat and ionic liquid integrated electrolyte system. The fabricated device is specifically designed to reduce deterioration using a typical planar structure. In the presence of sweat with ionic liquid, the dual electrolyte mode supercapacitor exhibits a maximum areal capacitance of 3600 mF cm-2 , and the energy density is 450 mWhcm-2 , which is more than 100 times greater than that from previously reported supercapacitors. The supercapacitors were fabricated/attached directly to textile fabrics as well as ITO-PET (Indium tin oxide (ITO)-polyethylene terephthalate (PET) film to study their performance on the human body during exercise. The self-charging performance with respect to sweat wetting time for the sweat@ionic liquid dual electrolyte showed that the supercapacitor performed well on both fabric and film. These devices exhibited good response for pH effect and biocompatibility, and as such present a promising multi-functional energy system as a stable power source for next-generation wearable smart electronics.

Smartphone-Based Electrochemical Systems for Glucose Monitoring in Biofluids: A Review

As a vital biomarker, glucose plays an important role in multiple physiological and pathological processes. Thus, glucose detection has become an important direction in the electrochemical analysis field. In order to realize more convenient, real-time, comfortable and accurate monitoring, smartphone-based portable, wearable and implantable electrochemical glucose monitoring is progressing rapidly. In this review, we firstly introduce technologies integrated in smartphones and the advantages of these technologies in electrochemical glucose detection. Subsequently, this overview illustrates the advances of smartphone-based portable, wearable and implantable electrochemical glucose monitoring systems in diverse biofluids over the last ten years (2012-2022). Specifically, some interesting and innovative technologies are highlighted. In the last section, after discussing the challenges in this field, we offer some future directions, such as application of advanced nanomaterials, novel power sources, simultaneous detection of multiple markers and a closed-loop system.

Durability Study of Thermal Transfer Printed Textile Electrodes for Wearable Electronic Applications

Textile-based electronics hold great promise because they can endow wearable devices with soft and comfortable characteristics. However, the inherent porosity and fluffiness of fabrics result in high surface roughness, which presents great challenges in the manufacture of high-performance fabric electrodes. In this work, we propose a thermal transfer printing method to address the above challenges, in which electrodes or circuits of silver flake/thermoplastic polyurethane (TPU) composites are prefabricated on a release film by coating and laser engraving and then laminated by hot-pressing to a variety of fabrics and textiles. This universal and scalable production technique enables fabric electrodes to be made without compromising the original wearability, washability, and stretchability of textiles. The prepared fabric electrodes exhibit high conductivity (5.48 × 10⁴ S/cm), high adhesion (≥1750 N/m), good abrasion/washing resistance, high patterning resolution (∼40 μm), and good electromechanical performance up to 50% strain. To demonstrate the potential applications, we developed textile-based radio frequency identification (RFID) tags for remote identification and a large-sized heater for wearable thermotherapy. More importantly, the solvent-free thermal transfer printing technology developed in this paper enables people to DIY interesting flexible electronics on clothes with daily tools, which can promote the commercial application of smart textile-based electronics.

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.

Textile-based electrochemical sensors and their applications

Textile and their composite-based functional sensors are extensively acknowledged and preferred detection platforms in recent times. Developing suitable methodologies for fabricating textile sensors can be achieved either by integration of conductive fibers and yarns into textiles using technologies such as weaving, knitting and embroidery; or by functionalization of textile materials with conductive nanomaterials/inks using printing or coating methods. Textile materials are gaining enormous attention for fabricating soft lab-on-fabric devices due to their unique features such as high flexibility, wear and wash resistance, mechanical strength and promising sensing performances. Owing to these collective properties, textile-based electrochemical transducers are now showcasing rapid and accurate electrical measurements towards real time point-of-care diagnostics and environmental monitoring applications. The present review provides a brief overview of key progress made in the field of developing textile materials and their composites-based electrochemical sensors and biosensors in recent years where electrode configurations are specifically based on either natural or synthetic fabrics. Different ways to fabricate and functionalize textiles for their application in electrochemical analysis are briefly discussed. The review ends with a conclusive note focusing on the current challenges in the fabrication of textile-based stable electrochemical sensors and biosensors.

Multi-Layer Printable Lithium Ion Micro-Batteries with Remarkable Areal Energy Density and Flexibility for Wearable Smart Electronics

Pursuing high areal energy density and developing scalable fabrication strategies of micro-batteries are the key for the progressive printed microelectronics. Herein, the scalable fabrication of multi-layer printable lithium ion micro-batteries (LIMBs) with ultrahigh areal energy density and exceptional flexibility is reported, based on highly conductive and mechanically stable inks by fully incorporating the polyurethane binders in dibasic esters with high-conducting additives of graphene and carbon nanotubes into active materials to construct a cross-linked conductive network. Benefiting from relatively higher electrical conductivity (≈7000 mS cm^-1 ) and stably connected network of microelectrodes, the as-fabricated LIMBs by multi-layer printing display robust areal capacity of 398 µAh cm^-2 , and remarkable areal energy density of 695 μWh cm^-2 , which are much higher than most LIMBs reported. Further, the printed LIMBs show notable capacity retention of 88% after 3000 cycles, and outstanding flexibility without any structure degradation under various torsion states and folding angles. Importantly, a wearable smart bracelet, composed of a serially connected LIMBs pack, a temperature sensor, and a light-emitting diode, is realized for the automatic detection of body temperature. Therefore, this strategy of fabricating highly conductive and mechanically stable printable ink will open a new avenue for developing high-performance printable LIMBs for smart microelectronics.

Lab on a body for biomedical electrochemical sensing applications: The next generation of microfluidic devices

This chapter highlights applications of microfluidic devices toward on-body biosensors. The emerging application of microfluidics to on-body bioanalysis is a new strategy to establish systems for the continuous, real-time, and on-site determination of informative markers present in biofluids, such as sweat, interstitial fluid, blood, saliva, and tear. Electrochemical sensors are attractive to integrate with such microfluidics due to the possibility to be miniaturized. Moreover, on-body microfluidics coupled with bioelectronics enable smart integration with modern information and communication technology. This chapter discusses requirements and several challenges when developing on-body microfluidics such as difficulties in manipulating small sample volumes while maintaining mechanical flexibility, power-consumption efficiency, and simplicity of total automated systems. We describe key components, e.g., microchannels, microvalves, and electrochemical detectors, used in microfluidics. We also introduce representatives of advanced lab-on-a-body microfluidics combined with electrochemical sensors for biomedical applications. The chapter ends with a discussion of the potential trends of research in this field and opportunities. On-body microfluidics as modern total analysis devices will continue to bring several fascinating opportunities to the field of biomedical and translational research applications.

Recent progress in self-powered multifunctional e-skin for advanced applications

Electronic skin (e-skin), new generation of flexible wearable electronic devices, has characteristics including flexibility, thinness, biocompatibility with broad application prospects, and a crucial place in future wearable electronics. With the increasing demand for wearable sensor systems, the realization of multifunctional e-skin with low power consumption or even autonomous energy is urgently needed. The latest progress of multifunctional self-powered e-skin for applications in physiological health, human-machine interaction (HMI), virtual reality (VR), and artificial intelligence (AI) is presented here. Various energy conversion effects for the driving energy problem of multifunctional e-skin are summarized. An overview of various types of self-powered e-skins, including single-effect e-skins and multifunctional coupling-effects e-skin systems is provided, where the aspects of material preparation, device assembly, and output signal analysis of the self-powered multifunctional e-skin are described. In the end, the existing problems and prospects in this field are also discussed.

Graphene-enabled wearable sensors for healthcare monitoring

Wearable sensors in healthcare monitoring have recently found widespread applications in biomedical fields for their non- or minimal-invasive, user-friendly and easy-accessible features. Sensing materials is one of the major challenges to achieve these superiorities of wearable sensors for healthcare monitoring, while graphene-based materials with many favorable properties have shown great efficiency in sensing various biochemical and biophysical signals. In this paper, we review state-of-the-art advances in the development and modification of graphene-based materials (i.e., graphene, graphene oxide and reduced graphene oxide) for fabricating advanced wearable sensors with 1D (fibers), 2D (films) and 3D (foams/aerogels/hydrogels) macroscopic structures. We summarize the structural design guidelines, sensing mechanisms, applications and evolution of the graphene-based materials as wearable sensors for healthcare monitoring of biophysical signals (e.g., mechanical, thermal and electrophysiological signals) and biochemical signals from various body fluids and exhaled gases. Finally, existing challenges and future prospects are presented in this area.