Design and application of 'J-shaped' stress-strain behavior in stretchable electronics: a review

Flexible and robust polyaniline/cross-linked collagen sponge with fibrils network structure as a piezoresistive sensing material

The polyaniline/cross-linked collagen sponge (PANI/CCS) was synthesized by polymerizing PANI onto the collagen skeleton using mesoscopic collagen fibrils (CFs) as building blocks, serving as a piezoresistive sensing material. The structure and morphology of PANI/CCS were characterized using scanning electron microscopy (SEM), Fourier infrared spectroscopy (FTIR), X-ray photoelectron spectroscopy (XPS), and thermal analysis (TA). The mechanical properties of PANI/CCS could be controlled by adjusting the CFs content and polymerization conditions. PANI/CCS treated with pure water exhibited exceptional compressive elasticity under 1000 compression cycles, demonstrating a wide strain range (0-85 %), rapid response time (200 ms), recovery time (90 ms), and high sensitivity (6.72 at 40-50 % strain). The treatment of the ionic liquid further improved the elasticity and the strain sensing range (0-95 %). The presence of PANI nanoparticles and mesoscopic collagen fibrils imparted antibacterial properties, stability in solvents, and biodegradability to PANI/CCS. Utilizing PANI/CCS as a piezoresistive sensing material enabled monitoring human movement behavior through the assembled sensor, showing significant potential for flexible wearable devices.

Breaking the Saturation of Sensitivity for Ultrawide Range Flexible Pressure Sensors by Soft-Strain Effect

The flexible pressure sensors with a broad pressure range and unsaturated sensitivity are highly desired in practical applications. However, pressure sensors by piezoresistive effect are always limited by the compressibility of sensing layers, resulting in a theoretically decreasing sensitivity of less than 100%. Here, a unique strategy is proposed that utilizes the strain effect, simultaneously achieving a trade-off between a wider pressure detection range and unsaturated sensitivity. Ascribed to the strain effect of sensing layers induced by interlaced microdomes, the sensors possess an increased sensitivity (5.22-70 MPa-1) over an ultrawide pressure range (45 Pa-4.1 MPa), a high-pressure resolution (5 Pa), fast response/recovery time (30/45 ms), and a robust response under a high-pressure loading of 3.5 MPa for more than 5000 cycles. These superior sensing performances allow the sensor to monitor large pressure. The flexible pressure sensor array can assist doctors in restoring the neutral mechanical axis, tracking knee flexion angles, and extracting gait features. Moreover, the flexible sensing array can be integrated into the joint motion surveillance system to map the balance medial-lateral contact forces on the metal compartments in real time, demonstrating the potential for further development into precise medical human-machine interfaces during total knee replacement surgery.

Highly Compressible, Superabsorbent, and Biocompatible Hybrid Cryogel Constructs Comprising Functionalized Chitosan and St. John's Wort Extract

Biobased porous hydrogels enriched with phytocompounds-rich herbal extracts have aroused great interest in recent years, especially in healthcare. In this study, new macroporous hybrid cryogel constructs comprising thiourea-containing chitosan (CSTU) derivative and a Hypericum perforatum L. extract (HYPE), commonly known as St John's wort, were prepared by a facile one-pot ice-templating strategy. Benefiting from the strong interactions between the functional groups of the CSTU matrix and those of polyphenols in HYPE, the hybrid cryogels possess excellent liquid absorption capacity, mechanical resilience, antioxidant performance, and a broad spectrum of antibacterial activity simultaneously. Thus, owing to their design, the hybrid constructs exhibit an interconnected porous architecture with the ability to absorb over 33 and 136 times their dry weight, respectively, when contacted with a phosphate buffer solution (pH 7.4) and an acidic aqueous solution (pH 2). These cryogel constructs have extremely high compressive strengths ranging from 839 to 1045 kPa and withstand elevated strains of over 70% without developing fractures. Moreover, the water-swollen hybrid cryogels with the highest HYPE content revealed a complete and instant shape recovery after uniaxial compression. The incorporation of HYPE into CSTU cryogels enabled substantial improvement in scavenging reactive oxygen species and an expanded antibacterial spectrum toward multiple pathogens, including Gram-positive bacteria (Staphylococcus aureus and Staphylococcus epidermidis), Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa), and fungi (Candida albicans). Cell viability experiments demonstrated the cytocompatibility of the 3D cryogel constructs, which did not induce changes in the fibroblast morphology. This work showcases a simple and effective strategy to immobilize HYPE extracts on CSTU 3D networks, allowing the development of novel multifunctional platforms with promising potential in hemostasis, wound dressing, and dermal regeneration scaffolds.

Self-Healing Materials for Bioelectronic Devices

Though the history of self-healing materials stretches far back to the mid-20th century, it is only in recent years where such unique classes of materials have begun to find use in bioelectronics-itself a burgeoning area of research. Inspired by the natural ability of biological tissue to self-repair, self-healing materials play a multifaceted role in the context of soft, wireless bioelectronic systems, in that they can not only serve as a protective outer shell or substrate for the internal electronic circuitry-analogous to the mechanical barrier that skin provides for the human body-but also, and most importantly, act as an active sensing safeguard against mechanical damage to preserve device functionality and enhance overall durability. This perspective presents the historical overview, general design principles, recent developments, and future outlook of self-healing materials for bioelectronic devices, which integrates topics in many research disciplines-from materials science and chemistry to electronics and bioengineering-together.

Skin Comfort Sensation with Mechanical Stimulus from Electronic Skin

The field of electronic skin has received considerable attention due to its extensive potential applications in areas including tactile sensing and health monitoring. With the development of electronic skin devices, electronic skin can be attached to the surface of human skin for long-term health monitoring, which makes comfort an essential factor that cannot be ignored in the design of electronic skin. Therefore, this paper proposes an assessment method for evaluating the comfort of electronic skin based on neurodynamic analysis. The holistic analysis framework encompasses the mechanical model of the skin, the modified Hodgkin-Huxley model for the transduction of stimuli, and the gate control theory for the modulation and perception of pain sensation. The complete process, from mechanical stimulus to the generation of pain perception, is demonstrated. Furthermore, the influence of different factors on pain perception is investigated. Sensation and comfort diagrams are provided to assess the mechanical comfort of electronic skin. The comfort assessment method proposed in this paper provides a theoretical basis when assessing the comfort of electronic skin.

Size effect in polymeric lattice materials with size-dependent Poisson's ratio caused by Cosserat elasticity

Polymeric lattice materials with micro/nano-structures are attractive for applications in a wide range of bioengineering systems. Resent experimental results show that elastic constitutive law of polymer materials is in line with the Cosserat elasticity. In this work, a Cosserat continuum spectral element method is employed to explore the size-dependent mechanical performance of polymer polymeric lattice with horseshoe microstructures, efficiently. The mechanical performance predicted by the proposed method agrees very well with the experiment data. Our results demonstrate that size effects are significant in polymeric lattice materials. The size-dependent negative Poisson's ratio is found in the polymeric lattice materials with the same topological structure due to the size effect caused by the Cosserat elasticity of the polymer materials. It could be implied that it is possible to continuously adjust the negative Poisson's ratio of the polymeric lattice material over a wide range by only changing its microstructural size.

Approximation of extracted features enabling 3D design tuning for reproducing the mechanical behaviour of biological soft tissues

This article describes a new method, inspired by machine learning, to mimic the mechanical behaviour of target biological soft tissues with 3D printed materials. The principle is to optimise the structure of a 3D printed composite consisting of a geometrically tunable fibre embedded in a soft matrix. Physiological features are extracted from experimental stress-strain curves of several biological soft tissues. Then, using a cubic Bézier curve as the composite inner fibre, we optimised its geometric parameters, amplitude and height, to generate a specimen that exhibits a stress-strain curve in accordance with the extracted features of tensile tests. From this first phase, we created a database of specimen geometries that can be used to reproduce a wide variety of biological soft tissues. We applied this process to two soft tissues with very different behaviours: the mandibular periosteum and the calvarial periosteum. The results show that our method can successfully reproduce the mechanical behaviour of these tissues. This highlights the versatility of this approach and demonstrates that it can be extended to mimic various biological soft tissues.

3D printing sequentially strengthening high-strength natural polymer hydrogel bilayer scaffold for cornea regeneration

3D printing of high-strength natural polymer biodegradable hydrogel scaffolds simultaneously resembling the biomechanics of corneal tissue and facilitating tissue regeneration remains a huge challenge due to the inherent brittleness of natural polymer hydrogels and the demanding requirements of printing. Herein, concentrated aqueous solutions of gelatin and carbohydrazide-modified alginate (Gel/Alg-CDH) are blended to form a natural polymer hydrogel ink, where the hydrazides in Alg-CDH are found to form strong hydrogen bonds with the gelatin. The hydrogen-bonding-strengthened Gel/Alg-CDH hydrogel demonstrates an appropriate thickened viscosity and shear thinning for extrusion printing. The strong hydrogen bonds contribute to remarkably increased mechanical properties of Gel/Alg-CDH hydrogel with a maximum elongation of over 400%. In addition, sequentially Ca2+-physical crosslinking and then moderately chemical crosslinking significantly enhance the mechanical properties of Gel/Alg-CDH hydrogels that ultimately exhibit an intriguing J-shaped stress-strain curve (tensile strength of 1.068 MPa and the toughness of 677.6 kJ/m2). The dually crosslinked Gel-Alg-CDH-Ca2+-EDC hydrogels demonstrate a high transparency, physiological swelling stability and rapid enzymatic degradability, as well as suturability. The growth factor and drug-loaded biomimetic bilayer hydrogel scaffold are customized via a multi-nozzle printing system. This bioactive bilayer hydrogel scaffold considerably promotes regeneration of corneal epithelium and stroma and inhibits cornea scarring in rabbit cornea keratoplasty.

The Application of a Multi-Material Flexible Chain Mail for the Design of an Artificial Spinal Disc to Reproduce Natural Nonlinear and Anisotropic Rotational Behavior

Inspired by the potential of architected materials for achieving biomimicking functionalities and the advancement of multi-material additive manufacturing to fabricate parts with complex structures and heterogeneous material distributions, this study investigates the feasibility of using a multi-material, flexible chain mail sheet for the design of an additively manufactured artificial spinal disc for reproducing patient-specific anisotropic and nonlinear rotational behaviors. The application of a chain mail-based structure is motivated by its similarities in behaviors compared with a natural disc's fiber network that likewise has negligible bending stiffness and shape-changing ability. The proposed approach for the chain mail sheet design includes an initial characterization of the uniaxial tensile responses of the chain mail unit cell defined as the basic building block of the chain mail sheet, modeling and response calculation, and material optimization. Results show that the additively manufactured chain mail sheet is not only able to exhibit a natural strain-stiffening rotational response but also is able to reproduce natural anisotropy of three natural disc specimens in the six most common rotational scenarios in daily life. This study shows the potential of additively manufactured mechanical-metamaterials-inspired structures for implant design to restore natural mechanics.

Mechanical characterization and design of biomaterials for nucleus pulposus replacement and regeneration

Biomaterials for nucleus pulposus (NP) replacement and regeneration have great potential to restore normal biomechanics in degenerated intervertebral discs following nucleotomy. Mechanical characterizations are essential for assessing the efficacy of biomaterial implants for clinical applications. While traditional compression tests are crucial to quantify various modulus values, relaxation behaviors and fatigue resistance, rheological measurements should also be conducted to investigate the viscoelastic properties, injectability, and overall stability upon deformation. To recapitulate the physiological in vivo environment, the use of spinal models is necessary to evaluate the risk of implant extrusion and the restoration of biomechanics under different loading conditions. When designing devices for NP replacement, injectable materials are ideal to fully fill the nucleus cavity and prevent implant migration. In addition to achieving biocompatibility and desirable mechanical characteristics, biomaterial implants should be optimized to avoid implant extrusion or re-herniation post-operatively. This review discusses the most commonly used testing protocols for assessing mechanical properties of biomaterial implants and serves as reference material for enabling researchers to characterize NP implants through a unified approach whereby newly developed biomaterials may be compared and contrasted to existing devices.

Gelatin-Based Metamaterial Hydrogel Films with High Conformality for Ultra-Soft Tissue Monitoring

Implantable hydrogel-based bioelectronics (IHB) can precisely monitor human health and diagnose diseases. However, achieving biodegradability, biocompatibility, and high conformality with soft tissues poses significant challenges for IHB. Gelatin is the most suitable candidate for IHB since it is a collagen hydrolysate and a substantial part of the extracellular matrix found naturally in most tissues. This study used 3D printing ultrafine fiber networks with metamaterial design to embed into ultra-low elastic modulus hydrogel to create a novel gelatin-based conductive film (GCF) with mechanical programmability. The regulation of GCF nearly covers soft tissue mechanics, an elastic modulus from 20 to 420 kPa, and a Poisson's ratio from - 0.25 to 0.52. The negative Poisson's ratio promotes conformality with soft tissues to improve the efficiency of biological interfaces. The GCF can monitor heartbeat signals and respiratory rate by determining cardiac deformation due to its high conformability. Notably, the gelatin characteristics of the biodegradable GCF enable the sensor to monitor and support tissue restoration. The GCF metamaterial design offers a unique idea for bioelectronics to develop implantable sensors that integrate monitoring and tissue repair and a customized method for endowing implanted sensors to be highly conformal with soft tissues.

Sustainable electronic textiles towards scalable commercialization

Textiles represent a fundamental material format that is extensively integrated into our everyday lives. The quest for more versatile and body-compatible wearable electronics has led to the rise of electronic textiles (e-textiles). By enhancing textiles with electronic functionalities, e-textiles define a new frontier of wearable platforms for human augmentation. To realize the transformational impact of wearable e-textiles, materials innovations can pave the way for effective user adoption and the creation of a sustainable circular economy. We propose a repair, recycle, replacement and reduction circular e-textile paradigm. We envisage a systematic design framework embodying material selection and biofabrication concepts that can unify environmental friendliness, market viability, supply-chain resilience and user experience quality. This framework establishes a set of actionable principles for the industrialization and commercialization of future sustainable e-textile products.

Embedding Living Cells with a Mechanically Reinforced and Functionally Programmable Hydrogel Fiber Platform

Living materials represent a new frontier in functional material design, integrating synthetic biology tools to endow materials with programmable, dynamic, and life-like characteristics. However, a major challenge in creating living materials is balancing the tradeoff between structural stability, mechanical performance, and functional programmability. To address this challenge, a sheath-core living hydrogel fiber platform that synergistically integrates living bacteria with hydrogel fibers to achieve both functional diversity and structural and mechanical robustness is proposed. In the design, microfluidic spinning is used to produce hydrogel fiber, which offers advantages in both structural and functional designability due to their hierarchical porous architectures that can be tailored and their mechanical performance that can be enhanced through a variety of post-processing approaches. By introducing living bacteria, the platform is endowed with programmable functionality and life-like capabilities. This work reconstructs the genetic circuits of living bacteria to express chromoproteins and fluorescent proteins as two prototypes that enable the coloration of living fibers and sensing water pollutants by monitoring the amount of fluorescent protein expressed. Altogether, this study establishes a structure-property-function optimized living hydrogel fiber platform, providing a new tool for accelerating the practical applications of the emerging living material systems.

Thermoelectric Freeze-Casting of Biopolymer Blends: Fabrication and Characterization of Large-Size Scaffolds for Nerve Tissue Engineering Applications

Peripheral nerve injuries (PNIs) are detrimental to the quality of life of affected individuals. Patients are often left with life-long ailments that affect them physically and psychologically. Autologous nerve transplant is still the gold standard treatment for PNIs despite limited donor site and partial recovery of nerve functions. Nerve guidance conduits are used as a nerve graft substitute and are efficient for the repair of small nerve gaps but require further improvement for repairs exceeding 30 mm. Freeze-casting is an interesting fabrication method for the conception of scaffolds meant for nerve tissue engineering since the microstructure obtained comprises highly aligned micro-channels. The present work focuses on the fabrication and characterization of large scaffolds (35 mm length, 5 mm diameter) made of collagen/chitosan blends by freeze-casting via thermoelectric effect instead of traditional freezing solvents. As a freeze-casting microstructure reference, scaffolds made from pure collagen were used for comparison. Scaffolds were covalently crosslinked for better performance under load and laminins were further added to enhance cell interactions. Microstructural features of lamellar pores display an average aspect ratio of 0.67 ± 0.2 for all compositions. Longitudinally aligned micro-channels are reported as well as enhanced mechanical properties in traction under physiological-like conditions (37 °C, pH = 7.4) resulting from crosslinking treatment. Cell viability assays using a rat Schwann cell line derived from sciatic nerve (S16) indicate that scaffold cytocompatibility is similar between scaffolds made from collagen only and scaffolds made from collagen/chitosan blend with high collagen content. These results confirm that freeze-casting via thermoelectric effect is a reliable manufacturing strategy for the fabrication of biopolymer scaffolds for future peripheral nerve repair applications.

Extremely Robust and Multifunctional Nanocomposite Fibers for Strain-Unperturbed Textile Electronics

Textile electronics are needed that can achieve strain-unaltered performance when they undergo irregular and repeated strain deformation. Such strain-unaltered textile electronics require advanced fibers that simultaneously have high functionalities and extreme robustness as fabric materials. Current synthetic nanocomposite fibers based on inorganic matrix have remarkable functionalities but often suffer from low robustness and poor tolerance against crack formation. Here, we present a design for a high-performance multifunctional nanocomposite fiber that is mechanically and electrically robust, which was realized by crosslinking titanium carbide (MXene) nanosheets with a slide-ring polyrotaxane to form an internal mechanically-interlocked network. This inorganic matrix nanocomposite fiber featured distinct strain-hardening mechanical behavior and exceptional load-bearing capability (toughness approaching 60 MJ m^-3 and ductility over 27%). It retained 100% of its ductility after cyclic strain loading. Moreover, the high electrical conductivity (>1.1 × 10⁵ S m^-1 ) and electrochemical performance (>360 F cm^-3 ) of the nanocomposite fiber can be well retained after subjecting the fiber to extensive (>25% strain) and long-term repeated (10 000 cycles) dimensional changes. Such superior robustness allowed for the fabrication of the nanocomposite fibers into various robust wearable devices, such as textile-based electromechanical sensors with strain-unalterable sensing performance and fiber-shaped supercapacitors with invariant electrochemical performance for 10 000 strain loading cycles.

Advanced Bionic Attachment Equipment Inspired by the Attachment Performance of Aquatic Organisms: A Review

In nature, aquatic organisms have evolved various attachment systems, and their attachment ability has become a specific and mysterious survival skill for them. Therefore, it is significant to study and use their unique attachment surfaces and outstanding attachment characteristics for reference and develop new attachment equipment with excellent performance. Based on this, in this review, the unique non-smooth surface morphologies of their suction cups are classified and the key roles of these special surface morphologies in the attachment process are introduced in detail. The recent research on the attachment capacity of aquatic suction cups and other related attachment studies are described. Emphatically, the research progress of advanced bionic attachment equipment and technology in recent years, including attachment robots, flexible grasping manipulators, suction cup accessories, micro-suction cup patches, etc., is summarized. Finally, the existing problems and challenges in the field of biomimetic attachment are analyzed, and the focus and direction of biomimetic attachment research in the future are pointed out.

A smart adhesive Janus hydrogel for non-invasive cardiac repair and tissue adhesion prevention

Multifunctional hydrogel with asymmetric and reversible adhesion characteristics is essential to handle the obstructions towards bioapplications of trauma removal and postoperative tissue synechia. Herein, we developed a responsively reversible and asymmetrically adhesive Janus hydrogel that enables on-demand stimuli-triggered detachment for efficient myocardial infarction (MI) repair, and synchronously prevents tissue synechia and inflammatory intrusion after surgery. In contrast with most irreversibly and hard-to-removable adhesives, this Janus hydrogel exhibited a reversible adhesion capability and can be noninvasively detached on-demand just by slight biologics. It is interesting that the adhesion behaves exhibited a molecularly encoded adhesion-adaptive stiffening feature similar to the self-protective stress-strain effect of biological tissues. In vitro and in vivo experiments demonstrated that Janus hydrogel can promote the maturation and functions of cardiomyocytes, and facilitate MI repair by reducing oxidative damage and inflammatory response, reconstructing electrical conduction and blood supply in infarcted area. Furthermore, no secondary injury and tissue synechia were triggered after transplantation of Janus hydrogel. This smart Janus hydrogel reported herein offers a potential strategy for clinically transformable cardiac patch and anti-postoperative tissue synechia barrier.

Flexible Metamaterial Electronics

Over the last decade, extensive efforts have been made on utilizing advanced materials and structures to improve the properties and functionalities of flexible electronics. While the conventional ways are approaching their natural limits, a revolutionary strategy, namely metamaterials, is emerging toward engineering structural materials to break the existing fetters. Metamaterials exhibit supernatural physical behaviors, in aspects of mechanical, optical, thermal, acoustic, and electronic properties that are inaccessible in natural materials, such as tunable stiffness or Poisson's ratio, manipulating electromagnetic or elastic waves, and topological and programmable morphability. These salient merits motivate metamaterials as a brand-new research direction and have inspired extensive innovative applications in flexible electronics. Here, such a groundbreaking interdisciplinary field is first coined as "flexible metamaterial electronics," focusing on enhancing and innovating functionalities of flexible electronics via the design of metamaterials. Herein, the latest progress and trends in this infant field are reviewed while highlighting their potential value. First, a brief overview starts with introducing the combination of metamaterials and flexible electronics. Then, the developed applications are discussed, such as self-adaptive deformability, ultrahigh sensitivity, and multidisciplinary functionality, followed by the discussion of potential prospects. Finally, the challenges and opportunities facing flexible metamaterial electronics to advance this cutting-edge field are summarized.

Stretchable Conductive Tubular Composites Based on Braided Carbon Nanotube Yarns with an Elastomer Matrix

We report an innovative approach to creating stretchable conductive materials composed of a tubular shell made from braided carbon nanotube yarns (CNTYs) embedded in an elastomeric matrix. For stretchable electronics, both mechanical properties and electrical conductivities are of interest. Consequently, both the mechanical behavior and electrical conductivities under large deformations were investigated. A new hyperelastic composite model was developed to predict the large deformation response to applied stress for a braid in a tubular elastomer composite. The composite demonstrated a hyperelastic response due to the architecture of the braid, and the behavior was affected by the braiding angle, braid modulus, and volume fraction of fibers. The elastomer matrix was considered a neo-Hookean material and represented by the Yeoh model. An interaction parameter was proposed to account for the effect of the elastomer/braid cooperative restriction as observed in experimental and calculated results. This novel approach enabled the determination of the constitutive behavior of the composite in large deformations (>150%), taking into account the elastomer and yarn properties and braid configurations. The model exhibited good agreement with the experimental results. As the CNTYs are conductive, a stretchable conductive composite was obtained having a resistivity of 5.01 × 10^-4 and 5.67 × 10^-5 Ω·cm for the 1-ply and 4-ply composites, respectively. The resistivity remained constant through cyclic loading under large deformations in tension until mechanical failure. The material has potential for use in stretchable electronics applications.

Inverse Design of Mechanical Metamaterials with Target Nonlinear Response via a Neural Accelerated Evolution Strategy

Materials with target nonlinear mechanical response can support the design of innovative soft robots, wearable devices, footwear, and energy-absorbing systems, yet it is challenging to realize them. Here, mechanical metamaterials based on hinged quadrilaterals are used as a platform to realize target nonlinear mechanical responses. It is first shown that by changing the shape of the quadrilaterals, the amount of internal rotations induced by the applied compression can be tuned, and a wide range of mechanical responses is achieved. Next, a neural network is introduced that provides a computationally inexpensive relationship between the parameters describing the geometry and the corresponding stress-strain response. Finally, it is shown that by combining the neural network with an evolution strategy, one can efficiently identify geometries resulting in a wide range of target nonlinear mechanical responses and design optimized energy-absorbing systems, soft robots, and morphing structures.

Recent advances in microsystem approaches for mechanical characterization of soft biological tissues

Microsystem technologies for evaluating the mechanical properties of soft biological tissues offer various capabilities relevant to medical research and clinical diagnosis of pathophysiologic conditions. Recent progress includes (1) the development of tissue-compliant designs that provide minimally invasive interfaces to soft, dynamic biological surfaces and (2) improvements in options for assessments of elastic moduli at spatial scales from cellular resolution to macroscopic areas and across depths from superficial levels to deep geometries. This review summarizes a collection of these technologies, with an emphasis on operational principles, fabrication methods, device designs, integration schemes, and measurement features. The core content begins with a discussion of platforms ranging from penetrating filamentary probes and shape-conformal sheets to stretchable arrays of ultrasonic transducers. Subsequent sections examine different techniques based on planar microelectromechanical system (MEMS) approaches for biocompatible interfaces to targets that span scales from individual cells to organs. One highlighted example includes miniature electromechanical devices that allow depth profiling of soft tissue biomechanics across a wide range of thicknesses. The clinical utility of these technologies is in monitoring changes in tissue properties and in targeting/identifying diseased tissues with distinct variations in modulus. The results suggest future opportunities in engineered systems for biomechanical sensing, spanning a broad scope of applications with relevance to many aspects of health care and biology research.

Elastomeric tubes with self-regulated distension

Compliant elastomer tubing with a fabric "jacket" has been essential in various applications as soft robotic actuators, such as in biomedical exomuscles and massage therapy implements. Here, our study shows that a similar design concept can be an effective strategy in realizing passive regulation in the tube's distension, as well as in preventing aneurysm-like asymmetric rupture of the tube. A custom hydraulic pressure testing rig was built to perform experiments. The jacketed tubes initially deform rapidly as pressure increases, but a self-regulation behavior suppresses the tube's continued distension by strain-stiffening of the "jacket". In addition, highly asymmetric distension, common to elastomeric tubes due to imperfection in fabrication, is prevented dramatically by the "jacket". A three-dimensional finite element model predicts the distension of all tested tubes quantitatively across the entire experimental pressure ranges and beyond. Incorporating custom-designed kirigami relief patterns in the "jackets" expands the potential of the elastomeric tubes.

Mechanically and electrically biocompatible hydrogel ionotronic fibers for fabricating structurally stable implants and enabling noncontact physioelectrical modulation

Narrowing the mechanical and electrical mismatch between tissue and implantable microelectronics is essential for reducing immune responses and modulating physioelectrical signals. Nevertheless, the design of such implantable microelectronics remains a challenge due to the limited availability of suitable materials. Here, the fabrication of an electrically and mechanically biocompatible alginate hydrogel ionotronic fiber (AHIF) is reported, which is constructed by combing ionic chelation-assisted wet-spinning and mechanical training. The synergistic effects of these two processes allow the alginate to form a highly-oriented nanofibril and molecular network, with a hierarchical structure highly similar to that of natural fibers. These favourable structural features endow AHIF with tissue-mimicking mechanical characteristics, such as self-stiffening and soft tissue-like mechanical properties. In addition, tissue-like chemical components, i.e., biomacromolecules, Ca²⁺ ions, and water, endow AHIF with properties including biocompatibility and tissue-matching conductivity. These advantages bring light to the application of AHIFs in electrically-conductive implantable devices. As a prototype, an AHIF is designed to perform physioelectrical modulation through noncontact electromagnetic induction. Through experimental and machine learning optimizations, physioelectrical-like signals generated by the AHIF are used to identify the geometry and tension state of the implanted device in the body. Such an intelligent AHIF system has promising application prospects in bioelectronics, IntelliSense, and human-machine interactions.

Micromechanically-Powered Rolling Locomotion of a Twisted-Crystal Optical-Waveguide Cavity as a Mobile Light Polarization Rotor

We demonstrate mechanically-powered rolling locomotion of a twisted-microcrystal optical-waveguide cavity on the substrate, rotating the output signal's linear-polarization. Self-assembly of (E)-2-bromo-6-(((4-methoxyphenyl)imino)methyl)-4-nitrophenol produces naturally twisted microcrystals. The strain between several intergrowing, orientationally mismatched nanocrystalline fibres dictates the pitch lengths of the twisted crystals. The crystals are flexible, perpendicular to twisted (001) and (010) planes due to π⋅⋅⋅π stacking, C-H⋅⋅⋅Br, N-H⋅⋅⋅O and C-H⋅⋅⋅O interactions. The twisted crystals in their straight and bent geometries guide fluorescence along their body axes and display optical modes. Depending upon the degree of mechanical rolling locomotion, the crystal-waveguide cavity correspondingly rotates the output signal polarization. The presented twisted-crystal cavity with a combination of mechanical locomotion and photonic attributes unfolds a new dimension in mechanophotonics.

Thermally Drawn Highly Conductive Fibers with Controlled Elasticity

Electronic fabrics necessitate both electrical conductivity and, like any textile, elastic recovery. Achieving both requirements on the scale of a single fiber remains an unmet need. Here, two approaches for achieving conductive fibers (10⁷ S m^-1 ) reaching 50% elongation while maintaining minimal change in resistance (<0.5%) in embedded metallic electrodes are introduced. The first approach involves inducing a buckling instability in a metal microwire within a cavity of a thermally drawn elastomer fiber. The second approach relies on twisting an elastomer fiber to yield helical metal electrodes embedded in a stretchable yarn. The scalability of both approaches is illustrated in apparatuses for continuous buckling and twisting that yield tens of meters of elastic conducting fibers. Through experimental and analytical methods, it is elucidated how geometric parameters, such as buckling pre-strain and helical angle, as well as materials choice, control not only the fiber's elasticity but also its Young's modulus. Links between mechanical and electrical properties are exposed. The resulting fibers are used to construct elastic fabrics that contain diodes, by weaving and knitting, thus demonstrating the scalable fabrication of conformable and stretchable antennas that support optical data transmission.

Nanopillar Templating Augments the Stiffness and Strength in Biopolymer Films

Natural load-bearing mammalian tissues, such as cartilage and ligaments, contain ∼70% water yet can be mechanically stiff and strong due to the highly templated structures within. Here, we present a bioinspired approach to significantly stiffen and strengthen biopolymer hydrogels and films through the combination of nanoscale architecture and templated microstructure. Imprinted submicrometer pillar arrays absorb energy and deflect cracks. The produced chitosan hydrogels show nanofiber chains aligned by nanopillar topography, subsequently templating the microstructure throughout the film. These templated nanopillar chitosan hydrogels mechanically outperform unstructured flat hydrogels, with increases in the moduli of ∼160%, up to ∼20 MPa, and work at break of ∼450%, up to 8.5 MJ m^-3. Furthermore, the strength at break increases by ∼350%, up to ∼37 MPa, and it is one of the strongest hydrogels yet reported. The nanopillar templating strategy is generalizable to other biopolymers capable of forming oriented domains and strong interactions. Overall, this process yields hydrogel films that demonstrate mechanical performance comparable to that of other stiff, strong hydrogels and natural tissues.

Long-term reliable physical health monitoring by sweat pore-inspired perforated electronic skins

Electronic skins (e-skins)-electronic sensors mechanically compliant to human skin-have long been developed as an ideal electronic platform for noninvasive human health monitoring. For reliable physical health monitoring, the interface between the e-skin and human skin must be conformal and intact consistently. However, conventional e-skins cannot perfectly permeate sweat in normal day-to-day activities, resulting in degradation of the intimate interface over time and impeding stable physical sensing. Here, we present a sweat pore-inspired perforated e-skin that can effectively suppress sweat accumulation and allow inorganic sensors to obtain physical health information without malfunctioning. The auxetic dumbbell through-hole patterns in perforated e-skins lead to synergistic effects on physical properties including mechanical reliability, conformability, areal mass density, and adhesion to the skin. The perforated e-skin allows one to laminate onto the skin with consistent homeostasis, enabling multiple inorganic sensors on the skin to reliably monitor the wearer's health over a period of weeks.

4D Printing of Bioinspired Absorbable Left Atrial Appendage Occluders: A Proof-of-Concept Study

The significant mismatch of mechanical properties between the implanted medical device and biological tissue is prone to cause wear and even perforation. In addition, the limited biocompatibility and nondegradability of commercial Nitinol-based occlusion devices can easily lead to other serious complications, such as allergy and corrosion. The present study aims to develop a 4D printed patient-specific absorbable left atrial appendage occluder (LAAO) that can match the deformation of left atrial appendage (LAA) tissue to reduce complications. The desirable bioinspired network is explored by iterative optimization to mimic the stress-strain curve of LAA tissue and LAAOs are designed based on the optimal network. In vitro degradation tests are carried out to evaluate the effects of degradation on mechanical properties. In addition, 48 weeks of long-term subcutaneous implantation of the occluder shows favorable biocompatibility, and the 20-cycle compression test demonstrates outstanding durability of LAAO. Besides, a rapid, complete, and remote-controlled 4D transformation process of LAAO is achieved under the trigger of the magnetic field. The deployment of the LAAO in an isolated swine heart initially exhibits its feasibility for transcatheter LAA occlusion. To the best of our knowledge, this is the first demonstration of the 4D printed LAA occlusion device. It is worth noting that the bioinspired design concept is not only applicable to occlusion devices, but also to many other implantable medical devices, which is conducive to reducing complications, and a broad range of appealing application prospects can be foreseen.

Material innovation and mechanics design for substrates and encapsulation of flexible electronics: a review

Advances in materials and mechanics designs have led to the development of flexible electronics, which have important applications to human healthcare due to their good biocompatibility and conformal integration with biological tissue. Material innovation and mechanics design have played a key role in designing the substrates and encapsulations of flexible electronics for various bio-integrated systems. This review first introduces the inorganic materials and novel organic materials used for the substrates and encapsulation of flexible electronics, and summarizes their mechanics properties, permeability and optical transmission properties. The structural designs of the substrates are then introduced to ensure the reliability of flexible electronics, including the patterned and pre-strained designs to improve the stretchability, and the strain-isolation and -limiting substrates to reduce the deformation. Some emerging encapsulations are presented to protect the flexible electronics from degradation, environmental erosion or contamination, though they may slightly reduce the stretchability of flexible electronics.

Influence of pre-polymerisation atmosphere on the properties of pre- and poly(glycerol sebacate)

Poly(glycerol sebacate) (PGS) is a versatile biodegradable biomaterial on account of its adjustable mechanical properties as an elastomeric polyester. Nevertheless, it has shown dissimilar results when synthesised by different research groups under equivalent synthesis conditions. This lack of reproducibility proves how crucial it is to understand the effect of the parameters involved on its manufacturing and characterize the polymer networks obtained. Several studies have been conducted in recent years to understand the role of temperature, time, and the molar ratio of its monomers, while the influence of the atmosphere applied during its pre-polymerisation remained unknown. The results obtained here allow for a better understanding about the effect of inert (Ar and N₂) and oxidative (oxygen, dry air, and humid air) atmospheres on the extent of the reaction. The molecular pattern of intermediate pre-polymers and the gelation time and morphology of their corresponding cured PGS networks were studied as well. Overall, inert atmospheres promote a rather linear growth of macromers, with scarce branches, resulting in loose elastomers with long chains mainly crosslinked. Conversely, oxygen in the latter atmospheres promotes branching through secondary hydroxyl groups, leading to less-crosslinked 'defective' networks. In this way, the pre-polymerisation atmosphere could be used advantageously to adjust the reactivity of secondary hydroxyls, in order to modulate branching in the elastomeric PGS networks obtained to suit the properties required in a particular application.

Mechanically driven strategies to improve electromechanical behaviour of printed stretchable electronic systems

Stretchable electronics promise to extend the application range of conventional electronics by enabling them to keep their electrical functionalities under system deformation. Within this framework, development of printable silver-polymer composite inks is making possible to realize several of the expected applications for stretchable electronics, which range from seamless sensors for human body measurement (e.g. health patches) to conformable injection moulded structural electronics. However, small rigid electric components are often incorporated in these devices to ensure functionality. Under mechanical loading, these rigid elements cause strain concentrations and a general deterioration of the system's electrical performance. This work focuses on different strategies to improve electromechanical performance by investigating the deformation behaviour of soft electronic systems comprising rigid devices through Finite Element analyses. Based on the deformation behaviour of a simple stretchable device under tensile loading, three general strategies were proposed: local component encapsulation, direct component shielding, and strain dispersion. The FE behaviour achieved using these strategies was then compared with the experimental results obtained for each design, highlighting the reasons for their different resistance build-up. Furthermore, crack formation in the conductive tracks was analysed under loading to highlight its link with the evolution of the system electrical performance.

Flexible Hybrid Sensors for Health Monitoring: Materials and Mechanisms to Render Wearability

Wearable electronics have revolutionized the way physiological parameters are sensed, detected, and monitored. In recent years, advances in flexible and stretchable hybrid electronics have created emergent properties that enhance the compliance of devices to our skin. With their unobtrusive attributes, skin conformable sensors enable applications toward real-time disease diagnosis and continuous healthcare monitoring. Herein, critical perspectives of flexible hybrid electronics toward the future of digital health monitoring are provided, emphasizing its role in physiological sensing. In particular, the strategies within the sensor composition to render flexibility and stretchability while maintaining excellent sensing performance are considered. Next, novel approaches to the functionalization of the sensor for physical or biochemical stimuli are extensively covered. Subsequently, wearable sensors measuring physical parameters such as strain, pressure, temperature, as well as biological changes in metabolites and electrolytes are reported. Finally, their implications toward early disease detection and monitoring are discussed, concluding with a future perspective into the challenges and opportunities in emerging wearable sensor designs for the next few years.

Mechanically-Guided Structural Designs in Stretchable Inorganic Electronics

Over the past decade, the area of stretchable inorganic electronics has evolved very rapidly, in part because the results have opened up a series of unprecedented applications with broad interest and potential for impact, especially in bio-integrated systems. Low modulus mechanics and the ability to accommodate extreme mechanical deformations, especially high levels of stretching, represent key defining characteristics. Most existing studies exploit structural material designs to achieve these properties, through the integration of hard inorganic electronic components configured into strategic 2D/3D geometries onto patterned soft substrates. The diverse structural geometries developed for stretchable inorganic electronics are summarized, covering the designs of functional devices and soft substrates, with a focus on fundamental principles, design approaches, and system demonstrations. Strategies that allow spatial integration of 3D stretchable device layouts are also highlighted. Finally, perspectives on the remaining challenges and open opportunities are provided.

Flexible Hybrid Electronics for Digital Healthcare

Recent advances in material innovation and structural design provide routes to flexible hybrid electronics that can combine the high-performance electrical properties of conventional wafer-based electronics with the ability to be stretched, bent, and twisted to arbitrary shapes, revolutionizing the transformation of traditional healthcare to digital healthcare. Here, material innovation and structural design for the preparation of flexible hybrid electronics are reviewed, a brief chronology of these advances is given, and biomedical applications in bioelectrical monitoring and stimulation, optical monitoring and treatment, acoustic imitation and monitoring, bionic touch, and body-fluid testing are described. In conclusion, some remarks on the challenges for future research of flexible hybrid electronics are presented.

Bioinspired, Microstructured Silk Fibroin Adhesives for Flexible Skin Sensors

Wearable epidermal sensors are of great importance to the next generation of personalized healthcare. The adhesion between the flexible sensor and skin surface is critical for obtaining accurate, reliable, and stable signals. Herein we present a facile approach to fabricate a microstructured, natural silk fibroin protein-based adhesive for achieving highly conformal, comfortable, adjustable, and biocompatible adhesion on the skin surface. The microstructured fibroin adhesive (MSFA) exhibits reliable and stable bonding force on skin surfaces, even under humid or wet conditions, and can be easily peeled off from the skin without causing significant pain. Such an MSFA can greatly improve the sensitivity and reusability of epidermal strain sensors because of its conformal and tunable adhesion on skin surfaces. The MFSA has a great potential to be applied as a functional adhesive for various epidermal electronic sensors in the era of personalized healthcare.

Wrinkled double network hydrogel via simple stretch-recovery

We propose a new strategy for inducing different viscoelastic behaviors inside a double network hydrogel to achieve regular wrinkles with multiple dimensions.

Toward Imperfection-Insensitive Soft Network Materials for Applications in Stretchable Electronics

Development of stretchable devices with mechanical responses that mimic those of biological tissues/organs is of particular importance for the long-term biointegration, as the discomfort induced by the mechanical mismatch can be minimized. Recent works have established the bioinspired designs of soft network materials that can precisely reproduce the unconventional J-shaped stress-strain curves of human skin at different regions. Existing studies mostly focused on the design, fabrication, and modeling of perfect soft network materials. When utilized as the substrates of biointegrated electronics, the soft network designs, however, often need to incorporate deterministic holes, a type of imperfection, to accommodate hard, inorganic electronic components. Understanding of the effect of hole imperfections on the mechanical properties of soft network materials is thereby essential in practical applications. This paper presents a combined experimental and computational study of the stretchability and elastic modulus of imperfect soft network materials consisting of circular holes with a variety of diameters. Both the size and location of the circular-hole imperfections are shown to have profound influences on the stretchability. Based on these results, design guidelines of imperfection-insensitive network materials are introduced. For the imperfections that result in an evident reduction of stretchability, an effective reinforcement approach is presented by enlarging the width of horseshoe microstructures at strategic locations, which can enhance the stretchability considerably. A stretchable and imperfection-insensitive integrated device with a light-emitting diode embedded in the network material serves a demonstrative application.

Mimicking "J-Shaped" and Anisotropic Stress-Strain Behavior of Human and Porcine Aorta by Fabric-Reinforced Elastomer Composites

An ex vivo heart perfusion device preserves the donor heart in a warm beating state during transfer between extraction and implantation surgeries. One of the current challenges includes the use of rigid and noncompliant plastic tubes, which causes injuries to the heart at the junction between the tissue and the tube. The compliant and rapidly strain-stiffening mechanical property that generates a "J-shaped" stress-strain behavior is necessary for producing the Windkessel effect, which ensures continuous flow of blood through the aorta. In this study, we mimic the J-shaped and anisotropic stress-strain behavior of human aorta in synthetic elastomers to replace the problematic noncompliant plastic tube. First, we assess the mechanical properties of human (n = 1) and porcine aorta (n = 14) to quantify the nonlinear and anisotropic behavior under uniaxial tensile stress from five different regions of the aorta. Second, fabric-reinforced elastomer composites were prepared by reinforcing silicone elastomers with embedded fabrics in a trilayer geometry. The knitted structures of the fabric provide strain-stiffening as well as anisotropic mechanical properties of the resulting composite in a deterministic manner. By optimizing the combination between different elastomers and fabrics, the resulting composites matched the J-shaped and anisotropic stress-strain behavior of natural human and porcine aorta. Finally, improved analytical constitutive models based on Gent's and Mooney-Rivlin's constitutive model (to describe the elastomer matrix) combined with Holzapfel-Gasser-Ogden's model (to represent the stiffer fabrics) were developed to describe the J-shaped behavior of the natural aortas and the fabric-reinforced composites. We anticipate that the suggested fabric-reinforced silicone elastomer composite design concept can be used to develop complex soft biomaterials, as well as in emerging engineering fields such as soft robotics and microfluidics, where the Windkessel effect can be useful in regulating the flow of fluids.

A widely adaptable analytical method for thermal analysis of flexible electronics with complex heat source structures

Flexible electronics, as a relatively new category of device, exhibit prodigious potential in many applications, especially in bio-integrated fields. It is critical to understand that thermal management of certain kinds of exothermic flexible electronics is a crucial issue, whether to avoid or to take advantage of the excessive temperature. A widely adaptable analytical method, validated by finite-element analysis and experiments, is conducted to investigate the thermal properties of exothermic flexible electronics with a heat source in complex shape or complex array layout. The main theoretical strategy to obtain the thermal field is through an integral along the complex curve source region. The results predicted by the analytical model enable accurate control of temperature and heat flow in the flexible electronics, which may help in the design and fabrication of flexible electronic devices in the future.

Soft elastomeric composite materials with skin-inspired mechanical properties for stretchable electronic circuits

The stretchable version of electronic circuits harnesses commercial chip scale components to achieve complex functionality and mechanical deformability, which represents an emerging technology to expand the application of conventional electronics on rigid wafers. The bottleneck lies in the lack of a robust approach for the collective integration of off-the-shelf components into a reliable system. In this study, an elastomeric composite material with skin-like mechanical responses and spatially heterogeneous rigidity is reported as an attractive platform for stretchable circuit systems. The approach utilizes a high modulus microstructure embedded in the matrix of a soft elastomer to achieve programmable mechanical properties, thereby offering selective strain isolation for fragile components and overall protection against excessive loads. A low cost procedure involving laser ablation and blade coating is established to create the composite material matching with the circuit design. In addition, ultrasonic atomization of liquid metal into microparticles allows flexible preparations of deformable conductors in the forms of interconnects and contacts. An LED matrix is demonstrated as a prototype circuit system with excellent durability to withstand repetitive stretching and external impacts. Stretchable circuit systems based on soft elastomeric composite materials may find potential uses in health monitoring, mechatronic prosthetics, and soft robotics.

Design and applications of stretchable and self-healable conductors for soft electronics

Soft and conformable electronics are emerging rapidly and is envisioned as the future of next-generation electronic devices where devices can be readily deployed in various environments, such as on-body, on-skin or as a biomedical implant. Modern day electronics require electrical conductors as the fundamental building block for stretchable electronic devices and systems. In this review, we will study the various strategies and methods of designing and fabricating materials which are conductive, stretchable and self-healable, and explore relevant applications such as flexible and stretchable sensors, electrodes and energy harvesters.

Stretchable Micromotion Sensor with Enhanced Sensitivity Using Serpentine Layout

The application of the serpentine mesh layout in stretchable electronics provides a feasible method to achieve the desired stretchability by structural design instead of modifying the intrinsic mechanical properties of the applied materials. However, previous works using the serpentine layout mainly focused on the optimization of structural stretchability. In this paper, the serpentine mesh design concept is used to transform the high-performance but hard-to-stretch piezoelectric film into a stretchable form. The serpentine layout design strategies for the piezoelectric film, which aim at not only desired stretchability but also high utilization of the strain in the piezoelectric film during deformation, are discussed with experimental and computational results. A stretchable micromotion sensor with high sensitivity is realized using the piezoelectric film with a serpentine layout. Human voice recognition applications of the sensor, including speech pattern recognition with machine learning, are demonstrated with the sensor integrated with a wireless module. The stretchable micromotion sensor with a serpentine layout illustrates the broader application of serpentine layout design in the functional materials of stretchable electronics, which can further extend the range of available functional materials for novel stretchable electronic devices.

Bioinspired baroplastic glycosaminoglycan sealants for soft tissues

We describe biomimetic adhesives inspired by the marine glues fabricated by the sandcastle worm. The formation of stable polyelectrolyte complexes between poly-L-lysine (PLL) and glycosaminoglycans (GAGs) with different sulfation degree - heparin (HEP), chondroitin sulfate (CS) and hyaluronic acid (HA) - is optimized by zeta-potential titrations. These PLL/GAG complexes are transformed into compact polyelectrolyte complexes (coPECs) with controlled water contents and densities via baroplastic processing. Rotational shear tests demonstrate that coPECs containing sulfated GAGs (HEP or CS) have solid-like properties, whereas HA-based complexes form highly hydrated viscous-like networks. The adhesiveness of the generated coPECs (normalized lap shear strength) is tested in dry and wet states using polystyrene and rabbit skin, respectively. In dry state, the adhesives exhibit lap shear strengths in the order of hundreds of kPa, with coPLL/HEP and coPLL/CS being about 1.5 times stronger than coPLL/HA. In wet state, all coPECs seal rabbit skin and recover over 60% of the elongation capacity of intact skin with coPLL/HA providing the sturdiest adhesion (∼85% elongation recovery). We demonstrate that this is due to the higher water fraction that improves the bonding between the wet specimens, showcasing the potential superior mechanical recovery on injured tissues. STATEMENT OF SIGNIFICANCE: The development of medical sealants with sufficient adhesive strength in the presence of water and moist remains a huge challenge. We present glycosaminoglycans (GAGs) as biomaterials for the assembly of baroplastics with strong adhesive strength to soft tissues at physiological conditions. Baroplastics with tacky properties were generated by a mild assembly process based on polyelectrolyte complexation and compaction. These materials behave as versatile sealants: their adhesiveness can be adjusted to either dry or wet specimens because of the different sulfation degree of GAGs. These sealants were noncytotoxic towards L929 cells and allowed the damaged skin to recover a great deal of its native elasticity: they preserved the J-shaped stress/strain mechanical response that is typical of biological soft tissues.

Toughening stretchable fibers via serial fracturing of a metallic core

Tough, biological materials (e.g., collagen or titin) protect tissues from irreversible damage caused by external loads. Mimicking these protective properties is important in packaging and in emerging applications such as durable electronic skins and soft robotics. This paper reports the formation of tough, metamaterial-like core-shell fibers that maintain stress at the fracture strength of a metal throughout the strain of an elastomer. The shell experiences localized strain enhancements that cause the higher modulus core to fracture repeatedly, increasing the energy dissipated during extension. Normally, fractures are catastrophic. However, in this architecture, the fractures are localized to the core. In addition to dissipating energy, the metallic core provides electrical conductivity and enables repair of the fractured core for repeated use. The fibers are 2.5 times tougher than titin and hold more than 15,000 times their own weight for a period 100 times longer than a hollow elastomeric fiber.

Bio-Integrated Wearable Systems: A Comprehensive Review

Bio-integrated wearable systems can measure a broad range of biophysical, biochemical, and environmental signals to provide critical insights into overall health status and to quantify human performance. Recent advances in material science, chemical analysis techniques, device designs, and assembly methods form the foundations for a uniquely differentiated type of wearable technology, characterized by noninvasive, intimate integration with the soft, curved, time-dynamic surfaces of the body. This review summarizes the latest advances in this emerging field of "bio-integrated" technologies in a comprehensive manner that connects fundamental developments in chemistry, material science, and engineering with sensing technologies that have the potential for widespread deployment and societal benefit in human health care. An introduction to the chemistries and materials for the active components of these systems contextualizes essential design considerations for sensors and associated platforms that appear in following sections. The subsequent content highlights the most advanced biosensors, classified according to their ability to capture biophysical, biochemical, and environmental information. Additional sections feature schemes for electrically powering these sensors and strategies for achieving fully integrated, wireless systems. The review concludes with an overview of key remaining challenges and a summary of opportunities where advances in materials chemistry will be critically important for continued progress.