Skin-Mountable Biosensors and Therapeutics: A Review

Evolution of Musculoskeletal Electronics

The musculoskeletal system, constituting the largest human physiological system, plays a critical role in providing structural support to the body, facilitating intricate movements, and safeguarding internal organs. By virtue of advancements in revolutionized materials and devices, particularly in the realms of motion capture, health monitoring, and postoperative rehabilitation, "musculoskeletal electronics" has actually emerged as an infancy area, but has not yet been explicitly proposed. In this review, the concept of musculoskeletal electronics is elucidated, and the evolution history, representative progress, and key strategies of the involved materials and state-of-the-art devices are summarized. Therefore, the fundamentals of musculoskeletal electronics and key functionality categories are introduced. Subsequently, recent advances in musculoskeletal electronics are presented from the perspectives of "in vitro" to "in vivo" signal detection, interactive modulation, and therapeutic interventions for healing and recovery. Additionally, nine strategy avenues for the development of advanced musculoskeletal electronic materials and devices are proposed. Finally, concise summaries and perspectives are proposed to highlight the directions that deserve focused attention in this booming field.

The Future of Nanotechnology-Driven Electrochemical and Electrical Point-of-Care Devices and Diagnostic Tests

Point-of-care (POC) devices have become rising stars in the biosensing field, aiming at prognosis and diagnosis of diseases with a positive impact on the patient but also on healthcare and social care systems. Putting the patient at the center of interest requires the implementation of noninvasive technologies for collecting biofluids and the development of wearable platforms with integrated artificial intelligence-based tools for improved analytical accuracy and wireless readout technologies. Many electrical and electrochemical transducer technologies have been proposed for POC-based sensing, but several necessitate further development before being widely deployable. This review focuses on recent innovations in electrochemical and electrical biosensors and their growth opportunities for nanotechnology-driven multidisciplinary approaches. With a focus on analytical aspects to pave the way for future electrical/electrochemical diagnostics tests, current limitations and drawbacks as well as directions for future developments are highlighted.

Recent Advances in Bioelectronics for Localized Drug Delivery

The last decade has witnessed remarkable advancements in bioelectronics, ushering in a new era of wearable and implantable devices for drug delivery. By utilizing miniaturized system design and/or flexible materials, bioelectronics illustrates ideal integration with target organs and tissues, making them ideal platforms for localized drug delivery. Furthermore, the development of electrically assisted drug delivery systems has enhanced the efficiency and safety of therapeutic administration, particularly for the macromolecules that encounter additional challenges in penetrating biological barriers. In this review, a concise overview of recent progress in bioelectronic devices for in vivo localized drug delivery, with highlights on the latest trends in device design, working principles, and their corresponding functionalities, is provided. The reported systems based on their targeted delivery locations as wearable systems, ingestible systems, and implantable systems are categorized. Each category is introduced in detail by highlighting the special requirements for devices and the corresponding solutions. The remaining challenges in this field and future directions are also discussed.

Algae-based approaches for Holistic wastewater management: A low-cost paradigm

Aquatic algal communities demonstrated their appeal for diverse industrial applications due to their vast availability, ease of harvest, lower production costs, and ability to biosynthesize valuable molecules. Algal biomass is promising because it can multiply in water and on land. Integrated algal systems have a significant advantage in wastewater treatment due to their ability to use phosphorus and nitrogen, simultaneously accumulating heavy metals and toxic substances. Several species of microalgae have adapted to thrive in these harsh environmental circumstances. The potential of algal communities contributes to achieving the United Nations' sustainable development goals in improving aquaculture, combating climate change, reducing carbon dioxide (CO2) emissions, and providing biomass as a biofuel feedstock. Algal-based biomass processing technology facilitates the development of a circular bio-economy that is both commercially and ecologically viable. An integrated bio-refinery process featuring zero waste discharge could be a sustainable solution. In the current review, we will highlight wastewater management by algal species. In addition, designing and optimizing algal bioreactors for wastewater treatment have also been incorporated.

Cell Viability Assessment of PEDOT Conducting Polymer-Coated Microneedles for Skin Sampling

Recently, transdermal monitoring and drug delivery have gained much interest, owing to the introduction of the minimally invasive microneedle (MN) device. The advancement of electroactive MNs electrically assisted in the capture of biomarkers or the triggering of drug release. Recent works have combined conducting polymers (CPs) onto MNs owing to the soft nature of the polymers and their tunable ionic and electronic conductivity. Though CPs are reported to work safely in the body, their biocompatibility in the skin has been insufficiently investigated. Furthermore, during electrical biasing of CPs, they undergo reduction or oxidation, which in practical terms leads to release/exchange of ions, which could pose biological risks. This work investigates the viability and proliferation of skin cells upon exposure to an electrochemically biased MN pair comprising two differently doped poly(3,4-ethylenedioxy-thiophene) (PEDOT) polymers that have been designed for skin sampling use. The impact of biasing on human keratinocytes and dermal fibroblasts was determined at different initial cell seeding densities and incubation periods. Indirect testing was employed, whereby the culture media was first exposed to PEDOTs prior to the addition of this extract to cells. In all conditions, both unbiased and biased PEDOT extracts showed no cytotoxicity, but the viability and proliferation of cells cultured at a low cell seeding density were lower than those of the control after 48 h of incubation.

Soft Bioelectronics for Therapeutics

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

Clinical applications of smart wearable sensors

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

Electrocardiogram Devices for Home Use: Technological and Clinical Scoping Review

BACKGROUND

Electrocardiograms (ECGs) are used by physicians to record, monitor, and diagnose the electrical activity of the heart. Recent technological advances have allowed ECG devices to move out of the clinic and into the home environment. There is a great variety of mobile ECG devices with the capabilities to be used in home environments.

OBJECTIVE

This scoping review aimed to provide a comprehensive overview of the current landscape of mobile ECG devices, including the technology used, intended clinical use, and available clinical evidence.

METHODS

We conducted a scoping review to identify studies concerning mobile ECG devices in the electronic database PubMed. Secondarily, an internet search was performed to identify other ECG devices available in the market. We summarized the devices' technical information and usability characteristics based on manufacturer data such as datasheets and user manuals. For each device, we searched for clinical evidence on the capabilities to record heart disorders by performing individual searches in PubMed and ClinicalTrials.gov, as well as the Food and Drug Administration (FDA) 510(k) Premarket Notification and De Novo databases.

RESULTS

From the PubMed database and internet search, we identified 58 ECG devices with available manufacturer information. Technical characteristics such as shape, number of electrodes, and signal processing influence the capabilities of the devices to record cardiac disorders. Of the 58 devices, only 26 (45%) had clinical evidence available regarding their ability to detect heart disorders such as rhythm disorders, more specifically atrial fibrillation.

CONCLUSIONS

ECG devices available in the market are mainly intended to be used for the detection of arrhythmias. No devices are intended to be used for the detection of other cardiac disorders. Technical and design characteristics influence the intended use of the devices and use environments. For mobile ECG devices to be intended to detect other cardiac disorders, challenges regarding signal processing and sensor characteristics should be solved to increase their detection capabilities. Devices recently released include the use of other sensors on ECG devices to increase their detection capabilities.

Craft-and-Stick Xurographic Manufacturing of Integrated Microfluidic Electrochemical Sensing Platform

An innovative modular approach for facile design and construction of flexible microfluidic biosensor platforms based on a dry manufacturing "craft-and-stick" approach is developed. The design and fabrication of the flexible graphene paper electrode (GPE) unit and polyethylene tetraphthalate sheet (PET)6/adhesive fluidic unit are completed by an economic and generic xurographic craft approach. The GPE widths and the microfluidic channels can be constructed down to 300 μm and 200 μm, respectively. Both units were assembled by simple double-sided adhesive tapes into a microfluidic integrated GPE (MF-iGPE) that are flexible, thin (<0.5 mm), and lightweight (0.4 g). We further functionalized the iGPE with Prussian blue and glucose oxidase for the fabrication of MF-iGPE glucose biosensors. With a closed-channel PET fluidic pattern, the MF-iGPE glucose biosensors were packaged and sealed to protect the integrated device from moisture for storage and could easily open with scissors for sample loading. Our glucose biosensors showed 2 linear dynamic regions of 0.05-1.0 and 1.0-5.5 mmol L^-1 glucose. The MF-iGPE showed good reproducibility for glucose detection (RSD < 6.1%, n = 6) and required only 10 μL of the analyte. This modular craft-and-stick manufacturing approach could potentially further develop along the concept of paper-crafted model assembly kits suitable for low-resource laboratories or classroom settings.

Wearable Plasmonic Sweat Biosensor for Acetaminophen Drug Monitoring

Monitoring the acetaminophen dosage is important to prevent the occurrence of adverse reactions such as liver failure and kidney damage. Traditional approaches to monitoring acetaminophen dosage mainly rely on invasive blood collection. Herein, we developed a noninvasive microfluidic-based wearable plasmonic sensor to achieve simultaneous sweat sampling and acetaminophen drug monitoring for vital signs. The fabricated sensor employs an Au nanosphere cone array as the key sensing component, which poses a substrate with surface-enhanced Raman scattering (SERS) activity to noninvasively and sensitively detect the fingerprint of acetaminophen molecules based on its unique SERS spectrum. The developed sensor enabled the sensitive detection and quantification of acetaminophen at concentrations as low as 0.13 μM. We further evaluated the sweat sensor integrated with a Raman spectrometer for monitoring acetaminophen in drug-administered subjects. These results indicated that the sweat sensor could measure acetaminophen levels and reflect drug metabolism. The sweat sensors have revolutionized wearable sensing technology by adopting label-free and sensitive molecular tracking methods for noninvasive and point-of-care drug monitoring and management.

Flexible Skin Patch Enabled Tumor Hybrid Thermophysical Therapy and Adaptive Antitumor Immune Response

Innovations on materials and technologies have greatly promoted the rapid development of wearable electronics from disease diagnosis to therapeutics. For superficial skin tumors, skin-attachable patches possess the advantages of minimally invasive property, alleviative side effects, and high efficiency. The development of noninvasive techniques and devices is still in urgent demands. Here, a flexible skin patch fabricated through a facile preparation method is reported for noninvasive hybrid thermophysical therapy and adaptative immune function enhancement. The liquid metal enabled skin patch is demonstrated with high conductivity, certain stability, biocompatibility, and an enhanced adhesive merit on skin surfaces for cryoablation therapy and magnetic hyperthermia therapy. The skin patch exhibits remarkably conformable heating and cooling performance toward the treatment of 4T1 breast tumors. The magnetic resonance images also indicate the significant tumor ablation effect. Interestingly, a relatively stable proportion of both CD8⁺ T and CD4⁺ T cells in the peripheral blood is identified after tumor therapy in comparison with the decreased trend in the untreated group, representing an efficient antitumor immune response induced by the skin patch. The developed skin patch would provide a promising noninvasive approach for tumor therapies by direct tumor destruction and maintenance of the antitumor immune response.

An Elastic and Damage-Tolerant Dry Epidermal Patch with Robust Skin Adhesion for Bioelectronic Interfacing

On-skin patches that record biopotential and biomechanical signals are essential for wearable healthcare monitoring, clinical treatment, and human-machine interaction. To acquire wearing comfort and high-quality signals, patches with tissue-like softness, elastic recovery, damage tolerance, and robust bioelectronic interface are highly desired yet challenging to achieve. Here, we report a dry epidermal patch made from a supramolecular polymer (SESA) and an in situ transferred carbon nanotubes' percolation network. The polymer possesses a hybrid structure of copolymerized permanent scaffold permeated by multiple dynamic interactions, which imparts a desired mechanical response transition from elastic recoil to energy dissipation with increased elongation. Such SESA-based patches are soft (Young's modulus ∼0.1 MPa) and elastic within physiologically relevant strain levels (97% elastic recovery at 50% tensile strain), intrinsically mechanical-electrical damage-resilient (∼90% restoration from damage after 5 min), and interference-immune in dynamic signal acquisition (stretch, underwater, sweat). We demonstrate its versatile physiological sensing applications, including electrocardiogram recording under various disturbances, machine-learning-enabled hand-gesture recognition through electromyogram measurement, subtle radial artery pulse, and drastic knee kinematics sensing. This epidermal patch offers a promising noninvasive, long-duration, and ambulant bioelectronic interfacing with anti-interference robustness.

A Soft Wearable Microfluidic Patch with Finger-Actuated Pumps and Valves for On-Demand, Longitudinal, and Multianalyte Sweat Sensing

Easy sample collection, physiological relevance, and ability to noninvasively and longitudinally monitor the human body are some of the key attributes of wearable sweat sensors. Examples typically include reversible sensors or an array of single-use sensors embedded in specialized microfluidics for temporal analysis of sweat. However, evolving this field to a level that truly represents "lab-on-skin" technology will require the incorporation of advanced functionalities that give the user the freedom to (1) choose the precise time for performing sample analysis and (2) select sensors from an array embedded within the device for performing condition-specific sample analysis. Here, we introduce new concepts in wearable microfluidic platforms that offer such capabilities. The described technology involves a series of finger-actuated pumps, valves, and sensors incorporated within soft, wearable microfluidics. The incoming sweat collects in the inlet chamber and can be analyzed by the user at the time of their choosing. On-demand sweat analyte assessment is achieved by pulling a thin tab to activate a pump which opens a valve and allows the pooled sweat to enter a chamber embedded with sensors for the desired analytes. The article describes a thorough characterization of the platform that demonstrates the robustness of the pumping, valving, and sensing aspects of the device under conditions mimicking real-life scenarios. A two-day-long human pilot study validates the system and illustrates the device's ability to offer on-demand, longitudinal, and multianalyte sensing. Our work represents the first example of a wearable system with such on-demand sensing capabilities and opens exciting avenues in sweat sensing for acquiring new insights into human physiology.

Wearable SERS Sensor Based on Omnidirectional Plasmonic Nanovoids Array with Ultra-High Sensitivity and Stability

Surface-enhanced Raman spectroscopy (SERS) is a promising technology for wearable sensors due to its fingerprint spectrum and high detection sensitivity. However, since SERS-activity is sensitive to both the distribution of "hotspots" and excitation angle, it is profoundly challenging to develop a wearable SERS sensor with high stability under various deformations during movements. Herein, inspired by omnidirectional light-harvesting of the compound eye of Xenos Peckii, a wearable SERS sensor is developed using omnidirectional plasmonic nanovoids array (OPNA), which is prepared by assembling a monolayer of metal nanoparticles into the artificial plasmonic compound-eye (APC). Specifically, APC is an interconnected frame containing omnidirectional "pockets" and acts as an "armour", not only rendering a broadband and omnidirectional enhancement of "hotspots" in the delicate nanoparticles array, but also maintaining an integrity of the "hotspots" against external mechanical deformations. Furthermore, an asymmetry super-hydrophilic pattern is fabricated on the surface of OPNA, endowing the hydrophobic OPNA with the ability to spontaneously extract and concentrate the analytes from sweat. Such an armored SERS sensor can enable the wearable and in situ analysis with high sensitivity and stability, exhibiting great potential in point-of-care analysis.

Skin bioelectronics towards long-term, continuous health monitoring

Skin bioelectronics are considered as an ideal platform for personalised healthcare because of their unique characteristics, such as thinness, light weight, good biocompatibility, excellent mechanical robustness, and great skin conformability. Recent advances in skin-interfaced bioelectronics have promoted various applications in healthcare and precision medicine. Particularly, skin bioelectronics for long-term, continuous health monitoring offer powerful analysis of a broad spectrum of health statuses, providing a route to early disease diagnosis and treatment. In this review, we discuss (1) representative healthcare sensing devices, (2) material and structure selection, device properties, and wireless technologies of skin bioelectronics towards long-term, continuous health monitoring, (3) healthcare applications: acquisition and analysis of electrophysiological, biophysical, and biochemical signals, and comprehensive monitoring, and (4) rational guidelines for the design of future skin bioelectronics for long-term, continuous health monitoring. Long-term, continuous health monitoring of advanced skin bioelectronics will open unprecedented opportunities for timely disease prevention, screening, diagnosis, and treatment, demonstrating great promise to revolutionise traditional medical practices.

Wearable electrochemical biosensors to measure biomarkers with complex blood-to-sweat partition such as proteins and hormones

Smart electronic devices based on micro-controllers, also referred to as fashion electronics, have raised wearable technology. These devices may process physiological information to facilitate the wearer's immediate biofeedback in close contact with the body surface. Standard market wearable devices detect observable features as gestures or skin conductivity. In contrast, the technology based on electrochemical biosensors requires a biomarker in close contact with both a biorecognition element and an electrode surface, where electron transfer phenomena occur. The noninvasiveness is pivotal for wearable technology; thus, one of the most common target tissues for real-time monitoring is the skin. Noninvasive biosensors formats may not be available for all analytes, such as several proteins and hormones, especially when devices are installed cutaneously to measure in the sweat. Processes like cutaneous transcytosis, the paracellular cell–cell unions, or even reuptake highly regulate the solutes content of the sweat. This review discusses recent advances on wearable devices based on electrochemical biosensors for biomarkers with a complex blood-to-sweat partition like proteins and some hormones, considering the commented release regulation mechanisms to the sweat. It highlights the challenges of wearable epidermal biosensors (WEBs) design and the possible solutions. Finally, it charts the path of future developments in the WEBs arena in converging/emerging digital technologies.

Flexible and Stretchable Bioelectronics

Medical science technology has improved tremendously over the decades with the invention of robotic surgery, gene editing, immune therapy, etc. However, scientists are now recognizing the significance of 'biological circuits' i.e., bodily innate electrical systems for the healthy functioning of the body or for any disease conditions. Therefore, the current trend in the medical field is to understand the role of these biological circuits and exploit their advantages for therapeutic purposes. Bioelectronics, devised with these aims, work by resetting, stimulating, or blocking the electrical pathways. Bioelectronics are also used to monitor the biological cues to assess the homeostasis of the body. In a way, they bridge the gap between drug-based interventions and medical devices. With this in mind, scientists are now working towards developing flexible and stretchable miniaturized bioelectronics that can easily conform to the tissue topology, are non-toxic, elicit no immune reaction, and address the issues that drugs are unable to solve. Since the bioelectronic devices that come in contact with the body or body organs need to establish an unobstructed interface with the respective site, it is crucial that those bioelectronics are not only flexible but also stretchable for constant monitoring of the biological signals. Understanding the challenges of fabricating soft stretchable devices, we review several flexible and stretchable materials used as substrate, stretchable electrical conduits and encapsulation, design modifications for stretchability, fabrication techniques, methods of signal transmission and monitoring, and the power sources for these stretchable bioelectronics. Ultimately, these bioelectronic devices can be used for wide range of applications from skin bioelectronics and biosensing devices, to neural implants for diagnostic or therapeutic purposes.

Recent advances in flexible and wearable sensors for monitoring chemical molecules

In recent years, real-time health management has received increasing attention, benefiting from the rapid development of flexible and wearable devices. Conventionally, flexible and wearable devices are used for collecting health data such as electrophysiological signals, blood pressure, heart rate, etc. The monitoring of chemical factors has shown growing significance, providing the basis for the screening, diagnosis, and treatment of many diseases. Nowadays, in order to understand the health status of the human body more comprehensively and accurately, researchers in the community have started putting effort into developing wearable devices for monitoring chemical factors. Progressively, more flexible chemical sensors with wearable real-time health-monitoring functionality have been developed thanks to advances relating to wireless communications and flexible electronics. In this review, we describe the variety of chemical molecules and information that can currently be monitored, including pH levels, glucose, lactate, uric acid, ion levels, cytokines, nutrients, and other biomarkers. This review analyzes the pros and cons of the most advanced wearable chemical sensors in terms of wearability. At the end of this review, we discuss the current challenges and development trends relating to flexible and wearable chemical sensors from the aspects of materials, electrode designs, and soft-hard interface connections.

Advanced Flexible Skin-Like Pressure and Strain Sensors for Human Health Monitoring

Recently, owing to their excellent flexibility and adaptability, skin-like pressure and strain sensors integrated with the human body have the potential for great prospects in healthcare. This review mainly focuses on the representative advances of the flexible pressure and strain sensors for health monitoring in recent years. The review consists of five sections. Firstly, we give a brief introduction of flexible skin-like sensors and their primary demands, and we comprehensively outline the two categories of design strategies for flexible sensors. Secondly, combining the typical sensor structures and their applications in human body monitoring, we summarize the recent development of flexible pressure sensors based on perceptual mechanism, the sensing component, elastic substrate, sensitivity and detection range. Thirdly, the main structure principles and performance characteristic parameters of noteworthy flexible strain sensors are summed up, namely the sensing mechanism, sensitive element, substrate, gauge factor, stretchability, and representative applications for human monitoring. Furthermore, the representations of flexible sensors with the favorable biocompatibility and self-driven properties are introduced. Finally, in conclusion, besides continuously researching how to enhance the flexibility and sensitivity of flexible sensors, their biocompatibility, versatility and durability should also be given sufficient attention, especially for implantable bioelectronics. In addition, the discussion emphasizes the challenges and opportunities of the above highlighted characteristics of novel flexible skin-like sensors.

Monitoring Symptoms of Infectious Diseases: Perspectives for Printed Wearable Sensors

Infectious diseases possess a serious threat to the world's population, economies, and healthcare systems. In this review, we cover the infectious diseases that are most likely to cause a pandemic according to the WHO (World Health Organization). The list includes COVID-19, Crimean-Congo Hemorrhagic Fever (CCHF), Ebola Virus Disease (EBOV), Marburg Virus Disease (MARV), Lassa Hemorrhagic Fever (LHF), Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), Nipah Virus diseases (NiV), and Rift Valley fever (RVF). This review also investigates research trends in infectious diseases by analyzing published research history on each disease from 2000-2020 in PubMed. A comprehensive review of sensor printing methods including flexographic printing, gravure printing, inkjet printing, and screen printing is conducted to provide guidelines for the best method depending on the printing scale, resolution, design modification ability, and other requirements. Printed sensors for respiratory rate, heart rate, oxygen saturation, body temperature, and blood pressure are reviewed for the possibility of being used for disease symptom monitoring. Printed wearable sensors are of great potential for continuous monitoring of vital signs in patients and the quarantined as tools for epidemiological screening.

Transdermal electroosmotic flow generated by a porous microneedle array patch

A microneedle array is an attractive option for a minimally invasive means to break through the skin barrier for efficient transdermal drug delivery. Here, we report the applications of solid polymer-based ion-conductive porous microneedles (PMN) containing interconnected micropores for improving iontophoresis, which is a technique of enhancing transdermal molecular transport by a direct current through the skin. The PMN modified with a charged hydrogel brings three innovative advantages in iontophoresis at once: (1) lowering the transdermal resistance by low-invasive puncture of the highly resistive stratum corneum, (2) transporting of larger molecules through the interconnected micropores, and (3) generating electroosmotic flow (EOF). In particular, the PMN-generated EOF greatly enhances the transdermal molecular penetration or extraction, similarly to the flow induced by external pressure. The enhanced efficiencies of the EOF-assisted delivery of a model drug (dextran) and of the extraction of glucose are demonstrated using a pig skin sample. Furthermore, the powering of the PMN-based transdermal EOF system by a built-in enzymatic biobattery (fructose / O₂ battery) is also demonstrated as a possible totally organic iontophoresis patch.

Fully organic compliant dry electrodes self-adhesive to skin for long-term motion-robust epidermal biopotential monitoring

Wearable dry electrodes are needed for long-term biopotential recordings but are limited by their imperfect compliance with the skin, especially during body movements and sweat secretions, resulting in high interfacial impedance and motion artifacts. Herein, we report an intrinsically conductive polymer dry electrode with excellent self-adhesiveness, stretchability, and conductivity. It shows much lower skin-contact impedance and noise in static and dynamic measurement than the current dry electrodes and standard gel electrodes, enabling to acquire high-quality electrocardiogram (ECG), electromyogram (EMG) and electroencephalogram (EEG) signals in various conditions such as dry and wet skin and during body movement. Hence, this dry electrode can be used for long-term healthcare monitoring in complex daily conditions. We further investigated the capabilities of this electrode in a clinical setting and realized its ability to detect the arrhythmia features of atrial fibrillation accurately, and quantify muscle activity during deep tendon reflex testing and contraction against resistance.

Reported wearable dry electrodes have limited long-term use due to their imperfect skin compliance and high motion artifacts. Here, the authors report an intrinsically conductive, stretchable polymer dry electrode with excellent self-adhesiveness for long-term high-quality biopotential detection.

A Method to Determine Human Skin Heat Capacity Using a Non-Invasive Calorimetric Sensor

A calorimetric sensor has been designed to measure the heat flow dissipated by a 2 x 2 cm² skin surface. In this work, a non-invasive method is proposed to determine the heat capacity and thermal conductance of the area of skin where the measurement is made. The method consists of programming a linear variation of the temperature of the sensor thermostat during its application to the skin. The sensor is modelled as a two-inputs and two-outputs system. The inputs are 1) the power dissipated by the skin and transmitted by conduction to the sensor, and 2) the power dissipated in the sensor thermostat to maintain the programmed temperature. The outputs are 1) the calorimetric signal and 2) the thermostat temperature. The proposed method consists of a sensor modelling that allows the heat capacity of the element where dissipation takes place (the skin) to be identified, and the transfer functions (TF) that link the inputs and outputs are constructed from its value. These TFs allow the determination of the heat flow dissipated by the surface of the human body as a function of the temperature of the sensor thermostat. Furthermore, as this variation in heat flow is linear, we define and determine an equivalent thermal resistance of the skin in the measured area. The method is validated with a simulation and with experimental measurements on the surface of the human body.

A wearable lab-on-a-patch platform with stretchable nanostructured biosensor for non-invasive immunodetection of biomarker in sweat

Conformable, wearable biosensor-integrated systems are a promising approach to non-invasive and quantitative on-body detection of biomarkers in body fluids. However, realizing such a system has been slowed by the difficulty of fabricating a soft affinity-based biosensor patch capable of precise on-body fluid handling with minimal wearer intervention and a simple measurement protocol. Herein, we demonstrate a conformable, wearable lab-on-a-patch (LOP) platform composed of a stretchable, label-free, impedimetric biosensor and a stretchable microfluidic device for on-body detection of the hormone biomarker, cortisol. The all-in-one, stretchable microfluidic device can precisely collect and deliver sweat for cortisol quantitation and offers one-touch operation of reagent delivery for simultaneous electrochemical signal generation and washing. Three-dimensional nanostructuring of the Au working electrode enables the high sensitivity required to detect the pM-levels of cortisol in sweat. Our integrated LOP detected sweat cortisol quantitatively and accurately during exercise. This LOP will open a new horizon for non-invasive, highly sensitive, and quantitative on-body immunodetection for wearable personal diagnostics.

Electro-mechanically controlled assembly of reconfigurable 3D mesostructures and electronic devices based on dielectric elastomer platforms

The manufacture of 3D mesostructures is receiving rapidly increasing attention, because of the fundamental significance and practical applications across wide-ranging areas. The recently developed approach of buckling-guided assembly allows deterministic formation of complex 3D mesostructures in a broad set of functional materials, with feature sizes spanning nanoscale to centimeter-scale. Previous studies mostly exploited mechanically controlled assembly platforms using elastomer substrates, which limits the capabilities to achieve on-demand local assembly, and to reshape assembled mesostructures into distinct 3D configurations. This work introduces a set of design concepts and assembly strategies to utilize dielectric elastomer actuators as powerful platforms for the electro-mechanically controlled 3D assembly. Capabilities of sequential, local loading with desired strain distributions allow access to precisely tailored 3D mesostructures that can be reshaped into distinct geometries, as demonstrated by experimental and theoretical studies of ∼30 examples. A reconfigurable inductive–capacitive radio-frequency circuit consisting of morphable 3D capacitors serves as an application example.