Paper-Based Flexible Electrode Using Chemically-Modified Graphene and Functionalized Multiwalled Carbon Nanotube Composites for Electrophysiological Signal Sensing

Progress and prospects in flexible tactile sensors

Flexible tactile sensors have the advantages of large deformation detection, high fault tolerance, and excellent conformability, which enable conformal integration onto the complex surface of human skin for long-term bio-signal monitoring. The breakthrough of flexible tactile sensors rather than conventional tactile sensors greatly expanded application scenarios. Flexible tactile sensors are applied in fields including not only intelligent wearable devices for gaming but also electronic skins, disease diagnosis devices, health monitoring devices, intelligent neck pillows, and intelligent massage devices in the medical field; intelligent bracelets and metaverse gloves in the consumer field; as well as even brain-computer interfaces. Therefore, it is necessary to provide an overview of the current technological level and future development of flexible tactile sensors to ease and expedite their deployment and to make the critical transition from the laboratory to the market. This paper discusses the materials and preparation technologies of flexible tactile sensors, summarizing various applications in human signal monitoring, robotic tactile sensing, and human-machine interaction. Finally, the current challenges on flexible tactile sensors are also briefly discussed, providing some prospects for future directions.

Electrochemical Chemically Based Sensors and Emerging Enzymatic Biosensors for Antidepressant Drug Detection: A Review

Major depressive disorder is a widespread condition with antidepressants as the main pharmacological treatment. However, some patients experience concerning adverse reactions or have an inadequate response to treatment. Analytical chromatographic techniques, among other techniques, are valuable tools for investigating medication complications, including those associated with antidepressants. Nevertheless, there is a growing need to address the limitations associated with these techniques. In recent years, electrochemical (bio)sensors have garnered significant attention due to their lower cost, portability, and precision. Electrochemical (bio)sensors can be used for various applications related to depression, such as monitoring the levels of antidepressants in biological and in environmental samples. They can provide accurate and rapid results, which could facilitate personalized treatment and improve patient outcomes. This state-of-the-art literature review aims to explore the latest advancements in the electrochemical detection of antidepressants. The review focuses on two types of electrochemical sensors: Chemically modified sensors and enzyme-based biosensors. The referred papers are carefully categorized according to their respective sensor type. The review examines the differences between the two sensing methods, highlights their unique features and limitations, and provides an in-depth analysis of each sensor.

Continuous physiological signal measurement over 24-hour periods to assess the impact of work-related stress and workplace violence

Work-related stress has long been recognized as an essential factor affecting employees' health and wellbeing. Repeated exposure to acute occupational stressors puts workers at high risk for depression, obesity, hypertension, and early death. Assessment of the effects of acute stress on workers' wellbeing usually relies on subjective self-reports, questionnaires, or measuring biometric and biochemical markers in long-cycle time intervals. This study aimed to develop and validate the use of a multiparameter wearable armband for continuous non-invasive monitoring of physiological states. Two worker populations were monitored 24 h/day: six loggers for one day and six ICU nurses working 12-hr shifts for one week. Stress responses in nurses were highly correlated with changes in heart rate variability (HRV) and pulse transit time (PTT). A rise in the low-to high-frequency (LF/LH) ratio in HRV was also coincident with stress responses. HRV on workdays decreased compared to non-work days, and PTT also exhibited a persistent decrease reflecting increased blood pressure. Compared to loggers, nurses were involved in high-intensity work activities 45% more often but were less active on non-work days. The wearable technology was well accepted by all worker participants and yielded high signal quality, critical factors for long-term non-invasive occupational health monitoring.

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

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

Electrochemical Sensors Based on MoSx -Functionalized Laser-Induced Graphene for Real-Time Monitoring of Phenazines Produced by Pseudomonas aeruginosa

Pseudomonas aeruginosa (P. aeruginosa) is an opportunistic pathogen causing infections in blood and implanted devices. Traditional identification methods take more than 24 h to produce results. Molecular biology methods expedite detection, but require an advanced skill set. To address these challenges, this work demonstrates functionalization of laser-induced graphene (LIG) for developing flexible electrochemical sensors for P. aeruginosa based on phenazines. Electrodeposition as a facile approach is used to functionalize LIG with molybdenum polysulfide (MoSx ). The sensor's limit of detection (LOD), sensitivity, and specificity are determined in broth, agar, and wound simulating medium (WSM). Control experiments with Escherichia coli, which does not produce phenazines, demonstrate specificity of sensors for P. aeruginosa. The LOD for pyocyanin (PYO) and phenazine-1-carboxylic acid (PCA) is 0.19 × 10-6  and 1.2 × 10-6  m, respectively. Furthermore, the highly stable sensors enable real-time monitoring of P. aeruginosa biofilms over several days. Comparing square wave voltammetry data over time shows time-dependent generation of phenazines. In particular, two configurations-"Normal" and "Flipped"-are studied, showing that the phenazines time dynamics vary depending on how cells interact with sensors. The reported results demonstrate the potential of the developed sensors for integration with wound dressings for early diagnosis of P. aeruginosa infection.

Graphene and graphene nanohybrid composites-based electrodes for physiological sensing applications

In this paper, three categories of ECG electrodes were fabricated. Graphene/PDMS(Polydimethylsiloxane)(G-I), Graphene/MWCNT-COOH(Carboxylic-acid functionalized Multi-walled Carbon Nanotubes)/PDMS(G-II),and Graphene/SWCNT-COOH(Carboxylic-acid functionalized Single-walled Carbon Nanotubes)/PDMS(G-III). Each group had thirteen electrodes with varying concentrations ranging from 0.1-5wt%. Since CNTs get tangled easily, it becomes necessary to disperse them properly. To achieve optimal dispersion, CNTs were first sonicated with Isopropyl Alcohol (IPA), and then with PDMS. Mold casting was the technique used for fabricating the electrodes. The results were compared with the conventional ECG electrodes. Best results were achieved from G-III at 3wt% as the value of capacitance is high (0.172nF) as compared to G-I and G-III values at 3wt% which are 0.036nF (0.036nF) and 0.015nF respectively. As capacitance has an inverse relationship with the resistance and impedance, thus at 3wt% the resistance (0.361MΩ) and impedance (0.36MΩ) values are low, which satisfies the relationship. The values of resistance and impedance of G-II are low when compared with the values of G-I and G-II. Great results and ECG waveform are achieved with 3wt% for G-II, which also uses less nanomaterials to produce such great ECG results. It was observed that even after using the electrodes for 5 days, the ECG signal did not degrade over time and no skin allergies were detected for any of the three groups. The ECG tracking system was developed on the concept of the Internet-of-Things (IoT) using various electronic hardware components and software solutions. The results from the fabricated electrodes were promising and were suitable for long-term, and continuous ECG monitoring.

Graphene-Based Flexible Electrode for Electrocardiogram Signal Monitoring

With the rapidly aging society and increased concern for personal cardiovascular health, novel, flexible electrodes suitable for electrocardiogram (ECG) signal monitoring are in demand. Based on the excellent electrical and mechanical properties of graphene and the rapid development of graphene device fabrication technologies, graphene-based ECG electrodes have recently attracted much attention, and many flexible graphene electrodes with excellent performance have been developed. To understand the current research progress of graphene-based ECG electrodes and help researchers clarify current development conditions and directions, we systematically review the recent advances in graphene-based flexible ECG electrodes. Graphene electrodes are classified as bionic, fabric-based, biodegradable, laser-induced/scribed, modified-graphene, sponge-like, invasive, etc., based on their design concept, structural characteristics, preparation methods, and material properties. Moreover, some categories are further divided into dry or wet electrodes. Then, their performance, including electrode–skin impedance, signal-to-noise ratio, skin compatibility, and stability, is analyzed. Finally, we discuss possible development directions of graphene ECG electrodes and share our views.

Advances in Soft and Dry Electrodes for Wearable Health Monitoring Devices

Electrophysiology signals are crucial health status indicators as they are related to all human activities. Current demands for mobile healthcare have driven considerable interest in developing skin-mounted electrodes for health monitoring. Silver-Silver chloride-based (Ag-/AgCl) wet electrodes, commonly used in conventional clinical practice, provide excellent signal quality, but cannot monitor long-term signals due to gel evaporation and skin irritation. Therefore, the focus has shifted to developing dry electrodes that can operate without gels and extra adhesives. Compared to conventional wet electrodes, dry ones offer various advantages in terms of ease of use, long-term stability, and biocompatibility. This review outlines a systematic summary of the latest research on high-performance soft and dry electrodes. In addition, we summarize recent developments in soft materials, biocompatible materials, manufacturing methods, strategies to promote physical adhesion, methods for higher breathability, and their applications in wearable biomedical devices. Finally, we discuss the developmental challenges and advantages of various dry electrodes, while suggesting research directions for future studies.

Graphene nanostructures for input-output bioelectronics

The ability to manipulate the electrophysiology of electrically active cells and tissues has enabled a deeper understanding of healthy and diseased tissue states. This has primarily been achieved via input/output (I/O) bioelectronics that interface engineered materials with biological entities. Stable long-term application of conventional I/O bioelectronics advances as materials and processing techniques develop. Recent advancements have facilitated the development of graphene-based I/O bioelectronics with a wide variety of functional characteristics. Engineering the structural, physical, and chemical properties of graphene nanostructures and integration with modern microelectronics have enabled breakthrough high-density electrophysiological investigations. Here, we review recent advancements in 2D and 3D graphene-based I/O bioelectronics and highlight electrophysiological studies facilitated by these emerging platforms. Challenges and present potential breakthroughs that can be addressed via graphene bioelectronics are discussed. We emphasize the need for a multidisciplinary approach across materials science, micro-fabrication, and bioengineering to develop the next generation of I/O bioelectronics.

A Novel Wearable Flexible Dry Electrode Based on Cowhide for ECG Measurement

The electrocardiogram (ECG) electrode, as a sensor, is an important part of the wearable ECG monitoring device. Natural leather is rarely used as the electrode substrate. In this paper, wearable flexible silver electrodes based on cowhide were prepared by sputtering and brush-painting. A signal generator, oscilloscope, impedance test instrument, and ECG monitor were used to build the test platform evaluating the performance of electrodes with six subjects. The lossless waveform transmission can be achieved with our electrodes. Therefore, the Pearson’s correlation coefficient calculated with input waveform and output waveform of the electrodes based on the top grain layer (GLE) and the split layer (SLE) of cowhide were 0.997 and 0.998 at 0.1 Hz respectively. The skin electrode impedance (Z) was tested, and the parameters of the equivalent circuit model of the skin electrode interface were calculated by a fitting method, indicating that the Z of the prepared electrodes was comparable with the standard gel electrode when the skin is moist enough. The signal-to-noise ratio of the ECG of the GLE and the SLE were 1.148 and 1.205 times that of the standard electrode in the standing posture, which meant the ECG measured by our electrodes was basically consistent with that measured by the standard electrode.

Introducing the Special Issue on “Ubiquitous Sensing for Smart Health Monitoring”

Sensors continue to pervade our surroundings in undiminished ways [...]

Carbon nanotube materials for electrocardiography

Carbon nanotubes (CNTs) as 1D nanomaterials of excellent physicochemical characteristics bring hope to compete and eventually conquer traditional solutions in electrocardiography - one of the most powerful and non-invasive diagnostic tools in cardiac disorders. Our review tracks (from 2008) the development of CNTs as critical components in the systems where CNTs serve mainly as electroconductive fillers hence enable recording electrocardiographs (ECG). The characteristics of the CNT-based ECG systems - mainly to-skin electrodes and in a few cases wiring - covers their electrical and mechanical performance (adhesivity, flexibility, elasticity) and qualitative biocompatibility. By comprehensive analysis of the state-of-art in this field, we intend to indicate the most important challenges for the CNT (and other) materials to be applied in scale-up solution for electrocardiography in the near future.

Flexible Electronics for Monitoring in vivo Electrophysiology and Metabolite Signals

Numerous efforts have been made to develop efficient biosensors for detecting analytes in the human body. However, biosensors are often developed on rigid materials, which limits their application on skin, organs, and other tissues in the human body where good flexibility is required. Developing flexible materials for biosensors that can be used on soft and irregularly shaped surfaces would significantly expand the clinical application of biosensors. In this review, we will provide a selective overview of recently developed flexible electronic devices and their applications for monitoring in vivo metabolite and electrophysiology signals. The article provides guidelines for the development of an in vivo signal monitoring system and emphasizes research from various disciplines for the further development of flexible electronics that can be used in more biomedical applications in the future.

Challenges in Design and Fabrication of Flexible/Stretchable Carbon- and Textile-Based Wearable Sensors for Health Monitoring: A Critical Review

To demonstrate the wearable flexible/stretchable health-monitoring sensor, it is necessary to develop advanced functional materials and fabrication technologies. Among the various developed materials and fabrication processes for wearable sensors, carbon-based materials and textile-based configurations are considered as promising approaches due to their outstanding characteristics such as high conductivity, lightweight, high mechanical properties, wearability, and biocompatibility. Despite these advantages, in order to realize practical wearable applications, electrical and mechanical performances such as sensitivity, stability, and long-term use are still not satisfied. Accordingly, in this review, we describe recent advances in process technologies to fabricate advanced carbon-based materials and textile-based sensors, followed by their applications such as human activity and electrophysiological sensors. Furthermore, we discuss the remaining challenges for both carbon- and textile-based wearable sensors and then suggest effective strategies to realize the wearable sensors in health monitoring.