Soft Material-Enabled, Flexible Hybrid Electronics for Medicine, Healthcare, and Human-Machine Interfaces

Soft Bioelectronics for Heart Monitoring

Cardiovascular diseases (CVDs) are a predominant global health concern, accounting for over 17.9 million deaths in 2019, representing approximately 32% of all global fatalities. In North America and Europe, over a million adults undergo cardiac surgeries annually. Despite the benefits, such surgeries pose risks and require precise postsurgery monitoring. However, during the postdischarge period, where monitoring infrastructures are limited, continuous monitoring of vital signals is hindered. In this area, the introduction of implantable electronics is altering medical practices by enabling real-time and out-of-hospital monitoring of physiological signals and biological information postsurgery. The multimodal implantable bioelectronic platforms have the capability of continuous heart sensing and stimulation, in both postsurgery and out-of-hospital settings. Furthermore, with the emergence of machine learning algorithms into healthcare devices, next-generation implantables will benefit artificial intelligence (AI) and connectivity with skin-interfaced electronics to provide more precise and user-specific results. This Review outlines recent advancements in implantable bioelectronics and their utilization in cardiovascular health monitoring, highlighting their transformative deployment in sensing and stimulation to the heart toward reaching truly personalized healthcare platforms compatible with the Sustainable Development Goal 3.4 of the WHO 2030 observatory roadmap. This Review also discusses the challenges and future prospects of these devices.

Implanted Carbon Nanotubes Harvest Electrical Energy from Heartbeat for Medical Implants

Reliability of power supply for current implantable electronic devices is a critical issue for longevity and for reducing the risk of device failure. Energy harvesting is an emerging technology, representing a strategy for establishing autonomous power supply by utilizing biomechanical movements in human body. Here, a novel "Twistron energy cell harvester" (TECH), consisting of coiled carbon nanotube yarn that converts mechanical energy of the beating heart into electrical energy, is presented. The performance of TECH is evaluated in an in vitro artificial heartbeat system which simulates the deformation pattern of the cardiac surface, reaching a maximum peak power of 1.42 W kg-1 and average power of 0.39 W kg-1 at 60 beats per minute. In vivo implantation of TECH onto the left ventricular surface in a porcine model continuously generates electrical energy from cardiac contraction. The generated electrical energy is used for direct pacing of the heart as documented by extensive electrophysiology mapping. Implanted modified carbon nanotubes are applicable as a source for harvesting biomechanical energy from cardiac motion for power supply or cardiac pacing.

Flexible Thermoelectric Wearable Architecture for Wireless Continuous Physiological Monitoring

Continuous monitoring of physiological signals from the human body is critical in health monitoring, disease diagnosis, and therapeutics. Despite the needs, the existing wearable medical devices rely on either bulky wired systems or battery-powered devices needing frequent recharging. Here, we introduce a wearable, self-powered, thermoelectric flexible system architecture for wireless portable monitoring of physiological signals without recharging batteries. This system harvests an exceptionally high open circuit voltage of 175-180 mV from the human body, powering the wireless wearable bioelectronics to detect electrophysiological signals on the skin continuously. The thermoelectric system shows long-term stability in performance for 7 days with stable power management. Integrating screen printing, laser micromachining, and soft packaging technologies enables a multilayered, soft, wearable device to be mounted on any body part. The demonstration of the self-sustainable wearable system for detecting electromyograms and electrocardiograms captures the potential of the platform technology to offer various opportunities for continuous monitoring of biosignals, remote health monitoring, and automated disease diagnosis.

Amineh R. Elbow Gesture Recognition with an Array of Inductive Sensors and Machine Learning

This work presents a novel approach for elbow gesture recognition using an array of inductive sensors and a machine learning algorithm (MLA). This paper describes the design of the inductive sensor array integrated into a flexible and wearable sleeve. The sensor array consists of coils sewn onto the sleeve, which form an LC tank circuit along with the externally connected inductors and capacitors. Changes in the elbow position modulate the inductance of these coils, allowing the sensor array to capture a range of elbow movements. The signal processing and random forest MLA to recognize 10 different elbow gestures are described. Rigorous evaluation on 8 subjects and data augmentation, which leveraged the dataset to 1270 trials per gesture, enabled the system to achieve remarkable accuracy of 98.3% and 98.5% using 5-fold cross-validation and leave-one-subject-out cross-validation, respectively. The test performance was then assessed using data collected from five new subjects. The high classification accuracy of 94% demonstrates the generalizability of the designed system. The proposed solution addresses the limitations of existing elbow gesture recognition designs and offers a practical and effective approach for intuitive human-machine interaction.

Biocompatible Electrical and Optical Interfaces for Implantable Sensors and Devices

Implantable bioelectronics hold tremendous potential in the field of healthcare, yet the performance of these systems heavily relies on the interfaces between artificial machines and living tissues. In this paper, we discuss the recent developments of tethered interfaces, as well as those of non-tethered interfaces. Among them, systems that study neural activity receive significant attention due to their innovative developments and high relevance in contemporary research, but other functional types of interface systems are also explored to provide a comprehensive overview of the field. We also analyze the key considerations, including perforation site selection, fixing strategies, long-term retention, and wireless communication, highlighting the challenges and opportunities with stable, effective, and biocompatible interfaces. Furthermore, we propose a primitive model of biocompatible electrical and optical interfaces for implantable systems, which simultaneously possesses biocompatibility, stability, and convenience. Finally, we point out the future directions of interfacing strategies.

Continuous real-time assessment of acute cognitive stress from cardiac mechanical signals captured by a skin-like patch

The inability to objectively quantify cognitive stress in real-time with wearable devices is a crucial unsolved problem with serious negative consequences for dementia and mental disability patients and those seeking to improve their quality of life. Here, we introduce a skin-like, wireless sternal patch that captures changes in cardiac mechanics due to stress manifesting in the seismocardiogram (SCG) signals. Judicious optimization of the device's micro-structured interconnections and elastomer integration yields a device that sufficiently matches the skin's mechanics, robustly yet gently adheres to the skin without aggressive tapes, and captures planar and longitudinal SCG waves well. The device transmits SCG beats in real-time to a user's device, where derived features relate to the heartbeat's mechanical morphology. The signals are assessed by a series of features in a support vector machine regressor. Controlled studies, compared to gold standard cortisol and following the validated imaging test, show an R-squared correlation of 0.79 between the stress prediction and cortisol change, significantly improving over prior works. Likewise, the system demonstrates excellent robustness to external temperature and physical recovery status while showing excellent accuracy and wearability in full-day use.

Nozzle-Free Printing of CNT Electronics Using Laser-Generated Focused Ultrasound

Printed electronics have made remarkable progress in recent years and inkjet printing (IJP) has emerged as one of the leading methods for fabricating printed electronic devices. However, challenges such as nozzle clogging, and strict ink formulation constraints have limited their widespread use. To address this issue, a novel nozzle-free printing technology is explored, which is enabled by laser-generated focused ultrasound, as a potential alternative printing modality called Shock-wave Jet Printing (SJP). Specifically, the performance of SJP-printed and IJP-printed bottom-gated carbon nanotube (CNT) thin film transistors (TFTs) is compared. While IJP required ten print passes to achieve fully functional devices with channel dimensions ranging from tens to hundreds of micrometers, SJP achieved comparable performance with just a single pass. For optimized devices, SJP demonstrated six times higher maximum mobility than IJP-printed devices. Furthermore, the advantages of nozzle-free printing are evident, as SJP successfully printed stored and unsonicated inks, delivering moderate electrical performance, whereas IJP suffered from nozzle clogging due to CNT agglomeration. Moreover, SJP can print significantly longer CNTs, spanning the entire range of tube lengths of commercially available CNT ink. The findings from this study contribute to the advancement of nanomaterial printing, ink formulation, and the development of cost-effective printable electronics.

Sustainable Production Insight Through LCA and LCC Analysis of Injection Overmolded Structural Electronics Manufactured through Roll-to-Roll Processes

Printed electronics (PE) have provided new material and application opportunities for devices and systems as well as new manufacturing routes that all need to be considered for commercialization. This paper introduces a case study with universally relevant manufacturing processes and applications in the PE area, focusing on the Life Cycle Assessment (LCA) and Life Cycle Costing (LCC) of the Personal Activity Monitor (PAM) device. In the study, the PAM device's most important costs and environmental impacts during the prototype pilot production and device use phases are identified and assessed. Additionally, the potential environmental impacts of post-consumption scenarios are considered. The LCA results indicate that the roll-to-roll (R2R) assembly of electronics and the R2R injection over-molding are generally the most prominent production process steps affecting the results. From the LCC perspective, the capitial expenditure (CAPEX) contributor is the R2R assembly pilot line, due to its high investment cost and long operating time compare to other production assets. The traditional electronic components are the major operating expenditures (OPEX), especially the microcontroller units (MCUs) and accelerometers, in contrast to the low impact from the printed electronics. There are several advantages to applying LCA and LCC since they provide explanations of the relationships between cost, environmental, design, and manufacturing characteristics.

SIS-Based Electrostatic Spinning High-Safety Lithium-Ion Battery Separators

As an important component, the properties of separators directly affect the capacity, life, and safety performance of lithium-ion batteries (LIBs). The high thermal stability and safety application value of the thermoplastic elastomer poly(styrene-b-isoprene-b-styrene) block copolymer (SIS) with different block ratios were explored to enhance the thermal stability and mechanical strength of the cross-linked polyacrylonitrile (PAN) membranes by vulcanization cross-linking and heat treatment. Among these membranes, the sample named the S/PAN/SIS-4019 separator was confirmed to be a self-closing separator that can cope with the thermal runaway, attributing to the continued fusion of the SIS soft and hard segments in the cross-linked structure under high-temperature heat treatment. Moreover, the tensile strength of S/PAN/SIS-4019 separator increased to 17.49 MPa, which was better than that of Celgard 2400, PAN, and other inlay separators. Using S/PAN/SIS-4019 as a battery separator, lithium-ion batteries showed a superior electrochemical performance compared to the usage of Celgard 2400. Owing to the stable pore structure and thermally protected self-shutdown mechanism, the overall properties of the obtained cross-linked separator were improved in terms of higher thermal stability, high ionic conductivity, and electrochemical properties.

Flexible triboelectric nanogenerators using transparent copper nanowire electrodes: energy harvesting, sensing human activities and material recognition

Triboelectric nanogenerators (TENGs) have emerged as a promising green technology to efficiently harvest otherwise wasted mechanical energy from the environment and human activities. However, cost-effective and reliably performing TENGs require rational integration of triboelectric materials, spacers, and electrodes. The present work reports for the first time the use of oxydation-resistant pure copper nanowires (CuNWs) as an electrode to develop a flexible, and inexpensive TENG through a potentially scalable approach involving vacuum filtration and lactic acid treatment. A ∼6 cm2 device yields a remarkable open circuit voltage (Voc) of 200 V and power density of 10.67 W m-2 under human finger tapping. The device is robust, flexible and noncytotoxic as assessed by stretching/bending maneuvers, corrosion tests, continuous operation for 8000 cycles, and biocompatibility tests using human fibroblast cells. The device can power 115 light emitting diodes (LEDs) and a digital calculator; sense bending and motion from the human hand; and transmit Morse code signals. The robustness, flexibility, transparency, and non-cytotoxicity of the device render it particularly promising for a wide range of energy harvesting and advanced healthcare applications, such as sensorised smart gloves for tactile sensing, material identification and safer surgical intervention.

Algal-based wood as a green and sustainable alternative for environmentally friendly & flexible electronic devices membrane bioreactor

Electronic are usually constructed from non-renewable, non-biodegradable, and hazardous materials. Due to the frequent upgrading or discarding of electronic devices, which contributes significantly to environmental pollution, there is a high demand for electronics made from renewable and biodegradable materials with less harmful components. To this end, due to their flexibility, strong mechanical, and optical properties, wood-based electronics have become very appealing as substrates especially for flexible electronics and optoelectronics. However, incorporating numerous features including high conductivity and transparency, flexibility, and mechanical robustness into an environmentally friendly electronic device remains very challenging. Herein, authors have provided the techniques used to fabricate sustainable wood based flexible electronics coupled with their chemical, mechanical, optical, thermal, thermomechanical, and surface properties for various applications. Additionally, the synthesis of a conductive ink based on lignin and the development of translucent wood as a substrate are covered. Future developments and broader applications of wood-based flexible materials are discussed in the final section of the study, with an emphasis on their potential in fields including wearable electronics, renewable energy, and biomedical devices. This research improves upon prior efforts by demonstrating new ways to simultaneously attain better mechanical and optical qualities and environmental sustainability.

Electrospun cellulose acetate nanofibrous composites for multi-responsive shape memory actuators and self-powered pressure sensors

Soft actuators and sensors have attracted extensive scientific interest attributed to their great potential applications in various fields, but the integration of actuating and sensing functions in one material is still a big challenge. Here, we developed an electrospun cellulose acetate (CA)/carbon nanotube nanofiborous composite with both functional applications as multi-responsive shape memory actuators and triboelectric nanogenerator (TENG) based sensors. Attributed to excellent thermo- and light-induced shape memory performance, the CA nanofiborous composites showed high heavy-lift capability as light driven actuators, able to lift burdens 1050 times heavier than their own weight. The CA nanofiborous membranes based TENG exhibited high output performance with open-circuit voltage, short-circuit density, and instantaneous power density about 103.2 V, 7.93 mA m^-2 and 0.74 W m^-2, respectively. The fabricated TENG based pressure sensor exhibited a high sensitivity of 3.03 V kPa^-1 below 6.8 kPa and 0.11 V kPa^-1 in the pressure range from 6.8 to 65 kPa, which can be effectively used to monitor human motion state and measure wind velocity. It is expected that the electrospun composites with actuating and sensing functions will show prosperous applications prospects in soft robotics.

Impact of Planar and Vertical Organic Field-Effect Transistors on Flexible Electronics

The development of flexible and conformable devices, whose performance can be maintained while being continuously deformed, provides a significant step toward the realization of next-generation wearable and e-textile applications. Organic field-effect transistors (OFETs) are particularly interesting for flexible and lightweight products, because of their low-temperature solution processability, and the mechanical flexibility of organic materials that endows OFETs the natural compatibility with plastic and biodegradable substrates. Here, an in-depth review of two competing flexible OFET technologies, planar and vertical OFETs (POFETs and VOFETs, respectively) is provided. The electrical, mechanical, and physical properties of POFETs and VOFETs are critically discussed, with a focus on four pivotal applications (integrated logic circuits, light-emitting devices, memories, and sensors). It is pointed out that the flexible function of the relatively newer VOFET technology, along with its perspective on advancing the applicability of flexible POFETs, has not been reviewed so far, and the direct comparison regarding the performance of POFET- and VOFET-based flexible applications is most likely absent. With discussions spanning printed and wearable electronics, materials science, biotechnology, and environmental monitoring, this contribution is a clear stimulus to researchers working in these fields to engage toward the plentiful possibilities that POFETs and VOFETs offer to flexible electronics.

Early career scientists converse on the future of soft robotics

During the recent decade, we have witnessed an extraordinary flourishing of soft robotics. Rekindled interest in soft robots is partially associated with the advances in manufacturing techniques that enable the fabrication of sophisticated multi-material robotic bodies with dimensions ranging across multiple length scales. In recent manuscripts, a reader might find peculiar-looking soft robots capable of grasping, walking, or swimming. However, the growth in publication numbers does not always reflect the real progress in the field since many manuscripts employ very similar ideas and just tweak soft body geometries. Therefore, we unreservedly agree with the sentiment that future research must move beyond "soft for soft's sake." Soft robotics is an undoubtedly fascinating field, but it requires a critical assessment of the limitations and challenges, enabling us to spotlight the areas and directions where soft robots will have the best leverage over their traditional counterparts. In this perspective paper, we discuss the current state of robotic research related to such important aspects as energy autonomy, electronic-free logic, and sustainability. The goal is to critically look at perspectives of soft robotics from two opposite points of view provided by early career researchers and highlight the most promising future direction, that is, in our opinion, the employment of soft robotic technologies for soft bio-inspired artificial organs.

Graphene e-tattoos for unobstructive ambulatory electrodermal activity sensing on the palm enabled by heterogeneous serpentine ribbons

Electrodermal activity (EDA) is a popular index of mental stress. State-of-the-art EDA sensors suffer from obstructiveness on the palm or low signal fidelity off the palm. Our previous invention of sub-micron-thin imperceptible graphene e-tattoos (GET) is ideal for unobstructive EDA sensing on the palm. However, robust electrical connection between ultrathin devices and rigid circuit boards is a long missing component for ambulatory use. To minimize the well-known strain concentration at their interfaces, we propose heterogeneous serpentine ribbons (HSPR), which refer to a GET serpentine partially overlapping with a gold serpentine without added adhesive. A fifty-fold strain reduction in HSPR vs. heterogeneous straight ribbons (HSTR) has been discovered and understood. The combination of HSPR and a soft interlayer between the GET and an EDA wristband enabled ambulatory EDA monitoring on the palm in free-living conditions. A newly developed EDA event selection policy leveraging unbiased selection of phasic events validated our GET EDA sensor against gold standards.

A Smart Pen Based on Triboelectric Effects for Handwriting Pattern Tracking and Biometric Identification

The rapid development of artificial intelligence places high demands on human-machine interfaces. Various types of huma-machine interfaces have been implemented, including smart keyboards, electronic skins, and wearable motion sensors. Handwriting behavior has a high degree of interaction freedom, and handwriting characteristics offer high-security standards for human-machine systems. Herein, we propose a portable smart pen integrated with triboelectric displacement vector sensors to trace handwriting trajectories for human-machine interactions and biometric identification. A triboelectric pressure sensor array is evenly distributed along the pen case to sense displacement vectors, and an additional triboelectric sensor is placed on top of the pen to detect vertical force. By leveraging the resin pen refill as a tribopositive material and a nanowired polyethylene tribonegative layer attached to a Cu electrode, triboelectric signals are generated during the writing/moving process. The calculation and analysis of the sensor signals enable the recognition of handwritten patterns, including Latin letters and Arabic numerals. Moreover, the smart pen can be used to authenticate users based on their unique handwriting patterns, which can help take human-machine interfaces and cyber security to the next level. Furthermore, a custom smart pen operation mode that enables the control of a slide presentation demonstrates the smart pen's potential for various human-machine interface applications.

A Self-Powered Triboelectric Nanogenerator Based on Intelligent Interactive System for Police Shooting Training Monitoring and Virtual Reality Interaction

A self-powered triboelectric nanogenerator (SPTENG) based on triboelectric effect and an intelligent interactive system are fabricated for monitoring shooting training and virtual training. The SPTENG is composed of latex and PTFE and an intelligent system. Based on triboelectric effect, the SPTENG can be used to monitor the progress of trigger pressing without a power supply (this is supplied by trigger movements). Because of the flexible properties, it can be attached to a trigger conveniently to monitor the progress of trigger pressing, such as trigger time, trigger stability, etc. Meanwhile, as part of an intelligent shooting system, police can formulate a standard scheme according to signals to improve their skills. Furthermore, they can use it to train between reality and virtuality. Therefore, it has a wide development space in human-computer interaction and real-time information processing.

Influence of microstructural alterations of liquid metal and its interfacial interactions with rubber on multifunctional properties of soft composite materials

Liquid metal (LM)-based polymer composites are currently new breakthrough and emerging classes of soft multifunctional materials (SMMs) having immense transformative potential for soft technological applications. Currently, room-temperature LMs, mostly eutectic gallium‑indium and Galinstan alloys are used to integrate with soft polymer due to their outstanding properties such as high conductivity, fluidity, low adhesion, high surface tension, low cytotoxicity, etc. The microstructural alterations and interfacial interactions controlling the efficient integration of LMs with rubber are the most critical aspects for successful implementation of multifunctionality in the resulting material. In this review article, a fundamental understanding of microstructural alterations of LMs to the formation of well-defined percolating networks inside an insulating rubber matrix has been established by exploiting several existing theoretical and experimental studies. Furthermore, effects of the chemical modifications of an LM surface and its interfacial interactions on the compatibility between solid rubber and fluid filler phase have been discussed. The presence of thin oxide layer on the LM surface and the effects and challenges it poses to the adequate functionalization of these materials have been discussed. Plausible applications of SMMs in different soft matter technologies, like soft robotics, flexible electronics, soft actuators, sensors, etc. have been provided. Finally, the current technical challenges and further prospective to the development of SMMs using non‑silicone rubbers have been critically discussed. This review is anticipated to infuse a new impetus to the associated research communities for the development of next generation SMMs.

Thermally switchable, crystallizable oil and silicone composite adhesives for skin-interfaced wearable devices

Continuous health monitoring is essential for clinical care, especially for patients in neonatal and pediatric intensive care units. Monitoring currently requires wired biosensors affixed to the skin with strong adhesives that can cause irritation and iatrogenic injuries during removal. Emerging wireless alternatives are attractive, but requirements for skin adhesives remain. Here, we present a materials strategy enabling wirelessly triggered reductions in adhesive strength to eliminate the possibility for injury during removal. The materials involve silicone composites loaded with crystallizable oils with melting temperatures close to, but above, surface body temperature. This solid/liquid phase transition occurs upon heating, reducing the adhesion at the skin interface by more than 75%. Experimental and computational studies reveal insights into effects of oil mixed randomly and patterned deterministically into the composite. Demonstrations in skin-integrated sensors that include wirelessly controlled heating and adhesion reduction illustrate the broad utility of these ideas in clinical-grade health monitoring.

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.

Flexible Electronics and Devices as Human-Machine Interfaces for Medical Robotics

Medical robots are invaluable players in non-pharmaceutical treatment of disabilities. Particularly, using prosthetic and rehabilitation devices with human-machine interfaces can greatly improve the quality of life for impaired patients. In recent years, flexible electronic interfaces and soft robotics have attracted tremendous attention in this field due to their high biocompatibility, functionality, conformability, and low-cost. Flexible human-machine interfaces on soft robotics will make a promising alternative to conventional rigid devices, which can potentially revolutionize the paradigm and future direction of medical robotics in terms of rehabilitation feedback and user experience. In this review, the fundamental components of the materials, structures, and mechanisms in flexible human-machine interfaces are summarized by recent and renowned applications in five primary areas: physical and chemical sensing, physiological recording, information processing and communication, soft robotic actuation, and feedback stimulation. This review further concludes by discussing the outlook and current challenges of these technologies as a human-machine interface in medical robotics.

Automatic and Accurate Sleep Stage Classification via a Convolutional Deep Neural Network and Nanomembrane Electrodes

Sleep stage classification is an essential process of diagnosing sleep disorders and related diseases. Automatic sleep stage classification using machine learning has been widely studied due to its higher efficiency compared with manual scoring. Typically, a few polysomnography data are selected as input signals, and human experts label the corresponding sleep stages manually. However, the manual process includes human error and inconsistency in the scoring and stage classification. Here, we present a convolutional neural network (CNN)-based classification method that offers highly accurate, automatic sleep stage detection, validated by a public dataset and new data measured by wearable nanomembrane dry electrodes. First, our study makes a training and validation model using a public dataset with two brain signal and two eye signal channels. Then, we validate this model with a new dataset measured by a set of nanomembrane electrodes. The result of the automatic sleep stage classification shows that our CNN model with multi-taper spectrogram pre-processing achieved 88.85% training accuracy on the validation dataset and 81.52% prediction accuracy on our laboratory dataset. These results validate the reliability of our classification method on the standard polysomnography dataset and the transferability of our CNN model for other datasets measured with the wearable electrodes.

Research Progress on the Flexibility of an Implantable Neural Microelectrode

Neural microelectrode is the important bridge of information exchange between the human body and machines. By recording and transmitting nerve signals with electrodes, people can control the external machines. At the same time, using electrodes to electrically stimulate nerve tissue, people with long-term brain diseases will be safely and reliably treated. Young's modulus of the traditional rigid electrode probe is not matched well with that of biological tissue, and tissue immune rejection is easy to generate, resulting in the electrode not being able to achieve long-term safety and reliable working. In recent years, the choice of flexible materials and design of electrode structures can achieve modulus matching between electrode and biological tissue, and tissue damage is decreased. This review discusses nerve microelectrodes based on flexible electrode materials and substrate materials. Simultaneously, different structural designs of neural microelectrodes are reviewed. However, flexible electrode probes are difficult to implant into the brain. Only with the aid of certain auxiliary devices, can the implant be safe and reliable. The implantation method of the nerve microelectrode is also reviewed.

Toward Flexible Zinc-Air Batteries with Self-Supported Air Electrodes

The compelling demand for higher energy performance, flexibility, and miniaturization is the main driving force of the energy storage and conversion industry's quest for flexible devices based on new integration and fabrication process. Herein, the recent advances on the development of flexible zinc-air batteries based on self-supported air electrodes are summarized, focusing on the multiscale and systematic design principles for the design of flexible air electrodes. With the electrocatalytic activity regulation and structural engineering strategies, the rational design of self-supported air electrodes is discussed in integrated devices to underpin the good flexibility for wearable requirement. The perspectives on promising developments of flexible zinc-air batteries and the accumulated knowledge from other flexible devices are also addressed for promoting the advances on flexible zinc-air batteries.

Malignancies and Biosensors: A Focus on Oral Cancer Detection through Salivary Biomarkers

Oral cancer is among the deadliest types of malignancy due to the late stage at which it is usually diagnosed, leaving the patient with an average five-year survival rate of less than 50%. The booming field of biosensing and point of care diagnostics can, in this regard, play a major role in the early detection of oral cancer. Saliva is gaining interest as an alternative biofluid for non-invasive diagnostics, and many salivary biomarkers of oral cancer have been proposed. While these findings are promising for the application of salivaomics tools in routine practice, studies on larger cohorts are still needed for clinical validation. This review aims to summarize the most recent development in the field of biosensing related to the detection of salivary biomarkers commonly associated with oral cancer. An introduction to oral cancer diagnosis, prognosis and treatment is given to define the clinical problem clearly, then saliva as an alternative biofluid is presented, along with its advantages, disadvantages, and collection procedures. Finally, a brief paragraph on the most promising salivary biomarkers introduces the sensing technologies commonly exploited to detect oral cancer markers in saliva. Hence this review provides a comprehensive overview of both the clinical and technological advantages and challenges associated with oral cancer detection through salivary biomarkers.

Wireless Soft Scalp Electronics and Virtual Reality System for Motor Imagery-Based Brain-Machine Interfaces

Motor imagery offers an excellent opportunity as a stimulus-free paradigm for brain-machine interfaces. Conventional electroencephalography (EEG) for motor imagery requires a hair cap with multiple wired electrodes and messy gels, causing motion artifacts. Here, a wireless scalp electronic system with virtual reality for real-time, continuous classification of motor imagery brain signals is introduced. This low-profile, portable system integrates imperceptible microneedle electrodes and soft wireless circuits. Virtual reality addresses subject variance in detectable EEG response to motor imagery by providing clear, consistent visuals and instant biofeedback. The wearable soft system offers advantageous contact surface area and reduced electrode impedance density, resulting in significantly enhanced EEG signals and classification accuracy. The combination with convolutional neural network-machine learning provides a real-time, continuous motor imagery-based brain-machine interface. With four human subjects, the scalp electronic system offers a high classification accuracy (93.22 ± 1.33% for four classes), allowing wireless, real-time control of a virtual reality game.

Recent Advances in Printing Technologies of Nanomaterials for Implantable Wireless Systems in Health Monitoring and Diagnosis

The development of wireless implantable sensors and integrated systems, enabled by advances in flexible and stretchable electronics technologies, is emerging to advance human health monitoring, diagnosis, and treatment. Progress in material and fabrication strategies allows for implantable electronics for unobtrusive monitoring via seamlessly interfacing with tissues and wirelessly communicating. Combining new nanomaterials and customizable printing processes offers unique possibilities for high-performance implantable electronics. Here, this report summarizes the recent progress and advances in nanomaterials and printing technologies to develop wireless implantable sensors and electronics. Advances in materials and printing processes are reviewed with a focus on challenges in implantable applications. Demonstrations of wireless implantable electronics and advantages based on these technologies are discussed. Lastly, existing challenges and future directions of nanomaterials and printing are described.

Preparation parameters of polyaniline/polyvinyl chloride flexible wires for electrical conductivity performance analysis based on orthogonal arrays

A flexible polyaniline/polyvinyl chloride (PVC) polymer conductive wire was prepared using flexible PVC polymer as the substrate by the swelling – in-situ polymerization method, the line-shaped dents were pressed on the substrate by the thermodynamic pre-deformation treatment technology. Based on the orthogonal test method, the effects of five main influencing factors – swelling time (A), swelling temperature (B), oxidation temperature (C), oxidation time (D), and oxidant concentration (E) – on the conductivity of the prepared polyaniline/PVC conductive wire was investigated. The results of the orthogonal array testing were subjected to range analysis and analysis of variance (ANOVA), and the influencing factors, in terms of significance, follow the order of swelling temperature, oxidation time, swelling time, oxidation temperature, and oxidant concentration, with the optimal factor-level combination being A₂B₂C₂D₂E₂, which led to a desirable conductivity up to 1.19 × 10⁻¹ S/cm. In addition, the influence of different conductive line size characteristics on the molecular structure, microstructure, and conductivity of polyaniline/PVC flexible conductive wire was further studied. On the microstructure, as the line width increases, the infrared absorption intensity ratio of the quinone ring and the benzene ring in the polyaniline/PVC conductive wires gradually approaches 1. The microstructure, as the line width of the polyaniline/PVC conductive wire increases, the formed polyaniline gradually changes from flakes and granules to fibrous strips and entangles with each other to form a spatial network structure. The conductivity of the wire increases with the increase of its width up to 1.48 × 10⁻¹ S/cm.

Development of Nanosensors Based Intelligent Packaging Systems: Food Quality and Medicine

The issue of medication noncompliance has resulted in major risks to public safety and financial loss. The new omnipresent medicine enabled by the Internet of things offers fascinating new possibilities. Additionally, an in-home healthcare station (IHHS), it is necessary to meet the rapidly increasing need for routine nursing and on-site diagnosis and prognosis. This article proposes a universal and preventive strategy to drug management based on intelligent and interactive packaging (I2Pack) and IMedBox. The controlled delamination material (CDM) seals and regulates wireless technologies in novel medicine packaging. As such, wearable biomedical sensors may capture a variety of crucial parameters via wireless communication. On-site treatment and prediction of these critical factors are made possible by high-performance architecture. The user interface is also highlighted to make surgery easier for the elderly, disabled, and patients. Land testing incorporates and validates an approach for prototyping I2Pack and iMedBox. Additionally, sustainability, increased product safety, and quality standards are crucial throughout the life sciences. To achieve these standards, intelligent packaging is also used in the food and pharmaceutical industries. These technologies will continuously monitor the quality of a product and communicate with the user. Data carriers, indications, and sensors are the three most important groups. They are not widely used at the moment, although their potential is well understood. Intelligent packaging should be used in these sectors and the functionality of the systems and the values presented in this analysis.

Flexible Hybrid Electronics for Monitoring Hypoxia

Hypoxia refers to insufficient oxygen amounts at the tissue level unable to maintain adequate homeostasis. Severe hypoxia may occur in the absence of subjective breathlessness due to respiratory failure. Precise monitoring of low blood oxygen saturation is crucially desired, catering to the clinical requirements. However, current pulse oximeters cannot function well in monitoring peripheral oxygen saturation limited by the weak peripheral blood circulation at a low oxygen level. In this work, we propose a flexible hybrid electronic (FHE) with a compact structure and high sensitivity for conveniently monitoring hypoxia. This FHE is composed of 10-µm thickness semiconductors with different materials, functionalities, and sizes. Its performance is demonstrated by monitoring arterial blood oxygen saturation (SaO₂) at the body's different arteries. The absolute error is less than 2% within a SaO₂ ranging from 99% to 63%. The efficient techniques presented in this work may bring light to the next-generation flexible hybrid electronics and provide potential widespread use in research and clinical applications, especially for emergency treatment.

Artificial Skin Perception

Skin is the largest organ, with the functionalities of protection, regulation, and sensation. The emulation of human skin via flexible and stretchable electronics gives rise to electronic skin (e-skin), which has realized artificial sensation and other functions that cannot be achieved by conventional electronics. To date, tremendous progress has been made in data acquisition and transmission for e-skin systems, while the implementation of perception within systems, that is, sensory data processing, is still in its infancy. Integrating the perception functionality into a flexible and stretchable sensing system, namely artificial skin perception, is critical to endow current e-skin systems with higher intelligence. Here, recent progress in the design and fabrication of artificial skin perception devices and systems is summarized, and challenges and prospects are discussed. The strategies for implementing artificial skin perception utilize either conventional silicon-based circuits or novel flexible computing devices such as memristive devices and synaptic transistors, which enable artificial skin to surpass human skin, with a distributed, low-latency, and energy-efficient information-processing ability. In future, artificial skin perception would be a new enabling technology to construct next-generation intelligent electronic devices and systems for advanced applications, such as robotic surgery, rehabilitation, and prosthetics.

Fabrication, characterization and applications of graphene electronic tattoos

Numerous fields of science and technology, including healthcare, robotics and bioelectronics, have begun to switch their research direction from developing 'high-end, high-cost' tools towards 'high-end, low-cost' solutions. Graphene electronic tattoos (GETs), whose fabrication protocol is discussed in this work, are ideal building blocks of future wearable technology due to their outstanding electromechanical properties. The GETs are composed of high-quality, large-scale graphene that is transferred onto tattoo paper, resulting in an electronic device that is applied onto skin like a temporary tattoo. Here, we provide a comprehensive GET fabrication protocol, starting from graphene growth and ending with integration onto human skin. The methodology presented is unique since it utilizes high-quality electronic-grade graphene, while the processing is done by using low-cost and off-the-shelf methods, such as a mechanical cutter plotter. The GETs can be either used in combination with advanced scientific equipment to perform precision experiments, or with low-cost electrophysiology boards, to conduct similar operations from home. In this protocol, we showcase how GETs can be applied onto the human body and how they can be used to obtain a variety of biopotentials, including electroencephalogram (brain waves), electrocardiogram (heart activity), electromyogram (muscle activity), as well as monitoring of body temperature and hydration. With graphene available from commercial sources, the whole protocol consumes ~3 h of labor and does not require highly trained personnel. The protocol described in this work can be readily replicated in simple laboratories, including high school facilities.

Development of robust, ultra-smooth, flexible and transparent regenerated silk composite films for bio-integrated electronic device applications

Regenerated Silk Fibroin (RSF) films are considered promising substrate candidates primarily in the field of bio-integrated electronic device applications. The key issues that ought to be addressed to exploit the inherent advantages of silk thin films include enhancing their flexibility and chemical durability. Such films find a plethora of applications, the significant one being conformal, transparent microelectrode arrays. Elevated temperatures that are regularly used in lithographic processes tend to dehydrate RSF films, making them brittle. Furthermore, the solvents/etchants used in typical device fabrication results in the formation of micro-cracks. This paper addressed both these issues by developing composite films and studying the effect of biodegradable additives in enhancing flexibility and chemical durability without compromising on optical transparency and surface smoothness. Through our rigorous experimentation, regenerated silk blended with Polyvinyl Alcohol (Silk/PVA) is identified as the composite for achieving the objectives. Furthermore, the Cyto-compatibility studies suggest that Silk/PVA, along with all other silk composites, have shown above 80% cell viability, as verified using L929 fibroblast cell lines. Going a step further, we demonstrated the successful patterning of 32 channel optically transparent microelectrode array (MEA) pattern, with a minimum feature size of 5 μm above the free-standing and optically transparent Silk/PVA composite film.

Wireless, continuous monitoring of daily stress and management practice via soft bioelectronics

Stress has become a significant factor, directly affecting human health. Due to the numerous sources of stress that are inevitable in daily life, effective management of stress is essential to maintain a healthy life. Recent advancements in wearable devices allow monitoring stress levels via the detection of galvanic skin response on the skin. Some of these devices show the capability of assessing stress relief methods. However, prior works have been limited in a controlled laboratory setting with a short period assessment (<1 h) of stress intervention. The existing systems' main issues include motion artifacts and discomfort caused by rigid and bulky electronics and mandatory device connection on active fingers. Here, we introduce soft, wireless, skin-like electronics (SKINTRONICS) that offers continuous, portable daily stress and management practice monitoring. The ultrathin, lightweight, all-in-one device captures the change of a subject's stress over six continuous hours during everyday activities, including desk work, cleaning, and resting. At the same time, the SKINTRONICS proves that typical stress alleviation methods (mindfulness and meditation) can reduce stress levels, even in the middle of the day, which is supported by statistical analysis. The low-profile, wireless, gel-free device shows enhanced breathability and minimized motion artifacts compared to a commercial stress monitor. Collectively, this study shows the first demonstration of soft, nanomembrane bioelectronics for long-term, continuous assessment of stress and intervention effectiveness throughout daily life.

Toward nanobioelectronic medicine: Unlocking new applications using nanotechnology

Bioelectronic medicine aims to interface electronic technology with biological components and design more effective therapeutic and diagnostic tools. Advances in nanotechnology have moved the field forward improving the seamless interaction between biological and electronic components. In the lab many of these nanobioelectronic devices have the potential to improve current treatment approaches, including those for cancer, cardiovascular disorders, and disease underpinned by malfunctions in neuronal electrical communication. While promising, many of these devices and technologies require further development before they can be successfully applied in a clinical setting. Here, we highlight recent work which is close to achieving this goal, including discussion of nanoparticles, carbon nanotubes, and nanowires for medical applications. We also look forward toward the next decade to determine how current developments in nanotechnology could shape the growing field of bioelectronic medicine. This article is categorized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > Biosensing.

Soft Wireless Bioelectronics and Differential Electrodermal Activity for Home Sleep Monitoring

Sleep is an essential element to human life, restoring the brain and body from accumulated fatigue from daily activities. Quantitative monitoring of daily sleep quality can provide critical feedback to evaluate human health and life patterns. However, the existing sleep assessment system using polysomnography is not available for a home sleep evaluation, while it requires multiple sensors, tabletop electronics, and sleep specialists. More importantly, the mandatory sleep in a designated lab facility disrupts a subject’s regular sleep pattern, which does not capture one’s everyday sleep behaviors. Recent studies report that galvanic skin response (GSR) measured on the skin can be one indicator to evaluate the sleep quality daily at home. However, the available GSR detection devices require rigid sensors wrapped on fingers along with separate electronic components for data acquisition, which can interrupt the normal sleep conditions. Here, we report a new class of materials, sensors, electronics, and packaging technologies to develop a wireless, soft electronic system that can measure GSR on the wrist. The single device platform that avoids wires, rigid sensors, and straps offers the maximum comfort to wear on the skin and minimize disruption of a subject’s sleep. A nanomaterial GSR sensor, printed on a soft elastomeric membrane, can have intimate contact with the skin to reduce motion artifact during sleep. A multi-layered flexible circuit mounted on top of the sensor provides a wireless, continuous, real-time recording of GSR to classify sleep stages, validated by the direct comparison with the standard method that measures other physiological signals. Collectively, the soft bioelectronic system shows great potential to be working as a portable, at-home sensor system for assessing sleep quality before a hospital visit.

Recent advances in graphene-based nanobiosensors for salivary biomarker detection

As biosensing research is rapidly advancing due to significant developments in materials, chemistry, and electronics, researchers strive to build cutting-edge biomedical devices capable of detecting health-monitoring biomarkers with high sensitivity and specificity. Biosensors using nanomaterials are highly promising because of the wide detection range, fast response time, system miniaturization, and enhanced sensitivity. In the recent development of biosensors and electronics, graphene has rapidly gained popularity due to its superior electrical, biochemical, and mechanical properties. For biomarker detection, human saliva offers easy access with a large variety of analytes, making it a promising candidate for its use in point-of-care (POC) devices. Here, we report a comprehensive review that summarizes the most recent graphene-based nanobiosensors and oral bioelectronics for salivary biomarker detection. We discuss the details of structural designs of graphene electronics, use cases of salivary biomarkers, the performance of existing sensors, and applications in health monitoring. This review also describes current challenges in materials and systems and future directions of the graphene bioelectronics for clinical POC applications. Collectively, the main contribution of this paper is to deliver an extensive review of the graphene-enabled biosensors and oral electronics and their successful applications in human salivary biomarker detection.

A tough, anti-freezing and conductive nanocomposite interpenetrated organohydrogel mediated by hydrogen bonding

Conductive hydrogels have received extensive attention in the field of stretchable electric materials due to their good flexibility and conductivity.

Printed, Wireless, Soft Bioelectronics and Deep Learning Algorithm for Smart Human-Machine Interfaces

Recent advances in flexible materials and wearable electronics offer a noninvasive, high-fidelity recording of biopotentials for portable healthcare, disease diagnosis, and machine interfaces. Current device-manufacturing methods, however, still heavily rely on the conventional cleanroom microfabrication that requires expensive, time-consuming, and complicated processes. Here, we introduce an additive nanomanufacturing technology that explores a contactless direct printing of aerosol nanomaterials and polymers to fabricate stretchable sensors and multilayered wearable electronics. Computational and experimental studies prove the mechanical flexibility and reliability of soft electronics, considering direct mounting to the deformable human skin with a curvilinear surface. The dry, skin-conformal graphene biosensor, without the use of conductive gels and aggressive tapes, offers an enhanced biopotential recording on the skin and multiple uses (over ten times) with consistent measurement of electromyograms. The combination of soft bioelectronics and deep learning algorithm allows classifying six classes of muscle activities with an accuracy of over 97%, which enables wireless, real-time, continuous control of external machines such as a robotic hand and a robotic arm. Collectively, the comprehensive study of nanomaterials, flexible mechanics, system integration, and machine learning shows the potential of the printed bioelectronics for portable, smart, and persistent human-machine interfaces.

Soft Nanomembrane Sensors and Flexible Hybrid Bioelectronics for Wireless Quantification of Blepharospasm

Blepharospasm (BL) is characterized by involuntary closures of the eyelids due to spasms of the orbicularis oculi muscle. The gold standard for clinical evaluation of BL involves visual inspection for manual rating scales. This approach is highly subjective and error prone. Unfortunately, there are currently no simple quantitative systems for accurate and objective diagnostics of BL. Here, we introduce a soft, flexible hybrid bioelectronic system that offers highly conformal, gentle lamination on the skin, while enabling wireless, quantitative detection of electrophysiological signals. Computational and experimental studies of soft materials and flexible mechanics provide a set of key fundamental design factors for a low-profile bioelectronic system. The nanomembrane soft electrodes, mounted around the eyes, are capable of accurately measuring clinical symptoms, including the frequency of blinking, the duration of eye closures during spasms, as well as combinations of blinking and spasms. The use of a deep-learning, convolutional neural network, with the bioelectronics offers objective, real-time classification of key pathological features in BL. The wearable bioelectronics outperform the conventional manual clinical rating, as shown by a pilot study with 13 patients. In vivo demonstration of the bioelectronics with these patients indicates the device as an easy-to-use solution for objective quantification of BL.

Elastomers without Covalent Cross-Linking: Concatenated Rings Giving Rise to Elasticity

There is intense interest in making mechanically stable elastomers with properties resembling those of human muscles for use in soft robotics. Recently, a polydimethylsiloxane (PDMS) elastomer prepared without the use of cross-linking moieties from heterobifunctional PDMS macromonomers of intermediate molecular weight has been shown to exhibit surprising inherent softness and excellent stability upon both large deformation and swelling, in clear contradiction of classical rubber elasticity theories. In this work, this unexpected elasticity is shown to originate from concatenated rings.

Breathable, large-area epidermal electronic systems for recording electromyographic activity during operant conditioning of H-reflex

Operant conditioning of Hoffmann's reflex (H-reflex) is a non-invasive and targeted therapeutic intervention for patients with movement disorders following spinal cord injury. The reflex-conditioning protocol uses electromyography (EMG) to measure reflexes from specific muscles elicited using transcutaneous electrical stimulation. Despite recent advances in wearable electronics, existing EMG systems that measure muscle activity for operant conditioning of spinal reflexes still use rigid metal electrodes with conductive gels and aggressive adhesives, while requiring precise positioning to ensure reliability of data across experimental sessions. Here, we present the first large-area epidermal electronic system (L-EES) and demonstrate its use in every step of the reflex-conditioning protocol. The L-EES is a stretchable and breathable composite of nanomembrane electrodes (16 electrodes in a four by four array), elastomer, and fabric. The nanomembrane electrode array enables EMG recording from a large surface area on the skin and the breathable elastomer with fabric is biocompatible and comfortable for patients. We show that L-EES can record direct muscle responses (M-waves) and H-reflexes, both of which are comparable to those recorded using conventional EMG recording systems. In addition, L-EES may improve the reflex-conditioning protocol; it has potential to automatically optimize EMG electrode positioning, which may reduce setup time and error across experimental sessions.

The Evolution of Flexible Electronics: From Nature, Beyond Nature, and To Nature

The flourishing development of multifunctional flexible electronics cannot leave the beneficial role of nature, which provides continuous inspiration in their material, structural, and functional designs. During the evolution of flexible electronics, some originated from nature, some were even beyond nature, and others were implantable or biodegradable eventually to nature. Therefore, the relationship between flexible electronics and nature is undoubtedly vital since harmony between nature and technology evolution would promote the sustainable development. Herein, materials selection and functionality design for flexible electronics that are mostly inspired from nature are first introduced with certain functionality even beyond nature. Then, frontier advances on flexible electronics including the main individual components (i.e., energy (the power source) and the sensor (the electric load)) are presented from nature, beyond nature, and to nature with the aim of enlightening the harmonious relationship between the modern electronics technology and nature. Finally, critical issues in next-generation flexible electronics are discussed to provide possible solutions and new insights in prospective exploration directions.

Stretchable Nanocomposite Sensors, Nanomembrane Interconnectors, and Wireless Electronics toward Feedback-Loop Control of a Soft Earthworm Robot

Sensors that can detect external stimuli and perceive the surrounding areas could offer an ability for soft biomimetic robots to use the sensory feedback for closed-loop control of locomotion. Although various types of biomimetic robots have been developed, few systems have included integrated stretchable sensors and interconnectors with miniaturized electronics. Here, we introduce a soft, stretchable nanocomposite system with built-in wireless electronics with an aim for feedback-loop motion control of a robotic earthworm. The nanostructured strain sensor, based on a carbon nanomaterial and a low-modulus silicone elastomer, allows for seamless integration with the body of the soft robot that can accommodate large strains caused by bending, stretching, and physical interactions with obstacles. A scalable, cost-effective, and screen-printing method manufactures an array of the strain sensors that are conductive and stretchable over 100% with a gauge factor over 38. An array of nanomembrane interconnectors enables a reliable connection between soft sensors and wireless electronics while tolerating the robot's multimodal movements. A set of computational and experimental studies of soft materials, stretchable mechanics, and hybrid packaging provides the key design factors for a reliable, nanocomposite sensor system. The miniaturized wireless circuit, embedded in the robot joint, offers real-time monitoring of strain changes during the motions of a robotic segment. Collectively, the soft sensor system presented in this work shows great potential to be integrated with other flexible, stretchable electronics for applications in soft robotics, wearable devices, and human-machine interfaces.

Contactless Capacitive Electrocardiography Using Hybrid Flexible Printed Electrodes

Traditional capacitive electrocardiogram (cECG) electrodes suffer from limited patient comfort, difficulty of disinfection and low signal-to-noise ratio in addition to the challenge of integrating them in wearables. A novel hybrid flexible cECG electrode was developed that offers high versatility in the integration method, is well suited for large-scale manufacturing, is easy to disinfect in clinical settings and exhibits better performance over a comparable rigid contactless electrode. The novel flexible electrode meets the frequency requirement for clinically important QRS complex detection (0.67-5 Hz) and its performance is improved over rigid contactless electrode across all measured metrics as it maintains lower cut-off frequency, higher source capacitance and higher pass-band gain when characterized over a wide spectrum of patient morphologies. The results presented in this article suggest that the novel flexible electrode could be used in a medical device for cECG acquisition and medical diagnosis. The novel design proves also to be less sensitive to motion than a reference rigid electrode. We therefore anticipate it can represent an important step towards improving the repeatability of cECG methods while requiring less post-processing. This would help making cECG a viable method for remote cardiac health monitoring.

Devising Materials Manufacturing Toward Lab-to-Fab Translation of Flexible Electronics

Flexible electronics have witnessed exciting progress in academia over the past decade, but most of the research outcomes have yet to be translated into products or gain much market share. For mass production and commercialization, industrial adoption of newly developed functional materials and fabrication techniques is a prerequisite. However, due to the disparate features of academic laboratories and industrial plants, translating materials and manufacturing technologies from labs to fabs is notoriously difficult. Therefore, herein, key challenges in the materials manufacturing of flexible electronics are identified and discussed for its lab-to-fab translation, along the four stages in product manufacturing: design, materials supply, processing, and integration. Perspectives on industry-oriented strategies to overcome some of these obstacles are also proposed. Priorities for action are outlined, including standardization, iteration between basic and applied research, and adoption of smart manufacturing. With concerted efforts from academia and industry, flexible electronics will bring a bigger impact to society as promised.

Advanced Nanomaterials, Printing Processes, and Applications for Flexible Hybrid Electronics

Recent advances in nanomaterial preparation and printing technologies provide unique opportunities to develop flexible hybrid electronics (FHE) for various healthcare applications. Unlike the costly, multi-step, and error-prone cleanroom-based nano-microfabrication, the printing of nanomaterials offers advantages, including cost-effectiveness, high-throughput, reliability, and scalability. Here, this review summarizes the most up-to-date nanomaterials, methods of nanomaterial printing, and system integrations to fabricate advanced FHE in wearable and implantable applications. Detailed strategies to enhance the resolution, uniformity, flexibility, and durability of nanomaterial printing are summarized. We discuss the sensitivity, functionality, and performance of recently reported printed electronics with application areas in wearable sensors, prosthetics, and health monitoring implantable systems. Collectively, the main contribution of this paper is in the summary of the essential requirements of material properties, mechanisms for printed sensors, and electronics.