Novel Flexible Wearable Sensor Materials and Signal Processing for Vital Sign and Human Activity Monitoring

Validations of various in-hand object manipulation strategies employing a novel tactile sensor developed for an under-actuated robot hand

Prisma Hand II is an under-actuated prosthetic hand developed at the University of Naples, Federico II to study in-hand manipulations during grasping activities. 3 motors equipped on the robotic hand drive 19 joints using elastic tendons. The operations of the hand are achieved by combining tactile hand sensing with under-actuation capabilities. The hand has the potential to be employed in both industrial and prosthetic applications due to its dexterous motion capabilities. However, currently there are no commercially available tactile sensors with compatible dimensions suitable for the prosthetic hand. Hence, in this work, we develop a novel tactile sensor designed based on an opto-electronic technology for the Prisma Hand II. The optimised dimensions of the proposed sensor made it possible to be integrated with the fingertips of the prosthetic hand. The output voltage obtained from the novel tactile sensor is used to determine optimum grasping forces and torques during in-hand manipulation tasks employing Neural Networks (NNs). The grasping force values obtained using a Convolutional Neural Network (CNN) and an Artificial Neural Network (ANN) are compared based on Mean Square Error (MSE) values to find out a better training network for the tasks. The tactile sensing capabilities of the proposed novel sensing method are presented and compared in simulation studies and experimental validations using various hand manipulation tasks. The developed tactile sensor is found to be showcasing a better performance compared to previous version of the sensor used in the hand.

Hybrid Integration of Wearable Devices for Physiological Monitoring

Wearable devices can provide timely, user-friendly, non- or minimally invasive, and continuous monitoring of human health. Recently, multidisciplinary scientific communities have made significant progress regarding fully integrated wearable devices such as sweat wearable sensors, saliva sensors, and wound sensors. However, the translation of these wearables into markets has been slow due to several reasons associated with the poor system-level performance of integrated wearables. The wearability consideration for wearable devices compromises many properties of the wearables. Besides, the limited power capacity of wearables hinders continuous monitoring for extended duration. Furthermore, peak-power operations for intensive computations can quickly create thermal issues in the compact form factor that interfere with wearability and sensor operations. Moreover, wearable devices are constantly subjected to environmental, mechanical, chemical, and electrical interferences and variables that can invalidate the collected data. This generates the need for sophisticated data analytics to contextually identify, include, and exclude data points per multisensor fusion to enable accurate data interpretation. This review synthesizes the challenges surrounding the wearable device integration from three aspects in terms of hardware, energy, and data, focuses on a discussion about hybrid integration of wearable devices, and seeks to provide comprehensive guidance for designing fully functional and stable wearable devices.

Review on design of real-time posture monitoring system for the cervical region

In cervical health, the Posture Monitoring System (PMS) employs sensors to capture and transmit posture data to the cloud via Wi-Fi. This systematic review examines wearable PMS devices for cervical posture, analysing their attributes, findings, and limitations. Using systematic literature analysis, related studies were collected from diverse databases concentrating on wearable cervical posture devices. The review analysed the outcomes of each neck posture and each monitor type on the CVA ratio based on PMS. However, limitations, such as small sample sizes, limited functions, and privacy concerns were noted across the devices. The findings underscore the importance of considering user comfort and data accuracy in designing and implementing wearable posture monitors. Future studies should also explore the integration of advanced technologies and user-centred design principles to develop more accurate and user-friendly devices.

Applications of flexible electronics related to cardiocerebral vascular system

Ensuring accessible and high-quality healthcare worldwide requires field-deployable and affordable clinical diagnostic tools with high performance. In recent years, flexible electronics with wearable and implantable capabilities have garnered significant attention from researchers, which functioned as vital clinical diagnostic-assisted tools by real-time signal transmission from interested targets in vivo. As the most crucial and complex system of human body, cardiocerebral vascular system together with heart-brain network attracts researchers inputting profuse and indefatigable efforts on proper flexible electronics design and materials selection, trying to overcome the impassable gulf between vivid organisms and rigid inorganic units. This article reviews recent breakthroughs in flexible electronics specifically applied to cardiocerebral vascular system and heart-brain network. Relevant sensor types and working principles, electronics materials selection and treatment methods are expounded. Applications of flexible electronics related to these interested organs and systems are specially highlighted. Through precedent great working studies, we conclude their merits and point out some limitations in this emerging field, thus will help to pave the way for revolutionary flexible electronics and diagnosis assisted tools development.

Sensor-Based Wearable Systems for Monitoring Human Motion and Posture: A Review

In recent years, marked progress has been made in wearable technology for human motion and posture recognition in the areas of assisted training, medical health, VR/AR, etc. This paper systematically reviews the status quo of wearable sensing systems for human motion capture and posture recognition from three aspects, which are monitoring indicators, sensors, and system design. In particular, it summarizes the monitoring indicators closely related to human posture changes, such as trunk, joints, and limbs, and analyzes in detail the types, numbers, locations, installation methods, and advantages and disadvantages of sensors in different monitoring systems. Finally, it is concluded that future research in this area will emphasize monitoring accuracy, data security, wearing comfort, and durability. This review provides a reference for the future development of wearable sensing systems for human motion capture.

Recent Progress in Flexible and Wearable All Organic Photoplethysmography Sensors for SpO2 Monitoring

Flexible and wearable biosensors are the next-generation healthcare devices that can efficiently monitor human health conditions in day-to-day life. Moreover, the rapid growth and technological advancements in wearable optoelectronics have promoted the development of flexible organic photoplethysmography (PPG) biosensor systems that can be implanted directly onto the human body without any additional interface for efficient bio-signal monitoring. As an example, the pulse oximeter utilizes PPG signals to monitor the oxygen saturation (SpO2 ) in the blood volume using two distinct wavelengths with organic light emitting diode (OLED) as light source and an organic photodiode (OPD) as light sensor. Utilizing the flexible and soft properties of organic semiconductors, pulse oximeter can be both flexible and conformal when fabricated on thin polymeric substrates. It can also provide highly efficient human-machine interface systems that can allow for long-time biological integration and flawless measurement of signal data. In this work, a clear and systematic overview of the latest progress and updates in flexible and wearable all-organic pulse oximetry sensors for SpO2 monitoring, including design and geometry, processing techniques and materials, encapsulation and various factors affecting the device performance, and limitations are provided. Finally, some of the research challenges and future opportunities in the field are mentioned.

The Influence of the Washing Process on the Impedance of Textronic Radio Frequency Identification Transponder Antennas

Antennas dedicated to RFID systems created on textile substrates should maintain strictly defined parameters. During washing, the materials from which such antennas are made are exposed to mechanical and chemical exposure-degradation of the parameters characterizing those materials may occur, which in turn may lead to a change in the parameters of the antenna. For research purposes, four groups of model dipole antennas (sewn with two types of conductive threads on two fabrics) were created and then they were subjected to several washing processes. After each stage of the experiment, the impedance parameters of the demonstration antennas were measured using indirect measurements. Based on the obtained results, it was found that these parameters change their values during washing, and that this is influenced by a number of factors, e.g., shrinkage of the substrate fabric.

Fast electro-plasmonic detection of heart signal in Balb/C cells onto one-dimensional plasmonic grating

The heart is a vital and complex organ in the human body that forms with most organs between the second week of pregnancy, and fetal heart rate is an important indicator or biological index to know the condition of fetal well-being. In general, long-term measurement of fetal heart rate is the most widely used method of providing information about fetal health. In addition to fetal life, growth, and maturity, information such as congenital heart disease, often due to structural or functional defects in heart structure that often occur during the first trimester of pregnancy during fetal development, can be detected by continuous monitoring of fetal heart rate. The gold standard for monitoring the fetus's health is the use of non-invasive methods and portable devices so that while maintaining the health of the mother and fetus, it provides the possibility of continuous monitoring, especially for mothers who have a high-risk pregnancy. Therefore, the present study aimed to propose a low-cost, compact, and portable device for recording the heart rate of 18-day-old fetal mouse heart cells. Introduced device allows non-invasive heart rate monitoring instantly and without side effects for mouse fetal heart cells. One-dimensional gold-plated plasmonic specimens as a physiological signal recorder are mainly chips with nanoarray of resonant nanowire patterns perform in an integrated platform. Here the surface plasmon waves generated in a one-dimensional plasmonic sample are paired with an electrical wave from the heart pulse, and this two-wave pairing is used to record and detect the heart rate of fetal heart cells with high accuracy and good sensitivity. This measurement was performed in normal mode and two different stimulation modes. Stimulation of cells was performed once using adrenaline and again with electrical stimulation. Our results show that our sensor is sensitive enough to detect heart rate in both standard and excitatory states and is also well able to detect and distinguish between changes in heart rate caused by different excitatory conditions.

Hydration Assessment Using the Bio-Impedance Analysis Method

Body hydration is considered one of the most important physiological parameters to measure and one of the most challenging. Current methods to assess hydration are invasive and require costly clinical settings. The bio-impedance analysis offers a noninvasive and inexpensive tool to assess hydration, and it can be designed to be used in wearable health devices. The use of wearable electronics in healthcare applications has received increased attention over the last decade. New, emerging medical devices feature continuous patient monitoring and data collection to provide suitable treatment and preventive actions. In this paper, a model of human skin is developed and simulated to be used as a guide to designing a dehydration monitoring system based on a bio-impedance analysis technique. The study investigates the effect of applying different frequencies on the dielectric parameters of the skin and the resulting measured impedance. Two different interdigitated electrode designs are presented, and a comparison of the measurements is presented. The rectangular IDE is printed and tested on subjects to validate the bio-impedance method and study the interpretation of its results. The proposed design offers a classification criterion that can be used to assess dehydration without the need for a complex mathematical model. Further clinical testing and data are needed to refine and finalize the criteria.

Motion Analysis of Football Kick Based on an IMU Sensor

A greater variety of technologies are being applied in sports and health with the advancement of technology, but most optoelectronic systems have strict environmental restrictions and are usually costly. To visualize and perform quantitative analysis on the football kick, we introduce a 3D motion analysis system based on a six-axis inertial measurement unit (IMU) to reconstruct the motion trajectory, in the meantime analyzing the velocity and the highest point of the foot during the backswing. We build a signal processing system in MATLAB and standardize the experimental process, allowing users to reconstruct the foot trajectory and obtain information about the motion within a short time. This paper presents a system that directly analyzes the instep kicking motion rather than recognizing different motions or obtaining biomechanical parameters. For the instep kicking motion of path length around 3.63 m, the root mean square error (RMSE) is about 0.07 m. The RMSE of the foot velocity is 0.034 m/s, which is around 0.45% of the maximum velocity. For the maximum velocity of the foot and the highest point of the backswing, the error is approximately 4% and 2.8%, respectively. With less complex hardware, our experimental results achieve excellent velocity accuracy.

Silver Nanowires in Stretchable Resistive Strain Sensors

Silver nanowires (AgNWs), having excellent electrical conductivity, transparency, and flexibility in polymer composites, are reliable options for developing various sensors. As transparent conductive electrodes (TCEs), AgNWs are applied in optoelectronics, organic electronics, energy devices, and flexible electronics. In recent times, research groups across the globe have been concentrating on developing flexible and stretchable strain sensors with a specific focus on material combinations, fabrication methods, and performance characteristics. Such sensors are gaining attention in human motion monitoring, wearable electronics, advanced healthcare, human-machine interfaces, soft robotics, etc. AgNWs, as a conducting network, enhance the sensing characteristics of stretchable strain-sensing polymer composites. This review article presents the recent developments in resistive stretchable strain sensors with AgNWs as a single or additional filler material in substrates such as polydimethylsiloxane (PDMS), thermoplastic polyurethane (TPU), polyurethane (PU), and other substrates. The focus is on the material combinations, fabrication methods, working principles, specific applications, and performance metrics such as sensitivity, stretchability, durability, transparency, hysteresis, linearity, and additional features, including self-healing multifunctional capabilities.

Smart Clothing Framework for Health Monitoring Applications

Wearable technologies are making a significant impact on people’s way of living thanks to the advancements in mobile communication, internet of things (IoT), big data and artificial intelligence. Conventional wearable technologies present many challenges for the continuous monitoring of human health conditions due to their lack of flexibility and bulkiness in size. Recent development in e-textiles and the smart integration of miniature electronic devices into textiles have led to the emergence of smart clothing systems for remote health monitoring. A novel comprehensive framework of smart clothing systems for health monitoring is proposed in this paper. This framework provides design specifications, suitable sensors and textile materials for smart clothing (e.g., leggings) development. In addition, the proposed framework identifies techniques for empowering the seamless integration of sensors into textiles and suggests a development strategy for health diagnosis and prognosis through data collection, data processing and decision making. The conceptual technical specification of smart clothing is also formulated and presented. The detailed development of this framework is presented in this paper with selected examples. The key challenges in popularizing smart clothing and opportunities of future development in diverse application areas such as healthcare, sports and athletics and fashion are discussed.

Smart Chemical Engineering-Based Lightweight and Miniaturized Attachable Systems for Advanced Drug Delivery and Diagnostics

Smart attachable systems have attracted much attention owing to their capabilities in terms of body performance evaluation, disease diagnostics, and drug delivery. Recent advances in chemical and engineering techniques provide many opportunities to improve device fabrication and applications owing to the advantages of being lightweight and easy to control as well as their battery absence and functional diversity. This review highlights the latest developments in the field of chemical engineering-based lightweight and miniaturized attachable systems, which are mainly inspired by the natural world. Their applications for real-time monitoring, point-of-care sampling, biomarker detection, and controlled release are discussed thoroughly with respect to specific products/prototypes. The perspectives of the field, including persistence guarantee, burden reduction, and personality improvement, are also discussed. It is believed that chemical engineering-based lightweight and miniaturized attachable systems have good potential in both clinical and industrial fields, indicating a large potential to improve human lives in the near future.

Accuracy and reliability of a wireless vital signs monitor for hospitalized patients in a low-resource setting

Objective

The purpose of this study was to evaluate the accuracy and reliability of neoGuard in comparison to a conventional bedside monitor on patients in a low-resource clinical setting.

Design

This was a single-arm methods comparison study involving the use of a wearable vital signs monitor (neoGuardTM) versus a conventional bedside monitor (Edan iM8).

Setting

The study was conducted at Jinja Regional Referral Hospital, a tertiary care hospital situated in Eastern Uganda.

Participants

Thirty patients (10 male, 20 female) were enrolled from the adult recovery ward at JRRH. Participants were eligible for the study if they were at least 18 years of age, had 2 sets of normal vital sign measurements obtained 1 h apart, and were able and willing to provide informed consent.

Main Outcome and Measures

The primary outcome measures were (i) bias (mean deviation) and (ii) limits of agreement [95% CI]. Bland-Altman plots were generated to illustrate the level of agreement between the neoGuardTM technology and the Edan iM8 monitor.

Results

Bland-Altman analysis was performed for 24 participants; datasets from six participants were excluded due to missing or invalid measurements. Findings showed a moderate level of agreement for measurement of SpO2, PR, and RR, with >80% of subject means falling within the predefined acceptability limits. However, there was also notable variation in accuracy between subjects, with large standard deviations observed for measurement of all four parameters. While the level of agreement for measurement of temperature was low, this is partly explained by limitations in the comparison method.

Flexible Wearables for Plants

The excellent stretchability and biocompatibility of flexible sensors have inspired an emerging field of plant wearables, which enable intimate contact with the plants to continuously monitor the growth status and localized microclimate in real-time. Plant flexible wearables provide a promising platform for the development of plant phenotype and the construction of intelligent agriculture via monitoring and regulating the critical physiological parameters and microclimate of plants. Here, the emerging applications of plant flexible wearables together with their pros and cons from four aspects, including physiological indicators, surrounding environment, crop quality, and active control of growth, are highlighted. Self-powered energy supply systems and signal transmission mechanisms are also elucidated. Furthermore, the future opportunities and challenges of plant wearables are discussed in detail.

Binder-free printed PEDOT wearable sensors on everyday fabrics using oxidative chemical vapor deposition

Polymeric sensors on fabrics have vast potential toward the development of versatile applications, particularly when the ready-made wearable or fabric can be directly coated. However, traditional coating approaches, such as solution-based methods, have limitations in achieving uniform and thin films because of the poor surface wettability of fabrics. Herein, to realize a uniform poly(3,4-ethylenedioxythiophene) (PEDOT) layer on various everyday fabrics, we use oxidative chemical vapor deposition (oCVD). The oCVD technique is a unique method capable of forming patterned polymer films with controllable thicknesses while maintaining the inherent advantages of fabrics, such as exceptional mechanical stability and breathability. Utilizing the superior characteristics of oCVD PEDOT, we succeed in fabricating blood pressure– and respiratory rate–monitoring sensors by directly depositing and patterning PEDOT on commercially available disposable gloves and masks, respectively. Those results are expected to pave efficient and facile ways for skin-compatible and affordable sensors for personal health care monitoring.

The Relationship between Stress Levels Measured by a Questionnaire and the Data Obtained by Smart Glasses and Finger Pulse Oximeters among Polish Dental Students

Stress is a physical, mental, or emotional response to a change and is a significant problem in modern society. In addition to questionnaires, levels of stress may be assessed by monitoring physiological signals, such as via photoplethysmogram (PPG), electroencephalogram (EEG), electrocardiogram (ECG), electrodermal activity (EDA), facial expressions, and head and body movements. In our study, we attempted to find the relationship between the perceived stress level and physiological signals, such as heart rate (HR), head movements, and electrooculographic (EOG) signals. The perceived stress level was acquired by self-assessment questionnaires in which the participants marked their stress level before, during, and after performing a task. The heart rate was acquired with a finger pulse oximeter and the head movements (linear acceleration and angular velocity) and electrooculographic signals were recorded with JINS MEME ES_R smart glasses (JINS Holdings, Inc., Tokyo, Japan). We observed significant differences between the perceived stress level, heart rate, the power of linear acceleration, angular velocity, and EOG signals before performing the task and during the task. However, except for HR, these signals were poorly correlated with the perceived stress level acquired during the task.

Soft Electronic Materials with Combinatorial Properties Generated via Mussel-Inspired Chemistry and Halloysite Nanotube Reinforcement

Soft and electrically active materials are currently being utilized for intelligent systems, including electronic skin, cybernetics, soft robotics, and wearable devices. However, fabricating materials that fulfill the complex requirements of such advanced applications remains a challenge. These attributes include electronic, adhesive, self-healing, flexible, moldable, printable, and strong mechanical properties. Inspired by the recent interest in transforming monofunctional materials into multifunctional ones through nanoreinforcement and mussel-inspired chemistry, we have designed a simple two-step methodology based on halloysite nanotube (HNT) and polydopamine (PDA) to address the grand challenges in the field. In brief, HNTs were coated with PDA and embedded within a poly(vinyl alcohol) (PVA)-based polymeric matrix in combination with ferric ions (Fe³⁺). The final composite displayed a 3-fold increase in electrical conductivity, a 20-fold increase in mechanical stiffness, and a 7-fold increase in energy dissipation in comparison to their nonfunctional counterparts, which arose from a combination of nanotube alignment and mussel-inspired chemistry. Moreover, the developed composite could elongate up to 30000% of its original length, maintain its electrical properties after 600% strain, self-heal within seconds (both electrically and mechanically), and display strain-sensitivity. Finally, it was 3D-printable and thus amenable for engineering of customized wearable electronics.

Automatic Acute Stroke Symptom Detection and Emergency Medical Systems Alerting by Mobile Health Technologies: A Review

OBJECTIVES

To survey recent advances in acute stroke symptom automatic detection and Emergency Medical Systems (EMS) alerting by mobile health technologies.

MATERIALS AND METHODS

Narrative review RESULTS: Delayed activation of EMS for stroke symptoms by patients and witnesses deprives patients of rapid access to brain-saving therapies and occurs due to public unawareness of stroke features, cognitive and motor deficits produced by the stroke itself, and sleep onset. A promising emerging approach to overcoming the inherent biologic constraints of patient capacity to self-detect and respond to stroke symptoms is continuous monitoring by mobile health technologies with wireless sensors and artificial intelligence recognition systems. This review surveys 11 sensing technologies - accelerometers, gyroscopes, magnetometers, pressure sensors, touch screen and keyboard input detectors, artificial vision, and artificial hearing; and 10 consumer device form factors in which they are increasingly implemented: smartphones, smart speakers, smart watches and fitness bands, smart speakers/voice assistants, home health robots, smart clothing, smart beds, closed circuit television, smart rings, and desktop/laptop/tablet computers.

CONCLUSIONS

The increase in computing power, wearable sensors, and mobile connectivity have ushered in an array of mobile health technologies that can transform stroke detection and EMS activation. By continuously monitoring a diverse range of biometric parameters, commercially available devices provide the technologic capability to detect cardinal language, motor, gait, and sensory signs of stroke onset. Intensified translational research to convert the promise of these technologies to validated, accurate real-world deployments are an important next priority for stroke investigation.

Systematic Review on Human Skin-Compatible Wearable Photoplethysmography Sensors

The rapid advances in human-friendly and wearable photoplethysmography (PPG) sensors have facilitated the continuous and real-time monitoring of physiological conditions, enabling self-health care without being restricted by location. In this paper, we focus on state-of-the-art skin-compatible PPG sensors and strategies to obtain accurate and stable sensing of biological signals adhered to human skin along with light-absorbing semiconducting materials that are classified as silicone, inorganic, and organic absorbers. The challenges of skin-compatible PPG-based monitoring technologies and their further improvements are also discussed. We expect that such technological developments will accelerate accurate diagnostic evaluation with the aid of the biomedical electronic devices.

Textile Electrodes: Influence of Knitting Construction and Pressure on the Contact Impedance

Textile electrodes, also called textrodes, for biosignal monitoring as well as electrostimulation are central for the emerging research field of smart textiles. However, so far, only the general suitability of textrodes for those areas was investigated, while the influencing parameters on the contact impedance related to the electrode construction and external factors remain rather unknown. Therefore, in this work, six different knitted electrodes, applied both wet and dry, were compared regarding the influence of specific knitting construction parameters on the three-electrode contact impedance measured on a human forearm. Additionally, the influence of applying pressure was investigated in a two-electrode setup using a water-based agar dummy. Further, simulation of an equivalent circuit was used for quantitative evaluation. Indications were found that the preferred electrode construction to achieve the lowest contact impedance includes a square shaped electrode, knitted with a high yarn density and, in the case of dry electrodes, an uneven surface topography consisting of loops, while in wet condition a smooth surface is favorable. Wet electrodes are showing a greatly reduced contact impedance and are therefore to be preferred over dry ones; however, opportunities are seen for improving the electrode performance of dry electrodes by applying pressure to the system, thereby avoiding disadvantages of wet electrodes with fluid administration, drying-out of the electrolyte, and discomfort arising from a "wet feeling".

Electronic-components less fully textile multiple resonant combiners for body-centric near field communication

Smart and e-textiles have nowadays an important increasing place in the garment industry. The rise of embedded telecommunications, especially smartphones in our pocket, enables us to provide a power source and a wireless link for smart textiles. The main issue is to develop garments able to receive power from smartphones and communicate with them without flexibility and comfort constraints bound to embedded solid-state electronic components. Consequently, this article aims to develop a fully textile NFC combiner to transfer data and power between a smartphone and sensors without any electronic components. It precisely describes textile NFC multiple combiners composed of textile NFC antennas linked by two-wire transmission lines. Also, theoretical analysis, simulations, and experiments have been conducted to adapt the resonant frequency of such structures to the NFC technology (13.56 MHz). Finally, our article generalizes textile NFC combiner resonant frequency equations for multiple combiners with any number of antennas.

Flexible ferroelectric wearable devices for medical applications

Wearable electronics are becoming increasingly important for medical applications as they have revolutionized the way physiological parameters are monitored. Ferroelectric materials show spontaneous polarization below the Curie temperature, which changes with electric field, temperature, and mechanical deformation. Therefore, they have been widely used in sensor and actuator applications. In addition, these materials can be used for conversion of human-body energy into electricity for powering wearable electronics. In this paper, we review the recent advances in flexible ferroelectric materials for wearable human energy harvesting and sensing. To meet the performance requirements for medical applications, the most suitable materials and manufacturing techniques are reviewed. The approaches used to enhance performance and achieve long-term sustainability and multi-functionality by integrating other active sensing mechanisms (e.g. triboelectric and piezoresistive effects) are discussed. Data processing and transmission as well as the contribution of wearable piezoelectric devices in early disease detection and monitoring vital signs are reviewed.

Bending Setups for Reliability Investigation of Flexible Electronics

Flexible electronics is a rapidly growing technology for a multitude of applications. Wearables and flexible displays are some application examples. Various technologies and processes are used to produce flexible electronics. An important aspect to be considered when developing these systems is their reliability, especially with regard to repeated bending. In this paper, the frequently used methods for investigating the bending reliability of flexible electronics are presented. This is done to provide an overview of the types of tests that can be performed to investigate the bending reliability. Furthermore, it is shown which devices are developed and optimized to gain more knowledge about the behavior of flexible systems under bending. Both static and dynamic bending test methods are presented.

A Multichannel Flexible Optoelectronic Fiber Device for Distributed Implantable Neurological Stimulation and Monitoring

Optical fibers made of polymeric materials possess high flexibility that can potentially integrate with flexible electronic devices to realize complex functions in biology and neurology. Here, a multichannel flexible device based on four individually addressable optical fibers transfer-printed with flexible electronic components and controlled by a wireless circuit is developed. The resulting device offers excellent mechanics that is compatible with soft and curvilinear tissues, and excellent diversity through switching different light sources. The combined configuration of optical fibers and flexible electronics allows optical stimulation in selective wavelengths guided by the optical fibers, while conducting distributed, high-throughput biopotential sensing using the flexible microelectrode arrays. The device has been demonstrated in vivo with rats through optical stimulation and simultaneously monitoring of spontaneous/evoked spike signals and local field potentials using 32 microelectrodes in four brain regions. Biocompatibility of the device has been characterized by behavior and immunohistochemistry studies, demonstrating potential applications of the device in long-term animal studies. The techniques to integrate flexible electronics with optical fibers may inspire the development of more flexible optoelectronic devices for sophisticated applications in biomedicine and biology.

The Importance of Respiratory Rate Monitoring: From Healthcare to Sport and Exercise

Respiratory rate is a fundamental vital sign that is sensitive to different pathological conditions (e.g., adverse cardiac events, pneumonia, and clinical deterioration) and stressors, including emotional stress, cognitive load, heat, cold, physical effort, and exercise-induced fatigue. The sensitivity of respiratory rate to these conditions is superior compared to that of most of the other vital signs, and the abundance of suitable technological solutions measuring respiratory rate has important implications for healthcare, occupational settings, and sport. However, respiratory rate is still too often not routinely monitored in these fields of use. This review presents a multidisciplinary approach to respiratory monitoring, with the aim to improve the development and efficacy of respiratory monitoring services. We have identified thirteen monitoring goals where the use of the respiratory rate is invaluable, and for each of them we have described suitable sensors and techniques to monitor respiratory rate in specific measurement scenarios. We have also provided a physiological rationale corroborating the importance of respiratory rate monitoring and an original multidisciplinary framework for the development of respiratory monitoring services. This review is expected to advance the field of respiratory monitoring and favor synergies between different disciplines to accomplish this goal.

Accurate Spirometry with Integrated Barometric Sensors in Face-Worn Garments

Cardiorespiratory (CR) signals are crucial vital signs for fitness condition tracking, medical diagnosis, and athlete performance evaluation. Monitoring such signals in real-life settings is among the most widespread applications of wearable computing. We investigate how miniaturized barometers can be used to perform accurate spirometry in a wearable system that is built on off-the-shelf training masks often used by athletes as a training aid. We perform an evaluation where differential barometric pressure sensors are compared concurrently with a digital spirometer, during an experimental setting of clinical forced vital capacity (FVC) test procedures with 20 participants. The relationship between the two instruments is derived by mathematical modeling first, then by various regression methods from experiment data. The results show that the error of FVC vital values between the two instruments can be as low as 2∼3%. Beyond clinical tests, the method can also measure continuous tidal breathing air volumes with a 1∼3% error margin. Overall, we conclude that barometers with millimeter footprints embedded in face mask apparel can perform similarly to a digital spirometer to monitor breathing airflow and volume in pulmonary function tests.

Wearable technology for baby monitoring: a review

Sudden Infant Death Syndrome (SIDS) is one of the major reasons for infant death. Millennial parents' growing concern of SIDS has resulted in the springing up demand for health care services, and the invention of wearable baby monitoring systems. The development of wearable electronics and communication technologies has intensified the potential use of wearable technology in healthcare purposes. As infants are vulnerable to sleeping conditions, effective health monitoring using wearable technology can detect unexpected fall of respiratory rate, heart rate, and oxygen level and alleviate parents' anxiety by notifying sudden critical situations. The purpose of this review paper is to explore and summarize recent developments in the field of baby monitoring wearable technology and their functions to acquiring real-time vital signs. Technological breakthroughs in the field of physical biosensors and electronics integrate into textile materials and their applications in monitoring human vital signs such as heart rate, oxygen level, blood pressure, body temperature, and respiratory rate have discussed. A brief introduction to future challenges and recommended considerations during designing baby healthcare wearable technology has also covered.

Strain-Insensitive Elastic Surface Electromyographic (sEMG) Electrode for Efficient Recognition of Exercise Intensities

Surface electromyography (sEMG) sensors are widely used in the fields of ergonomics, sports science, and medical research. However, current sEMG sensors cannot recognize the various exercise intensities efficiently because of the strain interference, low conductivity, and poor skin-conformability of their electrodes. Here, we present a highly conductive, strain-insensitive, and low electrode-skin impedance elastic sEMG electrode, which consists of a three-layered structure (polydimethylsiloxane/galinstan + polydimethylsiloxane/silver-coated nickel + polydimethylsiloxane). The bottom layer of the electrode consists of vertically conductive magnetic particle paths, which are insensitive to stretching strain, collect sEMG charge from human skin, and finally transfer it to processing circuits via an intermediate layer. Our skin-friendly electrode exhibits high conductivity (0.237 and 1.635 mΩ.cm resistivities in transverse and longitudinal directions, respectively), low electrode-skin impedance (47.23 kΩ at 150 Hz), excellent strain-insensitivity (10% change of electrode-skin impedance within the 0%-25% strain range), high fatigue resistance (>1500 cycles), and good conformability with skin. During various exercise intensities, the signal-to-noise ratio (SNR) of our electrode increased by 22.53 dB, which is 206% and 330% more than that of traditional Ag/AgCl and copper electrode, respectively. The ability of our electrode to efficiently recognize various exercise intensities confirms its great application potential for the field of sports health.

Carbon Nanotube Yarn for Fiber-Shaped Electrical Sensors, Actuators, and Energy Storage for Smart Systems

Smart systems are those that display autonomous or collaborative functionalities, and include the ability to sense multiple inputs, to respond with appropriate operations, and to control a given situation. In certain circumstances, it is also of great interest to retain flexible, stretchable, portable, wearable, and/or implantable attributes in smart electronic systems. Among the promising candidate smart materials, carbon nanotubes (CNTs) exhibit excellent electrical and mechanical properties, and structurally fabricated CNT-based fibers and yarns with coil and twist further introduce flexible and stretchable properties. A number of notable studies have demonstrated various functions of CNT yarns, including sensors, actuators, and energy storage. In particular, CNT yarns can operate as flexible electronic sensors and electrodes to monitor strain, temperature, ionic concentration, and the concentration of target biomolecules. Moreover, a twisted CNT yarn enables strong torsional actuation, and coiled CNT yarns generate large tensile strokes as an artificial muscle. Furthermore, the reversible actuation of CNT yarns can be used as an energy harvester and, when combined with a CNT supercapacitor, has promoted the next-generation of energy storage systems. Here, progressive advances of CNT yarns in electrical sensing, actuation, and energy storage are reported, and the future challenges in smart electronic systems considered.

A Multi-Parametric Wearable System to Monitor Neck Movements and Respiratory Frequency of Computer Workers

Musculoskeletal disorders are the most common form of occupational ill-health. Neck pain is one of the most prevalent musculoskeletal disorders experienced by computer workers. Wrong postural habits and non-compliance of the workstation to ergonomics guidelines are the leading causes of neck pain. These factors may also alter respiratory functions. Health and safety interventions can reduce neck pain and, more generally, the symptoms of musculoskeletal disorders and reduce the consequent economic burden. In this work, a multi-parametric wearable system based on two fiber Bragg grating sensors is proposed for monitoring neck movements and breathing activity of computer workers. The sensing elements were positioned on the neck, in the frontal and sagittal planes, to monitor: (i) flexion-extension and axial rotation repetitions, and (ii) respiratory frequency. In this pilot study, five volunteers were enrolled and performed five repetitions of both flexion-extension and axial rotation, and ten breaths of both quite breathing and tachypnea. Results showed the good performances of the proposed system in monitoring the aforementioned parameters when compared to optical reference systems. The wearable system is able to well-match the trend in time of the neck movements (both flexion-extension and axial rotation) and to estimate mean and breath-by-breath respiratory frequency values with percentage errors ≤6.09% and ≤1.90%, during quiet breathing and tachypnea, respectively.

A Wide-Range, Wireless Wearable Inertial Motion Sensing System for Capturing Fast Athletic Biomechanics in Overhead Pitching

The standard technology used to capture motion for biomechanical analysis in sports has employed marker-based optical systems. While these systems are excellent at providing positional information, they suffer from a limited ability to accurately provide fundamental quantities such as velocity and acceleration (hence forces and torques) during high-speed motion typical of many sports. Conventional optical systems require considerable setup time, can exhibit sensitivity to extraneous light, and generally sample too slowly to accurately capture extreme bursts of athletic activity. In recent years, wireless wearable sensors have begun to penetrate devices used in sports performance assessment, offering potential solutions to these limitations. This article, after determining pressing problems in sports that such sensors could solve and surveying the state-of-the-art in wearable motion capture for sports, presents a wearable dual-range inertial and magnetic sensor platform that we developed to enable an end-to-end investigation of high-level, very wide dynamic-range biomechanical parameters. We tested our system on collegiate and elite baseball pitchers, and have derived and measured metrics to glean insight into performance-relevant motion. As this was, we believe, the first ultra-wide-range wireless multipoint and multimodal inertial and magnetic sensor array to be used on elite baseball pitchers, we trace its development, present some of our results, and discuss limitations in accuracy from factors such as soft-tissue artifacts encountered with extreme motion. In addition, we discuss new metric opportunities brought by our systems that may be relevant for the assessment of micro-trauma in baseball.

Recent Developments in Printing Flexible and Wearable Sensing Electronics for Healthcare Applications

Wearable biosensors attract significant interest for their capabilities in real-time monitoring of wearers' health status, as well as the surrounding environment. Sensor patches are embedded onto the human epidermis accompanied by data readout and signal conditioning circuits with wireless communication modules for transmitting data to the computing devices. Wearable sensors designed for recognition of various biomarkers in human epidermis fluids, such as glucose, lactate, pH, cholesterol, etc., as well as physiological indicators, i.e., pulse rate, temperature, breath rate, respiration, alcohol, activity monitoring, etc., have potential applications both in medical diagnostics and fitness monitoring. The rapid developments in solution-based nanomaterials offered a promising perspective to the field of wearable sensors by enabling their cost-efficient manufacturing through printing on a wide range of flexible polymeric substrates. This review highlights the latest key developments made in the field of wearable sensors involving advanced nanomaterials, manufacturing processes, substrates, sensor type, sensing mechanism, and readout circuits, and ends with challenges in the future scope of the field. Sensors are categorized as biological and fluidic, mounted directly on the human body, or physiological, integrated onto wearable substrates/gadgets separately for monitoring of human-body-related analytes, as well as external stimuli. Special focus is given to printable materials and sensors, which are key enablers for wearable electronics.

An Ultra-Shapeable, Smart Sensing Platform Based on a Multimodal Ferrofluid-Infused Surface

The development of wearable, all-in-one sensors that can simultaneously monitor several hazard conditions in a real-time fashion imposes the emergent requirement for a smart and stretchable hazard avoidance sensing platform that is stretchable and skin-like. Multifunctional sensors with these features are problematic and challenging to accomplish. In this context, a multimodal ferrofluid-based triboelectric nanogenerator (FO-TENG), featuring sensing capabilities to a variety of hazard stimulus such as a strong magnetic field, noise level, and falling or drowning is reported. The FO-TENG consists of a deformable elastomer tube filled with a ferrofluid, as a triboelectric layer, surrounded by a patterned copper wire, as an electrode, endowing the FO-TENG with excellent waterproof ability, conformability, and stretchability (up to 300%). In addition, The FO-TENG is highly flexible and sustains structural integrity and detection capability under repetitive deformations, including bending and twisting. This FO-TENG represents a smart multifaceted sensing platform that has a unique capacity in diverse applications including hazard preventive wearables, and remote healthcare monitoring.

Bio-Integrated Wearable Systems: A Comprehensive Review

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

Non-Invasive Flexible and Stretchable Wearable Sensors With Nano-Based Enhancement for Chronic Disease Care

Advances in flexible and stretchable electronics, functional nanomaterials, and micro/nano manufacturing have been made in recent years. These advances have accelerated the development of wearable sensors. Wearable sensors, with excellent flexibility, stretchability, durability, and sensitivity, have attractive application prospects in the next generation of personal devices for chronic disease care. Flexible and stretchable wearable sensors play an important role in endowing chronic disease care systems with the capability of long-term and real-time tracking of biomedical signals. These signals are closely associated with human body chronic conditions, such as heart rate, wrist/neck pulse, blood pressure, body temperature, and biofluids information. Monitoring these signals with wearable sensors provides a convenient and non-invasive way for chronic disease diagnoses and health monitoring. In this review, the applications of wearable sensors in chronic disease care are introduced. In addition, this review exploits a comprehensive investigation of requirements for flexibility and stretchability, and methods of nano-based enhancement. Furthermore, recent progress in wearable sensors-including pressure, strain, electrophysiological, electrochemical, temperature, and multifunctional sensors-is presented. Finally, opening research challenges and future directions of flexible and stretchable sensors are discussed.

Multiband ultra-thin flexible on-body transceivers for wearable health informatics

Substantial concentration has been associated to the monitoring of vital signs and human activity using wireless body area networks. However, one of the key technical challenges is to characterize an optimized transceiver geometry for desired isolation/bandwidth and specific absorption rate (SAR) characteristics, independent of transceiver chip on-body location. A microwave performance evaluation of monopole wearable transceiver was completed and results presented. A novel on-body antenna transceiver was designed, simulated and fabricated using an ultra-thin substrate RO 3010 (h = 250 µm) that ensures compactness and enhanced flexibility. The designed transceiver was evolved using very high value of dielectric constant using CST® Studio Suit and FEKO® numerical platforms. The on-body characterization for both fatty and bone tissues was experimentally verified for a bandwidth of 200 MHz. The fabricated configuration and real-time testing provides very promising microwave radiation parameters with a gain of 2.69 dBi, S₁₁ < - 13 dB at an operational frequency of 2.46 GHz. Multi-banding was achieved by introducing fractals in the design of the printed monopole. SAR calculations for feet, head and arm at microwave power levels ranging from 100 to 800 mW are incorporated. Furthermore, the real time data acquisition using developed transceiver and its experimental verification is illustrated.

Experimental Characterization of Inkjet-Printed Stretchable Circuits for Wearable Sensor Applications

This paper introduces a cost-effective method for the fabrication of stretchable circuits on polydimethylsiloxane (PDMS) using inkjet printing of silver nanoparticle ink. The fabrication method, presented here, allows for the development of fully stretchable and wearable sensors. Inkjet-printed sinusoidal and horseshoe patterns are experimentally characterized in terms of the effect of their geometry on stretchability, while maintaining adequate electrical conductivity. The optimal fabricated circuit, with a horseshoe pattern at an angle of 45°, is capable of undergoing an axial stretch up to a strain of 25% with a resistance under 800 Ω. The conductivity of the circuit is fully reversible once it is returned to its pre-stretching state. The circuit could also undergo up to 3000 stretching cycles without exhibiting a significant change in its conductivity. In addition, the successful development of a novel inkjet-printed fully stretchable and wearable version of the conventional pulse oximeter is demonstrated. Finally, the resulting sensor is evaluated in comparison to its commercially available counterpart.

Human Motion Recognition by Textile Sensors Based on Machine Learning Algorithms

Wearable sensors for human physiological monitoring have attracted tremendous interest from researchers in recent years. However, most of the research involved simple trials without any significant analytical algorithms. This study provides a way of recognizing human motion by combining textile stretch sensors based on single-walled carbon nanotubes (SWCNTs) and spandex fabric (PET/SP) and machine learning algorithms in a realistic application. In the study, the performance of the system will be evaluated by identification rate and accuracy of the motion standardized. This research aims to provide a realistic motion sensing wearable product without unnecessary heavy and uncomfortable electronic devices.

Flexible plastic, paper and textile lab-on-a chip platforms for electrochemical biosensing

Flexible biosensors represent an increasingly important and rapidly developing field of research. Flexible materials offer several advantages as supports of biosensing platforms in terms of flexibility, weight, conformability, portability, cost, disposability and scope for integration. On the other hand, electrochemical detection is perfectly suited to flexible biosensing devices. The present paper reviews the field of integrated electrochemical bionsensors fabricated on flexible materials (plastic, paper and textiles) which are used as functional base substrates. The vast majority of electrochemical flexible lab-on-a-chip (LOC) biosensing devices are based on plastic supports in a single or layered configuration. Among these, wearable devices are perhaps the ones that most vividly demonstrate the utility of the concept of flexible biosensors while diagnostic cards represent the state-of-the art in terms of integration and functionality. Another important type of flexible biosensors utilize paper as a functional support material enabling the fabrication of low-cost and disposable paper-based devices operating on the lateral flow, drop-casting or folding (origami) principles. Finally, textile-based biosensors are beginning to emerge enabling real-time measurements in the working environment or in wound care applications. This review is timely due to the significant advances that have taken place over the last few years in the area of LOC biosensors and aims to direct the readers to emerging trends in this field.

Characteristics and Outcomes of Out-of-Hospital Cardiac Arrest Occurring While in a Motor Vehicle

This study aimed to investigate the incidence, patient characteristics, and outcomes of out-of-hospital cardiac arrest (OHCA) occurring while in a motor vehicle in Osaka City, Japan (with a population of 2.6 million), from 2009 to 2015. The OHCA data used in this study were obtained from the population-based Utstein-style registry in Osaka City. Patients who had OHCA occurring while in a motor vehicle were included. The primary end point was 1-month survival with favorable neurologic outcome after OHCA. During the study period, 18,458 OHCAs were observed, and 264 of them (1.4%) occurred while on or in a motor vehicle (drivers, n = 179; nondrivers, n = 85). The overall incidence rate of OHCAs occurring while in a motor vehicle was 14.0 per million population per year (drivers, 9.5; nondrivers, 4.5). In the drivers with OHCAs, 78 (43.6%) and 101 (56.4%) cases were of medical origin and traffic injuries, respectively. Approximately half of OHCAs with a medical origin in drivers presumably occurred while driving (46.2%, 36 of 78). The overall proportion of 1-month survival with favorable neurologic outcome after OHCA was 6.4% (17 of 264). In the drivers, the proportion of OHCAs with a medical origin and because of traffic injuries were 11.5% (9 of 78) and 2.0% (2 of 101) (p = 0.008), respectively. In conclusion, although OHCAs occurring while in a motor vehicle represented a small subset of the overall OHCA burden, a relatively large number of cardiac arrests with a medical origin occurred in drivers.

Integration of Heterogeneous Materials for Wearable Sensors

Wearable sensors are of interest for several application areas, most importantly for their potential to allow for the design of personal continuous health monitoring systems. For wearable sensors, flexibility is required and imperceptibility is desired. Wearable sensors must be robust to strain, motion, and environmental exposure. A number of different strategies have been utilized to achieve flexibility, imperceptibility, and robustness. All of these approaches require the integration of materials having a range of chemical, mechanical, and thermal properties. We have given a concise review of the range of materials that must be incorporated in wearable sensors regardless of the strategies adopted to achieve wearability. We first describe recent advances in the range of wearable sensing materials and their processing requirements and then discuss the potential routes to the integration of these heterogeneous materials.

Novel Tactile Sensor Technology and Smart Tactile Sensing Systems: A Review

During the last decades, smart tactile sensing systems based on different sensing techniques have been developed due to their high potential in industry and biomedical engineering. However, smart tactile sensing technologies and systems are still in their infancy, as many technological and system issues remain unresolved and require strong interdisciplinary efforts to address them. This paper provides an overview of smart tactile sensing systems, with a focus on signal processing technologies used to interpret the measured information from tactile sensors and/or sensors for other sensory modalities. The tactile sensing transduction and principles, fabrication and structures are also discussed with their merits and demerits. Finally, the challenges that tactile sensing technology needs to overcome are highlighted.