The potential of mixed carbon-helium beams for online treatment verification: a simulation and treatment planning study

OBJECTIVE

Recently, a new and promising approach for range verification was proposed. This method requires the use of two different ion species. Due to their equal magnetic rigidity, fully ionized carbon and helium ions can be simultaneously accelerated in accelerators like synchrotrons. At sufficiently high treatment energies, helium ions can exit the patient distally, reaching approximately three times the range of carbon ions at an equal energy per nucleon. Therefore, the proposal involves adding a small helium fluence to the carbon ion beam and utilizing helium as an online range probe during radiation therapy. This work aims to develop a software framework for treatment planning and motion verification in range-guided radiation therapy using mixed carbon-helium beams.

APPROACH

The developed framework is based on the open-source treatment planning toolkit matRad. Dose distributions and helium radiographs were simulated using the open-source Monte Carlo package TOPAS. Beam delivery system parameters were obtained from the Heidelberg Ion Therapy Center, and imaging detectors along with reconstruction were facilitated by ProtonVDA. Methods for reconstructing the most likely patient positioning error scenarios and the motion phase of 4DCT are presented for prostate and lung cancer sites.

MAIN RESULTS

The developed framework provides the capability to calculate and optimize treatment plans for mixed carbon-helium ion therapy. It can simulate the treatment process and generate helium radiographs for simulated patient geometry, including small beam views. Furthermore, motion reconstruction based on these radiographs seems possible with preliminary validation.

SIGNIFICANCE

The developed framework can be applied for further experimental work with the promising mixed carbon-helium ion implementation of range-guided radiotherapy. It offers opportunities for adaptation in particle therapy, improving dose accumulation, and enabling patient anatomy reconstruction during radiotherapy. .

Anti-Freezing and Ultrasensitive Zwitterionic Betaine Hydrogel-Based Strain Sensor for Motion Monitoring and Human-Machine Interaction

Ultrasensitive and reliable conductive hydrogels are significant in the construction of human-machine twinning systems. However, in extremely cold environments, freezing severely limits the application of hydrogel-based sensors. Herein, building on biomimetics, a zwitterionic hydrogel was elaborated for human-machine interaction employing multichemical bonding synergies and experimental signal analyses. The covalent bonds, hydrogen bonds, and electrostatic interactions construct a dense double network structure favorable for stress dispersion and hydrogen bond regeneration. In particular, zwitterions and ionic conductors maintained excellent strain response (99 ms) and electrical sensitivity (gauge factor = 14.52) in the dense hydrogel structure while immobilizing water molecules to enhance the weather resistance (-68 °C). Inspired by the high sensitivity, zwitterionic hydrogel-based strain sensors and remote-control gloves were designed by analyzing the experimental signals, demonstrating promising potential applications within specialized flexible materials and human-machine symbiotic systems.

Self-healing flexible strain sensor fabricated through 3D printing template sacrifice for motion monitoring with enhanced healing and mechanical performance

With the advancements in flexible materials and information technology, flexible sensors are becoming increasingly pervasive in various aspects of life and production. They hold immense potential for further development in areas such as motion detection, electronic skin, soft robots, and wearable devices. Aminopropyl-terminated polydimethylsiloxane (PDMS) was used as the raw material, while a diisocyanate reagent served as the cross-linking agent for the polymerization reaction, which involved the introduction of ureido groups, containing N-H and C=O bonds, into the long siloxane chain. The dynamic hydrogen bonding between the clusters completes the self-healing of the material. Using 1-[3-(trimethoxysilyl)propyl]urea as a grafting agent, the urea groups are introduced into graphene oxide and carbon nanotubes (CNTs) as conductive fillers. Subsequently, a flexible polymer is used as the substrate to prepare conductive flexible self-healing composites. By controlling the amount of conductive fillers, flexible strain materials with varying sensitivities are obtained. Design the structure of the flexible strain sensor using three-dimensional (3D) modeling software with deposition printing method.

Sandwich-Like Flexible Breathable Strain Sensor with Tunable Thermal Regulation Capability for Human Motion Monitoring

High-performance flexible strain sensors with synergistic and outstanding thermal regulation function are poised to make a significant impact on next-generation multifunctional sensors. However, it has long been intractable to optimize the sensing performance and high thermal conductivity simultaneously. Herein, a novel flexible sandwich-like strain sensor with advanced thermal regulation capability was prepared by assembling electrospun thermoplastic polyurethane (TPU) fibrous membrane, MXene layer, and TPU/boron nitride nanosheet (BNNS) composite films. The as-prepared sensor demonstrates a wide strain working range (∼100% strain), an ultrahigh gauge factor (2080.9), and a satisfactory reliability. Meanwhile, benefiting from the uniform dispersion and promising orientation of BNNSs in TPU composites, the sensor possesses a high thermal conductivity of 1.5 W·m-1·K-1, guaranteeing wearer comfort. Additionally, the unique structure endows the sensor with high stretchability, breathability, biocompatibility, and tunable electromagnetic interference shielding performances. Furthermore, an integrated wireless motion monitoring device based on this sensor is rationally designed. It exhibits a fast response time, a wide recognition range, and the ability to maintain skin temperature during prolonged physical activity. These encouraging findings provide a new and feasible approach to designing high-performance and versatile flexible strain sensors with broad applications in advanced wearable technology.

Flat-Silk-Cocoon-Based Wearable Flexible Piezoresistive Sensor and Its Performance

Flexible sensors are becoming the focus of research because they are very vital for intelligent products, real-time data monitoring, and recording. The flat silk cocoon (FSC), as a special form of cocoon, has all the advantages of silk, which is an excellent biomass carbon-based material and a good choice for preparing flexible sensors. In this work, a flexible piezoresistive sensor was successfully prepared by encapsulating carbonized flat silk cocoons (CFSCs) using an elastic matrix polydimethylsiloxane (PDMS). The sensing performance of the material is 0.01 kPa-1, and the monitoring range can reach 680.57 kPa. It is proved that the sensor can detect human motion and has excellent durability (>800 cycles). In addition, a sensor array for a keyboard based on CFSCs was explored. The sensor has a low production cost and a simple preparation process, and it is sustainable and environmentally friendly. Thus, it may have potential applications in wearable devices and human-computer interactions.

Injectable Conductive Hydrogel with Self-Healing, Motion Monitoring, and Bacteria Theranostics for Bioelectronic Wound Dressing

Wounds at joints are difficult to treat and tend to recover more slowly due to the frequent motions. When using traditional hydrogel dressings, they are easy to crack and undergo bacterial infection, difficult to match and monitor the irregular wounds. Integrating multiple functions within a hydrogel dressing to achieve intelligent wound monitoring and healing remains a significant challenge. In this research, a multifunctional hydrogel is developed based on polysaccharide biopolymer, poly(vinyl alcohol), and hydroxylated graphene through dynamic borate ester bonding and supramolecular interaction. The prepared hydrogel not only exhibits rapid self-healing (within 60 s), injectable, conductive and motion monitoring properties, but also realizes in situ bacterial sensing and killing functions. It shows excellent bacterial sensitivity (within 15 min) and killing ability via the changes of electrical signals and photothermal therapy, avoiding the emergence of drug-resistant bacteria. In vivo experiments prove that the hydrogel can promote wound healing effectively. In addition, it displays great electromechanical performance to achieve real-time monitoring and prevent re-tearing of the wound at human joints. The injectable pH-responsive hydrogel with good biocompatibility demonstrates considerable potential as multifunctional bioelectronic dressing for the detection, treatment, management, and healing of infected joint wounds.

Exploration on flexible wearable sensor motion monitoring based on novel functional polymer conjugated materials

With the continuous development of flexible electronics, multi-functional device integration, artificial intelligence technology, etc., flexible wearable sensors are playing an increasingly important role in people's daily motion monitoring. However, current flexible wearable sensors have problems such as low accuracy, poor real-time performance, and poor stability in motion monitoring, which seriously hinder the better application of flexible wearable sensors and are not conducive to the collection and monitoring of motion signals. To this end, this paper designed a flexible wearable sensor motion monitoring system and tested its performance through the preparation and performance research of new functional polymer conjugated materials. The research results show that the motion monitoring system designed based on the new functional polymer conjugated material flexible wearable sensor has good monitoring accuracy and real-time performance. When the output data is 500 pieces, the running monitoring accuracy reaches 95.4%, and the monitoring feedback time is 0.321 s; the high jump movement monitoring accuracy rate reaches 97%, and the monitoring feedback time is 0.287 s; the long jump movement monitoring accuracy rate reaches 96%, and the monitoring feedback time is 0.296 s. This shows that the flexible wearable sensor motion monitoring system of this paper has better performance and can meet the current demand for accuracy and real-time motion monitoring. This study highlights the impact of new functional polymer conjugated materials on flexible wearable sensors, helping to further solve the deficiencies of flexible wearable sensors in sports monitoring and promote their better development.

A Fully Self-Powered Wearable Leg Movement Sensing System for Human Health Monitoring

Energy-autonomous wearable human activity monitoring is imperative for daily healthcare, benefiting from long-term sustainable uses. Herein, a fully self-powered wearable system, enabling real-time monitoring and assessments of human multimodal health parameters including knee joint movement, metabolic energy, locomotion speed, and skin temperature, which are fully self-powered by highly-efficient flexible thermoelectric generators (f-TEGs) is proposed and developed. The wearable system is composed of f-TEGs, fabric strain sensors, ultra-low-power edge computing, and Bluetooth. The f-TEGs worn on the leg not only harvest energy from body heat and supply power sustainably for the whole monitoring system, but also serve as zero-power motion sensors to detect limb movement and skin temperature. The fabric strain sensor made by printing PEDOT: PSS on pre-stretched nylon fiber-wrapped rubber band enables high-fidelity and ultralow-power measurements on highly-dynamic knee movements. Edge computing is elaborately designed to estimate multimodal health parameters including time-varying metabolic energy in real-time, which are wirelessly transmitted via Bluetooth. The whole monitoring system is operated automatically and intelligently, works sustainably in both static and dynamic states, and is fully self-powered by the f-TEGs.

Advancing Smart Textiles: Structural Evolution of Knitted Piezoresistive Strain Sensors for Enabling Precise Motion Capture

Recently, there has been remarkable progress in the development of smart textiles, especially knitted strain sensors, to achieve reliable sensor signals. Stable and reliable electro-mechanical properties of sensors are essential for using textile-based sensors in medical applications. However, the challenges associated with significant hysteresis and low gauge factor (GF) values remain for using strain sensors for motion capture. To evaluate these issues, a comprehensive investigation of the cyclic electro-mechanical properties of weft-knitted strain sensors was conducted in the present study to develop a drift-free elastic strain sensor with a robust sensor signal for motion capture for medical devices. Several variables are considered in the study, including the variation of the basic knit pattern, the incorporation of the electrically conductive yarn, and the size of the strain sensor. The effectiveness and feasibility of the developed knitted strain sensors are demonstrated through an experimental evaluation, by determining the gauge factor, its nonlinearity, hysteresis, and drift. The developed knitted piezoresistive strain sensors have a GF of 2.4, a calculated drift of 50%, 12.5% hysteresis, and 0.3% nonlinearity in parts.

Multifunctional Motion Sensing Enabled by Laser-Induced Graphene

The development of flexible sensors based on laser-induced graphene (LIG) has recently attracted much attention. It was commonly generated by laser-ablating commercial polyimide (PI). However, the weak mechanical extensibility of PI limits the development and diversified applications of LIG-based sensors. In this work, we adopted medical polyurethane (PU) tapes to peel off the LIG generated on PI and developed flexible and wearable sensors based on the proposed LIG/PU composite structure. Compared with other methods for LIG transfer, PU tape has many advantages, including a simplified process and being less time-consuming. We characterized the LIG samples generated under different laser powers and analyzed the property differences introduced by the transfer operation. We then studied the impact of fabrication mode on the strain sensitivity of the LIG/PU and optimized the design of a LIG/PU-based strain sensor, which possessed a gauge factor (GF) of up to 263.6 in the strain range of 75-90%. In addition, we designed a capacitive pressure sensor for tactile sensing, which is composed of two LIG/PU composite structures and a PI space layer. These LIG flexible devices can be used for human motion monitoring and tactile perception in sports events. This work provides a simple, fast, and low-cost way for the preparation of multifunctional sensor systems with good performance, which has a broad application prospect in human motion monitoring.

All-Fabric Tactile Sensors Based on Sandwich Structure Design with Tunable Responsiveness

Capacitance tactile sensors (TSs) based on electrode distance and contact area variations have been notably employed for various purposes due to their magnificent stress sensitivity. Nevertheless, developing TSs with tunable responsiveness in a broad pressure interval is crucial owing to the trade-off between sensitivity and linear identification range. Herein, a TS including Ag-coated Velcro and spacer fabric is constructed, where its sandwich framework provides a sizable expansion in compression deformation ability. In addition, a multilayered framework composed of the stacked TS from self-adhesive Velcro provides more contact area and significant deformation for stress distribution, further balancing the sensitivity, sensing range, and linearity for smart garment application. By utilizing the overlaid selection of multilayer structures, the all-textile TS demonstrates outstanding sensitivity with a one-layer structure (0.036 kPa^-1) over a pressure range of 0.2-5 kPa and retains a sensitivity of 0.002 kPa^-1 in a four-layer structure over a wide pressure range of 0.2-110 kPa, representing a significant improvement compared to previous results. The sensor possesses excellent performance in terms of response speed (104 ms), repeatability (10,000 cycles), and flexibility. In addition, its significant applications, involving human motion detection, pliable keyboards, and human-computer interface, are successfully shown. Based on the facile and scalable manufacturing approach, a suitable procedure is presented to construct next-generation wearable electronics.

Dual-Phase Inspired Soft Electronic Sensors with Programmable and Tunable Mechanical Properties

Wearable and stretchable sensors are important components to strictly monitor the behavior and health of humans and attract extensive attention. However, traditional sensors are designed with pure horseshoes or chiral metamaterials, which restrict the biological tissue engineer applications due to their narrow regulation ranges of the elastic modulus and the poorly adjustable Poisson's ratio. Inspired by the biological spiral microstructure, a dual-phase metamaterial (chiral-horseshoes) is designed and fabricated in this work, which possesses wide and programmable mechanical properties by tailoring the geometrical parameters. Experimental, numerical, and theoretical studies are conducted, which reveal that the designed microstructures can reproduce mechanical properties of most natural animals such as frogs, snakes, and rabbits skin. Furthermore, a flexible strain sensor with the gauge factor reaching 2 under 35% strain is fabricated, which indicates that the dual-phase metamaterials have a stable monitoring ability and can be potentially applied in the electronic skin. Finally, the flexible strain sensor is attached on the human skin, and it can successfully monitor the physiological behavior signals under various actions. In addition, the dual-phase metamaterial could combine with artificial intelligence algorithms to fabricate a flexible stretchable display. The dual-phase metamaterial with negative Poisson's ratio could decrease the lateral shrinkage and image distortion during the stretching process. This study offers a strategy for designing the flexible strain sensors with programmable, tunable mechanical properties, and the fabricated soft and high-precision wearable strain sensor can accurately monitor the skin signals under different human motions and potentially be applied for flexible display.

3D Printable Self-Adhesive and Self-Healing Ionotronic Hydrogels for Wearable Healthcare Devices

Ionotronic hydrogels have attracted significant attention in emerging fields such as wearable devices, flexible electronics, and energy devices. To date, the design of multifunctional ionotronic hydrogels with strong interfacial adhesion, rapid self-healing, three-dimensional (3D) printing processability, and high conductivity are key requirements for future wearable devices. Herein, we report the rational design and facile synthesis of 3D printable, self-adhesive, self-healing, and conductive ionotronic hydrogels based on the synergistic dual reversible interactions of poly(vinyl alcohol), borax, pectin, and tannic acid. Multifunctional ionotronic hydrogels exhibit strong adhesion to various substrates with different roughness and chemical components, including porcine skin, glass, nitrile gloves, and plastics (normal adhesion strength of 55 kPa on the skin). In addition, the ionotronic hydrogels exhibit intrinsic ionic conductivity imparting strain-sensing properties with a gauge factor of 2.5 up to a wide detection range of approximately 2000%, as well as improved self-healing behavior. Based on these multifunctional properties, we further demonstrate the use of ionotronic hydrogels in the 3D printing process for implementing complex patterns as wearable strain sensors for human motion detection. This study is expected to provide a new avenue for the design of multifunctional ionotronic hydrogels, enabling their potential applications in wearable healthcare devices.

Hierarchically Structured Carbon Nanofiber-Enabled Skin-Like Strain Sensors with Full-Range Human Motion Monitoring and Autonomous Self-Healing Capability

Flexible strain sensors that mimic the properties of human skin have recently attracted tremendous attention. However, integrating multiple functions of skin into one strain sensor, e.g., stretchability, full-range motion response, and self-healing capability, is still an enormous challenge. Herein, a skin-like strain sensor was presented by the construction of hierarchically structured carbon nanofibers (CNFs), followed by encapsulation of elastic self-healing polyurethane (PU). The hierarchical sensing structure was composed of diversified CNFs with orientations from highly aligned to randomly oriented, and their different fracture mechanisms enabled the resultant strain sensor to successfully integrate key sensing properties including high sensitivity (gauge factor of 90), wide sensing range (∼80% strain), and fast response (52 ms). These properties, combined with high stretchability (870%) and excellent stability (>2000 cycles), allowed the sensor to precisely detect full-range human motions from large joint motions to subtle physiological signals. Moreover, the strain sensor had spontaneous self-healing capability at room temperature with high healing efficiencies of 97.7%, while the healing process could substantially be accelerated by the natural sunlight (24 h → 0.5 h). The healed sensor possessed comparable stretchability, sensing performance, and accurate monitoring ability of subtle body signals with the original sensor. The biomimetic self-healing functionality along with skin-like sensing properties makes it attractive for next-generation wearable electronics.

Charge-Boosting Strategy for Wearable Nanogenerators Enabled by Integrated Piezoelectric/Conductive Nanofibers

The surface charge density enhancement by incorporating conductive paths into organic/inorganic piezoelectric composites is considered to be an effective way to achieve high-performance piezoelectric nanogenerators (PENGs). However, it is challenging to boost the charge density of aligned piezoelectric nanofibers due to the difficulty in efficiently building well-distributed conductive paths in their dense structure. In this work, a charge boosting strategy was proposed for enhancing the surface charge density of aligned piezoelectric nanofibers, that is, synchronously preparing piezoelectric/conductive hybrid nanofibers to realize the effective conductive paths for transferring the underlying charges to the surface of the PDMS/BaTiO₃ composites. To this end, antimony-doped tin oxide (ATO) conductive nanofibers and barium titanate (BaTiO₃) piezoelectric nanofibers with the same preparation conditions were selected and synchronously prepared by the polymer template electrospinning technology, followed by the calcination process. Benefiting from the well-distributed conductive paths for transferring the charges, the open-circuit voltage and short-circuit current of a PENG with 12 wt% ATO in hybrid nanofibers reached 46 V and 14.5 μA (30 kPa pressure), respectively, which were much higher than the pristine BaTiO₃-based PENG. The high piezoelectric performance of the developed PENGs guaranteed their great potential applications in powering wearable microelectronics and monitoring human activity. This charge boosting strategy via the piezoelectric/conductive hybrid nanofibers may inspire the further development of high-performance energy harvesting technology.

In Situ Forming Epidermal Bioelectronics for Daily Monitoring and Comprehensive Exercise

Conventional epidermal bioelectronics usually do not conform well with natural skin surfaces and are susceptible to motion artifact interference, due to incompatible dimensions, insufficient adhesion, imperfect compliance, and usually require complex manufacturing and high costs. We propose in situ forming hydrogel electrodes or electronics (ISF-HEs) that can establish highly conformal interfaces on curved biological surfaces without auxiliary adhesions. The ISF-HEs also have favorable flexibility and soft compliance comparable to human skin (≈0.02 kPa^-1), which can stably maintain synchronous movements with deformed skins. Thus, the as-prepared ISF-HEs can accurately monitor large and tiny human motions with short response time (≈180 ms), good biocompatibility, and excellent performance. The as-obtained nongapped hydrogel electrode-skin interfaces achieve ultralow interfacial impedance (≈50 KΩ), nearly an order of magnitude lower than commercial Ag|AgCl electrodes as well as other reported dry and wet electrodes, regardless of the intrinsic micro-obstacles (wrinkles, hair) and skin deformation interference. Therefore, the ISF-HEs can collect high-quality electrocardiography and surface electromyography (sEMG) signals, with high signal-to-noise ratio (SNR ≈ 32.04 dB), reduced signal crosstalk, and minimized motion artifact interference. Simultaneously monitoring human motions and sEMG signals have also been implemented for the general exercise status assessment, such as the shooting competition in the Olympics. The as-prepared ISF-HEs can be considered as supplements/substitutes of conventional electrodes in percutaneously noninvasive monitoring of multifunctional physiological signals for health and exercise status.

High-Sensitive Wearable Strain Sensors Based on the Carbon Nanotubes@Porous Soft Silicone Elastomer with Excellent Stretchability, Durability, and Biocompatibility

Wearable strain sensors can transfer human physical motions into digital features and connect the real world to the virtual world. However, there is still a huge challenge to prepare breathable strain sensors with good sensitivity, stretchability, softness, durability, and biocompatibility, simultaneously. Herein, we employ the soft silicone elastomer as a highly stretchable substrate and propose a new strain sensor based on the carbon nanotubes@porous soft silicone elastomer (CNTs@PSSE) by salt-template-assisted and dip-coating methods. The CNTs (conductive fillers) are firmly embedded in the PSSE. The obtained sensors exhibit excellent sensitivity up to 2845.1 and a large sensing strain range of 186%. Notably, the CNTs@PSSE sensors also possess strong robustness, which can resist ultrasonic deterioration and carry out more than 10,000 high-frequency stretch-relax cycles in the presence of an obvious notch caused by the scissor. Moreover, the excellent biocompatibility indicates that the sensors can be safely attached to human skin for precisely detecting full-range human motions and being configured on smart wireless gloves for synchronous control of the bionic hand robot.

IMU-Based Monitoring for Assistive Diagnosis and Management of IoHT: A Review

With the rapid development of Internet of Things (IoT) technologies, traditional disease diagnoses carried out in medical institutions can now be performed remotely at home or even ambient environments, yielding the concept of the Internet of Health Things (IoHT). Among the diverse IoHT applications, inertial measurement unit (IMU)-based systems play a significant role in the detection of diseases in many fields, such as neurological, musculoskeletal, and mental. However, traditional numerical interpretation methods have proven to be challenging to provide satisfying detection accuracies owing to the low quality of raw data, especially under strong electromagnetic interference (EMI). To address this issue, in recent years, machine learning (ML)-based techniques have been proposed to smartly map IMU-captured data on disease detection and progress. After a decade of development, the combination of IMUs and ML algorithms for assistive disease diagnosis has become a hot topic, with an increasing number of studies reported yearly. A systematic search was conducted in four databases covering the aforementioned topic for articles published in the past six years. Eighty-one articles were included and discussed concerning two aspects: different ML techniques and application scenarios. This review yielded the conclusion that, with the help of ML technology, IMUs can serve as a crucial element in disease diagnosis, severity assessment, characteristic estimation, and monitoring during the rehabilitation process. Furthermore, it summarizes the state-of-the-art, analyzes challenges, and provides foreseeable future trends for developing IMU-ML systems for IoHT.

Bioinspired Self-Powered Piezoresistive Sensors for Simultaneous Monitoring of Human Health and Outdoor UV Light Intensity

The exact fabrication of precise three-dimensional structures for piezoresistive sensors necessitates superior manufacturing methods or tooling, which are accompanied by time-consuming processes and the potential for environmental harm. Herein, we demonstrated a method for in situ synthesis of zinc oxide nanorod (ZnO NR) arrays on graphene-treated cotton and paper substrates and constructed highly sensitive, flexible, wearable, and chemically stable strain sensors. Based on the structure of pine trees and needles in nature, the hybrid sensing layer consisted of graphene-attached cotton or paper fibers and ZnO NRs, and the results showed a high sensitivity of 0.389, 0.095, and 0.029 kPa^-1 and an ultra-wide linear range of 0-100 kPa of this sensor under optimal conditions. Our study found that water absorption and swelling of graphene fibers and the associated reduction of pore size and growth of zinc oxide were detrimental to pressure sensor performance. A random line model was developed to examine the effects of different hydrothermal times on sensor performance. Meanwhile, pulse detection, respiration detection, speech recognition, and motion detection, including finger movements, walking, and throat movements, were used to show their practical application in human health activity monitoring. In addition, monolithically grown ZnO NRs on graphene cotton sheets had been integrated into a flexible sensing platform for outdoor UV photo-indication, which is, to our knowledge, the first successful case of an integrated UV photo-detector and motion sensor. Due to its excellent strain detection and UV detection abilities, these strategies are a step forward in developing wearable sensors that are cost-controllable and high-performance.

A Self-Powered Wearable Motion Sensor for Monitoring Volleyball Skill and Building Big Sports Data

A novel self-powered wearable motion sensor for monitoring the spiking gesture of volleyball athletes has been manufactured from piezoelectric PVDF film. The PVDF film can convert body mechanical energy into electricity through the piezoelectric effect, and the flexible device can be conformably attached on the hand or arm. The sensor can work independently without power supply and actively output piezoelectric signals as the sports information. The sensor can detect the tiny and fine motion of spiking movement in playing volleyball, reflecting the skill. Additionally, the sensor can also real-time monitor the pulse changes and language during a volleyball match. The self-powered sensors can link to a wireless transmitter for uploading the sports information and building big sports data. This work can provoke a new direction for real-time sports monitoring and promote the development of big sports data.

Fully Soft Pressure Sensor Based on Bionic Spine-Pillar Structure for Robotics Motion Monitoring

Soft and stretchable sensors are essential to the development of electronic skin, especially their potential applications in health care and intelligent robots, which have increasingly attracted attentions. Herein, inspired by the epidermal tissue hierarchy, we propose a high-sensitivity fully soft capacitive pressure sensor with bionic spine-pillar microstructure. Benefiting from the combination of the random microscale spines and the millimeter-sized pillar array prepared based on polydimethylsiloxane, the proposed sensor exhibits a well deformability, a high sensitivity up to 2.87 k/Pa at low-pressure range, and a broad linear pressure dynamic range from 5 Pa to 100 kPa. A simple equivalent circuit model was established to demonstrate the sensing mechanism and geometric effect. For practical application demonstrations, the sensor was utilized to monitor local subtle and large movements of the skin, such as finger bending, wrist bending, swallowing, and facial muscle movements. The sensor shows a conformality with human skin to follow the skin extension closely. Furthermore, the proposed sensing strategy can provide a distinguishable tactile feedback for controlling robot arm and soft claw in various tasks, illustrating its potential applications in robotics.

An Effective Self-Powered Piezoelectric Sensor for Monitoring Basketball Skills

Self-powered piezoelectric sensor can achieve real-time and harmless monitoring of motion processes without external power supply, which can be attached on body skin or joints to detect human motion and powered by mechanical energy. Here, a sensor for monitoring emergent motion is developed using the PVDF as active material and piezoelectric output as sensing signal. The multi-point control function enables the sensor to monitor the sequence of force order, angle change, and motion frequency of the “elbow lift, arm extension, and wrist compression” during shooting basketball. In addition, the sensor shows can simultaneously charge the capacitor to provide more power for intelligence, typically Bluetooth transmission. The sensor shows good performance in other field, such as rehabilitation monitoring and speech input systems. Therefore, the emerging application of flexible sensors have huge long-term prospects in sport big data collection and Internet of Things (IoT).

Highly Skin-Conformal Laser-Induced Graphene-Based Human Motion Monitoring Sensor

Bio-compatible strain sensors based on elastomeric conductive polymer composites play pivotal roles in human monitoring devices. However, fabricating highly sensitive and skin-like (flexible and stretchable) strain sensors with broad working range is still an enormous challenge. Herein, we report on a novel fabrication technology for building elastomeric conductive skin-like composite by mixing polymer solutions. Our e-skin substrates were fabricated according to the weight of polydimethylsiloxane (PDMS) and photosensitive polyimide (PSPI) solutions, which could control substrate color. An e-skin and 3-D flexible strain sensor was developed with the formation of laser induced graphene (LIG) on the skin-like substrates. For a one-step process, Laser direct writing (LDW) was employed to construct superior durable LIG/PDMS/PSPI composites with a closed-pore porous structure. Graphene sheets of LIG coated on the closed-porous structure constitute a deformable conductive path. The LIG integrated with the closed-porous structure intensifies the deformation of the conductive network when tensile strain is applied, which enhances the sensitivity. Our sensor can efficiently monitor not only energetic human motions but also subtle oscillation and physiological signals for intelligent sound sensing. The skin-like strain sensor showed a perfect combination of ultrawide sensing range (120% strain), large sensitivity (gauge factor of ~380), short response time (90 ms) and recovery time (140 ms), as well as superior stability. Our sensor has great potential for innovative applications in wearable health-monitoring devices, robot tactile systems, and human-machine interface systems.

UV-Protective, Self-Cleaning, and Antibacterial Nanofiber-Based Triboelectric Nanogenerators for Self-Powered Human Motion Monitoring

Equipping wearable electronics with special functions will endow them with more additional values and more comprehensive practical performance. Here, we report an ultraviolet (UV)-protective, self-cleaning, antibacterial, and self-powered all-nanofiber-based triboelectric nanogenerator (TENG) for mechanical energy harvesting and self-powered sensing, which is fabricated with Ag nanowires (NWs)/TPU nanofibers and the TiO₂@PAN networks through a facile electrospinning method. Due to the added TiO₂ nanoparticles (NPs), the TENG presents excellent UV-protective performance, including the ultraviolet protection factor (UPF) of ∼204, the transmittance of UVA (T_UVA) of ∼0.0574%, and the transmittance of UVB (T_UVB) ∼0.107%. Furthermore, under solar lighting for 25 min, most surface contamination can be degraded, and the decreased power output would be recovered. Owing to the coupled effects of TiO₂ NPs and Ag NWs, the TENG shows excellent antibacterial activity against Staphylococcus aureus. Due to the micro-to-nano hierarchical porous structure, the all-nanofiber-based TENG can serve as self-powered pedometers for detecting and tracking human motion behaviors. As a multifunctional self-powered device, the TENG prompts various applications in the fields of micro/nanopower sources, human movement monitoring, and human-machine interfaces, potentially providing an alternative energy solution and a multifunctional interactive platform for the next-generation wearable electronics.

Self-Powered Non-Contact Triboelectric Rotation Sensor with Interdigitated Film

Rotation detection is widely applied in industries. The current commonly used rotation detection system adopts a split structure, which requires stringent installation requirements and is difficult to miniaturize. This paper proposes a single-piece self-powered non-contact sensor with an interdigital sensitive layer to detect the rotation of objects. The electric field generated between a polyurethane (PU) film and a polytetrafluoroethylene (PTFE) film is utilized for perceiving the rotation. The surface of the PU film is subjected to wet etching with sulfuric acid to increase the surface area and charge density. Through finite element analysis and experimental testing, the effects of the areas of the sensitive films as well as the horizontal and vertical distances between them on the output voltage are analyzed. Tests are performed on adjustable-speed motors, human arms, and robotic arms. The results show that the sensor can detect the speed, the transient process of rotation, and the swing angle. The proposed rotation sensor has broad application prospects in the fields of mechanical automation, robotics, and Internet of Things (IoT).

Wearable Triboelectric/Aluminum Nitride Nano-Energy-Nano-System with Self-Sustainable Photonic Modulation and Continuous Force Sensing

Wearable photonics offer a promising platform to complement the thriving complex wearable electronics system by providing high-speed data transmission channels and robust optical sensing paths. Regarding the realization of photonic computation and tunable (de)multiplexing functions based on system-level integration of abundant photonic modulators, it is challenging to reduce the overwhelming power consumption in traditional current-based silicon photonic modulators. This issue is addressed by integrating voltage-based aluminum nitride (AlN) modulator and textile triboelectric nanogenerator (T-TENG) on a wearable platform to form a nano-energy-nano-system (NENS). The T-TENG transduces the mechanical stimulations into electrical signals based on the coupling of triboelectrification and electrostatic induction. The self-generated high-voltage from the T-TENG is applied to the AlN modulator and boosts its modulation efficiency regardless of AlN's moderate Pockels effect. Complementarily, the AlN modulator's capacitive nature enables the open-circuit operation mode of T-TENG, providing the integrated NENS with continuous force sensing capability which is notably uninfluenced by operation speeds. Furthermore, a physical model is proposed to describe the coupled AlN modulator/T-TENG system. With the enhanced photonic modulation and the open-circuit operation mode enabled by synergies between the AlN modulator and the T-TENG, optical Morse code transmission and continuous human motion monitoring are demonstrated for practical wearable applications.

A Highly Aligned Nanowire-Based Strain Sensor for Ultrasensitive Monitoring of Subtle Human Motion

Achieving highly accurate responses to external stimuli during human motion is a considerable challenge for wearable devices. The present study leverages the intrinsically high surface-to-volume ratio as well as the mechanical robustness of nanostructures for obtaining highly-sensitive detection of motion. To do so, highly-aligned nanowires covering a large area were prepared by capillarity-based mechanism. The nanowires exhibit a strain sensor with excellent gauge factor (≈35.8), capable of high responses to various subtle external stimuli (≤200 µm deformation). The wearable strain sensor exhibits also a rapid response rate (≈230 ms), mechanical stability (1000 cycles) and reproducibility, low hysteresis (<8.1%), and low power consumption (<35 µW). Moreover, it achieves a gauge factor almost five times that of microwire-based sensors. The nanowire-based strain sensor can be used to monitor and discriminate subtle movements of fingers, wrist, and throat swallowing accurately, enabling such movements to be integrated further into a miniaturized analyzer to create a wearable motion monitoring system for mobile healthcare.

Highly Wearable, Breathable, and Washable Sensing Textile for Human Motion and Pulse Monitoring

At present, pressure sensor textiles are of great significance in the area of wearable electronics, especially for making smart or intelligent textiles. However, the design of these textile-based devices with sensitive ability, simple fabrication, and low cost is still challenging. In this study, we developed a triboelectric sensing textile constructed with core-shell yarns. Nylon filament and polytetrafluoroethylene filament were selected as the positive and negative layers, respectively, in the woven structure while the built-in helical stainless steel yarn was serving as the inner electrode layer. The sensitivity of the sensing textile can reach up to 1.33 V·kPa^-1 and 0.32 V·kPa^-1 in the pressure range of 1.95-3.13 kPa and 3.20-4.61 kPa, respectively. This sensing textile presented good mechanical stability and sensing capability even after 4200 cycles of continuous operation or after 4 h continuous water washing. Benefiting from the favorable merits of being highly flexible, breathable, lightweight, and even dyeable, the fabricated device was capable of being placed on any desired body parts for quantifying the dynamic human motions. It can be effectively used to measure and monitor various human movements associated with different joints, such as the hand, elbow, knee, and underarm. Moreover, the sensing textile was able to capture real-time pulse signals and reflect the current health status for human beings. This study affords an innovative and promising track for multifunctional pressure sensor textiles with wide applications in smart textiles and personalized healthcare.

Motion Assessment for Accelerometric and Heart Rate Cycling Data Analysis

Motion analysis is an important topic in the monitoring of physical activities and recognition of neurological disorders. The present paper is devoted to motion assessment using accelerometers inside mobile phones located at selected body positions and the records of changes in the heart rate during cycling, under different body loads. Acquired data include 1293 signal segments recorded by the mobile phone and the Garmin device for uphill and downhill cycling. The proposed method is based upon digital processing of the heart rate and the mean power in different frequency bands of accelerometric data. The classification of the resulting features was performed by the support vector machine, Bayesian methods, k-nearest neighbor method, and neural networks. The proposed criterion is then used to find the best positions for the sensors with the highest discrimination abilities. The results suggest the sensors be positioned on the spine for the classification of uphill and downhill cycling, yielding an accuracy of 96.5% and a cross-validation error of 0.04 evaluated by a two-layer neural network system for features based on the mean power in the frequency bands 〈 3 , 8 〉 and 〈 8 , 15 〉 Hz. This paper shows the possibility of increasing this accuracy to 98.3% by the use of more features and the influence of appropriate sensor positioning for motion monitoring and classification.

Large-Area Integrated Triboelectric Sensor Array for Wireless Static and Dynamic Pressure Detection and Mapping

Large-area flexible pressure sensors are of paramount importance for various future applications, such as electronic skin, human-machine interfacing, and health-monitoring devices. Here, a self-powered and large-area integrated triboelectric sensor array (ITSA) based on coupling a triboelectric sensor array and an array chip of CD4066 through a traditional connection is reported. Enabled by a simple and cost-effective fabrication process, the size of the ITSA can be scaled up to 38 × 38 cm² . In addition, unlike previously proposed triboelectric sensors arrays, which can only react to the dynamic interaction, this ITSA is able to detect static and dynamic pressure. Moreover, through integrating the ITSA with a signal processing circuit, a complete wireless sensing system is present. Diverse applications of the system are demonstrated in detail, including detecting pressure, identifying position, tracking trajectory, and recognizing the profile of external contact objects. Thus, the ITSA in this work opens a new route in the direction of large-area, self-powered, and wireless triboelectric sensing systems.

Real-time intrafraction motion monitoring in external beam radiotherapy

Radiotherapy (RT) aims to deliver a spatially conformal dose of radiation to tumours while maximizing the dose sparing to healthy tissues. However, the internal patient anatomy is constantly moving due to respiratory, cardiac, gastrointestinal and urinary activity. The long term goal of the RT community to 'see what we treat, as we treat' and to act on this information instantaneously has resulted in rapid technological innovation. Specialized treatment machines, such as robotic or gimbal-steered linear accelerators (linac) with in-room imaging suites, have been developed specifically for real-time treatment adaptation. Additional equipment, such as stereoscopic kilovoltage (kV) imaging, ultrasound transducers and electromagnetic transponders, has been developed for intrafraction motion monitoring on conventional linacs. Magnetic resonance imaging (MRI) has been integrated with cobalt treatment units and more recently with linacs. In addition to hardware innovation, software development has played a substantial role in the development of motion monitoring methods based on respiratory motion surrogates and planar kV or Megavoltage (MV) imaging that is available on standard equipped linacs. In this paper, we review and compare the different intrafraction motion monitoring methods proposed in the literature and demonstrated in real-time on clinical data as well as their possible future developments. We then discuss general considerations on validation and quality assurance for clinical implementation. Besides photon RT, particle therapy is increasingly used to treat moving targets. However, transferring motion monitoring technologies from linacs to particle beam lines presents substantial challenges. Lessons learned from the implementation of real-time intrafraction monitoring for photon RT will be used as a basis to discuss the implementation of these methods for particle RT.

The accuracy of a 2D video-based lifting monitor

A widely used risk prediction tool, the revised NIOSH lifting equation (RNLE), provides the recommended weight limit (RWL), but is limited by analyst subjectivity, experience, and resources. This paper describes a robust, non-intrusive, straightforward approach to automatically extract spatial and temporal factors necessary for the RNLE using a single video camera in the sagittal plane. The participant's silhouette is segmented by motion information and the novel use of a ghosting effect provides accurate detection of lifting instances, and hand and feet location prediction. Laboratory tests using 6 participants, each performing 36 lifts, showed that a nominal 640 pixel × 480 pixel 2D video, in comparison to 3D motion capture, provided RWL estimations within 0.2 kg (SD = 1.0 kg). The linear regression between the video and 3D tracking RWL was R² = 0.96 (slope = 1.0, intercept = 0.2 kg). Since low definition video was used in order to synchronise with motion capture, better performance is anticipated using high definition video. Practitioner's summary: An algorithm for automatically calculating the revised NIOSH lifting equation using a single video camera was evaluated in comparison to laboratory 3D motion capture. The results indicate that this method has suitable accuracy for practical use and may be, particularly, useful when multiple lifts are evaluated. Abbreviations: 2D: Two-dimensional; 3D: Three-dimensional; ACGIH: American Conference of Governmental Industrial Hygienists; AM: asymmetric multiplier; BOL: beginning of lift; CM: coupling multiplier; DM: distance multiplier; EOL: end of lift; FIRWL: frequency independent recommended weight limit; FM: frequency multiplier; H: horizontal distance; HM: horizontal multiplier; IMU: inertial measurement unit; ISO: International Organization for Standardization; LC: load constant; NIOSH: National Institute for Occupational Safety and Health; RGB: red, green, blue; RGB-D: red, green, blue - depth; RNLE: revised NIOSH lifting equation; RWL: recommended weight limit; SD: standard deviation; TLV: threshold limit value; VM: vertical multiplier; V: vertical distance.

A fast volumetric 4D-MRI with sub-second frame rate for abdominal motion monitoring and characterization in MRI-guided radiotherapy

Background

To propose a fast volumetric 4D-MRI based on 3D pulse sequence acquisition for abdominal motion monitoring and characterization in MRI-guided radiotherapy (MRgRT).

Methods

A 3D spoiled gradient echo sequence volumetric interpolated breath-hold examination (VIBE) [repetition time/echo time (TR/TE) =0.53/1.57 ms, flip-angle =5°, receiver bandwidth (RBW) =1,400 Hz/voxel] based 4D-MRI acquisition, accelerated by 4-fold controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA), named CAIPIRINHA-VIBE 4D-MRI, was implemented on a 1.5T MRI simulator (MR-sim) and applied for abdominal imaging of nine healthy volunteers under free breathing. One hundred and forty-four dynamics of the entire abdomen volume (56 slices), in total 8,064 (144×56) images with a voxel size of 2.7×2.7×4.0 mm³, were acquired in 89 s for 4D-MRI. This CAIPIRINHA-VIBE 4D-MRI was qualitatively compared with a 2D half-Fourier acquisition single-shot turbo spin-echo (2D-HASTE) based 4D-MRI. The motions of liver dome, kidney and spleen were analyzed using the CAIPIRINHA-VIBE 4D-MRI data. The kidney motion was quantitatively characterized in terms of motion range and the correlations between left and right kidneys.

Results

CAIPIRINHA-VIBE 4D-MRI was successfully conducted in all subjects. CAIPIRINHA-VIBE 4D-MRI exhibited much higher effective volumetric temporal resolution (0.615 vs. ~5 s/volume) and better reconstructed volume consistency than 2D-HASTE 4D-MRI. CAIPIRINHA-VIBE 4D-MRI was able to characterize the respiratory motion of abdominal organs simultaneously in three orthogonal directions, and could potentially be used for whole abdomen deformable motion tracking. Renal motion range was most pronounced in superior-inferior (SI) direction (L: 10.03±2.65 mm; R: 10.38±2.80 mm), significantly larger (P<0.001) than that in anterior-posterior (AP) and the least in left-right (LR) directions. Right kidney had significantly larger mobility (4.18±2.19 vs. 2.32±1.34 mm, P=0.045) than left kidney in AP, but not in LR and SI directions. The Pearson correlation coefficients r between left and right kidney motion were 0.5063 (P=0.164), 0.6624 (P=0.052) and 0.5752 (P=0.105) in LR, AP and SI correspondingly. The correlation of renal motion in SI and AP was found significant in right kidney (r=0.843, P=0.004) but not in left kidney (r=0.467, P=0.205).

Conclusions

A fast volumetric 4D-MRI was implemented for abdominal motion monitoring in MRgRT. A sub-second volumetric temporal resolution of 0.615 s, covering the entire abdomen, was demonstrated for respiratory motion monitoring and characterization. This technique holds potentials for MRgRT applications.

Low-cost Kinect Version 2 imaging system for breath hold monitoring and gating: Proof of concept study for breast cancer VMAT radiotherapy

Voluntary inspiration breath hold (VIBH) for left breast cancer patients has been shown to be a safe and effective method of reducing radiation dose to the heart. Currently, VIBH protocol compliance is monitored visually. In this work, we establish whether it is possible to gate the delivery of radiation from an Elekta linac using the Microsoft Kinect version 2 (Kinect v2) depth sensor to measure a patient breathing signal. This would allow contactless monitoring during VMAT treatment, as an alternative to equipment-assisted methods such as active breathing control (ABC). Breathing traces were acquired from six left breast radiotherapy patients during VIBH. We developed a gating interface to an Elekta linac, using the depth signal from a Kinect v2 to control radiation delivery to a programmable motion platform following patient breathing patterns. Radiation dose to a moving phantom with gating was verified using point dose measurements and a Delta4 verification phantom. 60 breathing traces were obtained with an acquisition success rate of 100%. Point dose measurements for gated deliveries to a moving phantom agreed to within 0.5% of ungated delivery to a static phantom using both a conventional and VMAT treatment plan. Dose measurements with the verification phantom showed that there was a median dose difference of better than 0.5% and a mean (3% 3 mm) gamma index of 92.6% for gated deliveries when using static phantom data as a reference. It is possible to use a Kinect v2 device to monitor voluntary breath hold protocol compliance in a cohort of left breast radiotherapy patients. Furthermore, it is possible to use the signal from a Kinect v2 to gate an Elekta linac to deliver radiation only during the peak inhale VIBH phase.

Characterization of a novel liquid fiducial marker for multimodal image guidance in stereotactic body radiotherapy of prostate cancer

PURPOSE

Liquid fiducial markers have shown to be a promising alternative to solid gold markers in terms of imaging artifact reduction, patient comfort, and compatibility with different imaging modalities. This study aims to investigate the performance of the novel BioXmark^® liquid marker for state-of-the-art multimodal imaging used in prostate cancer (PCa) radiotherapy, encompassing kV CT/CBCT, multiparametric MRI, and kV x-ray imaging. In addition, automatic detection of the liquid markers in x-ray imaging for prostate motion monitoring during treatment was investigated.

METHODS

A total of eight BioXmark^® liquid markers with varying volumes (range 5-300 μL) were casted on a square grid into a gelatin phantom insert. A cylindrical gold marker (QLRAD, length = 7 mm, Ø = 1 mm) was inserted for reference. Liquid marker visibility and streaking artifacts in CT/CBCT imaging were evaluated by placing the gelatin phantom into a CIRS anthropomorphic phantom. Relevant MRI characteristics such as the T2 and T1 relaxation times, the ADC value, and the relative proton density (ρH) were quantified by placing the gelatin phantom insert next to a T1MES mapping phantom and a water-filled syringe for reference. Ex vivo multiparametric MRI images were acquired by placing the gelatin phantom next to a resected prostate specimen. Anterior-posterior x-ray projection images were obtained by placing the gelatin phantom insert on top of an anthropomorphic pelvic phantom with internal pelvic bony structures and were acquired for five positions relative to the bony anatomy and 24 clinically relevant x-ray exposure settings. To quantify individual automatic marker detection, single markers were artificially isolated in the x-ray images using postprocessing.

RESULTS

Markers of all sizes were clearly visible on CT and CBCT images with only the largest marker volumes (100-300 μL) displaying artifacts similar in size to the gold fiducial marker. Artifact size increased with increasing liquid marker volume. Liquid markers displayed good contrast in ex vivo T1-weighted and ρH-weighted images. The markers were not visible in the ex vivo T2-weighted image. The liquid markers induced a chemical shift artifact in the obtained ADC-map. Automated detection in x-ray imaging was feasible with high detection success (four of five positions) for marker volumes in the range of 25-200 μL. None of the liquid markers were detected successfully when superimposed on a bony edge, independent of their size.

CONCLUSIONS

This study is the first to show the compatibility of BioXmark^® liquid markers with multimodal image-guided radiotherapy for PCa. Compared to a solid gold marker, they had favorable results in both visibility and induced imaging artifacts. Liquid marker visibility in MRI imaging of the prostate does not solely depend on the low ρH value (not visible on T2-weighted image) but is also influenced by its relaxation times. Automated marker detection in x-ray images was feasible but better adapted marker detection algorithms are necessary for marker localization in the presence of bony edges. Hence, the liquid marker provides a minimally invasive (fine needles) and highly applicable alternative to current solid gold markers for multimodal image-guided prostate radiotherapy treatments.

Transparent and Flexible Triboelectric Sensing Array for Touch Security Applications

Tactile sensors with large-scale array and high sensitivity is essential for human-machine interaction, smart wearable devices, and mobile networks. Here, a transparent and flexible triboelectric sensing array (TSA) with fingertip-sized pixels is demonstrated by integrating ITO electrodes, FEP film, and signal transmission circuits on an undivided palm-sized polyethylene terephthalate substrate. The sensing pixels can be triggered by the corresponding external contact to induce the electrostatic potential in the transparent electrodes without power consumption, which is individually recognized by the sensor. By testing the response of the pixels, the electrical characterization is systematically investigated. The proposed TSA exhibits excellent durability, independence, and synchronicity, which is able to realize real-time touch sensing, spatial mapping, and motion monitoring. The integrated TSA has great potential for an active tactile system, human-machine interface, wearable electronics, private communication, and advanced security identification.

Tribotronic Transistor Array as an Active Tactile Sensing System

Large-scale tactile sensor arrays are of great importance in flexible electronics, human-robot interaction, and medical monitoring. In this paper, a flexible 10 × 10 tribotronic transistor array (TTA) is developed as an active tactile sensing system by incorporating field-effect transistor units and triboelectric nanogenerators into a polyimide substrate. The drain-source current of each tribotronic transistor can be individually modulated by the corresponding external contact, which has induced a local electrostatic potential to act as the conventional gate voltage. By scaling down the pixel size from 5 × 5 to 0.5 × 0.5 mm², the sensitivities of single pixels are systematically investigated. The pixels of the TTA show excellent durability, independence, and synchronicity, which are suitable for applications in real-time tactile sensing, motion monitoring, and spatial mapping. The integrated tribotronics provides an unconventional route to realize an active tactile sensing system, with prospective applications in wearable electronics, human-machine interfaces, fingerprint identification, and so on.