Skin-interfaced sensors in digital medicine: from materials to applications

Smart bandages for wound monitoring and treatment

Wound management plays a crucial role in nursing care as it facilitates effective wound healing and prevents infections. To overcome limitations associated with traditional treatment methods, various smart bandages have been developed. The monitoring of wound parameters and the implementation of targeted treatments are crucial aspects of smart bandage development. Smart bandages, as cutting-edge flexible wearable medical devices, integrate various sensing technologies, providing new insights for dynamic monitoring and personalized treatment of chronic wounds. This paper systematically summarizes the applications and developments of smart bandages in monitoring wound environmental parameters, focusing on two major detection methods: colorimetric sensing and electrochemical sensing. Colorimetric sensors typically rely on color changes induced by physiological parameters, which can not only be identified by the naked eye but also combined with image recognition algorithms for physiological parameter detection. Electrochemical sensors, on the other hand, modify electrodes with specific enzymes and detect physiological parameters through the electrical signals generated by redox reactions. In addition to sensing, this paper further explores the integrated application of three smart therapeutic strategies in smart bandages, including promoting cell proliferation and angiogenesis through electrical stimulation, achieving controlled drug release via responsive materials, and utilizing photothermal materials for efficient antibacterial treatment of wounds. Finally, the paper delves into the challenges these bandages face in system integration and clinical translation, and discusses their potential in personalized wound care.

Distinguishing severe sleep apnea from habitual snoring using a neck-wearable piezoelectric sensor and deep learning: A pilot study

This study explores the development of a deep learning model using a neck-wearable piezoelectric sensor to accurately distinguish severe sleep apnea syndrome (SAS) from habitual snoring, addressing the underdiagnosis of SAS in adults. From 2018 to 2020, 60 adult habitual snorers underwent polysomnography while wearing a neck piezoelectric sensor that recorded snoring vibrations (70-250 Hz) and carotid artery pulsations (0.01-1.5 Hz). The initial dataset comprised 1167 silence, 1304 snoring, and 399 noise samples from 20 participants. Using a hybrid deep learning model comprising a one-dimensional convolutional neural network and gated-recurrent unit, the model identified snoring and apnea/hypopnea events, with sleep phases detected via pulse wave variability criteria. The model's efficacy in predicting severe SAS was assessed in the remaining 40 participants, achieving snoring detection rates of 0.88, 0.86, and 0.92, with respective loss rates of 0.39, 0.90, and 0.23. Classification accuracy for severe SAS improved from 0.85 for total sleep time to 0.90 for partial sleep time, excluding the first sleep phase, demonstrating precision of 0.84, recall of 1.00, and an F1 score of 0.91. This innovative approach of combining a hybrid deep learning model with a neck-wearable piezoelectric sensor suggests a promising route for early and precise differentiation of severe SAS from habitual snoring, aiding guiding further standard diagnostic evaluations and timely patient management. Future studies should focus on expanding the sample size, diversifying the patient population, and external validations in real-world settings to enhance the robustness and applicability of the findings.

Toward Stretchable Flexible Integrated Sensor Systems

Skin-like flexible sensors hold great potential as the next generation of intelligent electronic devices owing to their broad applications in environmental monitoring, human-machine interfaces, the Internet of Things, and artificial intelligence. Flexible electronics inspired by human skin play a vital role in continuous and real-time health monitoring. This review summarizes recent progress in skin-mountable electronics developed by designing flexible electrodes and substrates into different structures, including serpentine, microcrack, wrinkle, and kirigami. Furthermore, this review briefly discusses advances in wearable integrated sensor systems that mimic the flexibility of human skin, as well as multisensing functions. In the future, innovations in stretchable integrated sensor systems will be crucial to develop next-generation intelligent skin-based sensors for practical applications such as medical diagnosis, treatment, and environment monitoring.

Enhanced Non-Invasive Radio Frequency Heating Using 2D Pyrite (Pyritene)

Radiofrequency (RF) heating is a new, less invasive alternative to invasive heating methods that use nanoparticles for tumour therapy. But pinpoint local heating is still hard. Molecular interactions form a hybrid structure with unique electrical characteristics that enable RF heating in this work, which explores RF heating in a biological cell (yeast)-2D FeS2 system. Substantial processes have been uncovered via experimental investigations and density functional theory (DFT) computations. At 3 W and 50 MHz, RF heating reaches 54°C in 40 s, which is enough to kill yeast cells, while current-voltage measurements reveal ionic diode-like properties. Interactions between yeast lipid molecules and 2D FeSk, as shown by density-functional theory calculations, cause an imbalance in the distribution of charges and the creation of polar, conductive channels. Insights into biological heating applications based on radio frequency (RF) technology are offered by this work, which lays forth a framework for investigating 2D material-biomolecule interactions.

Stretchable Multimodal Photonic Sensor for Wearable Multiparameter Health Monitoring

Stretchable sensors that can conformally interface with the skins for wearable and real-time monitoring of skin deformations, temperature, and sweat biomarkers offer critical insights for early disease prediction and diagnosis. Integration of multiple modalities in a single stretchable sensor to simultaneously detect these stimuli would provide a more comprehensive understanding of human physiology, which, however, has yet to be achieved. Here, this work reports, for the first time, a stretchable multimodal photonic sensor capable of simultaneously detecting and discriminating strain deformations, temperature, and sweat pH. The multimodal sensing abilities are enabled by realization of multiple sensing mechanisms in a hydrogel-coated polydimethylsiloxane (PDMS) optical fiber (HPOF), featured with high flexibility, stretchability, and biocompatibility. The integrated mechanisms are designed to operate at distinct wavelengths to facilitate stimuli decoupling and employ a ratiometric detection strategy for improved robustness and accuracy. To simplify sensor interrogation, spectrally-resolved multiband emissions are generated upon the excitation of a single-wavelength laser, utilizing upconversion luminescence (UCL) and radiative energy transfer (RET) processes. As proof of concept, this work demonstrates the feasibility of simultaneous monitoring of the heartbeat, respiration, body temperature, and sweat pH of a person in real-time, with only a single sensor.

Lighting the Path to Precision Healthcare: Advances and Applications of Wearable Photonic Sensors

Recent advancements in wearable photonic sensors have marked a transformative era in healthcare, enabling non-invasive, real-time, portable, and personalized medical monitoring. These sensors leverage the unique properties of light toward high-performance sensing in form factors optimized for real-world use. Their ability to offer solutions to a broad spectrum of medical challenges - from routine health monitoring to managing chronic conditions, inspires a rapidly growing translational market. This review explores the design and development of wearable photonic sensors toward various healthcare applications. The photonic sensing strategies that power these technologies are first presented, alongside a discussion of the factors that define optimal use-cases for each approach. The means by which these mechanisms are integrated into wearable formats are then discussed, with considerations toward material selection for comfort and functionality, component fabrication, and power management. Recent developments in the space are detailed, accounting for both physical and chemical stimuli detection through various non-invasive biofluids. Finally, a comprehensive situational overview identifies critical challenges toward translation, alongside promising solutions. Associated future outlooks detail emerging trends and mechanisms that stand to enable the integration of these technologies into mainstream healthcare practice, toward advancing personalized medicine and improving patient outcomes.

Bionic Recognition Technologies Inspired by Biological Mechanosensory Systems

Mechanical information is a medium for perceptual interaction and health monitoring of organisms or intelligent mechanical equipment, including force, vibration, sound, and flow. Researchers are increasingly deploying mechanical information recognition technologies (MIRT) that integrate information acquisition, pre-processing, and processing functions and are expected to enable advanced applications. However, this also poses significant challenges to information acquisition performance and information processing efficiency. The novel and exciting mechanosensory systems of organisms in nature have inspired us to develop superior mechanical information bionic recognition technologies (MIBRT) based on novel bionic materials, structures, and devices to address these challenges. Herein, first bionic strategies for information pre-processing are presented and their importance for high-performance information acquisition is highlighted. Subsequently, design strategies and considerations for high-performance sensors inspired by mechanoreceptors of organisms are described. Then, the design concepts of the neuromorphic devices are summarized in order to replicate the information processing functions of a biological nervous system. Additionally, the ability of MIBRT is investigated to recognize basic mechanical information. Furthermore, further potential applications of MIBRT in intelligent robots, healthcare, and virtual reality are explored with a view to solve a range of complex tasks. Finally, potential future challenges and opportunities for MIBRT are identified from multiple perspectives.

A bibliometric and visualization analysis of electrochemical biosensors for early diagnosis of eye diseases

Electrochemical biosensors can provide an economical, accurate and rapid method for early screening of disease biomarkers in clinical medicine due to their high sensitivity, selectivity, portability, low cost and easy manufacturing, and multiplexing capability. Tear, a fluid naturally secreted by the human body, is not only easily accessible but also contains a great deal of biological information. However, no bibliometric studies focus on applying electrochemical sensors in tear/eye diseases. Therefore, we utilized VOSviewer and CiteSpace, to perform a detailed bibliometric analysis of 114 papers in the field of research on the application of tear in electrochemical biosensors screened from Web of Science with the combination of Scimago Graphica and Microsoft Excel for visualization to show the current research hotspots and future trends. The results show that the research in this field started in 2008 and experienced an emerging period in recent years. Researchers from China and the United States mainly contributed to the thriving research areas, with 41 and 29 articles published, respectively. Joseph Wang from the University of California San Diego is the most influential author in the field, and Biosensors & Bioelectronics is the journal with the most published research and the most cited journal. The highest appearance keywords were "biosensor" and "tear glucose," while the most recent booming keywords "diagnosis" and "in-vivo" were. In conclusion, this study elucidates current trends, hotspots, and emerging frontiers, and provides future biomarkers of ocular and systemic diseases by electrochemical sensors in tear with new ideas and opinions.

Multifunctional Porous Soft Bioelectronics

Soft bioelectronics, seamlessly interfacing with the human body to enable both recording and modulation of curvilinear biological tissues and organs, have significantly driven fields such as digital healthcare, human-machine interfaces, and robotics. Nonetheless, intractable challenges persist due to the onerous demand for imperceptible, burden-free, and user-centric comfortable bioelectronics. Porous soft bioelectronics is a new way to a library of imperceptible bioelectronic systems, that form natural interfaces with the human body. In this review, we provide an overview of the development and recent advances in multifunctional porous engineered soft bioelectronics, aiming to bridge the gap between living biotic and stiff abiotic systems. We first discuss strategies for fabricating porous, soft, and stretchable bioelectronic materials, emphasizing the concept of materials-level porous engineering for breathable and imperceptible bioelectronics. Next, we summarize wearable bioelectronics devices and multimodal systems with porous configurations designed for on-skin healthcare applications. Moving beneath the skin, we discuss implantable devices and systems enabled by porous bioelectronics with tissue-like compliance. Finally, existing challenges and translational gaps are also proposed to usher further research efforts towards realizing practical and clinical applications of porous bioelectronic systems; thus, revolutionizing conventional healthcare and medical practices and opening up unprecedented opportunities for long-term, imperceptible, non-invasive, and human-centric healthcare networks.

Customized surface adhesive and wettability properties of conformal electronic devices

Conformal and body-adaptive electronics have revolutionized the way we interact with technology, ushering in a new era of wearable devices that can seamlessly integrate with our daily lives. However, the inherent mismatch between artificially synthesized materials and biological tissues (caused by irregular skin fold, skin hair, sweat, and skin grease) needs to be addressed, which can be realized using body-adaptive electronics by rational design of their surface adhesive and wettability properties. Over the past few decades, various approaches have been developed to enhance the conformability and adaptability of bioelectronics by (i) increasing flexibility and reducing device thickness, (ii) improving the adhesion and wettability between bioelectronics and biological interfaces, and (iii) refining the integration process with biological systems. Successful development of a conformal and body-adaptive electronic device requires comprehensive consideration of all three aspects. This review starts with the design strategies of conformal electronics with different surface adhesive and wettability properties. A series of conformal and body-adaptive electronics used in the human body under both dry and wet conditions are systematically discussed. Finally, the current challenges and critical perspectives are summarized, focusing on promising directions such as telemedicine, mobile health, point-of-care diagnostics, and human-machine interface applications.

Flexible Temperature Sensor with High Reproducibility and Wireless Closed-Loop System for Decoupled Multimodal Health Monitoring and Personalized Thermoregulation

Temperature and pulse waves are two fundamental indicators of body health. Specifically, thermoresistive flexible temperature sensors are one of the most applied sensors. However, they suffer from poor reproducibility of resistivity; and decoupling temperature from pressure/strain is still challenging. Besides, autonomous thermoregulation by wearable sensory systems is in high demand, but conventional commercial apparatuses are cumbersome and not suitable for long-term portable use. Here, a material-design strategy is developed to overcome the problem of poor reproducibility of resistivity by tuning the thermal expansion coefficient to nearly zero, precluding the detriment caused by shape expansion/shrinkage with temperature variation and achieving high reproducibility. The strategy also obtains more reliable sensitivity and higher stability, and the designed thermoresistive fiber has strain-insensitive sensing performance and fast response/recovery time. A smart textile woven by the thermoresistive fiber can decouple temperature and pulse without crosstalk; and a flexible wireless closed-loop system comprising the smart textile, a heating textile, a flexible diminutive control patch, and a smartphone is designed and constructed to monitor health status in real-time and autonomously regulate body temperature. This work offers a new route to circumvent temperature-sensitive effects for flexible sensors and new insights for personalized thermoregulation.

Microfluidic Wearable Electrochemical Sensor Based on MOF-Derived Hexagonal Rod-Shaped Porous Carbon for Sweat Metabolite and Electrolyte Analysis

Wearable sensors enable the noninvasive continuous analysis of biofluid, which is of great importance for healthcare monitoring. In this work, a wearable sensor was seamlessly integrated with a microfluidic chip which was prepared by a three-dimensional printing technology for noninvasive and multiplexed analysis of metabolite and electrolytes in human sweat. The microfluidic chip could enable rapid sampling of sweat, which avoids the sweat evaporation and contamination. Using a Zn metal-organic framework as a sacrificial template, the hexagonal rod-shaped porous carbon nanorod (PCN) with high porosity, a large specific surface area, and excellent conductivity was synthesized and exhibited the robust electrocatalytic ability of uric acid (UA) oxidation. Therefore, the PCN-based sensor showed high sensitivity and good selectivity of UA with a wide linear range of 10-200 μM and a low detection limit of 4.13 μM. Meanwhile, the potentiometry-based ion-selective electrode was constructed for detection of pH and K+, respectively, with good sensitivity, selectivity, reproducibility, and stability. In addition, the testing under different bending states demonstrated that mechanical deformation had little effect on the electrochemical performance of the wearable sensors. Furthermore, we evaluated the utility of the wearable sensor for multiplexed real-time analysis of UA, pH, and K+ in sweat during aerobic exercise, and the effect of the amount of consumed purine-rich foods on uric acid metabolite levels in sweat and urine was further investigated. The relationship between urine UA and sweat UA was obtained. Overall, this wearable sensor enables multiple electrolyte and metabolite analysis in different noninvasive biofluids, suggesting its potential application in personalized disease prevention.

Modeling Mass Transport Dynamics in Deformable Hydrogels during Evaporation

Hydrogels possess exceptional mechanical properties and biocompatibility, making them widely used in contemporary bioengineering. Specifically, in the development of wearable and implantable health monitoring devices as well as drug delivery systems, hydrogels are utilized to enable precise control over the transport of solutes. Nonetheless, predicting the distribution of substances within hydrogels still poses a significant challenge due to the complex interplay between the movement of water content, migration of solutes, and deformability of the hydrogel polymer network, which presents challenges to theoretical modeling. Our work introduces a numerical model that addresses the movement of water and solute within a flexible hydrogel, accounting for evaporation and/or moisture absorption at the boundary. The model solves for water saturation, solute concentration, and hydrogel deformation iteratively at each time step while computing the boundary movement velocity based on the transport process. By comparing the modeled results of geometry deformation and water and solute distributions during evaporation with our experiments, we demonstrate the accuracy and applicability of our proposed model. This capability to precisely analyze water and solute concentrations in deformable and nonuniform hydrogel environments paves the way for advancements in biosensing and drug delivery methods that rely on elastic porous materials.

Fabricated advanced textile for personal thermal management, intelligent health monitoring and energy harvesting

Fabrics are soft against the skin, flexible, easily accessible and able to wick away perspiration, to some extent for local private thermal management. In this review, we classify smart fabrics as passive thermal management fabrics and active thermal management fabrics based on the availability of outside energy consumption in the manipulation of heat generation and dissipation from the human body. The mechanism and research status of various thermal management fabrics are introduced in detail, and the article also analyses the advantages and disadvantages of various smart thermal management fabrics, achieving a better and more comprehensive comprehension of the current state of research on smart thermal management fabrics, which is quite an important reference guide for our future research. In addition, with the progress of science and technology, the social demand for fabrics has shifted from keeping warm to improving health and quality of life. E-textiles have potential value in areas such as remote health monitoring and life signal detection. New e-textiles are designed to mimic the skin, sense biological data and transmit information. At the same time, the ultra-moisturizing properties of the fabric's thermal management allow for applications beyond just the human body to energy. E-textiles hold great promise for energy harvesting and storage. The article also introduces the application of smart fabrics in life forms and energy harvesting. By combining electronic technology with textiles, e-textiles can be manufactured to promote human well-being and quality of life. Although smart textiles are equipped with more intelligent features, wearing comfort must be the first thing to be ensured in the multi-directional application of textiles. Eventually, we discuss the dares and prospects of smart thermal management fabric research.

Multifunctional Conductive Hydrogel Interface for Bioelectronic Recording and Stimulation

The past few decades have witnessed the rapid advancement and broad applications of flexible bioelectronics, in wearable and implantable electronics, brain-computer interfaces, neural science and technology, clinical diagnosis, treatment, etc. It is noteworthy that soft and elastic conductive hydrogels, owing to their multiple similarities with biological tissues in terms of mechanics, electronics, water-rich, and biological functions, have successfully bridged the gap between rigid electronics and soft biology. Multifunctional hydrogel bioelectronics, emerging as a new generation of promising material candidates, have authentically established highly compatible and reliable, high-quality bioelectronic interfaces, particularly in bioelectronic recording and stimulation. This review summarizes the material basis and design principles involved in constructing hydrogel bioelectronic interfaces, and systematically discusses the fundamental mechanism and unique advantages in bioelectrical interfacing with the biological surface. Furthermore, an overview of the state-of-the-art manufacturing strategies for hydrogel bioelectronic interfaces with enhanced biocompatibility and integration with the biological system is presented. This review finally exemplifies the unprecedented advancement and impetus toward bioelectronic recording and stimulation, especially in implantable and integrated hydrogel bioelectronic systems, and concludes with a perspective expectation for hydrogel bioelectronics in clinical and biomedical applications.

Hoffmeister Effect Optimized Hydrogel Electrodes with Enhanced Electrical and Mechanical Properties for Nerve Conduction Studies

Flexible epidermal electrodes hold substantial promise in realizing human electrophysiological information collections. Conventional electrodes exhibit certain limitations, including the requirement of skin pretreatment, reliance on external object-assisted fixation, and a propensity of dehydration, which severely hinder their applications in medical diagnosis. To tackle those issues, we developed a hydrogel electrode with both transcutaneous stimulation and neural signal acquisition functions. The electrode consists of a composite conductive layer (CCL) and adhesive conductive hydrogel (ACH). The CCL is designed as a laminated structure with high conductivity and charge storage capacity (CSC). Based on the optimization of Hoffmeister effect, the ACH demonstrates excellent electrical (resistivity of 3.56 Ω·m), mechanical (tensile limit of 1,650%), and adhesion properties (peeling energy of 0.28 J). The utilization of ACH as electrode/skin interface can reduce skin contact impedance and noise interference and enhance the CSC and charge injection capacity of electrodes. As a proof of concept, peripheral nerve conduction studies were performed on human volunteers to evaluate the as-fabricated hydrogel electrodes. Compared with the commercial electrodes, our hydrogel electrodes achieved better signal continuity and lower distortion, higher signal-to-noise ratio (~35 dB), and lower stimulation voltages (up to 27% lower), which can improve the safety and comfort of nerve conduction studies.

Nucleic acid-based wearable and implantable electrochemical sensors

The rapid advancements in nucleic acid-based electrochemical sensors for implantable and wearable applications have marked a significant leap forward in the domain of personal healthcare over the last decade. This technology promises to revolutionize personalized healthcare by facilitating the early diagnosis of diseases, monitoring of disease progression, and tailoring of individual treatment plans. This review navigates through the latest developments in this field, focusing on the strategies for nucleic acid sensing that enable real-time and continuous biomarker analysis directly in various biofluids, such as blood, interstitial fluid, sweat, and saliva. The review delves into various nucleic acid sensing strategies, emphasizing the innovative designs of biorecognition elements and signal transduction mechanisms that enable implantable and wearable applications. Special perspective is given to enhance nucleic acid-based sensor selectivity and sensitivity, which are crucial for the accurate detection of low-level biomarkers. The integration of such sensors into implantable and wearable platforms, including microneedle arrays and flexible electronic systems, actualizes their use in on-body devices for health monitoring. We also tackle the technical challenges encountered in the development of these sensors, such as ensuring long-term stability, managing the complexity of biofluid dynamics, and fulfilling the need for real-time, continuous, and reagentless detection. In conclusion, the review highlights the importance of these sensors in the future of medical engineering, offering insights into design considerations and future research directions to overcome existing limitations and fully realize the potential of nucleic acid-based electrochemical sensors for healthcare applications.

Wireless Technologies in Flexible and Wearable Sensing: From Materials Design, System Integration to Applications

Wireless and wearable sensors attract considerable interest in personalized healthcare by providing a unique approach for remote, noncontact, and continuous monitoring of various health-related signals without interference with daily life. Recent advances in wireless technologies and wearable sensors have promoted practical applications due to their significantly improved characteristics, such as reduction in size and thickness, enhancement in flexibility and stretchability, and improved conformability to the human body. Currently, most researches focus on active materials and structural designs for wearable sensors, with just a few exceptions reflecting on the technologies for wireless data transmission. This review provides a comprehensive overview of the state-of-the-art wireless technologies and related studies on empowering wearable sensors. The emerging functional nanomaterials utilized for designing unique wireless modules are highlighted, which include metals, carbons, and MXenes. Additionally, the review outlines the system-level integration of wireless modules with flexible sensors, spanning from novel design strategies for enhanced conformability to efficient transmitting data wirelessly. Furthermore, the review introduces representative applications for remote and noninvasive monitoring of physiological signals through on-skin and implantable wireless flexible sensing systems. Finally, the challenges, perspectives, and unprecedented opportunities for wireless and wearable sensors are discussed.

Extended Review Concerning the Integration of Electrochemical Biosensors into Modern IoT and Wearable Devices

Electrochemical biosensors include a recognition component and an electronic transducer, which detect the body fluids with a high degree of accuracy. More importantly, they generate timely readings of the related physiological parameters, and they are suitable for integration into portable, wearable and implantable devices that are significant relative to point-of-care diagnostics scenarios. As an example, the personal glucose meter fundamentally improves the management of diabetes in the comfort of the patients' homes. This review paper analyzes the principles of electrochemical biosensing and the structural features of electrochemical biosensors relative to the implementation of health monitoring and disease diagnostics strategies. The analysis particularly considers the integration of the biosensors into wearable, portable, and implantable systems. The fundamental aim of this paper is to present and critically evaluate the identified significant developments in the scope of electrochemical biosensing for preventive and customized point-of-care diagnostic devices. The paper also approaches the most important engineering challenges that should be addressed in order to improve the sensing accuracy, and enable multiplexing and one-step processes, which mediate the integration of electrochemical biosensing devices into digital healthcare scenarios.

Pursuing precision in medicine and nutrition: the rise of electrochemical biosensing at the molecular level

In the era that we seek personalization in material things, it is becoming increasingly clear that the individualized management of medicine and nutrition plays a key role in life expectancy and quality of life, allowing participation to some extent in our welfare and the use of societal resources in a rationale and equitable way. The implementation of precision medicine and nutrition are highly complex challenges which depend on the development of new technologies able to meet important requirements in terms of cost, simplicity, and versatility, and to determine both individually and simultaneously, almost in real time and with the required sensitivity and reliability, molecular markers of different omics levels in biofluids extracted, secreted (either naturally or stimulated), or circulating in the body. Relying on representative and pioneering examples, this review article critically discusses recent advances driving the position of electrochemical bioplatforms as one of the winning horses for the implementation of suitable tools for advanced diagnostics, therapy, and precision nutrition. In addition to a critical overview of the state of the art, including groundbreaking applications and challenges ahead, the article concludes with a personal vision of the imminent roadmap.

E-Tattoos: Toward Functional but Imperceptible Interfacing with Human Skin

The human body continuously emits physiological and psychological information from head to toe. Wearable electronics capable of noninvasively and accurately digitizing this information without compromising user comfort or mobility have the potential to revolutionize telemedicine, mobile health, and both human-machine or human-metaverse interactions. However, state-of-the-art wearable electronics face limitations regarding wearability and functionality due to the mechanical incompatibility between conventional rigid, planar electronics and soft, curvy human skin surfaces. E-Tattoos, a unique type of wearable electronics, are defined by their ultrathin and skin-soft characteristics, which enable noninvasive and comfortable lamination on human skin surfaces without causing obstruction or even mechanical perception. This review article offers an exhaustive exploration of e-tattoos, accounting for their materials, structures, manufacturing processes, properties, functionalities, applications, and remaining challenges. We begin by summarizing the properties of human skin and their effects on signal transmission across the e-tattoo-skin interface. Following this is a discussion of the materials, structural designs, manufacturing, and skin attachment processes of e-tattoos. We classify e-tattoo functionalities into electrical, mechanical, optical, thermal, and chemical sensing, as well as wound healing and other treatments. After discussing energy harvesting and storage capabilities, we outline strategies for the system integration of wireless e-tattoos. In the end, we offer personal perspectives on the remaining challenges and future opportunities in the field.

Soft Sensors and Actuators for Wearable Human-Machine Interfaces

Haptic human-machine interfaces (HHMIs) combine tactile sensation and haptic feedback to allow humans to interact closely with machines and robots, providing immersive experiences and convenient lifestyles. Significant progress has been made in developing wearable sensors that accurately detect physical and electrophysiological stimuli with improved softness, functionality, reliability, and selectivity. In addition, soft actuating systems have been developed to provide high-quality haptic feedback by precisely controlling force, displacement, frequency, and spatial resolution. In this Review, we discuss the latest technological advances of soft sensors and actuators for the demonstration of wearable HHMIs. We particularly focus on highlighting material and structural approaches that enable desired sensing and feedback properties necessary for effective wearable HHMIs. Furthermore, promising practical applications of current HHMI technology in various areas such as the metaverse, robotics, and user-interactive devices are discussed in detail. Finally, this Review further concludes by discussing the outlook for next-generation HHMI technology.

A physicochemical-sensing electronic skin for stress response monitoring

Approaches to quantify stress responses typically rely on subjective surveys and questionnaires. Wearable sensors can potentially be used to continuously monitor stress-relevant biomarkers. However, the biological stress response is spread across the nervous, endocrine, and immune systems, and the capabilities of current sensors are not sufficient for condition-specific stress response evaluation. Here we report an electronic skin for stress response assessment that non-invasively monitors three vital signs (pulse waveform, galvanic skin response and skin temperature) and six molecular biomarkers in human sweat (glucose, lactate, uric acid, sodium ions, potassium ions and ammonium). We develop a general approach to prepare electrochemical sensors that relies on analogous composite materials for stabilizing and conserving sensor interfaces. The resulting sensors offer long-term sweat biomarker analysis of over 100 hours with high stability. We show that the electronic skin can provide continuous multimodal physicochemical monitoring over a 24-hour period and during different daily activities. With the help of a machine learning pipeline, we also show that the platform can differentiate three stressors with an accuracy of 98.0%, and quantify psychological stress responses with a confidence level of 98.7%.

Direct Fabrication of Te-Doped Black Si with an Enhanced Photoelectric Performance by Femtosecond Laser Irradiation under Water

Tellurium (Te)-doped black silicon (Si) with enhanced absorption and photoelectric performance over a broad wavelength range of 0.2-2.5 μm was obtained using femtosecond (fs) laser irradiation in liquid water. Prior to laser irradiation, the Si sample was covered with a Te thin film (thickness 200 nm) over an adhesion layer of Cr (thickness 5 nm). Surface analyses by scanning electron microscopy and three-dimensional confocal microscopy evidence the presence of hierarchical surface structures combining quasi-periodic stripes with a spatial period of about 5 μm and subwavelength laser-induced periodic surface structures directed in directions parallel and perpendicular to the direction of the laser polarization, respectively. Moreover, the incorporation of Te generates intermediate levels within the Si bandgap. The Te-doped black Si shows a significant enhancement of the absorption, which reaches values of about 48% in the UV and visible (0.2-1.1 μm) and 70% in the near-infrared (1.1-2.5 μm) spectral ranges, respectively, due to the synergistic effects of multiscale surface structures and Te incorporation. Moreover, the surface reflectance is reduced to almost zero across the entire spectrum. The Te-doped black Si sample is used to realize a photodetector which displays an impressive photoelectric capability, being characterized by a responsivity of 328 mA/W, and an external quantum efficiency of 49.27% at a voltage bias of -10 V for 1064 nm light illumination, with rising and falling times of 55 and 67 ms, respectively. These figures remarkably outperform the response of unprocessed Si under the same experimental conditions.

Recent advances in wearable iontronic sensors for healthcare applications

Iontronic sensors have garnered significant attention as wearable sensors due to their exceptional mechanical performance and the ability to maintain electrical performance under various mechanical stimuli. Iontronic sensors can respond to stimuli like mechanical stimuli, humidity, and temperature, which has led to exploration of their potential as versatile sensors. Here, a comprehensive review of the recent researches and developments on several types of iontronic sensors (e.g., pressure, strain, humidity, temperature, and multi-modal sensors), in terms of their sensing principles, constituent materials, and their healthcare-related applications is provided. The strategies for improving the sensing performance and environmental stability of iontronic sensors through various innovative ionic materials and structural designs are reviewed. This review also provides the healthcare applications of iontronic sensors that have gained increased feasibility and broader applicability due to the improved sensing performance. Lastly, outlook section discusses the current challenges and the future direction in terms of the applicability of the iontronic sensors to the healthcare.

Direct-Ink-Writing 3D-Printed Bioelectronics

The development of wearable and implantable bioelectronics has garnered significant momentum in recent years, driven by the ever-increasing demand for personalized health monitoring, remote patient management, and real-time physiological data collection. The elevated sophistication and advancement of these devices have thus led to the use of many new and unconventional materials which cannot be fulfilled through traditional manufacturing techniques. Three-dimension (3D) printing, also known as additive manufacturing, is an emerging technology that opens new opportunities to fabricate next-generation bioelectronic devices. Some significant advantages include its capacity for material versatility and design freedom, rapid prototyping, and manufacturing efficiency with enhanced capabilities. This review provides an overview of the recent advances in 3D printing of bioelectronics, particularly direct ink writing (DIW), encompassing the methodologies, materials, and applications that have emerged in this rapidly evolving field. This review showcases the broad range of bioelectronic devices fabricated through 3D printing including wearable biophysical sensors, biochemical sensors, electrophysiological sensors, energy devices, multimodal systems, implantable devices, and soft robots. This review will also discuss the advantages, existing challenges, and outlook of applying DIW 3D printing for the development of bioelectronic devices toward healthcare applications.

Organic Electronics in Biosensing: A Promising Frontier for Medical and Environmental Applications

The promising field of organic electronics has ushered in a new era of biosensing technology, thus offering a promising frontier for applications in both medical diagnostics and environmental monitoring. This review paper provides a comprehensive overview of organic electronics' remarkable progress and potential in biosensing applications. It explores the multifaceted aspects of organic materials and devices, thereby highlighting their unique advantages, such as flexibility, biocompatibility, and low-cost fabrication. The paper delves into the diverse range of biosensors enabled by organic electronics, including electrochemical, optical, piezoelectric, and thermal sensors, thus showcasing their versatility in detecting biomolecules, pathogens, and environmental pollutants. Furthermore, integrating organic biosensors into wearable devices and the Internet of Things (IoT) ecosystem is discussed, wherein they offer real-time, remote, and personalized monitoring solutions. The review also addresses the current challenges and future prospects of organic biosensing, thus emphasizing the potential for breakthroughs in personalized medicine, environmental sustainability, and the advancement of human health and well-being.

Advanced Self-Powered Biofuel Cells with Capacitor and Nanogenerator for Biomarker Sensing

Self-powered biofuel cells (BFCs) have evolved for highly sensitive detection of biomarkers such as noncodon micro ribonucleic acids (miRNAs) in the presence of interfering substrates. Self-charging supercapacitive BFCs for in vivo and in vitro cellular microenvironments represent the most prevalent sensing mechanism for diagnosis. Therefore, self-powered biosensing (SPB) with a capacitor and contact separation with a triboelectric nanogenerator (TENG) offers electrochemical and colorimetric dual-mode detection via improved electrical signal intensity. In this review, we discuss three major components: stretchable self-powered BFC design, miRNA sensing, and impedance spectroscopy. A specific focus is given to 1) assembling of sensors for biomarkers, 2) electrical output signal intensification, and 3) role of supercapacitors and nanogenerators in SPBs. We outline the key features of stretchable SPBs and the sequence of miRNA sensing by SPBs. We have emphasized the need of a supercapacitor and nanogenerator for SPBs in the context of advanced assembly of the sensing unit. Finally, we outline the role of impedance spectroscopy in the detection and estimation of biomarkers. We highlight key challenges in SPBs for biomarker sensing, which needs improved sensing accuracy, integration strategies of electrochemical biosensing for in vitro and in vivo microenvironments, and the impact of miRNA sensing on cancer diagnostics. This article attempts a specific focus on the accuracy and limitations of sensing unit for miRNA biomarkers and associated tool for boosting electrical signal intensity for a potential big step further.

A three-level model for therapeutic drug monitoring of antimicrobials at the site of infection

The silent pandemic of bacterial antimicrobial resistance is a leading cause of death worldwide, prolonging hospital stays and raising health-care costs. Poor incentives to develop novel pharmacological compounds and the misuse of antibiotics contribute to the bacterial antimicrobial resistance crisis. Therapeutic drug monitoring (TDM) based on blood analysis can help alleviate the emergence of bacterial antimicrobial resistance and effectively decreases the risk of toxic drug concentrations in patients' blood. Antibiotic tissue penetration can vary in patients who are critically or chronically ill and can potentially lead to treatment failure. Antibiotics such as β-lactams and glycopeptides are detectable in non-invasively collectable biofluids, such as sweat and exhaled breath. The emergence of wearable sensors enables easy access to these non-invasive biofluids, and thus a laboratory-independent analysis of various disease-associated biomarkers and drugs. In this Personal View, we introduce a three-level model for TDM of antibiotics to describe concentrations at the site of infection (SOI) by use of wearable sensors. Our model links blood-based drug measurement with the analysis of drug concentrations in non-invasively collectable biofluids stemming from the SOI to characterise drug concentrations at the SOI. Finally, we outline the necessary clinical and technical steps for the development of wearable sensing platforms for SOI applications.

From Triboelectric Nanogenerator to Hybrid Energy Harvesters: A Review on the Integration Strategy toward High Efficiency and Multifunctionality

The rapid development of smart devices and electronic products puts forward higher requirements for power supply components. As a promising solution, hybrid energy harvesters that are based on a triboelectric nanogenerator (HEHTNG) show advantages of both high energy harvesting efficiency and multifunctionality. Aiming to systematically elaborate the latest research progress of a HEHTNG, this review starts by introducing its working principle with a focus on the combination of triboelectric nanogenerators with various other energy harvesters, such as piezoelectric nanogenerators, thermoelectric/pyroelectric nanogenerators, solar cells, and electromagnetic nanogenerators. While the performance improvement and integration strategies of HEHTNG toward environmental energy harvesting are emphasized, the latest applications of HEHTNGs as multifunctional sensors in human health detection are also illustrated. Finally, we discuss the main challenges and prospects of HEHTNGs, hoping that this work can provide a clear direction for the future development of intelligent energy harvesting systems for the Internet of Things.

3D-printed epifluidic electronic skin for machine learning-powered multimodal health surveillance

The amalgamation of wearable technologies with physiochemical sensing capabilities promises to create powerful interpretive and predictive platforms for real-time health surveillance. However, the construction of such multimodal devices is difficult to be implemented wholly by traditional manufacturing techniques for at-home personalized applications. Here, we present a universal semisolid extrusion-based three-dimensional printing technology to fabricate an epifluidic elastic electronic skin (e3-skin) with high-performance multimodal physiochemical sensing capabilities. We demonstrate that the e3-skin can serve as a sustainable surveillance platform to capture the real-time physiological state of individuals during regular daily activities. We also show that by coupling the information collected from the e3-skin with machine learning, we were able to predict an individual's degree of behavior impairments (i.e., reaction time and inhibitory control) after alcohol consumption. The e3-skin paves the path for future autonomous manufacturing of customizable wearable systems that will enable widespread utility for regular health monitoring and clinical applications.

A Computationally Assisted Approach for Designing Wearable Biosensors toward Non-Invasive Personalized Molecular Analysis

Wearable sweat sensors have the potential to revolutionize precision medicine as they can non-invasively collect molecular information closely associated with an individual's health status. However, the majority of clinically relevant biomarkers cannot be continuously detected in situ using existing wearable approaches. Molecularly imprinted polymers (MIPs) are a promising candidate to address this challenge but haven't yet gained widespread use due to their complex design and optimization process yielding variable selectivity. Here, QuantumDock is introduced, an automated computational framework for universal MIP development toward wearable applications. QuantumDock utilizes density functional theory to probe molecular interactions between monomers and the target/interferent molecules to optimize selectivity, a fundamentally limiting factor for MIP development toward wearable sensing. A molecular docking approach is employed to explore a wide range of known and unknown monomers, and to identify the optimal monomer/cross-linker choice for subsequent MIP fabrication. Using an essential amino acid phenylalanine as the exemplar, experimental validation of QuantumDock is performed successfully using solution-synthesized MIP nanoparticles coupled with ultraviolet-visible spectroscopy. Moreover, a QuantumDock-optimized graphene-based wearable device is designed that can perform autonomous sweat induction, sampling, and sensing. For the first time, wearable non-invasive phenylalanine monitoring is demonstrated in human subjects toward personalized healthcare applications.

Tremella polysaccharide-based conductive hydrogel with anti-freezing and self-healing ability for motion monitoring and intelligent interaction

The application of conductive hydrogels in flexible wearable devices has garnered significant attention. In this study, a self-healing, anti-freezing, and fire-resistant hydrogel strain sensor is successfully synthesized by incorporating sustainable natural biological materials, viz. Tremella polysaccharide and silk fiber, into a polyvinyl alcohol matrix with borax cross-linking. The resulting hydrogel exhibits excellent transparency, thermoplasticity, and remarkable mechanical properties, including a notable elongation (1107.3 %) and high self-healing rate (91.11 %) within 5 min, attributed to the dynamic cross-linking effect of hydrogen bonds and borax. A strain sensor based on the prepared hydrogel sensor can be used to accurately monitor diverse human movements, while maintaining exceptional sensing stability and durability under repeated strain cycles. Additionally, a hydrogel touch component is designed that can successfully interact with intelligent electronic devices, encompassing functions like clicking, writing, and drawing. These inherent advantages make the prepared hydrogel a promising candidate for applications in human health monitoring and intelligent electronic device interaction.

Adhesive Wearable Sensors for Electroencephalography from Hairy Scalp

Electroencephalography has garnered interest for applications in mobile healthcare, human-machine interfaces, and Internet of Things. Conventional electroencephalography relies on wet and dry electrodes. Despite favorable interface impedance of wet electrodes and skin, the application of a large amount of gel at their interface with skin limits the electroencephalography spatial resolution, increases the risk of shorting between electrodes, and makes them unsuited for long-term mobile recording. In contrast, dry electrodes are better suited for long-term recordings but susceptible to motion artifacts. In addition, both wet and dry electrodes are non-adhesive to the hairy scalp and mechanical support, or chemical adhesives are used to hold them in place. Herein, a conical microstructure array (CMSA) based sensor made of carbon nanotube-polydimethylsiloxane composite is reported. The CMSA sensor is fabricated using the innovative, cost-effective, and scalable method of viscosity-controlled dip-pull process. The sensor adheres to the hairy scalp by generating negative pressure in its conical microstructures when it is pressed against scalp. Aided by the application of a trace amount of gel, CMSA sensor establishes good electrical contact with the skin, enabling its applications in mobile electroencephalography over extended periods. Notably, the signal quality of CMSA sensors is comparable to that of medical-grade wet gel electrodes.

Electrochemical Wearable Biosensors and Bioelectronic Devices Based on Hydrogels: Mechanical Properties and Electrochemical Behavior

Hydrogel-based wearable electrochemical biosensors (HWEBs) are emerging biomedical devices that have recently received immense interest. The exceptional properties of HWEBs include excellent biocompatibility with hydrophilic nature, high porosity, tailorable permeability, the capability of reliable and accurate detection of disease biomarkers, suitable device-human interface, facile adjustability, and stimuli responsive to the nanofiller materials. Although the biomimetic three-dimensional hydrogels can immobilize bioreceptors, such as enzymes and aptamers, without any loss in their activities. However, most HWEBs suffer from low mechanical strength and electrical conductivity. Many studies have been performed on emerging electroactive nanofillers, including biomacromolecules, carbon-based materials, and inorganic and organic nanomaterials, to tackle these issues. Non-conductive hydrogels and even conductive hydrogels may be modified by nanofillers, as well as redox species. All these modifications have led to the design and development of efficient nanocomposites as electrochemical biosensors. In this review, both conductive-based and non-conductive-based hydrogels derived from natural and synthetic polymers are systematically reviewed. The main synthesis methods and characterization techniques are addressed. The mechanical properties and electrochemical behavior of HWEBs are discussed in detail. Finally, the prospects and potential applications of HWEBs in biosensing, healthcare monitoring, and clinical diagnostics are highlighted.

Application of Intelligent Medical Sensing Technology

With the popularization of intelligent sensing and the improvement of modern medical technology, intelligent medical sensing technology has emerged as the times require. This technology combines basic disciplines such as physics, mathematics, and materials with modern technologies such as semiconductors, integrated circuits, and artificial intelligence, and has become one of the most promising in the medical field. The core of intelligent medical sensor technology is to make existing medical sensors intelligent, portable, and wearable with full consideration of ergonomics and sensor power consumption issues in order to conform to the current trends in cloud medicine, personalized medicine, and health monitoring. With the development of automation and intelligence in measurement and control systems, it is required that sensors have high accuracy, reliability, and stability, as well as certain data processing capabilities, self-checking, self-calibration, and self-compensation, while traditional medical sensors cannot meet such requirements. In addition, to manufacture high-performance sensors, it is also difficult to improve the material process alone, and it is necessary to combine computer technology with sensor technology to make up for its performance shortcomings. Intelligent medical sensing technology combines medical sensors with microprocessors to produce powerful intelligent medical sensors. Based on the original sensor functions, intelligent medical sensors also have functions such as self-compensation, self-calibration, self-diagnosis, numerical processing, two-way communication, information storage, and digital output. This review focuses on the application of intelligent medical sensing technology in biomedical sensing detection from three aspects: physical sensor, chemical sensor, and biosensor.

Strong and Tough Nanostructured Hydrogels and Organogels Prepared by Polymerization-Induced Self-Assembly

In nature, the hierarchical structure of biological tissues endows them with outstanding mechanics and elaborated functions. However, it remains a great challenge to construct biomimetic hydrogels with well-defined nanostructures and good mechanical properties. Herein, polymerization-induced self-assembly (PISA) is for the first time exploited as a general strategy for nanostructured hydrogels and organogels with tailored nanodomains and outstanding mechanical properties. As a proof-of-concept, PISA of BAB triblock copolymer is used to fabricate hydrogels with precisely regulated spherical nanodomains. These nanostructured hydrogels are strong, tough, stretchable, and recoverable, with mechanical properties correlating to their nanostructure. The outstanding mechanical properties are ascribed to the unique network architecture, where the entanglements of the hydrophilic chains act as slip links that transmit the tension to the micellar crosslinkers, while the micellar crosslinkers dissipate the energy via reversible deformation and irreversible detachment of the constituting polymers. The general feasibility of the PISA strategy toward nanostructured gels is confirmed by the successful fabrication of nanostructured hydrogels, alcogels, poly(ethylene glycol) gels, and ionogels with various PISA formulations. This work has provided a general platform for the design and fabrication of biomimetic hydrogels and organogels with tailorable nanostructures and mechanics and will inspire the design of functional nanostructured gels.

Drug Delivery Systems for Personal Healthcare by Smart Wearable Patch System

Smart wearable patch systems that combine biosensing and therapeutic components have emerged as promising approaches for personalized healthcare and therapeutic platforms that enable self-administered, noninvasive, user-friendly, and long-acting smart drug delivery. Sensing components can continuously monitor physiological and biochemical parameters, and the monitoring signals can be transferred to various stimuli using actuators. In therapeutic components, stimuli-responsive carrier-based drug delivery systems (DDSs) provide on-demand drug delivery in a closed-loop manner. This review provides an overview of the recent advances in smart wearable patch systems, focusing on sensing components, stimuli, and therapeutic components. Additionally, this review highlights the potential of fully integrated smart wearable patch systems for personalized medicine. Furthermore, challenges associated with the clinical applications of this system and future perspectives are discussed, including issues related to drug loading and reloading, biocompatibility, accuracy of sensing and drug delivery, and largescale fabrication.

Ultrathin, Soft, Bioresorbable Organic Electrochemical Transistors for Transient Spatiotemporal Mapping of Brain Activity

A critical challenge lies in the development of the next-generation neural interface, in mechanically tissue-compatible fashion, that offer accurate, transient recording electrophysiological (EP) information and autonomous degradation after stable operation. Here, an ultrathin, lightweight, soft and multichannel neural interface is presented based on organic-electrochemical-transistor-(OECT)-based network, with capabilities of continuous high-fidelity mapping of neural signals and biosafety active degrading after performing functions. Such platform yields a high spatiotemporal resolution of 1.42 ms and 20 µm, with signal-to-noise ratio up to ≈37 dB. The implantable OECT arrays can well establish stable functional neural interfaces, designed as fully biodegradable electronic platforms in vivo. Demonstrated applications of such OECT implants include real-time monitoring of electrical activities from the cortical surface of rats under various conditions (e.g., narcosis, epileptic seizure, and electric stimuli) and electrocorticography mapping from 100 channels. This technology offers general applicability in neural interfaces, with great potential utility in treatment/diagnosis of neurological disorders.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Dual Structural Design of Platinum-Nickel Hydrogels for Wearable Glucose Biosensing with Ultrahigh Stability

Wearable glucose sensors are of great significance and highly required in mobile health monitoring and management but suffering from limited long-term stability and wearable adaptability. Here a simultaneous component and structure engineering strategy is presented, which involves Pt with abundant Ni to achieve three-dimensional, dual-structural Pt-Ni hydrogels with interconnected networks of PtNi nanowires and Ni(OH)₂ nanosheets, showing prominent electrocatalytic activity and stability in glucose oxidation under neutral condition. Specifically, the PtNi_(1:3) dual hydrogels shows 2.0 and 270.6 times' activity in the glucose electro-oxidation as much as the pure Pt and Ni hydrogels. Thanks to the high activity, structural stability, good flexibility, and self-healing property, the PtNi_(1:3) dual gel-based non-enzymatic glucose sensing chip is endowed with high performance. It features a high sensitivity, an excellent selectivity and flexibility, and particularly an outstanding long-term stability over 2 months. Together with a pH sensor and a wireless circuit, an accurate, real-time, and remote monitoring of sweat glucose is achieved. This facile design of novel dual-structural metallic hydrogels sheds light to rationally develop new functional materials for high-performance wearable biosensors.

Electronic textiles: New age of wearable technology for healthcare and fitness solutions

Sedentary lifestyles and evolving work environments have created challenges for global health and cause huge burdens on healthcare and fitness systems. Physical immobility and functional losses due to aging are two main reasons for noncommunicable disease mortality. Smart electronic textiles (e-textiles) have attracted considerable attention because of their potential uses in health monitoring, rehabilitation, and training assessment applications. Interactive textiles integrated with electronic devices and algorithms can be used to gather, process, and digitize data on human body motion in real time for purposes such as electrotherapy, improving blood circulation, and promoting wound healing. This review summarizes research advances on e-textiles designed for wearable healthcare and fitness systems. The significance of e-textiles, key applications, and future demand expectations are addressed in this review. Various health conditions and fitness problems and possible solutions involving the use of multifunctional interactive garments are discussed. A brief discussion of essential materials and basic procedures used to fabricate wearable e-textiles are included. Finally, the current challenges, possible solutions, opportunities, and future perspectives in the area of smart textiles are discussed.

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

A stretchable wireless wearable bioelectronic system for multiplexed monitoring and combination treatment of infected chronic wounds

Chronic nonhealing wounds are one of the major and rapidly growing clinical complications all over the world. Current therapies frequently require emergent surgical interventions, while abuse and misapplication of therapeutic drugs often lead to an increased morbidity and mortality rate. Here, we introduce a wearable bioelectronic system that wirelessly and continuously monitors the physiological conditions of the wound bed via a custom-developed multiplexed multimodal electrochemical biosensor array and performs noninvasive combination therapy through controlled anti-inflammatory antimicrobial treatment and electrically stimulated tissue regeneration. The wearable patch is fully biocompatible, mechanically flexible, stretchable, and can conformally adhere to the skin wound throughout the entire healing process. Real-time metabolic and inflammatory monitoring in a series of preclinical in vivo experiments showed high accuracy and electrochemical stability of the wearable patch for multiplexed spatial and temporal wound biomarker analysis. The combination therapy enabled substantially accelerated cutaneous chronic wound healing in a rodent model.

Press-N-Go On-Skin Sensor with High Interfacial Toughness for Continuous Healthcare Monitoring

On-skin electronic sensors are demanded for healthcare monitoring such as the continuous recording of biopotential and motion signals from patients. However, the mechanical mismatches and poor interface adhesion at the skin/sensor interfaces always cause high interfacial impedance and artifacts, frequent interfacial failure, and unexpected depletion of the device, which significantly limit the performance of the sensors. We here develop an on-skin sensor based on a conductive pressure-sensitive tape, which is assembled from supramolecular dual-cross-linked hydrogel composites. Both covalent and noncovalent cross-links in the hydrogel networks could harvest high flexibility, pressure-sensitive adhesion, and high interfacial toughness altogether, enabling a convenient "Press-N-Go" application of the sensor on human skin without additional pre/post-treatment on the skin or the senor. The high conformability and low resistivity of the tape can sustainably lower the interfacial impedance and thus improve signal quality in various measurement conditions. Our design provides a feasible path to develop interface-toughened on-skin electronics, which is desired in dynamic human-machine interfaces.

Device integration of electrochemical biosensors

Electrochemical biosensors incorporate a recognition element and an electronic transducer for the highly sensitive detection of analytes in body fluids. Importantly, they can provide rapid readouts and they can be integrated into portable, wearable and implantable devices for point-of-care diagnostics; for example, the personal glucose meter enables at-home assessment of blood glucose levels, greatly improving the management of diabetes. In this Review, we discuss the principles of electrochemical biosensing and the design of electrochemical biosensor devices for health monitoring and disease diagnostics, with a particular focus on device integration into wearable, portable and implantable systems. Finally, we outline the key engineering challenges that need to be addressed to improve sensing accuracy, enable multiplexing and one-step processes, and integrate electrochemical biosensing devices in digital health-care pathways.

Scalable and Degradable Dextrin-Based Elastomers for Wearable Touch Sensing

Elastomer-based wearables can improve people's lives; however, frictional wear caused by manipulation may pose significant concerns regarding their durability and sustainability. To address the aforementioned issue, a new class of advanced scalable supersoft elastic transparent material (ASSETm) is reported, which offers a unique combination of scalability (20 g scale), stretchability (up to 235%), and enzymatic degradability (up to 65% in 30 days). The key feature of our design is to render native dextrin hydrophobic, which turns it into a macroinitiator for bulk ring-opening polymerization. Based on ASSETm, a self-powered touch sensor (ASSETm-TS) for touch sensing and non-contact approaching detection, possessing excellent electrical potential (up to 65 V) and rapid response time (60 ms), is fabricated. This work is a step toward developing sustainable soft electronic systems, and ASSETm's tunability enables further improvement of electrical outputs, enhancing human-interactive applications.

Recent Progress in Piezoelectric-Triboelectric Effects Coupled Nanogenerators

Piezoelectric and triboelectric nanogenerators have been widely studied in the past years for their advantages of easy design/manufacturing, small size, and flexibility. Nanogenerators that are developed based on the coupled piezoelectric and triboelectric effects (PTCNG) can make full use of the mechanical energies and achieve both higher output and sensing performance. This review aims to cover the recent research progress of PTCNG by presenting in detail their key technologies in terms of operating principles, integration concept, and performance enhancement strategies, with a focus on their structural simplification and efficiency performance improvement. The latest applications of PTCNG in tactile sensors and energy-harvesting system are also illustrated. Finally, we discuss the main challenges and prospects for the future development of PTCNG, hoping that this work can provide a new insight into the development of all-in-one mechanical energy-scavenging and sensing devices.

Steroid hormone-inducible biosensor based on EGFP-tagged and environmental application

Steroid hormones as a class of emerging organic pollutant and high concern, due to their potential risks for human and environmental. Accurate analytical methods of steroid hormones are necessary in quantifying and monitoring. Biosensor is a promising technique. In this study, though part of 3α-HSD DNA to construct a regulatory plasmid and with the EGFP reporter gene to generate a reporter plasmid. Separately transformed into Escherichia coli strain BL21 and extracted the cell lysates as novel biosensor reagents. Analyzed the total amounts of steroid hormones in water, sediment, and soil samples using biosensor reagents, and compared these results with those obtained by HPLC. In summary, detection method using an EGFP reporter that can detect trace amounts of steroid hormones to reached fg/L. The optimal reaction time range and temperature were 30 min and 30 °C, respectively, while the most suitable organic solvent for the steroid hormone was 100% ethanol, up to 96-well plate format. This method is very suitable for high-throughput detection of environmental steroid hormone pollutants.

Ultrapermeable and Wet-Adhesive Monolayer Porous Film for Stretchable Epidermal Electrode

Noninvasive electrophysiological signal monitoring is significant for health care and scientific research. The simultaneous achievement of wet adhesion, stretchability, breathability, and low contact impedance is highly recommended in the epidermal electrode but still challenging. In this work, a monolayer porous film electrode with a pore size and wall thickness of less than ∼10 μm is fabricated via the breath figure method (BFM) and metal sputtering, and it was subsequently applied using epidermal electrophysiological monitoring. The ultrahigh permeability is comparable to the naked skin because the through holes of the monolayer porous film match well with the pores on human skin. The stretchability of 50% is realized with the combination of Au microcrack and the monolayer porous structure. The wet adhesion of 0.17 N/cm is established on the chemical bonding between the electrode and the epidermis. The contact impedance is comparable with the gold standard Ag/AgCl gel electrode, especially after sweating. Stable and precise electrophysiological signals are measured. Especially, the perspiration resistance of the monolayer porous film outperforms that of the gel electrode. The monolayer porous structure provides a new avenue to improve the breathability of the epidermal electronics.