Simple Approach to High-Performance Stretchable Heaters Based on Kirigami Patterning of Conductive Paper for Wearable Thermotherapy Applications

Stretchable multifunctional wearable system for real-time and on-demand thermotherapy of arthritis

Thermotherapy is a conventional and effective physiotherapy for arthritis. However, the current thermotherapy devices are often bulky and lack real-time temperature feedback and self-adjustment functions. Here, we developed a multifunctional wearable system for real-time thermotherapy of arthritic joints based on a multilayered flexible electronic device consisting of homomorphic hollow thin-film sensors and heater. The kirigami-serpentine thin-film sensors provide stretchability and rapid response to changes in environmental temperature and humidity, and the homomorphic design offers easy de-coupling of dual-modal sensing signals. Based on a closed-loop control, the thin-film Joule heater exhibits rapid and stable temperature regulation capability, with thermal response time < 1 s and maximum deviation < 0.4 °C at 45 °C. Based on the multifunctional wearable system, we developed a series of user-friendly gears and demonstrated programmable on-demand thermotherapy, real-time personal thermal management, thermal dehumidification, and relief of the pain via increasing blood perfusion. Our innovation offers a promising solution for arthritis management and has the potential to benefit the well-being of thousands of patients.

DNA-RNA hybrids in inflammation: sources, immune response, and therapeutic implications

Cytoplasmic DNA-RNA hybrids are emerging as important immunogenic nucleic acids, that were previously underappreciated. DNA-RNA hybrids, formed during cellular processes like transcription and replication, or by exogenous pathogens, are recognized by pattern recognition receptors (PRRs), including cGAS, DDX41, and TLR9, which trigger immune responses. Post-translational modifications (PTMs) including ubiquitination, phosphorylation, acetylation, and palmitoylation regulate the activity of PRRs and downstream signaling molecules, fine-tuning the immune response. Targeting enzymes involved in DNA-RNA hybrid metabolism and PTMs regulation offers therapeutic potential for inflammatory diseases. Herein, we discuss the sources, immune response, and therapeutic implications of DNA-RNA hybrids in inflammation, highlighting the significance of DNA-RNA hybrids as potential targets for the treatment of inflammation.

Recent Advances in Wearable Thermal Devices for Virtual and Augmented Reality

Thermal technologies that effectively deliver thermal stimulation through skin-integrated systems and enable temperature perception via the activation of cutaneous thermoreceptors are key to enhancing immersive experiences in virtual and augmented reality (VR/AR) through multisensory engagement. However, recent advancements and commercial adoption have predominantly focused on haptic rather than thermal technology. This review provides an overview of recent advancements in wearable thermal devices (WTDs) designed to reconstruct artificial thermal sensations for VR/AR applications. It examines key thermal stimulation parameters, including stimulation area, magnitude, and duration, with a focus on thermal perception mechanisms and thermoreceptor distribution in the skin. Input power requirements for surpassing thermal perception thresholds are discussed based on analytical modeling. Material choices for WTDs, including metal nanowires, carbon nanotubes, liquid metals, thermoelectric devices, and passive cooling elements, are introduced. The functionalities, device designs, operation modes, fabrication processes, and electrical and mechanical properties of various WTDs are analyzed. Representative applications illustrate how flexible, thin WTDs enable immersive VR/AR experiences through spatiotemporal, programmable stimulation. A concluding section summarizes key challenges and future opportunities in advancing skin-integrated VR/AR systems.

High-Resolution Stretchable Soft Liquid Metal Circuits Based on Cu-Ga Alloying and Femtosecond Laser Ablation

Flexible electronic circuits are critical in biomedical devices, human-machine interfaces, and wearable sensing systems, which further require flexible conductive materials with high conductivity, stretchability, and electrical stability. Liquid metal (LM) has attracted much attention due to its unique metallic conductivity and room-temperature fluidic properties. However, LM's high surface tension properties increase the difficulty of patterning processing. Here, we report a scalable and simple fabrication method based on femtosecond laser ablation for the facile fabrication of patterned LM and Cu composite electrodes (LM@Cu) on flexible substrates. The LM@Cu electrodes, fabricated utilizing the exceptional micro-nanoprocessing precision and three-dimensional fabrication capabilities of femtosecond lasers, exhibit high resolution (approximately 5 μm), superior electrical conductivity (4.08 × 104 S/cm), and enhanced stability. In addition to planar circuits, we successfully fabricated 3D-patterned LM@Cu electrode circuits on PDMS hemispheres. The presence of ultrathin copper foils significantly improves the wettability of LM on the substrate, and the occurrence of alloying reactions between LM and Cu circumvents the challenges posed by the high surface tension of LM in pattern fabrication. We further investigated the electromechanical properties of the patterned LM@Cu electrodes under twisting, bending, and stretching in detail. In addition, the LM@Cu electrodes serve as an interface between rigid electronic devices and flexible substrates. When suffering external damage, LM@Cu electrodes remain working after simple brush coating due to the excellent fluidity of LM. To explore this fabrication approach's potential, we demonstrate various applications in wearable electronics, including stretchable luminous wristbands, flexible wearable strain sensors, and "visible" thermotherapy panels for relieving aching joints.

Materials, Structure, and Interface of Stretchable Interconnects for Wearable Bioelectronics

Since wearable technologies for telemedicine have emerged to tackle global health concerns, the demand for well-attested wearable healthcare devices with high user comfort also arises. Skin-wearables for health monitoring require mechanical flexibility and stretchability for not only high compatibility with the skin's dynamic nature but also a robust collection of fine health signals from within. Stretchable electrical interconnects, which determine the device's overall integrity, are one of the fundamental units being understated in wearable bioelectronics. In this review, a broad class of materials and engineering methodologies recently researched and developed are presented, and their respective attributes, limitations, and opportunities in designing stretchable interconnects for wearable bioelectronics are offered. Specifically, the electrical and mechanical characteristics of various materials (metals, polymers, carbons, and their composites) are highlighted, along with their compatibility with diverse geometric configurations. Detailed insights into fabrication techniques that are compatible with soft substrates are also provided. Importantly, successful examples of establishing reliable interfacial connections between soft and rigid elements using novel interconnects are reviewed. Lastly, some perspectives and prospects of remaining research challenges and potential pathways for practical utilization of interconnects in wearables are laid out.

Evolution of Musculoskeletal Electronics

The musculoskeletal system, constituting the largest human physiological system, plays a critical role in providing structural support to the body, facilitating intricate movements, and safeguarding internal organs. By virtue of advancements in revolutionized materials and devices, particularly in the realms of motion capture, health monitoring, and postoperative rehabilitation, "musculoskeletal electronics" has actually emerged as an infancy area, but has not yet been explicitly proposed. In this review, the concept of musculoskeletal electronics is elucidated, and the evolution history, representative progress, and key strategies of the involved materials and state-of-the-art devices are summarized. Therefore, the fundamentals of musculoskeletal electronics and key functionality categories are introduced. Subsequently, recent advances in musculoskeletal electronics are presented from the perspectives of "in vitro" to "in vivo" signal detection, interactive modulation, and therapeutic interventions for healing and recovery. Additionally, nine strategy avenues for the development of advanced musculoskeletal electronic materials and devices are proposed. Finally, concise summaries and perspectives are proposed to highlight the directions that deserve focused attention in this booming field.

Recent Research on Preparation and Application of Smart Joule Heating Fabrics

Multifunctional wearable heaters have attracted much attention for their effective applications in personal thermal management and medical therapy. Compared to passive heating, Joule heating offers significant advantages in terms of reusability, reliable temperature control, and versatile coupling. Joule-heated fabrics make wearable electronics smarter. This review critically discusses recent advances in Joule-heated smart fabrics, focusing on various fabrication strategies based on material-structure synergy. Specifically, various applicable conductive materials with Joule heating effect are first summarized. Subsequently, different preparation methods for Joule heating fabrics are compared, and then their various applications in smart clothing, healthcare, and visual indication are discussed. Finally, the challenges faced in developing these smart Joule heating fabrics and their possible solutions are discussed.

Kirigami-enabled stretchable laser-induced graphene heaters for wearable thermotherapy

Flexible and stretchable heaters are increasingly recognized for their great potential in wearable thermotherapy to treat muscle spasms, joint injuries and arthritis. However, issues like lengthy processing, high fabrication cost, and toxic chemical involvement are obstacles on the way to popularize stretchable heaters for medical use. Herein, using a single-step customizable laser fabrication method, we put forward the design of cost-effective wearable laser-induced graphene (LIG) heaters with kirigami patterns, which offer multimodal stretchability and conformal fit to the skin around the human body. First, we develop the manufacturing process of the LIG heaters with three different kirigami patterns enabling reliable stretchability by out-of-plane buckling. Then, by adjusting the laser parameters, we confirm that the LIG produced by medium laser power could maintain a balance between mechanical strength and electrical conductivity. By optimizing cutting-spacing ratios through experimental measurements of stress, resistance and temperature profiles, as well as finite element analysis (FEA), we determine that a larger cutting-spacing ratio within the machining precision will lead to better mechanical, electrical and heating performance. The optimized stretchable heater in this paper could bear significant unidirectional strain over 100% or multidirectional strain over 20% without major loss in conductivity and heating performance. On-body tests and fatigue tests also proved great robustness in practical scenarios. With the advantage of safe usage, simple and customizable fabrication, easy bonding with skin, and multidirectional stretchability, the on-skin heaters are promising to substitute the traditional heating packs/wraps for thermotherapy.

Wireless Battery-free and Fully Implantable Organ Interfaces

Advances in soft materials, miniaturized electronics, sensors, stimulators, radios, and battery-free power supplies are resulting in a new generation of fully implantable organ interfaces that leverage volumetric reduction and soft mechanics by eliminating electrochemical power storage. This device class offers the ability to provide high-fidelity readouts of physiological processes, enables stimulation, and allows control over organs to realize new therapeutic and diagnostic paradigms. Driven by seamless integration with connected infrastructure, these devices enable personalized digital medicine. Key to advances are carefully designed material, electrophysical, electrochemical, and electromagnetic systems that form implantables with mechanical properties closely matched to the target organ to deliver functionality that supports high-fidelity sensors and stimulators. The elimination of electrochemical power supplies enables control over device operation, anywhere from acute, to lifetimes matching the target subject with physical dimensions that supports imperceptible operation. This review provides a comprehensive overview of the basic building blocks of battery-free organ interfaces and related topics such as implantation, delivery, sterilization, and user acceptance. State of the art examples categorized by organ system and an outlook of interconnection and advanced strategies for computation leveraging the consistent power influx to elevate functionality of this device class over current battery-powered strategies is highlighted.

Stretchable Electronics with Strain-Resistive Performance

Stretchable electronics have attracted tremendous attention amongst academic and industrial communities due to their prospective applications in personal healthcare, human-activity monitoring, artificial skins, wearable displays, human-machine interfaces, etc. Other than mechanical robustness, stable performances under complex strains in these devices that are not for strain sensing are equally important for practical applications. Here, a comprehensive summarization of recent advances in stretchable electronics with strain-resistive performance is presented. First, detailed overviews of intrinsically strain-resistive stretchable materials, including conductors, semiconductors, and insulators, are given. Then, systematic representations of advanced structures, including helical, serpentine, meshy, wrinkled, and kirigami-based structures, for strain-resistive performance are summarized. Next, stretchable arrays and circuits with strain-resistive performance, that integrate multiple functionalities and enable complex behaviors, are introduced. This review presents a detailed overview of recent progress in stretchable electronics with strain-resistive performances and provides a guideline for the future development of stretchable electronics.

Injection Molding of Liquid Metal by Harnessing Nonstick Molds

The fluid nature of liquid metals combined with their ability to form a solid native oxide skin enables them to be patterned in ways that would be challenging for solid metals. The present work shows a unique way of patterning liquid metals by injecting liquid metals into a mold. The mold contains a nonstick coating that enables the removal of the mold, thereby leaving just the liquid metal on the target substrate. This approach offers the simplicity and structural control of molding but without having the mold become part of the device. Thus, the metal can be encapsulated with very soft polymers that collapse if used as microchannels. The same mold can be used multiple times for high-volume patterning of liquid metal. The injection molding method is rapid and reliably produces structures with complex geometries on both flat and curved surfaces. We demonstrate the method by fabricating an elastomeric Joule heater and an electroadhesive soft gripper to show the potential of the method for soft and stretchable devices.

Materials-Driven Soft Wearable Bioelectronics for Connected Healthcare

In the era of Internet-of-things, many things can stay connected; however, biological systems, including those necessary for human health, remain unable to stay connected to the global Internet due to the lack of soft conformal biosensors. The fundamental challenge lies in the fact that electronics and biology are distinct and incompatible, as they are based on different materials via different functioning principles. In particular, the human body is soft and curvilinear, yet electronics are typically rigid and planar. Recent advances in materials and materials design have generated tremendous opportunities to design soft wearable bioelectronics, which may bridge the gap, enabling the ultimate dream of connected healthcare for anyone, anytime, and anywhere. We begin with a review of the historical development of healthcare, indicating the significant trend of connected healthcare. This is followed by the focal point of discussion about new materials and materials design, particularly low-dimensional nanomaterials. We summarize material types and their attributes for designing soft bioelectronic sensors; we also cover their synthesis and fabrication methods, including top-down, bottom-up, and their combined approaches. Next, we discuss the wearable energy challenges and progress made to date. In addition to front-end wearable devices, we also describe back-end machine learning algorithms, artificial intelligence, telecommunication, and software. Afterward, we describe the integration of soft wearable bioelectronic systems which have been applied in various testbeds in real-world settings, including laboratories that are preclinical and clinical environments. Finally, we narrate the remaining challenges and opportunities in conjunction with our perspectives.

A thin-film polymer heating element with a continuous silver nanowires network embedded inside

This study presents a method for fabricating a film-based heating element using a polymer material with an array of intersecting conductive elements embedded within it. Track-etched membranes (TM) with a thickness of 10μm were used as the template, and their pores were filled with metal, forming a three-dimensional grid. Due to the unique manufacturing process of TM, the pores inside intersect with each other, allowing for contacts between individual nanowires (NWs) when filled with metal. Experimental results demonstrated that filling the TM pores with silver allows for heating temperatures up to 78 degrees without deformation or damage to the heating element. The resulting flexible heating element can be utilized in medical devices for heating purposes or as a thermal barrier coating.

Facile filter cloth brush-coating of large-area uniform silver nanowire conductive films for paper-based heater

Filter cloth brush-coating (FCBC), using soft filter cloth as a brush-coating medium, in conjunction with viscous silver nanowire (AgNW) conductive solution, is used to prepare AgNW conductive films. The density and uniformity of AgNWs deposited on the substrate are controlled by the interplay between the filter cloth aperture, the conductive solution viscosity, and the brush-coating speed. Further, with appropriate AgNW concentration and flow rate, uniform AgNW transparent conductive film with sheet resistance of 18 Ω sq-1and transmittance of 94% at 550 nm is acquired by FCBC. Due to the precise control of the coating process in FCBC, large-area uniform AgNW conductive film fabricated on printing paper has a low non-uniformity factor of 1.2% at a sheet resistance of 19.0 Ω sq-1. The resultant paper-based AgNW film heater shows sensitive and stable heating performance. FCBC shows great potential in producing large-area uniform AgNW films on various substrates.

A kirigami-enabled electrochromic wearable variable-emittance device for energy-efficient adaptive personal thermoregulation

For centuries, people have put effort to improve the thermal performance of clothing to adapt to varying temperatures. However, most clothing we wear today only offers a single-mode insulation. The adoption of active thermal management devices, such as resistive heaters, Peltier coolers, and water recirculation, is limited by their excessive energy consumption and form factor for long-term, continuous, and personalized thermal comfort. In this paper, we developed a wearable variable-emittance (WeaVE) device, enabling the tunable radiative heat transfer coefficient to fill the missing gap between thermoregulation energy efficiency and controllability. WeaVE is an electrically driven, kirigami-enabled electrochromic thin-film device that can effectively tune the midinfrared thermal radiation heat loss of the human body. The kirigami design provides stretchability and conformal deformation under various modes and exhibits excellent mechanical stability after 1,000 cycles. The electronic control enables programmable personalized thermoregulation. With less than 5.58 mJ/cm2 energy input per switching, WeaVE provides 4.9°C expansion of the thermal comfort zone, which is equivalent to a continuous power input of 33.9 W/m2. This nonvolatile characteristic substantially decreases the required energy while maintaining the on-demand controllability, thereby providing vast opportunities for the next generation of smart personal thermal managing fabrics and wearable technologies.

Advanced thermal sensing techniques for characterizing the physical properties of skin

Measurements of the thermal properties of the skin can serve as the basis for a noninvasive, quantitative characterization of dermatological health and physiological status. Applications range from the detection of subtle spatiotemporal changes in skin temperature associated with thermoregulatory processes, to the evaluation of depth-dependent compositional properties and hydration levels, to the assessment of various features of microvascular/macrovascular blood flow. Examples of recent advances for performing such measurements include thin, skin-interfaced systems that enable continuous, real-time monitoring of the intrinsic thermal properties of the skin beyond its superficial layers, with a path to reliable, inexpensive instruments that offer potential for widespread use as diagnostic tools in clinical settings or in the home. This paper reviews the foundational aspects of the latest thermal sensing techniques with applicability to the skin, summarizes the various devices that exploit these concepts, and provides an overview of specific areas of application in the context of skin health. A concluding section presents an outlook on the challenges and prospects for research in this field.

Engineering by Cuts: How Kirigami Principle Enables Unique Mechanical Properties and Functionalities

Kirigami, the ancient art of paper cutting, has evolved into a design and fabrication framework to engineer multi-functional materials and structures at vastly different scales. By slit cutting with carefully designed geometries, desirable mechanical behaviors-such as accurate shape morphing, tunable auxetics, super-stretchability, buckling, and multistability-can be imparted to otherwise inflexible sheet materials. In addition, the kirigami sheet provides a versatile platform for embedding different electronic and responsive components, opening up avenues for building the next generations of metamaterials, sensors, and soft robotics. These promising potentials of kirigami-based engineering have inspired vigorous research activities over the past few years, generating many academic publications. Therefore, this review aims to provide insights into the recent advance in this vibrant field. In particular, this paper offers the first comprehensive survey of unique mechanical properties induced by kirigami cutting, their underlying physical principles, and their corresponding applications. The synergies between design methodologies, mechanics modeling, advanced fabrication, and material science will continue to mature this promising discipline.

An Analytic Model of Transient Heat Conduction for Bi-Layered Flexible Electronic Heaters by Symplectic Superposition

In a flexible electronic heater (FEH), periodic metal wires are often encapsulated into the soft elastic substrate as heat sources. It is of great significance to develop analytic models on transient heat conduction of such an FEH in order to provide a rapid analysis and preliminary designs based on a rapid parameter analysis. In this study, an analytic model of transient heat conduction for bi-layered FEHs is proposed, which is solved by a novel symplectic superposition method (SSM). In the Laplace transform domain, the Hamiltonian system-based governing equation for transient heat conduction is introduced, and the mathematical techniques incorporating the separation of variables and symplectic eigen expansion are manipulated to yield the temperature solutions of two subproblems, which is followed by superposition for the temperature solution of the general problem. The Laplace inversion gives the eventual temperature solution in the time domain. Comprehensive time-dependent temperatures by the SSM are presented in tables and figures for benchmark use, which agree well with their counterparts by the finite element method. A parameter analysis on the influence of the thermal conductivity ratio is also studied. The exceptional merit of the SSM is on a direct rigorous derivation without any assumption/predetermination of solution forms, and thus, the method may be extended to more heat conduction problems of FEHs with more complex structures.

The Joule Heating Effect of a Foldable and Cuttable Sheet Made of SWCNT/ANF Composite

A foldable and cuttable sheet heater was fabricated using single-walled carbon nanotubes (SWCNTs) and aramid nanofibers (ANFs). SWCNTs are particularly well suited for Joule heating based on their high thermal stability, electrical properties, high current density, and aspect ratio. When the SWCNT/ANF composite reaches a high temperature during Joule heating, ANFs will endure this temperature due to their impressive thermal stability, derived from aramid fibers. With the aim of achieving a synergistic effect between the SWCNTs and ANFs, 0-100 wt% SWCNT/ANF composite sheets were fabricated by tip-type sonication and vacuum filtration. After assessing the thermal stability and electrical properties of the composite sheets, the Joule heating effect was analyzed. TGA showed that our sheet had high thermal stability in an air condition up to around 500 °C. The electrical conductivity of the composite sheet was improved as the amount of SWCNT added rose to 790.0 and 747.5 S/cm in the 75 and 100_SWCNTs/ANF, respectively. The maximum heating temperature, up to 280 °C, reached by Joule heating was measured as a function of SWCNT content and input voltage, and the relationship among SWCNT content, input voltage, heating temperature, and electric power was described. Mechanical properties were also measured in a temperature range similar to the heating temperature of 300 °C reached by Joule heating. Ultimately, we obtained a foldable and cuttable composite sheet with a stretchable structure, capable of being molded into a variety of shapes. This energy-efficient material can potentially be employed in any device in which a heater is required to deliver high temperatures.

Wireless interfaces for brain neurotechnologies

Wireless interfaces enable brain-implanted devices to remotely interact with the external world. They are critical components in modern research and clinical neurotechnologies and play a central role in determining their overall size, lifetime and functionality. Wireless interfaces use a wide range of modalities-including radio-frequency fields, acoustic waves and light-to transfer energy and data to and from an implanted device. These forms of energy interact with living tissue through distinct mechanisms and therefore lead to systems with vastly different form factors, operating characteristics, and safety considerations. This paper reviews recent advances in the development of wireless interfaces for brain neurotechnologies. We summarize the requirements that state-of-the-art brain-implanted devices impose on the wireless interface, and discuss the working principles and applications of wireless interfaces based on each modality. We also investigate challenges associated with wireless brain neurotechnologies and discuss emerging solutions permitted by recent developments in electrical engineering and materials science. This article is part of the theme issue 'Advanced neurotechnologies: translating innovation for health and well-being'.

Thermal Management of Serpentine Flexible Heater Based on the Orthotropic Heat Conduction Model

Flexible heaters can perfectly fit with undevelopable surfaces for heating in many practical applications such as thermotherapy, defogging/deicing systems and warming garments. Considering the requirement for stretchability in a flexible heater, certain spacing needs to be retained between serpentine heat sources for deformation which will inevitably bring critical challenges to the thermal uniformity. In order to reconcile these two conflicting aspects, a novel method is proposed by embedding the serpentine heat source in orthotropic layers to achieve comprehensive performance in stretchability and uniform heating. Such a scheme takes advantage of the ability of orthotropic material to control the heat flow distribution via orthotropic thermal conductivity. In this paper, an analytical heat conduction model with orthotropic substrate and encapsulation is calculated using Fourier cosine transform, which is validated by finite element analysis (FEA). Meanwhile, the effects of the orthotropic substrate or encapsulation with different ratios of thermal conductivity and the geometric spacing on the thermal properties are investigated, which can help guide the design and fabrication of flexible heaters to achieve the goal of uniform heating.

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

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

A Biaxially Stretchable and Self-Sensing Textile Heater Using Silver Nanowire Composite

Wearable heaters have garnered significant attention from academia and industry for their great potential in thermotherapy. Silver nanowire (AgNW) is a promising conductive material for flexible and stretchable electrodes. Here, a resistive, biaxially stretchable heater based on AgNW composite is reported for the first time, where a AgNW percolation network is encased in a thin polyimide (PI) film and integrated with a highly stretchable textile. AgNW/PI is patterned with a 2D Kirigami structure, which enables constant resistance under a large tensile strain (up to uniaxial 100% strain and 50% biaxial strain). The heater can achieve a high temperature of ∼140 °C with a low current of 0.125 A, fast heating and cooling rates of ∼16.5 and ∼14.1 °C s^-1, respectively, and stable performance over 400 heating cycles. A feedback control system is developed to provide constant heating temperature under a temperature change of the surrounding environment. Demonstrated applications in applying thermotherapy at the curvilinear surface of the knee using the stretchable heater illustrate its promising potential for wearable applications.

Simple and cost-effective microfabrication of flexible and stretchable electronics for wearable multi-functional electrophysiological monitoring

The fabrication of flexible and stretchable electronics is a critical requirement for the successful application of wearable healthcare devices. Although such flexible electronics have been commonly fabricated by microelectromechanical system (MEMS) technologies, they require a specialised equipment for vacuum deposition, photolithography, and wet and dry etching. A photolithography-free simple patterning method using a desktop plotter cutter has been proposed; however, the metal formation and electrode opening still rely on the MEMS technology. To address this issue, we demonstrate a simple, rapid, cost-effective, and a complete microfabrication process for flexible and stretchable sensor platforms encompassing conductor formation and patterning to encapsulate and open sensing windows, which only require an economic plotter cutter and readily available supplies. Despite its simplicity, the proposed process could stably create microscale features of 200 μm wide conductor lines and 1 mm window openings, which are in the useful range for various wearable applications. The feasibility of the simple fabrication of multi-functional sensors for various physiological monitoring applications was successfully demonstrated in electrochemical (glucose), electrical (electrocardiogram), mechanical (strain), and thermal (body temperature) modalities.

Wearable and Implantable Soft Bioelectronics: Device Designs and Material Strategies

High-performance wearable and implantable devices capable of recording physiological signals and delivering appropriate therapeutics in real time are playing a pivotal role in revolutionizing personalized healthcare. However, the mechanical and biochemical mismatches between rigid, inorganic devices and soft, organic human tissues cause significant trouble, including skin irritation, tissue damage, compromised signal-to-noise ratios, and limited service time. As a result, profuse research efforts have been devoted to overcoming these issues by using flexible and stretchable device designs and soft materials. Here, we summarize recent representative research and technological advances for soft bioelectronics, including conformable and stretchable device designs, various types of soft electronic materials, and surface coating and treatment methods. We also highlight applications of these strategies to emerging soft wearable and implantable devices. We conclude with some current limitations and offer future prospects of this booming field.

Recent advances in printed flexible heaters for portable and wearable thermal management

Flexible resistive heaters (FRHs) with high heating performance, large-area thermal homogeneity, and excellent thermal stability are very desirable in modern life, owing to their tremendous potential for portable and wearable thermal management applications, such as body thermotherapy, on-demand drug delivery, and artificial intelligence. Printed electronic (PE) technologies, as emerging methods combining conventional printing techniques with solution-processable functional ink have been proposed to be promising strategies for the cost-effective, large-scale, and high-throughput fabrication of printed FRHs. This review summarizes recent progress in the main components of FRHs, including conductive materials and flexible or stretchable substrates, focusing on the formulation of conductive ink systems for making printed FRHs by a variety of PE technologies including screen printing, inkjet printing, roll-to-roll (R2R) printing and three-dimensional (3D) printing. Various challenges facing the commercialization of printed FRHs and improved methods for portable and wearable thermal management applications have been discussed in detail to overcome these problems.

High-Performance Laminated Fabric with Enhanced Photothermal Conversion and Joule Heating Effect for Personal Thermal Management

Multifunctional wearable heaters have attracted much attention owing to their efficient application in personal thermal management. Inspired by the polar bear's thermal management, a laminated fabric with enhanced photothermal conversion, mid-infrared reflection, thermal insulation, and electrical heating performance was developed in this work, which was made of CNT/cellulose aerogel layers, cotton fabrics, and copper nanowire (CuNW)-based conductive network (CNN) layers. The CNN layer made up of highly conductive CuNWs not only exhibits better conductivity to realize the Joule heating effect but also possesses a human mid-infrared reflection property. Moreover, the other side of the cotton fabric was laminated with CNT/cellulose aerogel, which enables the fabric to have a good photothermal conversion ability and thermal insulation performance. The temperature of the laminated fabric could reach to 70 °C within 80 s under 1.8 V; it requires more than 500 s to return to room temperature (28.7 °C). When the light intensity was adjusted to 1000 W/m², the temperature of the laminated fabric was about 74.0 °C after lighting for 280 s. Our work provides a new approach to improving the performance and energy-saving of personal thermal management fabrics.

Highly stretchable large area woven, knitted and robust braided textile based interconnection for stretchable electronics

With the rapid development of stretchable and wearable technologies, stretchable interconnection technology also demanded along it. Stretchable interconnections should have high stretchability and stable conductivity for use as an electrode. In addition, to develop to commercialization scale from research scale, a simple fabrication process that can be scaled up, and the stretchable interconnection should be able to be electrically connected to devices or modules directly. To date, printable conductor inks, liquid metals and stretchable structured interconnections have been reported for stretchable interconnections. These approaches have demonstrated high stretchability and conductivity, but in aspect of scale, it is appropriate to apply in micro-scale devices. For requirements of stretchability, conductivity and direct integration into meso- or centimeter-scale electronic devices or modules, here we introduce stretchable interconnections with a textile structure composed of metal fibers. The stretchable woven and knitted textiles show 67% strain and stable conductivity, and the cylindrical textile shows more than 700% strain with high strength. The stretchable textiles were fabricated using a weaving, knitting and braiding machine that can be used to produce textiles without any limit to length or area. These textiles exhibit high and stable conductivity even under deformation, and can be directly integrated into devices or modules by soldering. These high-performance stretchable textiles have great potential for commercial applications.

Design of a Kirigami Structure with a Large Uniform Deformation Region

We designed a kirigami structure with a particular shape at both ends to provide a large uniform deformation region when stretched. When a kirigami structure is stretched, non-deformation regions, where the regions' cuts do not open, and non-uniform deformation regions, where the regions' cuts are not uniformly deformed, are produced. The extent of the non-deformation and non-uniform deformation regions increases in proportion to the number of cut cycles in the width direction n _w this reduces the percentage of the uniform deformation region. We propose a method that increases the uniform deformation region in a kirigami structure by deforming the shape of the ends from a rectangle to a trapezoid when stretched. The proposed kirigami structure has separation lines at both ends that separate cuts in the width direction, and the position of contacts at both ends are moved to the center. The proposed kirigami structure has a large uniform deformation region, even when n _w is large, as evidenced by calculating the area of open cuts under stretching. The product of our study realizes a stretchable electro device with a large area, which maintains the position of evenly mounted functional elements when stretched.

Rapid and economic preparation of wearable thermotherapy pad based on simple cut-patterning of metal foil supported by plastic sheets

Stretchable and skin-mountable heaters have found application in the emerging industry of wearable thermotherapy devices. However, despite their excellent heating performances, most of them commonly suffer from complex, time-consuming, costly, or insufficiently reproducible fabrication processes. In this study, we report a simple, economic, and reproducible strategy to fabricate high-performance stretchable heaters based on facile cut-patterning of plastic sheet/metal foil/plastic sheet (PMP) structures. Further, this method can be executed without expensive materials or cumbersome material synthesis. The fabricated PMP heater is confirmed to exhibit excellent and uniform heating performance at a low voltage and satisfactory electrothermal stability even under high strain and repeated loads. Additionally, the proposed heater designs can be easily customized by simply changing the computer-aided design drawings during the cutting process, which also enables fabrication of devices with large area. The fabricated PMP heater is confirmed to be able to maintain conformal contact with target surfaces even under stretched conditions, inducing a fairly uniform temperature distribution. Finally, it is successfully demonstrated that a PMP heating band can be easily worn on the wrist and is capable of transferring enough heat to increase blood perfusion in the heated area even at a low voltage, highlighting its potential in wearable thermotherapy.

A simple, economic, and reproducible fabrication route to high-performance stretchable heaters is proposed towards wearable thermotherapy.

Stretchable gas sensors for detecting biomarkers from humans and exposed environments

The recent advent of stretchable gas sensors demonstrates their capabilities to detect not only gaseous biomarkers from the human body but also toxic gas species from the exposed environment. To ensure accurate gas detection without device breakdown from the mechanical deformations, the stretchable gas sensors often rely on the direct integration of gas-sensitive nanomaterials on the stretchable substrate or fibrous network, as well as being configured into stretchable structures. The nanomaterials in the forms of nanoparticles, nanowires, or thin-films with nanometer thickness are explored for a variety of sensing materials. The commonly used stretchable structures in the stretchable gas sensors include wrinkled structures from a pre-strain strategy, island-bridge layouts or serpentine interconnects, strain isolation approaches, and their combinations. This review aims to summarize the recent advancement in novel nanomaterials, sensor design innovations, and new fabrication approaches of stretchable gas sensors.

Mechanically Cloaked Multiphase Magnetic Elastomer Soft Composites for Wearable Wireless Power Transfer

Wearable electronics allow for new and immersive experiences between technology and the human body, but conventional devices are made from rigid functional components that lack the necessary compliance to safely interact with human tissue. Recently, liquid inclusions have been incorporated into elastomer composites to produce functional materials with high extensibility and ultrasoft mechanical responses. While these materials have shown high thermal and electrical conductivity, there has been an absence of research into compliant magnetic materials through the incorporation of magnetic fluids. Compliant magnetic materials are important for applications in soft matter engineering including sensing, actuation, and power transfer for soft electronics and robotics. In this work, we establish a new class of highly functional soft materials with advanced magnetic and mechanical properties by dispersing magnetic colloidal suspensions as compliant fluid inclusions into soft elastomers. Significantly, the rigid magnetic particles are encapsulated by the fluid. This mechanically cloaks the solid particles and enables a fluid-like mechanical response while imparting high magnetic permeability to the composite. This microstructure reduces the modulus of the composite below that of the initial elastomer to <40 kPa while increasing the permeability by over 100% to greater than 2. We demonstrate the functionality of these materials through conformable magnetic backplanes, which enables a completely soft, coupled inductor system capable of transferring power up to 100% strain and wearable devices for wireless power transfer.

M13 Bacteriophage-Assisted Morphological Engineering of Crack-Based Sensors for Highly Sensitive and Wide Linear Range Strain Sensing

Despite their extraordinary mechanosensitivities, most channel-like crack-based strain sensors are limited by their poor levels of stretchability and linearity. This work presents a simple yet efficient way of modulating the cracking structure of thin metal films on elastomers to facilitate the development of high-performance wearable strain sensors. A net-shaped crack structure based on a thin platinum (Pt) film can be produced by coating an elastomer surface with M13 bacteriophages (phages) and consequently engineering the surface strain upon stretching. This process produces a Pt-on-phage (PoP) strain sensor that simultaneously exhibits high levels of stretchability (24%), sensitivity (maximum gauge factor ≈ 845.6 for 20-24%), and linearity (R² ≈ 0.988 up to 20%). In addition, the sensor performance can be further modulated by either changing the phage coating volume or adding a silver nanowire coating to the PoP sensor film. The balanced strain-sensing performance, combined with fast response times and high levels of mechanical flexibility and operational stability, enables the devices to detect a wide range of human motions in real time after being attached to various body parts. Furthermore, PoP-based strain sensors can be usefully extended to detect more complex multidimensional strains through further strain engineering on a cross-patterned PoP film.

Flexible MXene/Silver Nanowire-Based Transparent Conductive Film with Electromagnetic Interference Shielding and Electro-Photo-Thermal Performance

Transparent conductive film (TCF) is promising for optoelectronic instrument applications. However, designing a robust, stable, and flexible TCF that can shield electromagnetic waves and work in harsh conditions remains a challenge. Herein, a multifunctional and flexible TCF with effective electromagnetic interference shielding (EMI) performance and outstanding electro-photo-thermal effect is proposed by orderly coating Ti₃C₂T_x MXene and a silver nanowire (AgNW) hybrid conductive network using a simple and scalable solution-processed method. Typically, the air-plasma-treated polycarbonate (PC) film was sequentially spray-coated with MXene and AgNW to construct a highly conductive network, which was transferred and partly embedded into an ultrathin poly(vinyl alcohol) (PVA) film using spin coating coupled with hot pressing to enhance the interfacial adhesion. The peeled MXene/AgNW-PVA TCF exhibits an optimal optical and electrical performance of sheet resistance 18.3 Ω/sq and transmittance 52.3%. As a consequence, the TCF reveals an effective EMI shielding efficiency of 32 dB in X-band with strong interfacial adhesion and satisfactory flexibility. Moreover, the high electrical conductivity and localized surface plasmon resonance (LSPR) effect of hybrid conductive network endow the TCF with low-voltage-driven Joule heating performance and excellent photothermal effect, respectively, which can ensure the normal functioning under extreme cold condition. In view of the comprehensive performance, this work offers new solutions for next-generation transparent EMI shielding challenges.

Fundamentals of soft thermofluidic system design

The soft composition of many natural thermofluidic systems allows them to effectively move heat and control its transfer rate by dynamically changing shape (e.g. dilation or constriction of capillaries near our skin). So far, making analogous deformable "soft thermofluidic systems" has been limited by the low thermal conductivity of materials with suitable mechanical properties. By remaining soft and stretchable despite the addition of filler, elastomer composites with thermal conductivity enhanced by liquid-metal micro-droplets provide an ideal material for this application. In this work, we use these materials to develop an elementary thermofluidic system consisting of a soft, heat generating pipe that is internally cooled with flow of water and explore its thermal behavior as it undergoes large shape change. The transient device shape change invalidates many conventional assumptions employed in thermal design making analysis of this devices' operation a non-trivial undertaking. To this end, using time scale analysis we demonstrate when the conventional assumptions break down and highlight conditions under which the quasi-static assumption is applicable. In this gradual shape modulation regime the actuated devices' thermal behavior at a given stretch approaches that of a static device with equivalent geometry. We validate this time scale analysis by experimentally characterizing thermo-fluidic behavior of our soft system as it undergoes axial periodic extension-retraction at varying frequencies during operation. By doing so we explore multiple shape modulation regimes and provide a theoretical foundation to be used in the design of soft thermofluidic systems undergoing transient deformation.

On-Demand Printing of Wearable Thermotherapy Pad

Thermotherapy is an effective method for pain relief, recovery from injury, and general healthcare. The ordinary heat pad used for thermotherapy at home is not usually tailored to the individual but supplied in a few different pre-fixed sizes and shapes for mass marketing. A customized wearable heat pad often requires expert support. Herein, an instant, custom-fit, and on-demand heat pad for thermotherapy is demonstrated. The heater is directly printed using silver nanoparticle ink on an off-the-shelf medical grade tape by inkjet technology. By coating the tape with silica nanoparticles as ink-absorbing layer and chloride ions as chemical sintering agent, stable heater patterns are printed without the need for subsequent high temperature sintering process. A 3D scanner is used to acquire body information, and a customized heater is produced using the information. The printed heat pad is attached to the shoulder and the effect of thermotherapy is verified objectively through electroencephalography and subjectively through survey. This printed heat pad produced by simple and low-cost fabrication provides wearable medical devices for personal thermotherapy.

Textile-Integrated Thermocouples for Temperature Measurement

The integration of conductive materials in textiles is key for detecting temperature in the wearer´s environment. When integrating sensors into textiles, properties such as their flexibility, handle, and stretch must stay unaffected by the functionalization. Conductive materials are difficult to integrate into textiles, since wires are stiff, and coatings show low adhesion. This work shows that various substrates such as cotton, cellulose, polymeric, carbon, and optical fiber-based textiles are used as support materials for temperature sensors. Suitable measurement principles for use in textiles are based on resistance changes, optical interferences (fiber Bragg grating), or thermoelectric effects. This review deals with developments in the construction of temperature sensors and the production of thermocouples for use in textiles. The operating principle of thermocouples is based on temperature gradients building up between a heated and a cold junction of two conductors, which is converted to a voltage output signal. This work also summarizes integration methods for thermocouples and other temperature-sensing techniques as well as the manufacture of conductive materials in textiles. In addition, textile thermocouples are emphasized as suitable and indispensable elements in sensor concepts for smart textiles.

Functional Fibers, Composites and Textiles Utilizing Photothermal and Joule Heating

This review focuses on the mechanism of adjusting the thermal environment surrounding the human body via textiles. Recently highlighted technologies for thermal management are based on the photothermal conversion principle and Joule heating for wearable electronics. Recent innovations in this technology are described, with a focus on reports in the last three years and are categorized into three subjects: (1) thermal management technologies of a passive type using light irradiation of the outside environment (photothermal heating), (2) those of an active type employing external electrical circuits (Joule heating), and (3) biomimetic structures. Fibers and textiles from the design of fibers and textiles perspective are also discussed with suggestions for future directions to maximize thermal storage and to minimize heat loss.

Transparent Conductive Flexible Trilayer Films for a Deicing Window and Self-Recover Bending Sensor Based on a Single-Walled Carbon Nanotube/Polyvinyl Butyral Interlayer

A flexible transparent conductive film (TCF) is an important component in many modern smart devices. Recent TCF is always fabricated based on indium tin oxide (ITO). However, the drawbacks of ITO (e.g., brittle nature, high cost, and resource scarcity) and the complex preparation process of TCF limit the massive production and further application of TCF. Herein, a facile and low-cost method is proposed to prepare flexible TCF. Rolls of single-walled carbon nanotubes (SWCNTs)/polyvinyl butyral (PVB) interlayer film were first fabricated by the roll-to-roll (R2R) spraying method. Then, the interlayer film was laminated between polycarbonate (PC) films (0.1 mm in thickness) to fabricate a transparent (80% optical transmittance) but flexible trilayer film. Such a prepared trilayer film shows multifunctional applications. For example, on the one hand, high conductivity and uniform distribution of resistance ensure that it can work as a deicing window with good performance at a low voltage. On the other hand, its flexibility, rapid self-recovery, and stable response enable it to be used as a bending sensor, which shows remarkable stability, repeatability, and durability. This study provides a facile method to fabricate TCF based on commercial but low-cost materials, which is suitable for industrial production and wide practical applications.

Stretchable and Transparent Kirigami Conductor of Nanowire Percolation Network for Electronic Skin Applications

Recent research progress of relieving discomfort between electronics and human body involves serpentine designs, ultrathin films, and extraordinary properties of nanomaterials. However, these strategies addressed thus far each face own limitation for achieving desired form of electronic-skin applications. Evenly matched mechanical properties anywhere on the body and imperceptibility of electronics are two essentially required characteristics for future electronic-skin (E-skin) devices. Yet accomplishing these two main properties simultaneously is still very challenging. Hence, we propose a novel fabrication method to introduce kirigami approach to pattern a highly conductive and transparent electrode into diverse shapes of stretchable electronics with multivariable configurability for E-skin applications. These kirigami engineered patterns impart tunable elasticity to the electrodes, which can be designed to intentionally limit strain or grant ultrastretchability depending on applications over the range of 0 to over 400% tensile strain with strain-invariant electrical property and show excellent strain reversibility even after 10 000 cycles stretching while exhibiting high optical transparency (>80%). The versatility of this work is demonstrated by ultrastretchable transparent kirigami heater for personal thermal management and conformal transparent kirigami electrophysiology sensor for continuous health monitoring of human body conditions. Finally, by integrating E-skin sensors with quadrotor drones, we have successfully demonstrated human-machine-interface using our stretchable transparent kirigami electrodes.

A widely adaptable analytical method for thermal analysis of flexible electronics with complex heat source structures

Flexible electronics, as a relatively new category of device, exhibit prodigious potential in many applications, especially in bio-integrated fields. It is critical to understand that thermal management of certain kinds of exothermic flexible electronics is a crucial issue, whether to avoid or to take advantage of the excessive temperature. A widely adaptable analytical method, validated by finite-element analysis and experiments, is conducted to investigate the thermal properties of exothermic flexible electronics with a heat source in complex shape or complex array layout. The main theoretical strategy to obtain the thermal field is through an integral along the complex curve source region. The results predicted by the analytical model enable accurate control of temperature and heat flow in the flexible electronics, which may help in the design and fabrication of flexible electronic devices in the future.

Buckled Structures: Fabrication and Applications in Wearable Electronics

Wearable electronics have attracted a tremendous amount of attention due to their many potential applications, such as personalized health monitoring, motion detection, and smart clothing, where electronic devices must conformably form contacts with curvilinear surfaces and undergo large deformations. Structural design and material selection have been the key factors for the development of wearable electronics in the recent decades. As one of the most widely used geometries, buckling structures endow high stretchability, high mechanical durability, and comfortable contact for human-machine interaction via wearable devices. In addition, buckling structures that are derived from natural biosurfaces have high potential for use in cost-effective and high-grade wearable electronics. This review provides fundamental insights into buckling fabrication and discusses recent advancements for practical applications of buckled electronics, such as interconnects, sensors, transistors, energy storage, and conversion devices. In addition to the incorporation of desired functions, the simple and consecutive manipulation and advanced structural design of the buckled structures are discussed, which are important for advancing the field of wearable electronics. The remaining challenges and future perspectives for buckled electronics are briefly discussed in the final section.

High-Performance and Rapid-Response Electrical Heaters Based on Ultraflexible, Heat-Resistant, and Mechanically Strong Aramid Nanofiber/Ag Nanowire Nanocomposite Papers

High-performance and rapid response electrical heaters with ultraflexibility, superior heat resistance, and mechanical properties are highly desirable for the development of wearable devices, artificial intelligence, and high-performance heating systems in areas such as aerospace and the military. Herein, a facile and efficient two-step vacuum-assisted filtration followed by hot-pressing approach is presented to fabricate versatile electrical heaters based on the high-performance aramid nanofibers (ANFs) and highly conductive Ag nanowires (AgNWs). The resultant ANF/AgNW nanocomposite papers present ultraflexibility, extremely low sheet resistance (minimum R_s of 0.12 Ω/sq), and outstanding heat resistance (thermal degradation temperature above 500 °C) and mechanical properties (tensile strength of 285.7 MPa, tensile modulus of 6.51 GPa with a AgNW area fraction of 0.4 g/m²), benefiting from the partial embedding of AgNWs into the ANF substrate and the extensive hydrogen-bonding interactions. Moreover, the ANF/AgNW nanocomposite paper-based electrical heaters exhibit satisfyingly high heating temperatures (up to ∼200 °C) with rapid response time (10-30 s) at low AgNW area fractions and supplied voltages (0.5-5 V) and possess sufficient heating reliability, stability, and repeatability during the long-term and repeated heating and cooling cycles. Fully functional applications of the ANF/AgNW nanocomposite paper-based electrical heaters are demonstrated, indicating their excellent potential for emerging electronic applications such as wearable devices, artificial intelligence, and high-performance heating systems.

Design of Rigidity and Breaking Strain for a Kirigami Structure with Non-Uniform Deformed Regions

We modeled a kirigami structure by considering the influence of non-uniform deforming cuts in order to theoretically design the mechanical characteristics of the structure. It is known that the end regions of kirigami structures are non-uniformly deformed when stretched, because the deformation is inhibited at the regions close to both the ends connected to the uncut region in the longitudinal direction. The non-uniform deformation affects the overall mechanical characteristics of the structure. Our model was intended to elucidate how cuts at both ends influence these characteristics. We focused on the difference in the deformation degree caused by a cut between the regions close to the ends and the center of the stretched kirigami device. We proposed a model comprising of connected springs in series with different rigidities in the regions close to the ends and the center. The spring model showed good prediction tendency with regard to the curve of the stress–strain diagram obtained using the tensile test with a test piece. Therefore, the results show that it is possible to theoretically design the mechanical characteristics of a kirigami structure, and that such a design can well predict the influence of cuts, which induce non-uniform deformation at both ends.