Wearable multichannel pulse condition monitoring system based on flexible pressure sensor arrays

Prognosis of Cardiovascular Conditions Noninvasively Using Printable Elastomeric Electronic Skin

Lack of timely prognosis of cardiovascular condition (CVC) is resulting in increased mortality across the globe. Currently, available techniques are confined to medical facilities and need the intervention of specialists. Frequently, this impedes timely treatment, driven by socioeconomic factors. Consequently, the disease transcends toward incurable complications. In such a scenario, point-of-care diagnostic tools can help with prognosis at an early stage. Albeit there are such tools available, it is imperative to develop affordably in uncomplicated manufacturing techniques and should have simple readout and analysis modules for monitoring CVC. Accordingly, the solvent-free manufacturing of stencil printable liquid elastomer-carbon nanotube electronic skin-based strain sensor, capable of accurately detecting pulse (at different positions) and other parameters like augmentation index and stiffness index of artery related to the CVC, is reported. The Poincare plot, derived from the recorded data, measures heart rate variability, a key indicator linked to mortality. Thanks to the staggering linearity, gauge factor of 234.26, fast response time of 85 ms (measured from pulse data), and cyclic stability (over 500 cycles), assist in the ease of detection of vital parameters. Furthermore, the sensor patch demonstrates its capability to acquire pulse waves under different real-time artery conditions using cuff-based pressure applications.

Wearable blood pressure sensors for cardiovascular monitoring and machine learning algorithms for blood pressure estimation

With advances in materials science and medical technology, wearable sensors have become crucial tools for the early diagnosis and continuous monitoring of numerous cardiovascular diseases, including arrhythmias, hypertension and coronary artery disease. These devices employ various sensing mechanisms, such as mechanoelectric, optoelectronic, ultrasonic and electrophysiological methods, to measure vital biosignals, including pulse rate, blood pressure and changes in heart rhythm. In this Review, we provide a comprehensive overview of the current state of wearable cardiovascular sensors, focusing particularly on those that measure blood pressure. We explore biosignal sensing principles, discuss blood pressure estimation methods (including machine learning algorithms) and summarize the latest advances in cuffless wearable blood pressure sensors. Finally, we highlight the challenges of and offer insights into potential pathways for the practical application of cuffless wearable blood pressure sensors in the medical field from both technical and clinical perspectives.

Artificial Intelligence-Enabled Novel Atrial Fibrillation Diagnosis System Using 3D Pulse Perception Flexible Pressure Sensor Array

Atrial fibrillation (AF) as one of the most common cardiovascular diseases has attracted great attention due to its high disability and mortality rate. Thus, a timely and effective recognition method for AF is of great importance for diagnosing and preventing it. Herein, we proposed a novel intelligent sensing and recognition system for AF which combined Traditional Chinese Medicine (TCM), flexible wearable electronic devices, and artificial intelligence. Experiment and simulation synergistically verified that the flexible pressure sensor arrays designed according to the TCM theory could synchronously obtain the 3D pulses at Cun, Guan, and Chi. Combined with a homemade signal acquisition system and the pulse signals labeled by doctors of cardiovascular diseases, the differences in the 3D pulse signals between ones with AF and without can be picked up clearly. Enabled the convolutional neural network (CNN) and the pulse database, the recognition model was formed with a recognition rate of up to 90%. As a proof of concept, the artificial intelligence-enabled novel atrial fibrillation diagnosis system has been used to detect patients with AF in hospitals, showing 80% recognition rate. This work provides a new strategy to precisely diagnose and remotely treat AF, as well as to accelerate the development of Modern Chinese Medicine treatment.

Traditional Chinese Medicine (TCM)-Inspired Fully Printed Soft Pressure Sensor Array with Self-Adaptive Pressurization for Highly Reliable Individualized Long-Term Pulse Diagnostics

Reliable, non-invasive, continuous monitoring of pulse and blood pressure is essential for the prevention and diagnosis of cardiovascular diseases. However, the pulse wave varies drastically among individuals or even over time in the same individual, presenting significant challenges for the existing pulse sensing systems. Inspired by pulse diagnosis methods in traditional Chinese medicine (TCM), this work reports a self-adaptive pressure sensing platform (PSP) that combines the fully printed flexible pressure sensor array with an adaptive wristband-style pressure system can identify the optimal pulse signal. Besides the detected pulse rate/width/length, "Cun, Guan, Chi" position, and "floating, moderate, sinking" pulse features, the PSP combined with a machine learning-based linear regression model can also accurately predict blood pressure such as systolic, diastolic, and mean arterial pressure values. The developed diagnostic platform is demonstrated for highly reliable long-term monitoring and analysis of pulse and blood pressure across multiple human subjects over time. The design concept and proof-of-the-concept demonstrations also pave the way for the future developments of flexible sensing devices/systems for adaptive individualized monitoring in the complex practical environments for personalized medicine, along with the support for the development of digital TCM.

High‐Resolution Carbon‐Based Tactile Sensor Array for Dynamic Pulse Imaging

With the development of modern medicine, the importance of continuous and reliable pulse wave monitoring has increased significantly in physiological evaluation and disease diagnosis. Among them, the 3D reconstruction of the pulse wave is indispensable, and needs rely on ultra‐high resolution sensor arrays, that is, high spatial resolution, temporal resolution, and force resolution. Herein, a flexible high‐density 32 × 32 tactile sensor array based on pressure‐sensitive tunneling mechanism is develpoed. Conformal graphene nanowalls (GNWs) pattern arrays are deposited on micro‐pyramidal structural Si substrate via mask‐assisted plasma enhanced chemical vapor deposition (PECVD) method and are adopted as pressure‐sensitive electrode, exhibiting a spatial resolution of 64 dots/cm2, high sensitivity (222.36 kPa−1) and short response time (2 ms). More importantly, HfO2 tunneling layer can effectively suppress noise current, which made it sense weak pressure signals with 1/1000 force resolution and SNR of 36.32 dB. By leveraging its high‐resolution array, more holistic pulse signals are acquired and the 3D shape of the pulse wave are successfully replicated. This work shows high‐resolution sensors have significant promise for applications in remote intelligent diagnostics.

Nanoplasmonic biosensors for environmental sustainability and human health

Monitoring the health conditions of the environment and humans is essential for ensuring human well-being, promoting global health, and achieving sustainability. Innovative biosensors are crucial in accurately monitoring health conditions, uncovering the hidden connections between the environment and human well-being, and understanding how environmental factors trigger autoimmune diseases, neurodegenerative diseases, and infectious diseases. This review evaluates the use of nanoplasmonic biosensors that can monitor environmental health and human diseases according to target analytes of different sizes and scales, providing valuable insights for preventive medicine. We begin by explaining the fundamental principles and mechanisms of nanoplasmonic biosensors. We investigate the potential of nanoplasmonic techniques for detecting various biological molecules, extracellular vesicles (EVs), pathogens, and cells. We also explore the possibility of wearable nanoplasmonic biosensors to monitor the physiological network and healthy connectivity of humans, animals, plants, and organisms. This review will guide the design of next-generation nanoplasmonic biosensors to advance sustainable global healthcare for humans, the environment, and the planet.

Nano PDA@Tur-Modified Piezoelectric Sensors for Enhanced Sensitivity and Energy Harvesting

Tourmaline is known for its natural negative ion effect and far-infrared radiation function, which promote human blood circulation, relieve pain, regulate the endocrine system, and enhance immunity and other functions. These functions motivate the use of this material for enhanced sensitivity of wearable sensors. In this work, taking advantage of the unique multifunctions of tourmaline nanoparticles (Tur), highly boosted piezoelectricity was achieved by incorporating polydopamine (PDA)-modified Tur in PVDF. The PDA@Tur nanofillers not only effectively increased the β-phase content of PVDF but also played a major role in significantly enhancing piezoelectricity, wettability, elasticity, air permeability, and stability of the piezoelectric sensors. Especially, the maximum output voltage of the fiber membrane with 0.5 wt % PDA@Tur reached 31.0 V, being 4 times that of the output voltage of the pure PVDF fiber membrane. Meanwhile, the sensitivity reached 0.7011 V/kPa at 1-10 N, which was 3.6 times that of pure PVDF film (0.196 V/kPa). The power intensity reached 8 μW/cm2, being 5.55 times that of the pristine PVDF PENG (1.44 μW/cm2), and the piezoelectric coefficient from d33 m/PFM is 5.5 pC/N, higher than that of pristine PVDF PENG (3.1 pC/N). Output signal graphs corresponding to flapping, finger, knee, and elbow movements were detected. The response/recovery time of the sensor device was 24/19 ms. The piezoelectric nanogenerator (PENG) was capable of charging multiple capacitors to 2 V within a short time and lighting up 15 light-emitting diodes bulbs (LEDs) simultaneously with a single beat. In addition, a 4 × 4 row-column multiplexed sensor array was made of PENGs, which showed distinct responses to different stress areas in different sensor modules. This study demonstrated high-performance PDA@Tur PVDF-based PENG being capable of energy harvesting and sensing, providing a guideline for the design and buildup of wearable self-powered devices in healthcare and human-computer interaction.

Ag-thiolate interactions to enable an ultrasensitive and stretchable MXene strain sensor with high temporospatial resolution

High-sensitivity strain sensing elements with a wide strain range, fast response, high stability, and small sensing areas are desirable for constructing strain sensor arrays with high temporospatial resolution. However, current strain sensors rely on crack-based conductive materials having an inherent tradeoff between their sensing area and performance. Here, we present a molecular-level crack modulation strategy in which we use layer-by-layer assembly to introduce strong, dynamic, and reversible coordination bonds in an MXene and silver nanowire-matrixed conductive film. We use this approach to fabricate a crack-based stretchable strain sensor with a very small sensing area (0.25 mm2). It also exhibits an ultrawide working strain range (0.001-37%), high sensitivity (gauge factor ~500 at 0.001% and >150,000 at 35%), fast response time, low hysteresis, and excellent long-term stability. Based on this high-performance sensing element and facile assembly process, a stretchable strain sensor array with a device density of 100 sensors per cm2 is realized. We demonstrate the practical use of the high-density strain sensor array as a multichannel pulse sensing system for monitoring pulses in terms of their spatiotemporal resolution.

Wearable multichannel-active pressurized pulse sensing platform

With the modernization of traditional Chinese medicine (TCM), creating devices to digitalize aspects of pulse diagnosis has proved to be challenging. The currently available pulse detection devices usually rely on external pressure devices, which are either bulky or poorly integrated, hindering their practical application. In this work, we propose an innovative wearable active pressure three-channel pulse monitoring device based on TCM pulse diagnosis methods. It combines a flexible pressure sensor array, flexible airbag array, active pressure control unit, advanced machine learning approach, and a companion mobile application for human-computer interaction. Due to the high sensitivity (460.1 kPa-1), high linearity (R 2 > 0.999) and flexibility of the flexible pressure sensors, the device can accurately simulate finger pressure to collect pulse waves (Cun, Guan, and Chi) at different external pressures on the wrist. In addition, by measuring the change in pulse wave amplitude at different pressures, an individual's blood pressure status can be successfully predicted. This enables truly wearable, actively pressurized, continuous wireless dynamic monitoring of wrist pulse health. The innovative and integrated design of this pulse monitoring platform could provide a new paradigm for digitizing aspects of TCM and other smart healthcare systems.

Biocompatible Electronic Skins for Cardiovascular Health Monitoring

Cardiovascular diseases represent a significant threat to the overall well-being of the global population. Continuous monitoring of vital signs related to cardiovascular health is essential for improving daily health management. Currently, there has been remarkable proliferation of technology focused on collecting data related to cardiovascular diseases through daily electronic skin monitoring. However, concerns have arisen regarding potential skin irritation and inflammation due to the necessity for prolonged wear of wearable devices. To ensure comfortable and uninterrupted cardiovascular health monitoring, the concept of biocompatible electronic skin has gained substantial attention. In this review, biocompatible electronic skins for cardiovascular health monitoring are comprehensively summarized and discussed. The recent achievements of biocompatible electronic skin in cardiovascular health monitoring are introduced. Their working principles, fabrication processes, and performances in sensing technologies, materials, and integration systems are highlighted, and comparisons are made with other electronic skins used for cardiovascular monitoring. In addition, the significance of integrating sensing systems and the updating wireless communication for the development of the smart medical field is explored. Finally, the opportunities and challenges for wearable electronic skin are also examined.

Simultaneous Measurement of Local Pulse Wave Velocities in Radial Arteries Using a Soft Sensor Based on the Fiber Bragg Grating Technique

Arterial stiffness has been proved to be an important parameter in the evaluation of cardiovascular diseases, and Pulse Wave Velocity (PWV) is a strong indicator of arterial stiffness. Compared to regional PWV (PWV among different arteries), local PWV (PWV within a single artery) outstands in providing higher precision in indicating arterial properties, as regional PWVs are highly affected by multiple parameters, e.g., variations in blood vessel lengths due to individual differences, and multiple reflection effects on the pulse waveform. However, local PWV is less-developed due to its high dependency on the temporal resolution in synchronized signals with usually low signal-to-noise ratios. This paper presents a method for the noninvasive simultaneous measurement of two local PWVs in both left and right radial arteries based on the Fiber Bragg Grating (FBG) technique via correlation analysis of the pulse pairs at the fossa cubitalis and at the wrist. Based on the measurements of five male volunteers at the ages of 19 to 21 years old, the average left radial PWV ranged from 9.44 m/s to 12.35 m/s and the average right radial PWV ranged from 11.50 m/s to 14.83 m/s. What is worth mentioning is that a stable difference between the left and right radial PWVs was observed for each volunteer, ranging from 2.27 m/s to 3.04 m/s. This method enables the dynamic analysis of local PWVs and analysis of their features among different arteries, which will benefit the diagnosis of early-stage arterial stiffening and may bring more insights into the diagnosis of cardiovascular diseases.

An underwater vest containing an antioxidant MXene hydrogel for sensitive recognition of fish locomotion

The perception of fish locomotion is important for understanding their adaptive behaviors and ethological characteristics. However, the main strategy used for extracting fish attitudes involves the use of a vision-based monitoring system, which is limited in its range of observation and cannot perform tracking for long times. Here, we report the use of a wearable tagging electronic device, referred to as an underwater vest, to capture the surrounding flow field disturbances triggered by swimming or momentary postural changes. All of these goals were achieved by integrating a pair of pseudocapacitive pressure-sensing units and a flexible circuit board. Notably, additional conditions, such as variable hydraulic pressures and minimal changes in fish posture, require high stability and sensitivity of the sensing units. Thus, hybrid hydrogel electrodes were developed through cross-linking MXene with holey-reduced graphene oxide nanosheets and further modification with 1-ethyl-3-methylimidazolium dicyanamide ionic liquids, which increased the interfacial capacitance and long-term interfacial activity of the MXene. Consequently, the sensing unit exhibited ultrahigh sensitivity (Smax~136,207 kPa-1) in an aquatic environment for 60 days and superior high-pressure resolution (10 Pa) within a wide working range of 1 MPa. Ultimately, an underwater vest integrated with such sensing units clearly distinguished and recorded fish locomotion. We believe that the designed device may open avenues in flow field monitoring and ocean current detection and provide new insights into the development of sensitive underwater tagging.

A review of nanomaterials for biosensing applications

A biosensor is a device that reacts with the analyte to be analyzed, detects its concentration, and generates readable information, which plays an important role in medical diagnosis, detection of physiological indicators, and disease prevention. Nanomaterials have received increasing attention in the fabrication and improvement of biosensors due to their unique physicochemical and optical properties. In this paper, the properties of nanomaterials such as the size effect, optical and electrical properties, and their advantages in the field of biosensing are briefly summarized, and the application of nanomaterials can effectively improve the sensitivity and reduce the detection limit of biosensors. The advantages of commonly used nanomaterials such as gold nanoparticles (AuNPs), carbon nanotubes (CNTs), quantum dots (QDs), graphene, and magnetic nanobeads for biosensor applications are also reviewed. Besides, the two main types of biosensors using nanomaterials involved in their construction and their working principles are described, and the toxicity and biocompatibility of nanomaterials and the future direction of nanomaterial biosensors are discussed.

Paper-Based Supercapacitive Pressure Sensor for Wrist Arterial Pulse Waveform Monitoring

Recent developments in wearable pressure sensors have led to the need for high sensitivity and a broad sensing range to accurately detect various physiological states. However, high sensitivity does not always translate to a wide sensing range, and manufacturing sensors with such high sensitivity is a complex and expensive process. In this study, we present a capacitive pressure sensor based on tissue paper that is simple to produce and cost-effective yet still exhibits high linear sensitivity of 2.9 kPa-1 in the 0-16 kPa range. The linear sensitivity of 1.5 kPa-1 was achieved from 16 to 90 kPa. The sensor also demonstrated a fast response time of 0.2 s, excellent pressure resolution at both low and high pressures, and a sufficient signal-to-noise ratio, making it ideal for detecting wrist arterial pulse waveforms. We were also able to demonstrate the sensor's practicality in real-world applications by cycling it 5000 times and showing its capability to capture pulse waveforms from different arterial locations. These low-cost sensors possess all the intrinsic features necessary for efficient measurement of pulse waveforms, which may facilitate the diagnosis of cardiovascular diseases.

Reliable and Scalable Piezoresistive Sensors with an MXene/MoS2 Hierarchical Nanostructure for Health Signals Monitoring

The increased popularity of wearable electronic devices has led to a greater need for advanced sensors. However, fabricating pressure sensors that are flexible, highly sensitive, robust, and compatible with large-scale fabrication technology is challenging. This work investigates a piezoresistive sensor constructed from an MXene/MoS2 hierarchical nanostructure, which is obtained through an easy and inexpensive fabrication process. The sensor exhibits a high sensitivity of 0.42 kPa-1 (0-1.5 kPa), rapid response (∼36 ms), and remarkable mechanical durability (∼10,000 cycles at 13 kPa). The sensor has been demonstrated to be successful in detecting human motion, speech recognition, and physiological signals, particularly in analyzing human pulse. These data can be used to alert and identify irregularities in human health. Additionally, the sensing units are able to construct sensor arrays of various sizes and configurations, enabling pressure distribution imaging in a variety of application scenarios. This research proposes a cost-effective and scalable approach to fabricating piezoresistive sensors and sensor arrays, which can be utilized for monitoring human health and for use in human-machine interfaces.

Soft, flexible pressure sensors for pressure monitoring under large hydrostatic pressure and harsh ocean environments

Traditional rigid ocean pressure sensors typically require protection from bulky pressure chambers and complex seals to survive the large hydrostatic pressure and harsh ocean environment. Here, we introduce soft, flexible pressure sensors that can eliminate such a need and measure a wide range of hydrostatic pressures (0.1 MPa to 15 MPa) in environments that mimic the ocean, achieving small size, high flexibility, and potentially low power consumption. The sensors are fabricated from lithographically patterned gold thin films (100 nm thick) encapsulated with a soft Parylene C film and tested in a customized pressure vessel under well-controlled pressure and temperature conditions. Using a rectangular pressure sensor as an example, the resistance of the sensor is found to decrease linearly with the increase of the hydrostatic pressure from 0.1 MPa to 15 MPa. Finite element analysis (FEA) reveals the strain distributions in the pressure sensor under hydrostatic pressures of up to 15 MPa. The effect of geometry on sensor performance is also studied, and radially symmetric pressure sensors (like circular and spike-shaped) are shown to have more uniform strain distributions under large hydrostatic pressures and, therefore, have a potentially enhanced pressure measurement range. Pressure sensors of all geometries show high consistency and negligible hysteresis over 15 cyclic tests. In addition, the sensors exhibit excellent flexibility and operate reliably under a hydrostatic pressure of 10 MPa for up to 70 days. The developed soft pressure sensors are promising for integration with many platforms including animal tags, diver equipment, and soft underwater robotics.

Flexible Pressure Sensors and Machine Learning Algorithms for Human Walking Phase Monitoring

Soft sensors are attracting much attention from researchers worldwide due to their versatility in practical projects. There are already many applications of soft sensors in aspects of life, consisting of human-robot interfaces, flexible electronics, medical monitoring, and healthcare. However, most of these studies have focused on a specific area, such as fabrication, data analysis, or experimentation. This approach can lead to challenges regarding the reliability, accuracy, or connectivity of the components. Therefore, there is a pressing need to consider the sensor's placement in an overall system and find ways to maximize the efficiency of such flexible sensors. This paper proposes a fabrication method for soft capacitive pressure sensors with spacer fabric, conductive inks, and encapsulation glue. The sensor exhibits a good sensitivity of 0.04 kPa^-1, a fast recovery time of 7 milliseconds, and stability of 10,000 cycles. We also evaluate how to connect the sensor to other traditional sensors or hardware components. Some machine learning models are applied to these built-in soft sensors. As expected, the embedded wearables achieve a high accuracy of 96% when recognizing human walking phases.

Boron nitride-enabled printing of a highly sensitive and flexible iontronic pressure sensing system for spatial mapping

Recently, flexible iontronic pressure sensors (FIPSs) with higher sensitivities and wider sensing ranges than conventional capacitive sensors have been widely investigated. Due to the difficulty of fabricating the nanostructures that are commonly used on electrodes and ionic layers by screen printing techniques, strategies for fabricating such devices using these techniques to drive their mass production have rarely been reported. Herein, for the first time, we employed a 2-dimensional (2D) hexagonal boron nitride (h-BN) as both an additive and an ionic liquid reservoir in an ionic film, making the sensor printable and significantly improving its sensitivity and sensing range through screen printing. The engineered sensor exhibited high sensitivity (Smin> 261.4 kPa-1) and a broad sensing range (0.05-450 kPa), and it was capable of stable operation at a high pressure (400 kPa) for more than 5000 cycles. In addition, the integrated sensor array system allowed accurate monitoring of wrist pressure and showed great potential for health care systems. We believe that using h-BN as an additive in an ionic material for screen-printed FIPS could greatly inspire research on 2D materials for similar systems and other types of sensors. Hexagonal boron nitride (h-BN) was employed for the first time to make iontronic pressure sensor arrays with high sensitivity and a broad sensing range by screen printing.

Wearable Multi-Channel Pulse Signal Acquisition System Based on Flexible MEMS Sensor Arrays with TSV Structure

Micro-electro-mechanical system (MEMS) pressure sensors play a significant role in pulse wave acquisition. However, existing MEMS pulse pressure sensors bound with a flexible substrate by gold wire are vulnerable to crush fractures, leading to sensor failure. Additionally, establishing an effective mapping between the array sensor signal and pulse width remains a challenge. To solve the above problems, we propose a 24-channel pulse signal acquisition system based on a novel MEMS pressure sensor with a through-silicon-via (TSV) structure, which connects directly to a flexible substrate without gold wire bonding. Firstly, based on the MEMS sensor, we designed a 24-channel pressure sensor flexible array to collect the pulse waves and static pressure. Secondly, we developed a customized pulse preprocessing chip to process the signals. Finally, we built an algorithm to reconstruct the three-dimensional pulse wave from the array signal and calculate the pulse width. The experiments verify the high sensitivity and effectiveness of the sensor array. In particular, the measurement results of pulse width are highly positively correlated with those obtained via infrared images. The small-size sensor and custom-designed acquisition chip meet the needs of wearability and portability, meaning that it has significant research value and commercial prospects.

Recent Advancements in Physiological, Biochemical, and Multimodal Sensors Based on Flexible Substrates: Strategies, Technologies, and Integrations

Flexible wearable devices have been widely used in biomedical applications, the Internet of Things, and other fields, attracting the attention of many researchers. The physiological and biochemical information on the human body reflects various health states, providing essential data for human health examination and personalized medical treatment. Meanwhile, physiological and biochemical information reveals the moving state and position of the human body, and it is the data basis for realizing human-computer interactions. Flexible wearable physiological and biochemical sensors provide real-time, human-friendly monitoring because of their light weight, wearability, and high flexibility. This paper reviews the latest advancements, strategies, and technologies of flexibly wearable physiological and biochemical sensors (pressure, strain, humidity, saliva, sweat, and tears). Next, we systematically summarize the integration principles of flexible physiological and biochemical sensors with the current research progress. Finally, important directions and challenges of physiological, biochemical, and multimodal sensors are proposed to realize their potential applications for human movement, health monitoring, and personalized medicine.

Multichannel Flexible Pulse Perception Array for Intelligent Disease Diagnosis System

Pressure sensors with high sensitivity, a wide linear range, and a quick response time are critical for building an intelligent disease diagnosis system that directly detects and recognizes pulse signals for medical and health applications. However, conventional pressure sensors have limited sensitivity and nonideal response ranges. We proposed a multichannel flexible pulse perception array based on polyimide/multiwalled carbon nanotube-polydimethylsiloxane nanocomposite/polyimide (PI/MPN/PI) sandwich-structure pressure sensor that can be applied for remote disease diagnosis. Furthermore, we established a mechanical model at the molecular level and guided the preparation of MPN. At the structural level, we achieved high sensitivity (35.02 kPa-1) and a broad response range (0-18 kPa) based on a pyramid-like bilayer microstructure with different upper and lower surfaces. A 27-channel (3 × 9) high-density sensor array was integrated at the device level, which can extract the spatial and temporal distribution information on a pulse. Furthermore, two intelligent algorithms were developed for extracting six-dimensional pulse information and automatic pulse recognition (the recognition rate reaches 97.8%). The results indicate that intelligent disease diagnosis systems have great potential applications in wearable healthcare devices.

In-Memory Tactile Sensor with Tunable Steep-Slope Region for Low-Artifact and Real-Time Perception of Mechanical Signals

A tactile sensor needs to perceive static pressures and dynamic forces in real-time with high accuracy for early diagnosis of diseases and development of intelligent medical prosthetics. However, biomechanical and external mechanical signals are always aliased (including variable physiological and pathological events and motion artifacts), bringing great challenges to precise identification of the signals of interest (SOI). Although the existing signal segmentation methods can extract SOI and remove artifacts by blind source separation and/or additional filters, they may restrict the recognizable patterns of the device, and even cause signal distortion. Herein, an in-memory tactile sensor (IMT) with a dynamically adjustable steep-slope region (SSR) and nanocavity-induced nonvolatility (retention time >1000 s) is proposed on the basis of a machano-gated transistor, which directly transduces the tactile stimuli to various dope states of the channel. The programmable SSR endows the sensor with a critical window of responsiveness, realizing the perception of signals on demand. Owing to the nonvolatility of the sensor, the mapping of mechanical cues with high spatiotemporal accuracy and associative learning between two physical inputs are realized, contributing to the accurate assessment of the tissue health status and ultralow-power (about 25.1 μW) identification of an occasionally occurring tremor.

Flexible Wearable Sensors in Medical Monitoring

The popularity of health concepts and the wave of digitalization have driven the innovation of sensors in the medical field. Such continual development has made sensors progress in the direction of safety, flexibility, and intelligence for continuous monitoring of vital signs, which holds considerable promise for changing the way humans live and even treat diseases. To this end, flexible wearable devices with high performance, such as high sensitivity, high stability, and excellent biodegradability, have attracted strong interest from scientists. Herein, a review of flexible wearable sensors for temperature, heart rate, human motion, respiratory rate, glucose, and pH is highlighted. In addition, engineering issues are also presented, focusing on material selection, sensor fabrication, and power supply. Finally, potential challenges facing current technology and future directions of wearable sensors are also discussed.

Progress in Data Acquisition of Wearable Sensors

Wearable sensors have demonstrated wide applications from medical treatment, health monitoring to real-time tracking, human-machine interface, smart home, and motion capture because of the capability of in situ and online monitoring. Data acquisition is extremely important for wearable sensors, including modules of probes, signal conditioning, and analog-to-digital conversion. However, signal conditioning, analog-to-digital conversion, and data transmission have received less attention than probes, especially flexible sensing materials, in research on wearable sensors. Here, as a supplement, this paper systematically reviews the recent progress of characteristics, applications, and optimizations of transistor amplifiers and typical filters in signal conditioning, and mainstream analog-to-digital conversion strategies. Moreover, possible research directions on the data acquisition of wearable sensors are discussed at the end of the paper.

Development of Pressure Sensor Based Wearable Pulse Detection Device for Radial Pulse Monitoring

Wearable pulse detection devices can be used for daily human healthcare monitoring; however, the relatively poor flexibility and low sensitivity of the pulse detection devices are hindering the scrutiny of pulse information during pulse diagnosis of different pulse positions. This paper developed a novel and wearable pulse detection device based on three flexible pressure sensors using synthetic graphene and silver composites as the pressure sensing material. The structural design of the pulse detection device is firstly presented; the core component of pressure sensors is using the sawtooth protrusions to convert pressure induced by radial pulse vibrations into localized deformation of graphene composites. The fabricated pulse detection device is characterized by high pressure sensing performance, including relatively high sensitivity (8.65% kPa^-1), broad sensing range (12 kPa), and good dynamic response with a response time of about 100 ms. Then, the pulse detection device is worn on a human wrist to detect the pulses from three pulse positions, namely, 'Cun', 'Guan', and 'Chi', and the results demonstrated the capability of using our device to detect pulse signals. The physical conditions of the subject, such as arterial stiffness index, can be further analyzed through the characteristics of the acquired pulse signals, demonstrating the potential application of using wearable pulse detection devices for human health monitoring.

Multimodal Finger Pulse Wave Sensing: Comparison of Forcecardiography and Photoplethysmography Sensors

Pulse waves (PWs) are mechanical waves that propagate from the ventricles through the whole vascular system as brisk enlargements of the blood vessels' lumens, caused by sudden increases in local blood pressure. Photoplethysmography (PPG) is one of the most widespread techniques employed for PW sensing due to its ability to measure blood oxygen saturation. Other sensors and techniques have been proposed to record PWs, and include applanation tonometers, piezoelectric sensors, force sensors of different kinds, and accelerometers. The performances of these sensors have been analyzed individually, and their results have been found not to be in good agreement (e.g., in terms of PW morphology and the physiological parameters extracted). Such a comparison has led to a deeper comprehension of their strengths and weaknesses, and ultimately, to the consideration that a multimodal approach accomplished via sensor fusion would lead to a more robust, reliable, and potentially more informative methodology for PW monitoring. However, apart from various multichannel and multi-site systems proposed in the literature, no true multimodal sensors for PW recording have been proposed yet that acquire PW signals simultaneously from the same measurement site. In this study, a true multimodal PW sensor is presented, which was obtained by integrating a piezoelectric forcecardiography (FCG) sensor and a PPG sensor, thus enabling simultaneous mechanical-optical measurements of PWs from the same site on the body. The novel sensor performance was assessed by measuring the finger PWs of five healthy subjects at rest. The preliminary results of this study showed, for the first time, that a delay exists between the PWs recorded simultaneously by the PPG and FCG sensors. Despite such a delay, the pulse waveforms acquired by the PPG and FCG sensors, along with their first and second derivatives, had very high normalized cross-correlation indices in excess of 0.98. Six well-established morphological parameters of the PWs were compared via linear regression, correlation, and Bland-Altman analyses, which showed that some of these parameters were not in good agreement for all subjects. The preliminary results of this proof-of-concept study must be confirmed in a much larger cohort of subjects. Further investigation is also necessary to shed light on the physical origin of the observed delay between optical and mechanical PW signals. This research paves the way for the development of true multimodal, wearable, integrated sensors and for potential sensor fusion approaches to improve the performance of PW monitoring at various body sites.

Biocompatible Conductive Hydrogels: Applications in the Field of Biomedicine

The impact of COVID-19 has rendered medical technology an important factor to maintain social stability and economic increase, where biomedicine has experienced rapid development and played a crucial part in fighting off the pandemic. Conductive hydrogels (CHs) are three-dimensional (3D) structured gels with excellent electrical conductivity and biocompatibility, which are very suitable for biomedical applications. CHs can mimic innate tissue's physical, chemical, and biological properties, which allows them to provide environmental conditions and structural stability for cell growth and serve as efficient delivery substrates for bioactive molecules. The customizability of CHs also allows additional functionality to be designed for different requirements in biomedical applications. This review introduces the basic functional characteristics and materials for preparing CHs and elaborates on their synthetic techniques. The development and applications of CHs in the field of biomedicine are highlighted, including regenerative medicine, artificial organs, biosensors, drug delivery systems, and some other application scenarios. Finally, this review discusses the future applications of CHs in the field of biomedicine. In summary, the current design and development of CHs extend their prospects for functioning as an intelligent and complex system in diverse biomedical applications.