Tissue-like skin-device interface for wearable bioelectronics by using ultrasoft, mass-permeable, and low-impedance hydrogels

Regulating hydrogel mechanical properties with an electric field

Stimuli-responsive polymeric materials have attracted significant attention due to their ability to change properties in response to various external stimuli. Using an electric field as the stimulus is of particular interest as it possesses the potential for seamless integration of materials with electronic systems. While many materials with electric field responsive actuation have an associated mechanical property change, it is beneficial to develop materials that exhibit mechanical property changes without accompanying significant shape deformation. To address this challenge, here we designed a semi-interpenetrating polymer network (semi-IPN) hydrogel system containing both polyelectrolytes and salt ions, which enables electric field induced changes in mechanical properties while minimizing actuation. We first successfully verified the viability of our design by removing salt ions through a diffusion-only method where we witnessed the stiffness increased to 4.5 times the initial value while still being highly deformable. After this, we applied an electric field to transport the salt ions out of the hydrogel, as shown by both Raman spectroscopy and scanning electron microscopy. We were able to show a time-dependent stiffness increase, the maximum of which was 5 times the original stiffness. We quantified ion transport and water-splitting in the hydrogel by both experiments and simulations. Following this, we showed functional system reversibility by reversing the direction of the current to reinject salt ions into the semi-IPN hydrogel and reducing its stiffness to below the initial value. It's worth noting that our simulations enable us to understand the governing mechanisms behind ion generation and salt transport that leads to mechanical property changes. Finally, we were able to fabricate a spatially variable stiffness haptic interface with our hydrogel, with demonstrated reversibility and cyclability. This research can possibly find applications in soft robotics and haptics and also inspire the development of bio-compatible electronics related devices.

Breathable and imperceptible on-skin electronic tattoos with a hybrid of silk and cellulose and highly conductive electrodes for monitoring skin hydration

Skin, the largest organ protecting the body, acts as a pathway connecting the inside and outside of the body, allowing us to examine health conditions. Therefore, on-skin electronics are attractive for monitoring biosignals in daily life for point-on-care healthcare. However, integrating highly conductive electrodes while maintaining all the properties suitable for on-skin devices, such as flexibility, imperceptibility, breathability, and biocompatibility, is still challenging. Here, we present breathable and imperceptible electronic tattoos (E-tattoos), on which highly conductive gold (Au) electrodes are integrated. The E-tattoo, which a hybrid of two nanostructured biomaterials, ultrathin silk film and cellulose nanofiber mat, possesses all favorable properties for on-skin electronics. Due to the inherent strong adhesion of silk to Au, patterned Au electrodes, with a high conductivity (2.84 × 107 S/m) comparable to that of pure Au (4.01 × 107 S/m), can be integrated on the E-tattoo. High water-vapor transmission and low leakage current through E-tattoos provide skin-compatibility (nonirritating response). With these advantages, the E-tattoo is applied to monitor skin hydration. On-skin impedance measurements reveal dependency on skin hydration, and impedances measured with E-tattoos show better signal stability than those measured for Au nanomesh patches. This study presents a new on-skin electronic platform for monitoring skin conditions.

Smart Bioelectronics for Real-Time Diagnosis and Therapy of Body Organ Functions

Noncommunicable diseases (NCDs) associated with cardiovascular, neurological, and gastrointestinal disorders remain a leading cause of global mortality, sounding the alarm for the urgent need for better diagnostic and therapeutic solutions. Wearable and implantable biointegrated electronics offer a groundbreaking solution, combining real-time, high-resolution monitoring with innovative treatment capabilities tailored to specific organ functions. In this comprehensive review, we focus on the diseases affecting the brain, heart, gastrointestinal organs, bladder, and adrenal gland, along with their associated physiological parameters. Additionally, we provide an overview of the characteristics of these parameters and explore the potential of bioelectronic devices for in situ sensing and therapeutic applications and highlight the recent advancements in their deployment across specific organs. Finally, we analyze the current challenges and prospects of implementing closed-loop feedback control systems in integrated sensor-therapy applications. By emphasizing organ-specific applications and advocating for closed-loop systems, this review highlights the potential of future bioelectronics to address physiological needs and serves as a guide for researchers navigating the interdisciplinary fields of diagnostics, therapeutics, and personalized medicine.

Pd@Au Nanoframe Hydrogels for Closed-Loop Wound Therapy

In this work, a multifunctional Pd@Au nanoframe hydrogel was designed to detect uric acid (UA) for in situ monitoring of wound infection and enhance wound healing by a chemo-photothermal strategy. In acidic conditions, the Pd@Au nanoframe hydrogels show high peroxidase-like activity by catalyzing H2O2 to produce reactive oxygen species (ROS) to damage RNAs of bacteria and enhance antibacterial activity. Under Near-infrared (NIR) laser irradiation, the Pd@Au nanoframe hydrogels exhibit photothermal conversion performance; i.e., the color of Pd@Au nanoframe hydrogel solution varies from deep blue (0 s, 25.4 °C) to red (300 s, 50.1 °C) in infrared thermography. After loading the antibacterial mupirocin (M), the as-obtained M Pd@Au nanoframe hydrogels show a maximum cumulative release rate exceeding 90% for mupirocin, as controlled by NIR laser irradiation. In antimicrobial experiments in vitro, M Pd@Au nanoframe hydrogels exhibit NIR laser-driven antibacterial ability; i.e., 98% Escherichia coli are effectively killed in 10 min. After coating rabbit wounds with a UA sensing patch of M Pd@Au nanoframe hydrogels, wound status can be monitored in real time by detecting UA concentration, leading to rapid wound healing in 4 days by a new synergistic effect of chemo-photothermal strategy. This approach successfully confirms a closed-loop strategy, i.e., real-time monitoring the status of a wound and efficiently perform chemo-photothermal wound therapy, for wound healing by combining functional hydrogels, NIR laser irradiation, and pharmaceutical antibacterials.

Nanozymes meet hydrogels: Fabrication, progressive applications, and perspectives

Nanozyme, a class of emerging enzyme mimics, is the nanomaterials with enzyme-mimicking activity, which has obtained significant and widespread applications in various fields. However, they still face many challenges in practical applications (e.g., instability and low biocompatibility in the physiological environments), which affect their widespread applications to a certain extent. Hydrogels with superior performances (e.g., the controllable degradability, good biocompatibility, hydrophilic properties, and adjustable physical properties) may provide a promising strategy to make up the existing deficiencies of nanozymes in practical applications. Thus, the sapiential combination of nanozymes with hydrogels endows nanozyme hydrogels with both characteristics of nanozymes and properties of hydrogels, making nanozyme hydrogels become novel multifunctional materials. In this review, we comprehensively summarizes the preparation, properties, and progressive applications of nanozyme hydrogels. First of all, the main design and preparation strategies of nanozyme hydrogels are considerately summarized. Then, the properties of different nanozyme hydrogels are introduced. In addition, sophisticated applications of nanozyme hydrogels in the fields of biosensing, biomedicine applications, and environmental are comprehensively summarized. Most importantly, future obstacles and chances in this emerging field are profoundly proposed. This review will provide a new horizon for the development and future applications of novel nanozyme hydrogels.

Advances in Electrically Conductive Hydrogels: Performance and Applications

Electrically conductive hydrogels are highly hydrated 3D networks consisting of a hydrophilic polymer skeleton and electrically conductive materials. Conductive hydrogels have excellent mechanical and electrical properties and have further extensive application prospects in biomedical treatment and other fields. Whereas numerous electrically conductive hydrogels have been fabricated, a set of general principles, that can rationally guide the synthesis of conductive hydrogels using different substances and fabrication methods for various application scenarios, remain a central demand of electrically conductive hydrogels. This paper systematically summarizes the processing, performances, and applications of conductive hydrogels, and discusses the challenges and opportunities in this field. In view of the shortcomings of conductive hydrogels in high electrical conductivity, matchable mechanical properties, as well as integrated devices and machines, it is proposed to synergistically design and process conductive hydrogels with applications in complex surroundings. It is believed that this will present a fresh perspective for the research and development of conductive hydrogels, and further expand the application of conductive hydrogels.

Eco-Friendly Conductive Hydrogels: Towards Green Wearable Electronics

The rapid advancement of wearable electronics has catalyzed the development of flexible, lightweight, and highly conductive materials. Among these, conductive hydrogels have emerged as promising candidates due to their tissue-like properties, which can minimize the mechanical mismatch between flexible devices and biological tissues and excellent electrical conductivity, stretchability and biocompatibility. However, the environmental impact of synthetic components and production processes in conventional conductive hydrogels poses significant challenges to their sustainable application. This review explores recent advances in eco-friendly conductive hydrogels used in healthcare, focusing on their design, fabrication, and applications in green wearable electronics. Emphasis is placed on the use of natural polymers, bio-based crosslinkers, and green synthesis methods to improve sustainability while maintaining high performance. We discuss the incorporation of conductive polymers and carbon-based nanomaterials into environmentally benign matrices. Additionally, the article highlights strategies for improving the biodegradability, recyclability, and energy efficiency of these materials. By addressing current limitations and future opportunities, this review aims to provide a comprehensive understanding of environmentally friendly conductive hydrogels as a basis for the next generation of sustainable wearable technologies.

Functional-hydrogel-based electronic-skin patch for accelerated healing and monitoring of skin wounds

Conductive hydrogels feature reasonable electrical performance as well as tissue-like mechanical softness, thus positioning them as promising material candidates for soft bio-integrated electronics. Despite recent advances in materials and their processing technologies, however, facile patterning and monolithic integration of functional hydrogels (e.g., conductive, low-impedance, adhesive, and insulative hydrogels) for all-hydrogel-based soft bioelectronics still poses significant challenges. Here, we report material design, fabrication, and integration strategies for an electronic-skin (e-skin) patch based on functional hydrogels. The e-skin patch was fabricated by using photolithography-compatible functional hydrogels, such as poly(2-hydroxyethyl acrylate) (PHEA) hydrogel (substrate), Ag flake hydrogel (interconnection; conductivity: ∼571.43 S/cm), poly(3,4-ethylenedioxythiophene:polystyrene) (PEDOT:PSS) hydrogel (working electrode; impedance: ∼69.84 Ω @ 1 Hz), polydopamine (PDA) hydrogel (tissue adhesive; shear strength: ∼725.1 kPa), and poly(vinyl alcohol) (PVA) hydrogel (encapsulation). The properties of these functional hydrogels closely resemble those of human tissues in terms of water content and Young's modulus, enabling stable tissue-device interfacing in dynamically changing physiological environments. We demonstrated the efficacy of the e-skin patch through its application to accelerated healing and monitoring of skin wounds in mouse models - efficient fibroblast migration, proliferation, and differentiation promoted by electric field (EF) stimulation and iontophoretic drug delivery, and monitoring of the accelerated healing process through impedance mapping. The all-hydrogel-based e-skin patch is expected to create new opportunities for various clinically-relevant tissue interfacing applications.

Advances in wearable electronics for monitoring human organs: Bridging external and internal health assessments

Devices used for diagnosing disease are often large, expensive, and require operation by trained professionals, which can result in delayed diagnosis and missed opportunities for timely treatment. However, wearable devices are being recognized as a new approach to overcoming these difficulties, as they are small, affordable, and easy to use. Recent advancements in wearable technology have made monitoring information possible from the surface of organs like the skin and eyes, enabling accurate diagnosis of the user's internal status. In this review, we categorize the body's organs into external (e.g., eyes, oral cavity, neck, and skin) and internal (e.g., heart, brain, lung, stomach, and bladder) organ systems and introduce recent developments in the materials and designs of wearable electronics, including electrochemical and electrophysiological sensors applied to each organ system. Further, we explore recent innovations in wearable electronics for monitoring of deep internal organs, such as the heart, brain, and nervous system, using ultrasound, electrical impedance tomography, and temporal interference stimulation. The review also addresses the current challenges in wearable technology and explores future directions to enhance the effectiveness and applicability of these devices in medical diagnostics. This paper establishes a framework for correlating the design and functionality of wearable electronics with the physiological characteristics and requirements of various organ systems.

Network design for soft materials: addressing elasticity and fracture resistance challenges

Soft materials, such as elastomers and gels, feature crosslinked polymer chains that provide stretchable and elastic mechanical properties. These properties are derived from entropic elasticity, which limits energy dissipation and makes the material susceptible to fracture. To address this issue, network designs that dissipate energy through the plastic zone have been introduced to enhance toughness; however, this approach compromises elasticity, preventing the material from fully recovering its original shape after deformation. In this review, we describe the trade-off between fracture resistance and elasticity, exploring network designs that overcome this limitation to achieve both high toughness and low hysteresis. The development of soft materials that are both elastic and fracture-resistant holds significant promise for applications in stretchable electronics, soft robotics, and biomedical devices. By analyzing successful network designs, we identify strategies to further improve these materials and discuss potential enhancements based on existing limitations.

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.

Biointerface engineering of flexible and wearable electronics

Biointerface sensing is a cutting-edge interdisciplinary field that merges conceptual and practical aspects. Wearable bioelectronics enable efficient interaction and close contact with biological components such as tissues and organs, paving the way for a wide range of medical applications, including personal health monitoring and medical intervention. To be applicable in real-world settings, the patches must be stable and adhere to the skin without causing discomfort or allergies in both wet and dry conditions, as well as other desirable features such as being ultra-soft, thin, flexible, and stretchable. Biosensors have emerged as promising tools primarily used to directly detect biological and electrophysiological signals, enhancing the efficacy of personalized medical treatments and enabling accurate tracking of human well-being. This review highlights the engineering of skin-tissue surfaces/interfaces and their interactions with wearable patches, aiming for both a broad and in-depth understanding of the mechanical and physicochemical properties required for the advancement of flexible and wearable skin patches. Specifically, the advantages of flexible bioelectronics and sensors with optimized surface geometry for long-term diagnosis are discussed. This insight aims to guide the future development of functional materials that can interact with human tissue in a controlled manner. Finally, we provide perspectives on the challenges and potential applications of biointerface engineering in wearable devices.

Acid-Induced in Situ Phase Separation and Percolation for Constructing Bi-Continuous Phase Hydrogel Electrodes With Motion-Insensitive Property

Conducting polymer hydrogels have gained attention in the bioelectronics field due to their unique combination of biocompatibility and customizable mechanical properties. However, achieving both excellent conductivity and mechanical strength in a hydrogel remains a significant challenge, primarily because of the inherent conflict between the hydrophobic nature of conducting polymers and the hydrophilic characteristics of hydrogels. To address this issue, this work proposes a simple one-step acid-induced approach that not only promotes the gelation of hydrophilic polymers but also facilitates the in situ phase separation of hydrophobic conducting polymers under mild conditions. This results in a distinctive bi-continuous phase structure with exceptional electrical property (906 mS cm-1) and mechanical performance (fracture strain of 1103%). The hydrogel forms robust percolating networks that maintain structural integrity under mechanical stress due to their entropic elasticity, providing remarkable strain insensitivity, low mechanical hysteresis, and an impressive resilience (95%). Electrodes fabricated from the conductive hydrogel exhibit stable and minimal interfacial contact impedance with skin (1-6 kilohms at 1-100 Hz) and significantly lower noise power (4.9 µV2). This work believes that the motion-insensitive characteristics and mechanical robustness of this hydrogel will enable efficient and reliable monitoring of biological signals, establishing a new benchmark in the bioelectronics.

Bio-Inspired Highly Stretchable and Ultrafast Autonomous Self-Healing Supramolecular Hydrogel for Multifunctional Durable Self-Powered Wearable Devices

As skin bioelectronics advances, hydrogel wearable devices have broadened perspectives in environment sensing and health monitoring. However, their application is severely hampered by poor mechanical and self-healing properties, environmental sensitivity, and limited sensory functions. Herein, inspired by the hierarchical structure and unique cross-linking mechanism of hagfish slime, a self-powered supramolecular hydrogel is hereby reported, featuring high stretchability (>2800% strain), ultrafast autonomous self-healing capabilities (electrical healing time: 0.3 s), high self-adhesiveness (adhesion strength: 6.92 kPa), injectability, ease of shaping, antimicrobial properties, and biocompatibility. It is observed that by embedding with the highly hygroscopic salt LiCl in supramolecular hydrogel, the hydrogel not only showed excellent electrical conductivity but also presented favorable anti-freezing and water retention properties in extremely cold environments and natural settings. Given these attributes, the hydrogel served as a multifunctional durable self-powered wearable device with high sensitivity (gauge factor: 3.68), fast response time (160 ms), low detection limit, and frequency sensitivity. Moreover, the multifunctional applicability of this supramolecular hydrogel is further demonstrated in long-term cold environments sensing, remote medical communication, and underwater communication. Overall, these findings pave the way for the sustainable development of hydrogel-based wearable devices that are self-powered, durable, and offer high performance, environmental adaptability, and multi-sensory capabilities.

Permeable and Durable Liquid-Metal Fiber Mat as Implantable Physiological Electrodes with Long-Term Biocompatibility

Implantable physiological electrodes provide unprecedented opportunities for real-time and uninterrupted monitoring of biological signals. Most implantable electronics adopt thin-film substrates with low permeability that severely hampers tissue metabolism, impeding their long-term biocompatibility. Recent innovations have seen the advent of permeable electronics through the strategic modification of liquid metals (LMs) onto porous substrates. However, the durability of these electronics is limited by the inherent poor wettability of LMs, particularly within the intricate 3D skeleton of the porous substrate. Herein, the study reports a spatial wettability tuning strategy that solves the wettability issue of LMs within the porous substrates, enabling the LM physiological electrodes with high durability and long-term biocompatibility. The study demonstrates the use of the electrodes as implantable neural interface to realize in vivo acquisition of electrocardiograph and electrocorticogram signals with long-term biocompatibility and high signal-to-noise ratio. This work demonstrates a promising direction for rational design of durable implantable bioelectronics with long-term biocompatibility.

Flexible electronic brush: Real-time multimodal sensing powered by reservoir computing through whisker dynamics

Multimodal sensing using soft body dynamics plays a crucial role in controlling soft robotic motions. An intriguing application of such soft robot control is to mimic whiskers and digitize soft body motion through whisker dynamics. The challenge herein is to simultaneously monitor the directions, speed, force, and slip information of the whisker motion. The existing whisker-like sensors cannot detect slip information effectively. To address this challenge, this study develops a multitasking electronic brush (e-brush) composed of bundle of whiskers powered by reservoir computing (RC). Four pressure sensors are integrated into the brush to monitor its motion, speed, force, slip, and target surface. These sensors can provide long-term, low-pressure detection as low as 50 pascals, allowing for the precise monitoring of brush movements. A RC algorithm is developed to extract multiple brush motion parameters, including the slip. As a proof of concept for multitasking e-brush, the motion trajectory of handwriting is successfully detected.

In-Ear Electronics with Mechanical Adaptability for Physiological Sensing

Significant developments have been made in the field of wearable healthcare by utilizing soft materials for the construction of electronic sensors. However, the lack of adaptability to complex topologies, such as ear canal, results in inadequate sensing performance. Here, we report an in-ear physiological sensor with mechanical adaptability, which softens upon contact with the ear canal's skin, thus reducing the sensor-skin mechanical mismatch and interface impedance. An efficient strategy of mechanical adjustment and switching is exploited to increase the softness of the device, leading to a significant decrease in Young's modulus from 30.5 MPa of thermoplastic polyurethane (TPU) to 0.86 MPa of TPU/Ecoflex foam (TEF).The mechanical adaptability at body temperature endows the in-ear device improved device-canal contact area and interface stability. As a result, the TEF-based in-ear device demonstrates reliable sensing, low motion artifact, and high comfort in electroencephalography (EEG) and core body temperature sensing. High quality EEG signals of alpha, beta, delta, and gamma are measured during different activities. Moreover, the TEF-based in-ear device exhibits high reusability for over 4 months, which makes it suitable for long-term healthcare monitoring.

Recent Advances and Developments in Injectable Conductive Polymer Gels for Bioelectronics

Soft matter bioelectronics represents an emerging and interdisciplinary research frontier aiming to harness the synergy between biology and electronics for advanced diagnostic and healthcare applications. In this context, a whole family of soft gels have been recently developed with self-healing ability and tunable biological mimetic features to act as a tissue-like space bridging the interface between the electronic device and dynamic biological fluids and body tissues. This review article provides a comprehensive overview of electroactive polymer gels, formed by noncovalent intermolecular interactions and dynamic covalent bonds, as injectable electroactive gels, covering their synthesis, characterization, and applications. First, hydrogels crafted from conducting polymers (poly(3,4-ethylene-dioxythiophene) (PEDOT), polyaniline (PANi), and polypyrrole (PPy))-based networks which are connected through physical interactions (e.g., hydrogen bonding, π-π stacking, hydrophobic interactions) or dynamic covalent bonds (e.g., imine bonds, Schiff-base, borate ester bonds) are addressed. Injectable hydrogels involving hybrid networks of polymers with conductive nanomaterials (i.e., graphene oxide, carbon nanotubes, metallic nanoparticles, etc.) are also discussed. Besides, it also delves into recent advancements in injectable ionic liquid-integrated gels (iongels) and deep eutectic solvent-integrated gels (eutectogels), which present promising avenues for future research. Finally, the current applications and future prospects of injectable electroactive polymer gels in cutting-edge bioelectronic applications ranging from tissue engineering to biosensing are outlined.

Hydrogels in wearable neural interfaces

The integration of wearable neural interfaces (WNIs) with the human nervous system has marked a significant progression, enabling progress in medical treatments and technology integration. Hydrogels, distinguished by their high-water content, low interfacial impedance, conductivity, adhesion, and mechanical compliance, effectively address the rigidity and biocompatibility issues common in traditional materials. This review highlights their important parameters-biocompatibility, interfacial impedance, conductivity, and adhesiveness-that are integral to their function in WNIs. The applications of hydrogels in wearable neural recording and neurostimulation are discussed in detail. Finally, the opportunities and challenges faced by hydrogels for WNIs are summarized and prospected. This review aims to offer a thorough examination of hydrogel technology's present landscape and to encourage continued exploration and innovation. As developments progress, hydrogels are poised to revolutionize wearable neural interfaces, offering significant enhancements in healthcare and technological applications.

Graphical Abstract

Breathable and Stretchable Epidermal Electronics for Health Management: Recent Advances and Challenges

Advanced epidermal electronic devices, capable of real-time monitoring of physical, physiological, and biochemical signals and administering appropriate therapeutics, are revolutionizing personalized healthcare technology. However, conventional portable electronic devices are predominantly constructed from impermeable and rigid materials, which thus leads to the mechanical and biochemical disparities between the devices and human tissues, resulting in skin irritation, tissue damage, compromised signal-to-noise ratio (SNR), and limited operational lifespans. To address these limitations, a new generation of wearable on-skin electronics built on stretchable and porous substrates has emerged. These substrates offer significant advantages including breathability, conformability, biocompatibility, and mechanical robustness, thus providing solutions for the aforementioned challenges. However, given their diverse nature and varying application scenarios, the careful selection and engineering of suitable substrates is paramount when developing high-performance on-skin electronics tailored to specific applications. This comprehensive review begins with an overview of various stretchable porous substrates, specifically focusing on their fundamental design principles, fabrication processes, and practical applications. Subsequently, a concise comparison of various methods is offered to fabricate epidermal electronics by applying these porous substrates. Following these, the latest advancements and applications of these electronics are highlighted. Finally, the current challenges are summarized and potential future directions in this dynamic field are explored.

Spray-Coated Ultrathin and Porous Films for Physiological Sensing and Force Detection

Epidermal electronics employed on human skin for the long term require good breathability and nonforeign wearing. In this work, we combine phase separation and spray coating to fabricate a porous and ultrathin electrode within minutes as well as micrometer-scale porous pressure sensors. The resulting electrodes show a water vapor transmission rate of 18.4 mg·cm-2·h-1, sheet resistance of 5.2 Ω/sq, and thickness below 5 μm. The introduction of the biogel further reduced the electrode-skin impedance, which is lower than that of the commercial gel electrode, indicating that the electrode can have a high degree of conformal contact with the skin. The epidermal electronics prepared by this strategy exhibit an excellent performance in force sensing. Such results strongly prove the efficiency and practicality of the strategy.

Smart Gas Sensors: Recent Developments and Future Prospective

Gas sensor is an indispensable part of modern society with wide applications in environmental monitoring, healthcare, food industry, public safety, etc. With the development of sensor technology, wireless communication, smart monitoring terminal, cloud storage/computing technology, and artificial intelligence, smart gas sensors represent the future of gas sensing due to their merits of real-time multifunctional monitoring, early warning function, and intelligent and automated feature. Various electronic and optoelectronic gas sensors have been developed for high-performance smart gas analysis. With the development of smart terminals and the maturity of integrated technology, flexible and wearable gas sensors play an increasing role in gas analysis. This review highlights recent advances of smart gas sensors in diverse applications. The structural components and fundamental principles of electronic and optoelectronic gas sensors are described, and flexible and wearable gas sensor devices are highlighted. Moreover, sensor array with artificial intelligence algorithms and smart gas sensors in "Internet of Things" paradigm are introduced. Finally, the challenges and perspectives of smart gas sensors are discussed regarding the future need of gas sensors for smart city and healthy living.

Direct Metal Transfer on Swellable Hydrogel with Dehydration-Induced Physical Adhesion

Composites of hydrogels and metals are gaining interest because of each material's unique properties. However, the stable adhesion of metals on hydrogels is challenging due to the mechanical mismatch at the soft-hard interface and the liquidity of the water components in hydrogels. We propose a facile physical-adhesion method that involves the dehydration process of hydrogels to transfer metals from a glass substrate. This method is based on the hydrophobic interaction between polymer chains and metals and is stable, even in water. Continuous metal wiring was achieved on a swollen hydrogel, and electrical conduction was effective for a soft electronic device. Therefore, our method could be a versatile method for integrating hydrogels and metals.

Asymmetric Wettability Hydrogel Surfaces for Enduring Electromyographic Monitoring

Hydrogel electrode interfaces have shown tremendous promise in the acquisition of surface electromyography (EMG) signals. However, the perspiration or moisture environments will trigger the deadhesion between hydrogel electrodes and human skin. Despite the hydrophobic/hydrophilic surfaces can perform the anti-moisture or adhesion respectively, it remains a challenge to integrally form a Janus hydrogel with homogeneous mechanical elasticity and electronic performance. Herein, a surface induction strategy is proposed to approach the hydrophobic/hydrophilic hydrogel surfaces. The hydrophobic interaction between surfactants and molds regulates the distribution of hydrophobic/hydrophilic monomers on the surface. The hydrophobic molds induce a hydrophilic hydrogel surface, while the hydrophilic molds induce a hydrophobic surface. It presents a new phenomenon of reversal wettability inducing and optional hydrogel surfaces. The integral Janus hydrogel can be easily obtained by the hydrophilic molds. Balance of adhesion, elasticity, and conductivity endows the hydrogel electrode patch with durable conformal adhesion and high-fidelity EMG signals even in the sweaty epidermis due to the asymmetric wettability surfaces. This hydrogel performs the quantitative description of muscle strength and accurate fatigue assessment. It offers a reliable candidate for future practical applications in continuous digital healthcare and intelligent human-machine interaction, even the Metaverse.

Damage-free dry transfer method using stress engineering for high-performance flexible two- and three-dimensional electronics

Advanced transfer printing technologies have enabled the fabrication of high-performance flexible and stretchable devices, revolutionizing many research fields including soft electronics, optoelectronics, bioelectronics and energy devices. Despite previous innovations, challenges remain, such as safety concerns due to toxic chemicals, the expensive equipment, film damage during the transfer process and difficulty in high-temperature processing. Thus a new transfer printing process is needed for the commercialization of high-performance soft electronic devices. Here we propose a damage-free dry transfer printing strategy based on stress control of the deposited thin films. First, stress-controlled metal bilayer films are deposited using direct current magnetron sputtering. Subsequently, mechanical bending is applied to facilitate the release of the metal bilayer by increasing the overall stress. Experimental and simulation studies elucidate the stress evolution mechanisms during the processes. By using this method, we successfully transfer metal thin films and high-temperature-treated oxide thin films onto flexible or stretchable substrates, enabling the fabrication of two-dimensional flexible electronic devices and three-dimensional multifunctional devices.

Ambient Moisture-Driven Self-Powered Iontophoresis Patch for Enhanced Transdermal Drug Delivery

Iontophoretic transdermal drug delivery (TDD) devices are known to enhance the transdermal transport of drugs. However, conventional transdermal iontophoretic devices require external power sources, wired connections, or mechanical parts, which reduce the comfort level for patients during extended use. In this work, a self-powered, wearable transdermal iontophoretic patch (TIP) is proposed by harvesting ambient humidity for energy generation, enabling controlled TDD. This patch primarily uses moist-electric generators (MEGs) as its power source, thus obviating the need for complex power management modules and mechanical components. A single MEG unit can produce an open-circuit voltage of 0.80 V and a short-circuit current of 11.65 µA under the condition of 80% relative humidity. Amplification of the electrical output is feasible by connecting multiple generator units in series and parallel, facilitating the powering of certain commercial electronic devices. Subsequently, the MEG array is integrated with the TDD circuit to create the wearable TIP. After 20 min of application, the depth of drug penetration through the skin is observed to increase threefold. The effective promotion effect of TIP on the transdermal delivery of ionized drugs is corroborated by simulations and experiments. This wearable TIP offers a simple, noninvasive solution for TDD.

A Review of Conductive Hydrogel-Based Wearable Temperature Sensors

Conductive hydrogel has garnered significant attention as an emergent candidate for diverse wearable sensors, owing to its remarkable and tailorable properties such as flexibility, biocompatibility, and strong electrical conductivity. These attributes make it highly suitable for various wearable sensor applications (e.g., biophysical, bioelectrical, and biochemical sensors) that can monitor human health conditions and provide timely interventions. Among these applications, conductive hydrogel-based wearable temperature sensors are especially important for healthcare and disease surveillance. This review aims to provide a comprehensive overview of conductive hydrogel-based wearable temperature sensors. First, this work summarizes different types of conductive fillers-based hydrogel, highlighting their recent developments and advantages as wearable temperature sensors. Next, this work discusses the sensing characteristics of conductive hydrogel-based wearable temperature sensors, focusing on sensitivity, dynamic stability, stretchability, and signal output. Then, state-of-the-art applications are introduced, ranging from body temperature detection and wound temperature detection to disease monitoring. Finally, this work identifies the remaining challenges and prospects facing this field. By addressing these challenges with potential solutions, this review hopes to shed some light on future research and innovations in this promising field.

From lab to wearables: Innovations in multifunctional hydrogel chemistry for next-generation bioelectronic devices

Functional hydrogels have emerged as foundational materials in diagnostics, therapy, and wearable devices, owing to their high stretchability, flexibility, sensing, and outstanding biocompatibility. Their significance stems from their resemblance to biological tissue and their exceptional versatility in electrical, mechanical, and biofunctional engineering, positioning themselves as a bridge between living organisms and electronic systems, paving the way for the development of highly compatible, efficient, and stable interfaces. These multifaceted capability revolutionizes the essence of hydrogel-based wearable devices, distinguishing them from conventional biomedical devices in real-world practical applications. In this comprehensive review, we first discuss the fundamental chemistry of hydrogels, elucidating their distinct properties and functionalities. Subsequently, we examine the applications of these bioelectronics within the human body, unveiling their transformative potential in diagnostics, therapy, and human-machine interfaces (HMI) in real wearable bioelectronics. This exploration serves as a scientific compass for researchers navigating the interdisciplinary landscape of chemistry, materials science, and bioelectronics.

Introductory Review of Soft Implantable Bioelectronics Using Conductive and Functional Hydrogels and Hydrogel Nanocomposites

Interfaces between implantable bioelectrodes and tissues provide critical insights into the biological and pathological conditions of targeted organs, aiding diagnosis and treatment. While conventional bioelectronics, made from rigid materials like metals and silicon, have been essential for recording signals and delivering electric stimulation, they face limitations due to the mechanical mismatch between rigid devices and soft tissues. Recently, focus has shifted toward soft conductive materials, such as conductive hydrogels and hydrogel nanocomposites, known for their tissue-like softness, biocompatibility, and potential for functionalization. This review introduces these materials and provides an overview of recent advances in soft hydrogel nanocomposites for implantable electronics. It covers material strategies for conductive hydrogels, including both intrinsically conductive hydrogels and hydrogel nanocomposites, and explores key functionalization techniques like biodegradation, bioadhesiveness, injectability, and self-healing. Practical applications of these materials in implantable electronics are also highlighted, showcasing their effectiveness in real-world scenarios. Finally, we discuss emerging technologies and future needs for chronically implantable bioelectronics, offering insights into the evolving landscape of this field.

Flexible electronics for cardiovascular monitoring on complex physiological skins

Cardiovascular diseases (CVDs) pose a significant global health threat, responsible for a considerable portion of worldwide mortality. Flexible electronics enable continuous, noninvasive, real-time, and portable monitoring, providing an ideal platform for personalized healthcare. Nevertheless, challenges persist in sustaining stable adherence across diverse and intricate skin environments, hindering further advancement toward clinical applications. Strategies such as structural design and chemical modification can significantly enhance the environmental adaptability and monitoring performance of flexible electronics. This review delineates processing techniques, including structural design and chemical modification, to mitigate signal interference from sebaceous skin, motion artifacts from the skin in motion, and infection risks from fragile skin, thereby enabling the accurate monitoring of key cardiovascular indicators in complex physiological environments. Moreover, it delves into the potential for the strategic development and improvement of flexible electronics to ensure their alignment with complex physiological environment requirements, facilitating their transition to clinical applications.

Stretchable and biodegradable self-healing conductors for multifunctional electronics

As the regenerative mechanisms of biological organisms, self-healing provides useful functions for soft electronics or associated systems. However, there have been few examples of soft electronics where all components have self-healing properties while also ensuring compatibility between components to achieve multifunctional and resilient bio-integrated electronics. Here, we introduce a stretchable, biodegradable, self-healing conductor constructed by combination of two layers: (i) synthetic self-healing elastomer and (ii) self-healing conductive composite with additives. Abundant dynamic disulfide and hydrogen bonds of the elastomer and conductive composite enable rapid and complete recovery of electrical conductivity (~1000 siemens per centimeter) and stretchability (~500%) in response to repetitive damages, and chemical interactions of interpenetrated polymer chains of these components facilitate robust adhesion strength, even under extreme mechanical stress. System-level demonstration of soft, self-healing electronics with diagnostic/therapeutic functions for the urinary bladder validates the possibility for versatile, practical uses in biomedical research areas.

Soft Bioelectronics for Neuroengineering: New Horizons in the Treatment of Brain Tumor and Epilepsy

Soft bioelectronic technologies for neuroengineering have shown remarkable progress, which include novel soft material technologies and device design strategies. Such technological advances that are initiated from fundamental brain science are applied to clinical neuroscience and provided meaningful promises for significant improvement in the diagnosis efficiency and therapeutic efficacy of various brain diseases recently. System-level integration strategies in consideration of specific disease circumstances can enhance treatment effects further. Here, recent advances in soft implantable bioelectronics for neuroengineering, focusing on materials and device designs optimized for the treatment of intracranial disease environments, are reviewed. Various types of soft bioelectronics for neuroengineering are categorized and exemplified first, and then details for the sensing and stimulating device components are explained. Next, application examples of soft implantable bioelectronics to clinical neuroscience, particularly focusing on the treatment of brain tumor and epilepsy are reviewed. Finally, an ideal system of soft intracranial bioelectronics such as closed-loop-type fully-integrated systems is presented, and the remaining challenges for their clinical translation are discussed.

Multifunctional Conductive Hydrogel Interface for Bioelectronic Recording and Stimulation

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

Integrating conductive electrodes into hydrogel-based microfluidic chips for real-time monitoring of cell response

The conventional real-time screening in organs-on-chips is limited to optical tracking of pre-tagged cells and biological agents. This work introduces an efficient biofabrication protocol to integrate tunable hydrogel electrodes into 3D bioprinted-on-chips. We established our method of fabricating cell-laden hydrogel-based microfluidic chips through digital light processing-based 3D bioprinting. Our conductive ink includes poly-(3,4-ethylene-dioxythiophene)-polystyrene sulfonate (PEDOT: PSS) microparticles doped in polyethylene glycol diacrylate (PEGDA). We optimized the manufacturing process of PEDOT: PSS microparticles characterized our conductive ink for different 3D bioprinting parameters, geometries, and materials conditions. While the literature is limited to 0.5% w/v for PEDOT: PSS microparticle concentration, we increased their concentration to 5% w/v with superior biological responses. We measured the conductivity in the 3-15 m/m for a range of 0.5%-5% w/v microparticles, and we showed the effectiveness of 3D-printed electrodes for predicting cell responses when encapsulated in gelatin-methacryloyl (GelMA). Interestingly, a higher cellular activity was observed in the case of 5% w/v microparticles compared to 0.5% w/v microparticles. Electrochemical impedance spectroscopy measurements indicated significant differences in cell densities and spheroid sizes embedded in GelMA microtissues.

Electronic Skin for Health Monitoring Systems: Properties, Functions, and Applications

Electronic skin (e-skin), a skin-like wearable electronic device, holds great promise in the fields of telemedicine and personalized healthcare because of its good flexibility, biocompatibility, skin conformability, and sensing performance. E-skin can monitor various health indicators of the human body in real time and over the long term, including physical indicators (exercise, respiration, blood pressure, etc.) and chemical indicators (saliva, sweat, urine, etc.). In recent years, the development of various materials, analysis, and manufacturing technologies has promoted significant development of e-skin, laying the foundation for the application of next-generation wearable medical technologies and devices. Herein, the properties required for e-skin health monitoring devices to achieve long-term and precise monitoring and summarize several detectable indicators in the health monitoring field are discussed. Subsequently, the applications of integrated e-skin health monitoring systems are reviewed. Finally, current challenges and future development directions in this field are discussed. This review is expected to generate great interest and inspiration for the development and improvement of e-skin and health monitoring systems.

Highly stretchable dynamic hydrogels for soft multilayer electronics

Recent progress in the development of synthetic polymer networks has enabled the next generation of hydrogel-based machines and devices. The ability to mimic the mechanical and electrical properties of human tissue gives great potential toward the fields of bioelectronics and soft robotics. However, fabricating hydrogel devices that display high ionic conductivity while maintaining high stretchability and softness remains unmet. Here, we synthesize supramolecular poly(ionic) networks, which display high stretchability (>1500%), compressibility (>90%), and rapid self-recovery (<30 s), while achieving ionic conductivities of up to 0.1 S cm -1. Dynamic cross-links give rise to inter-layer adhesion and a stable interface is formed on account of ultrahigh binding affinities (>1013 M-2). Superior adherence between layers enabled the fabrication of an intrinsically stretchable hydrogel power source, paving the way for the next generation of multi-layer tissue mimetic devices.

Conductive block copolymer elastomers and psychophysical thresholding for accurate haptic effects

Electrotactile stimulus is a form of sensory substitution in which an electrical signal is perceived as a mechanical sensation. The electrotactile effect could, in principle, recapitulate a range of tactile experience by selective activation of nerve endings. However, the method has been plagued by inconsistency, galvanic reactions, pain and desensitization, and unwanted stimulation of nontactile nerves. Here, we describe how a soft conductive block copolymer, a stretchable layout, and concentric electrodes, along with psychophysical thresholding, can circumvent these shortcomings. These purpose-designed materials, device layouts, and calibration techniques make it possible to generate accurate and reproducible sensations across a cohort of 10 human participants and to do so at ultralow currents (≥6 microamperes) without pain or desensitization. This material, form factor, and psychophysical approach could be useful for haptic devices and as a tool for activation of the peripheral nervous system.

Skin-inspired, sensory robots for electronic implants

Drawing inspiration from cohesive integration of skeletal muscles and sensory skins in vertebrate animals, we present a design strategy of soft robots, primarily consisting of an electronic skin (e-skin) and an artificial muscle. These robots integrate multifunctional sensing and on-demand actuation into a biocompatible platform using an in-situ solution-based method. They feature biomimetic designs that enable adaptive motions and stress-free contact with tissues, supported by a battery-free wireless module for untethered operation. Demonstrations range from a robotic cuff for detecting blood pressure, to a robotic gripper for tracking bladder volume, an ingestible robot for pH sensing and on-site drug delivery, and a robotic patch for quantifying cardiac function and delivering electrotherapy, highlighting the application versatilities and potentials of the bio-inspired soft robots. Our designs establish a universal strategy with a broad range of sensing and responsive materials, to form integrated soft robots for medical technology and beyond.

Structuring and Shaping of Mechanically Robust and Functional Hydrogels toward Wearable and Implantable Applications

Hydrogels possess unique features such as softness, wetness, responsiveness, and biocompatibility, making them highly suitable for biointegrated applications that have close interactions with living organisms. However, conventional man-made hydrogels are usually soft and brittle, making them inferior to the mechanically robust biological hydrogels. To ensure reliable and durable operation of biointegrated wearable and implantable devices, mechanical matching and shape adaptivity of hydrogels to tissues and organs are essential. Recent advances in polymer science and processing technologies have enabled mechanical engineering and shaping of hydrogels for various biointegrated applications. In this review, polymer network structuring strategies at micro/nanoscales for toughening hydrogels are summarized, and representative mechanical functionalities that exist in biological materials but are not easily achieved in synthetic hydrogels are further discussed. Three categories of processing technologies, namely, 3D printing, spinning, and coating for fabrication of tough hydrogel constructs with complex shapes are reviewed, and the corresponding hydrogel toughening strategies are also highlighted. These developments enable adaptive fabrication of mechanically robust and functional hydrogel devices, and promote application of hydrogels in the fields of biomedical engineering, bioelectronics, and soft robotics.

Active biointegrated living electronics for managing inflammation

Seamless interfaces between electronic devices and biological tissues stand to revolutionize disease diagnosis and treatment. However, biological and biomechanical disparities between synthetic materials and living tissues present challenges at bioelectrical signal transduction interfaces. We introduce the active biointegrated living electronics (ABLE) platform, encompassing capabilities across the biogenic, biomechanical, and bioelectrical properties simultaneously. The living biointerface, comprising a bioelectronics layout and a Staphylococcus epidermidis-laden hydrogel composite, enables multimodal signal transduction at the microbial-mammalian nexus. The extracellular components of the living hydrogels, prepared through thermal release of naturally occurring amylose polymer chains, are viscoelastic, capable of sustaining the bacteria with high viability. Through electrophysiological recordings and wireless probing of skin electrical impedance, body temperature, and humidity, ABLE monitors microbial-driven intervention in psoriasis.

Permeable Bioelectronics toward Biointegrated Systems

Bioelectronics integrates electronics with biological organs, sustaining the natural functions of the organs. Organs dynamically interact with the external environment, managing internal equilibrium and responding to external stimuli. These interactions are crucial for maintaining homeostasis. Additionally, biological organs possess a soft and stretchable nature; encountering objects with differing properties can disrupt their function. Therefore, when electronic devices come into contact with biological objects, the permeability of these devices, enabling interactions and substance exchanges with the external environment, and the mechanical compliance are crucial for maintaining the inherent functionality of biological organs. This review discusses recent advancements in soft and permeable bioelectronics, emphasizing materials, structures, and a wide range of applications. The review also addresses current challenges and potential solutions, providing insights into the integration of electronics with biological organs.

Exploration of a machine learning approach for diagnosing sarcopenia among Chinese community-dwelling older adults using sEMG-based data

BACKGROUND

In the practical application of sarcopenia screening, there is a need for faster, time-saving, and community-friendly detection methods. The primary purpose of this study was to perform sarcopenia screening in community-dwelling older adults and investigate whether surface electromyogram (sEMG) from hand grip could potentially be used to detect sarcopenia using machine learning (ML) methods with reasonable features extracted from sEMG signals. The secondary aim was to provide the interpretability of the obtained ML models using a novel feature importance estimation method.

METHODS

A total of 158 community-dwelling older residents (≥ 60 years old) were recruited. After screening through the diagnostic criteria of the Asian Working Group for Sarcopenia in 2019 (AWGS 2019) and data quality check, participants were assigned to the healthy group (n = 45) and the sarcopenic group (n = 48). sEMG signals from six forearm muscles were recorded during the hand grip task at 20% maximal voluntary contraction (MVC) and 50% MVC. After filtering recorded signals, nine representative features were extracted, including six time-domain features plus three time-frequency domain features. Then, a voting classifier ensembled by a support vector machine (SVM), a random forest (RF), and a gradient boosting machine (GBM) was implemented to classify healthy versus sarcopenic participants. Finally, the SHapley Additive exPlanations (SHAP) method was utilized to investigate feature importance during classification.

RESULTS

Seven out of the nine features exhibited statistically significant differences between healthy and sarcopenic participants in both 20% and 50% MVC tests. Using these features, the voting classifier achieved 80% sensitivity and 73% accuracy through a five-fold cross-validation. Such performance was better than each of the SVM, RF, and GBM models alone. Lastly, SHAP results revealed that the wavelength (WL) and the kurtosis of continuous wavelet transform coefficients (CWT_kurtosis) had the highest feature impact scores.

CONCLUSION

This study proposed a method for community-based sarcopenia screening using sEMG signals of forearm muscles. Using a voting classifier with nine representative features, the accuracy exceeds 70% and the sensitivity exceeds 75%, indicating moderate classification performance. Interpretable results obtained from the SHAP model suggest that motor unit (MU) activation mode may be a key factor affecting sarcopenia.

A reconfigurable integrated smart device for real-time monitoring and synergistic treatment of rheumatoid arthritis

Rheumatoid arthritis (RA) is a global autoimmune disease that requires long-term management. Ambulatory monitoring and treatment of RA favors remission and rehabilitation. Here, we developed a wearable reconfigurable integrated smart device (ISD) for real-time inflammatory monitoring and synergistic therapy of RA. The device establishes an electrical-coupling and substance delivery interfaces with the skin through template-free conductive polymer microneedles that exhibit high capacitance, low impedance, and appropriate mechanical properties. The reconfigurable electronics drive the microneedle-skin interfaces to monitor tissue impedance and on-demand drug delivery. Studies in vitro demonstrated the anti-inflammatory effect of electrical stimulation on macrophages and revealed the molecular mechanism. In a rodent model, impedance sensing was validated to hint inflammation condition and facilitate diagnosis through machine learning model. The outcome of subsequent synergistic therapy showed notable relief of symptoms, elimination of synovial inflammation, and avoidance of bone destruction.

Beyond nothingness in the formation and functional relevance of voids in polymer films

Voids-the nothingness-broadly exist within nanomaterials and impact properties ranging from catalysis to mechanical response. However, understanding nanovoids is challenging due to lack of imaging methods with the needed penetration depth and spatial resolution. Here, we integrate electron tomography, morphometry, graph theory and coarse-grained molecular dynamics simulation to study the formation of interconnected nanovoids in polymer films and their impacts on permeance and nanomechanical behaviour. Using polyamide membranes for molecular separation as a representative system, three-dimensional electron tomography at nanometre resolution reveals nanovoid formation from coalescence of oligomers, supported by coarse-grained molecular dynamics simulations. Void analysis provides otherwise inaccessible inputs for accurate fittings of methanol permeance for polyamide membranes. Three-dimensional structural graphs accounting for the tortuous nanovoids within, measure higher apparent moduli with polyamide membranes of higher graph rigidity. Our study elucidates the significance of nanovoids beyond the nothingness, impacting the synthesis‒morphology‒function relationships of complex nanomaterials.

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

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

Low-impedance tissue-device interface using homogeneously conductive hydrogels chemically bonded to stretchable bioelectronics

Stretchable bioelectronics has notably contributed to the advancement of continuous health monitoring and point-of-care type health care. However, microscale nonconformal contact and locally dehydrated interface limit performance, especially in dynamic environments. Therefore, hydrogels can be a promising interfacial material for the stretchable bioelectronics due to their unique advantages including tissue-like softness, water-rich property, and biocompatibility. However, there are still practical challenges in terms of their electrical performance, material homogeneity, and monolithic integration with stretchable devices. Here, we report the synthesis of a homogeneously conductive polyacrylamide hydrogel with an exceptionally low impedance (~21 ohms) and a reasonably high conductivity (~24 S/cm) by incorporating polyaniline-decorated poly(3,4-ethylenedioxythiophene:polystyrene). We also establish robust adhesion (interfacial toughness: ~296.7 J/m2) and reliable integration between the conductive hydrogel and the stretchable device through on-device polymerization as well as covalent and hydrogen bonding. These strategies enable the fabrication of a stretchable multichannel sensor array for the high-quality on-skin impedance and pH measurements under in vitro and in vivo circumstances.

A Fully Elastic Wearable Electrochemical Sweat Detection System of Tree-Bionic Microfluidic Structure for Real-Time Monitoring

Fresh sweat contains a diverse range of physiological indicators that can effectively reflect changes in the body. However, existing wearable sweat detection systems face challenges in efficiently collecting and detecting fresh sweat in real-time. Additionally, they often lack the necessary deformation capabilities, resulting in discomfort for the wearer. Here, a fully elastic wearable electrochemical sweat detection system is developed that integrates a sweat-collecting microfluidic chip, a multi-parameter electrochemical sensor, a micro-heater, and a sweat detection elastic circuit board system. The unique tree-bionic structure of the microfluidic chip significantly enhances the efficiency of fresh sweat collection and discharge, enabling real-time detection by the electrochemical sensors. The sweat multi-parameter electrochemical sensor offers high-precision and high-sensitivity measurements of sodium ions, potassium ions, lactate, and glucose. The electronic system is built on an elastic circuit board that matches perfectly to wrinkled skin, ensuring improved wearing comfort and enabling multi-channel data sampling, processing, and wireless transmission. This state-of-the-art system represents a significant advancement in the field of elastic wearable sweat detection and holds promising potential for extending its capabilities to the detection of other sweat markers or various wearable applications.

Soft Sensors and Actuators for Wearable Human-Machine Interfaces

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

Flexible and Stretchable Light-Emitting Diodes and Photodetectors for Human-Centric Optoelectronics

Optoelectronic devices with unconventional form factors, such as flexible and stretchable light-emitting or photoresponsive devices, are core elements for the next-generation human-centric optoelectronics. For instance, these deformable devices can be utilized as closely fitted wearable sensors to acquire precise biosignals that are subsequently uploaded to the cloud for immediate examination and diagnosis, and also can be used for vision systems for human-interactive robotics. Their inception was propelled by breakthroughs in novel optoelectronic material technologies and device blueprinting methodologies, endowing flexibility and mechanical resilience to conventional rigid optoelectronic devices. This paper reviews the advancements in such soft optoelectronic device technologies, honing in on various materials, manufacturing techniques, and device design strategies. We will first highlight the general approaches for flexible and stretchable device fabrication, including the appropriate material selection for the substrate, electrodes, and insulation layers. We will then focus on the materials for flexible and stretchable light-emitting diodes, their device integration strategies, and representative application examples. Next, we will move on to the materials for flexible and stretchable photodetectors, highlighting the state-of-the-art materials and device fabrication methods, followed by their representative application examples. At the end, a brief summary will be given, and the potential challenges for further development of functional devices will be discussed as a conclusion.

Self-Healable, Self-Adhesive and Degradable MXene-Based Multifunctional Hydrogel for Flexible Epidermal Sensors

Conductive hydrogels have garnered significant interest in the realm of wearable flexible sensors due to their close resemblance to human tissue, wearability, and precise signal acquisition capabilities. However, the concurrent attainment of an epidermal hydrogel sensor incorporating reliable self-healing capabilities, biodegradability, robust adhesiveness, and the ability to precisely capture subtle electrophysiological signals poses a daunting and intricate challenge. Herein, an innovative MXene-based composite hydrogel (PBM hydrogel) with exceptional self-healing, self-adhesive, and versatile functionality is engineered through the integration of conductive MXene nanosheets into a well-structured poly(vinyl alcohol) (PVA) and bacterial cellulose (BC) hydrogel three-dimensional (3D) network, utilizing multiple dynamic cross-linking synergistic repeated freeze-thaw strategy. The hydrogel harnesses the presence of dynamically reversible borax ester bonds and multiple hydrogen bonds between its constituents, endowing it with rapid self-healing efficiency (97.8%) and formidable self-adhesive capability. The assembled PBM hydrogel epidermal sensor possesses a rapid response time (10 ms) and exhibits versatility in detecting diverse external stimuli and human movements such as vocalization, handwriting, joint motion, Morse code signals, and even monitoring infusion status. Additionally, the PBM hydrogel sensor offers the added advantage of swift degradation in phosphate-buffered saline solution (within a span of 56 days) and H2O2 solution (in just 53 min), maintaining an eco-friendly profile devoid of any environmental pollution. This work lays the groundwork for possible uses in electronic skins, interactions between humans and machines, and the monitoring of individualized healthcare.