A Robust Wearable Point-of-Care CNT-Based Strain Sensor for Wirelessly Monitoring Throat-Related Illnesses

Point-of-care testing (POC) has the ability to detect chronic and infectious diseases early or at the time of occurrence and provide a state-of-the-art personalized healthcare system. Recently, wearable and flexible sensors have been employed to analyze sweat, glucose, blood, and human skin conditions. However, a flexible sensing system that allows for the real-time monitoring of throat-related illnesses, such as salivary parotid gland swelling caused by flu and mumps, is necessary. Here, for the first time, a wearable, highly flexible, and stretchable piezoresistive sensing patch based on carbon nanotubes (CNTs) is reported, which can record muscle expansion or relaxation in real-time, and thus act as a next-generation POC sensor. The patch offers an excellent gauge factor for in-plane stretching and spatial expansion with low hysteresis. The actual extent of muscle expansion is calculated and the gauge factor for applications entailing volumetric deformations is redefined. Additionally, a bluetooth-low-energy system that tracks muscle activity in real-time and transmits the output signals wirelessly to a smartphone app is utilized. Numerical calculations verify that the low stress and strain lead to excellent mechanical reliability and repeatability. Finally, a dummy muscle is inflated using a pneumatic-based actuator to demonstrate the application of the affixed wearable next-generation POC sensor.     

Wearable and Highly Sensitive Graphene Strain Sensors for Human Motion Monitoring

Sensing strain of soft materials in small scale has attracted increasing attention. In this work, graphene woven fabrics (GWFs) are explored for highly sensitive sensing. A flexible and wearable strain sensor is assembled by adhering the GWFs on polymer and medical tape composite film. The sensor exhibits the following features: ultra‐light, relatively good sensitivity, high reversibility, superior physical robustness, easy fabrication, ease to follow human skin deformation, and so on. Some weak human motions are chosen to test the notable resistance change, including hand clenching, phonation, expression change, blink, breath, and pulse. Because of the distinctive features of high sensitivity and reversible extensibility, the GWFs based piezoresistive sensors have wide potential applications in fields of the displays, robotics, fatigue detection, body monitoring, and so forth.     

Self‐Powered Trajectory,Velocity, and Acceleration Tracking of a Moving Object/Body using a Triboelectric Sensor

Motion tracking is of great importance in a wide range of fields such as automation, robotics, security, sports and entertainment. Here, a self‐powered, single‐electrode‐based triboelectric sensor (TES) is reported to accurately detect the movement of a moving object/body in two dimensions. Based on the coupling of triboelectric effect and electrostatic induction, the movement of an object on the top surface of a polytetrafluoroethylene (PTFE) layer induces changes in the electrical potential of the patterned aluminum electrodes underneath. From the measurements of the output performance (open‐circuit voltage and short‐circuit current), the motion information about the object, such as trajectory, velocity, and acceleration is derived in conformity with the preset values. Moreover, the TES can detect motions of more than one objects moving at the same time. In addition, applications of the TES are demonstrated by using LED illuminations as real‐time indicators to visualize the movement of a sliding object and the walking steps of a person.     

Flexible and Highly Sensitive Strain Sensors Fabricated by Pencil Drawn for Wearable Monitor

Functional electrical devices have promising potentials in structural health monitoring system, human‐friendly wearable interactive system, smart robotics, and even future multifunctional intelligent room. Here, a low‐cost fabrication strategy to efficiently construct highly sensitive graphite‐based strain sensors by pencil‐trace drawn on flexible printing papers is reported. The strain sensors can be operated at only two batteries voltage of 3 V, and can be applied to variously monitoring microstructural changes and human motions with fast response/relaxation times of 110 ms, a high gauge factor (GF) of 536.6, and high stability >10 000 bending–unbending cycles. Through investigation of service behaviors of the sensors, it is found that the microcracks occur on the surface of the pencil‐trace and have a major influence on the functions of the strain sensors. These performances of the strain sensor attain and even surpass the properties of recent strain sensing devices with subtle design of materials and device architectures. The pen‐on‐paper (PoP) approach may further develop portable, environmentally friendly, and economical lab‐on‐paper applications and offer a valuable method to fabricate other multifunctional devices.     

Wearable Force Touch Sensor Array Using a Flexible and Transparent Electrode

Transparent electrodes have been widely used for various electronics and optoelectronics, including flexible ones. Many nanomaterial‐based electrodes, in particular 1D and 2D nanomaterials, have been proposed as next‐generation transparent and flexible electrodes. However, their transparency, conductivity, large‐area uniformity, and sometimes cost are not yet sufficient to replace indium tin oxide (ITO). Furthermore, the conventional ITO is quite rigid and susceptible to mechanical fractures under deformations (e.g., bending, folding). In this study, the authors report new advances in the design, fabrication, and integration of wearable and transparent force touch (touch and pressure) sensors by exploiting the previous efforts in stretchable electronics as well as novel ideas in the transparent and flexible electrode. The optical and mechanical experiment, along with simulation results, exhibit the excellent transparency, conductivity, uniformity, and flexibility of the proposed epoxy‐copper‐ITO (ECI) multilayer electrode. By using this multi‐layered ECI electrode, the authors present a wearable and transparent force touch sensor array, which is multiplexed by Si nanomembrane p‐i‐n junction‐type (PIN) diodes and integrated on the skin‐mounted quantum dot light‐emitting diodes. This novel integrated system is successfully applied as a wearable human–machine interface (HMI) to control a drone wirelessly. These advances in novel material structures and system‐level integration strategies create new opportunities in wearable smart displays.     

Stretchable‐Rubber‐Based Triboelectric Nanogenerator and Its Application as Self‐Powered Body Motion Sensors

A stretchable‐rubber‐based (SR‐based) triboelectric nanogenerator (TENG) is developed that can not only harvest energy but also serve as self‐powered multifunctional sensors. It consists of a layer of elastic rubber and a layer of aluminum film that acts as the electrode. By stretching and releasing the rubber, the changes of triboelectric charge distribution/density on the rubber surface relative to the aluminum surface induce alterations to the electrical potential of the aluminum electrode, leading to an alternating charge flow between the aluminum electrode and the ground. The unique working principle of the SR‐based TENG is verified by the coupling of numerical calculations and experimental measurements. A comprehensive study is carried out to investigate the factors that may influence the output performance of the SR‐based TENG. By integrating the devices into a sensor system, it is capable of detecting movements in different directions. Moreover, the SR‐based TENG can be attached to a human body to detect diaphragm breathing and joint motion. This work largely expands the applications of TENG not only as effective power sources but also as active sensors; and opens up a new prospect in future electronics.     

Carbonized Cotton Fabric for High‐Performance Wearable Strain Sensors

Recent years have witnessed the booming development of flexible strain sensors. To date, it is still a great challenge to fabricate strain sensors with both large workable strain range and high sensitivity. Cotton is an abundant supplied natural material composed of cellulose fibers and has been widely used for textiles and clothing. In this work, the fabrication of highly sensitive wearable strain sensors based on commercial plain weave cotton fabric, which is the most popular fabric for clothes, is demonstrated through a low‐cost and scalable process. The strain sensors based on carbonized cotton fabric exhibit fascinating performance, including large workable strain range (>140%), superior sensitivity (gauge factor of 25 in strain of 0%–80% and that of 64 in strain of 80%–140%), inconspicuous drift, and long‐term stability, simultaneously offering advantages of low cost and simplicity in device fabrication and versatility in applications. Notably, the strain sensor can detect a subtle strain of as low as 0.02%. Based on its superior performance, its applications in monitoring both vigorous and subtle human motions are demonstrated, showing its tremendous potential for applications in wearable electronics and intelligent robots.     

Engineering Materials for Electrochemical Sweat Sensing

Human sweat contains vast physiological information, which has been a promising resource for on-body and real-time health monitoring. Wearable sweat sensors have recently attracted an ever-increasing interest due to their promising capabilities for continuously tracking changes in health status. However, the commercialization of sweat sensors is seriously hindered by drawbacks of materials including high manufacturing and consumables costs, complex integration technology, as well as limited electrochemical signal transduction. In this review, sweat sensing principles are elaborately interpreted, and the latest advances in functional materials for biomarkers sensing in sweat are systematically summarized. Subsequently, the complex structure–activity relationships between various functional materials and sensing capabilities are further elucidated by coupling chemical structures, geometrics, electrochemical properties, and approaches for materials manufacturing. Furthermore, the integration of each component into sensing device for sweat detection and analysis is also discussed. Finally, challenges and opportunities for wearable sweat sensors are delineated in the development of future personalized and predictive healthcare.     

A Highly Stretchable Fiber‐Based Triboelectric Nanogenerator for Self‐Powered Wearable Electronics

The development of flexible and stretchable electronics has attracted intensive attention for their promising applications in next‐generation wearable functional devices. However, these stretchable devices that are made in a conventional planar format have largely hindered their development, especially in highly stretchable conditions. Herein, a novel type of highly stretchable, fiber‐based triboelectric nanogenerator (fiber‐like TENG) for power generation is developed. Owing to the advanced structural designs, including the fiber‐convolving fiber and the stretchable electrodes on elastic silicone rubber fiber, the fiber‐like TENG can be operated at stretching mode with high strains up to 70% and is demonstrated for a broad range of applications such as powering a commercial capacitor, LCD screen, digital watch/calculator, and self‐powered acceleration sensor. This work verifies the promising potential of a novel fiber‐based structure for both power generation and self‐powered sensing.     

On‐Body Bioelectronics: Wearable Biofuel Cells for Bioenergy Harvesting and Self‐Powered Biosensing

The growing power demands of wearable electronic devices have stimulated the development of on‐body energy‐harvesting strategies. This article reviews the recent progress on rapidly emerging wearable biofuel cells (BFCs), along with related challenges and prospects. Advanced on‐body BFCs in various wearable platforms, e.g., textiles, patches, temporary tattoo, or contact lenses, enable attractive advantages for bioenergy harnessing and self‐powered biosensing. These noninvasive BFCs open up unique opportunities for utilizing bioenergy or monitoring biomarkers present in biofluids, e.g., sweat, saliva, interstitial fluid, and tears, toward new biomedical, fitness, or defense applications. However, the realization of effective wearable BFC requires high‐quality enzyme‐electronic interface with efficient enzymatic and electrochemical processes and mechanical flexibility. Understanding the kinetics and mechanisms involved in the electron transfer process, as well as enzyme immobilization techniques, is essential for efficient and stable bioenergy harvesting under diverse mechanical strains and changing operational conditions expected in different biofluids and in a variety of outdoor activities. These key challenges of wearable BFCs are discussed along with potential solutions and future prospects. Understanding these obstacles and opportunities is crucial for transforming traditional bench‐top BFCs to effective and successful wearable BFCs.     

The Era of Digital Health: A Review of Portable and Wearable Affinity Biosensors

Digital health facilitated by wearable/portable electronics and big data analytics holds great potential in empowering patients with real‐time diagnostics tools and information. The detection of a majority of biomarkers at trace levels in body fluids using mobile health (mHealth) devices requires bioaffinity sensors that rely on “bioreceptors” for specific recognition. Portable point‐of‐care testing (POCT) bioaffinity sensors have demonstrated their broad utility for diverse applications ranging from health monitoring to disease diagnosis and management. In addition, flexible and stretchable electronics‐enabled wearable platforms have emerged in the past decade as an interesting approach in the ambulatory collection of real‐time data. Herein, the technological advancements of mHealth bioaffinity sensors evolved from laboratory assays to portable POCT devices, and to wearable electronics, are synthesized. The involved recognition events in the mHealth affinity biosensors enabled by bioreceptors (e.g., antibodies, DNAs, aptamers, and molecularly imprinted polymers) are discussed along with their transduction mechanisms (e.g., electrochemical and optical) and system‐level integration technologies. Finally, an outlook of the field is provided and key technological bottlenecks to overcome identified, in order to achieve a new sensing paradigm in wearable bioaffinity platforms.     

Wearable Stretchable Dry and Self-Adhesive Strain Sensors with Conformal Contact to Skin for High-Quality Motion Monitoring

Wearable stretchable strain sensors can have important applications in many areas. However, the high noise is a big hurdle for their application to monitor body movement. The noise is mainly due to the motion artifacts related to the poor contact between the sensors and skin. Here, wearable stretchable dry and self-adhesive strain sensors that can always form conformal contact to skin even during body movement are demonstrated. They are prepared via solution coating and consist of two layers, a dry adhesive layer made of biocompatible elastomeric waterborne polyurethane and a sensing layer made of a non-adhesive composite of reduced graphene oxide and carbon nanotubes. The adhesive layer makes the sensors conformal to skin, while the sensing layer exhibits a resistance sensitive to strain. The sensors are used to accurately monitor both small- and large-scale body movements, including various joint movements and muscle movements. They can always generate high-quality signals even on curvilinear skin surface and during irregular skin deformation. The sensitivity is remarkably higher while the noise is saliently lower than the non-adhesive strain sensors. They can also be used to monitor the movements along two perpendicular directions, which cannot be achieved by the non-adhesive strain sensors.     

Flexible Hybrid Electronics: Direct Interfacing of Soft and Hard Electronics for Wearable Health Monitoring

The interfacing of soft and hard electronics is a key challenge for flexible hybrid electronics. Currently, a multisubstrate approach is employed, where soft and hard devices are fabricated or assembled on separate substrates, and bonded or interfaced using connectors; this hinders the flexibility of the device and is prone to interconnect issues. Here, a single substrate interfacing approach is reported, where soft devices, i.e., sensors, are directly printed on Kapton polyimide substrates that are widely used for fabricating flexible printed circuit boards (FPCBs). Utilizing a process flow compatible with the FPCB assembly process, a wearable sensor patch is fabricated composed of inkjet‐printed gold electrocardiography (ECG) electrodes and a stencil‐printed nickel oxide thermistor. The ECG electrodes provide 1 mVp–p ECG signal at 4.7 cm electrode spacing and the thermistor is highly sensitive at normal body temperatures, and demonstrates temperature coefficient, α ≈ –5.84% K^–1 and material constant, β ≈ 4330 K. This sensor platform can be extended to a more sophisticated multisensor platform where sensors fabricated using solution processable functional inks can be interfaced to hard electronics for health and performance monitoring, as well as internet of things applications.     

Stretchable Composite Acoustic Transducer for Wearable Monitoring of Vital Signs

A highly flexible, stretchable, and mechanically robust low‐cost soft composite consisting of silicone polymers and water (or hydrogels) is reported. When combined with conventional acoustic transducers, the materials reported enable high performance real‐time monitoring of heart and respiratory patterns over layers of clothing (or furry skin of animals) without the need for direct contact with the skin. The approach enables an entirely new method of fabrication that involves encapsulation of water and hydrogels with silicones and exploits the ability of sound waves to travel through the body. The system proposed outperforms commercial, metal‐based stethoscopes for the auscultation of the heart when worn over clothing and is less susceptible to motion artefacts. The system both with human and furry animal subjects (i.e., dogs), primarily focusing on monitoring the heart, is tested; however, initial results on monitoring breathing are also presented. This work is especially important because it is the first demonstration of a stretchable sensor that is suitable for use with furry animals and does not require shaving of the animal for data acquisition.     

Biodegradable and Highly Deformable Temperature Sensors for the Internet of Things

Recent advances in biomaterials, thin film processing, and nanofabrication offer the opportunity to design electronics with novel and unique capabilities, including high mechanical stability and biodegradation, which are relevant in medical implants, environmental sensors, and wearable and disposable devices. Combining reliable electrical performance with high mechanical deformation and chemical degradation remains still challenging. This work reports temperature sensors whose material composition enables full biodegradation while the layout and ultrathin format ensure a response time of 10 ms and stable operation demonstrated by a resistance variation of less than 0.7% when the devices are crumpled, folded, and stretched up to 10%. Magnesium microstructures are encapsulated by a compostable‐certified flexible polymer which exhibits small swelling rate and a Young's modulus of about 500 MPa which approximates that of muscles and cartilage. The extension of the design from a single sensor to an array and its integration onto a fluidic device, made of the same polymer, provides routes for a smart biodegradable system for flow mapping. Proper packaging of the sensors tunes the dissolution dynamics to a few days in water while the connection to a Bluetooth module demonstrates wireless operation with 200 mK resolution prospecting application in food tracking and in medical postsurgery monitoring.     

Highly Stretchable,Global, and Distributed Local Strain Sensing Line Using GaInSn Electrodes for Wearable Electronics

For identifying human or finger movement, it is necessary to sense subtle movements at multiple points, including the local strain and global deformation simultaneously; however, this has not yet been realized. Therefore, a highly stretchable, global, and distributed local strain sensing electrode made of GaInSn and polydimethylsiloxane is developed for wearable devices. To investigate the electrical properties of multiple sections of the GaInSn electrode when stretching, tensile, cyclic, and three‐point‐bending tests are performed. The results demonstrate that the electrode can withstand a strain up to 50% and has little hysteresis without any delay. Moreover, the distributed local strain and global strain can be simultaneously measured using just a single electrode line. Finally, a prototype of a data glove as an application of the strain sensing line is manufactured, and it is demonstrated that the folding state of fingers could be identified. The proposed technology may allow the creation of a lightweight master hand manipulator or 3D data entry device.     

Coaxial Thermoplastic Elastomer‐Wrapped Carbon Nanotube Fibers for Deformable and Wearable Strain Sensors

Highly conductive and stretchable fibers are crucial components of wearable electronics systems. Excellent electrical conductivity, stretchability, and wearability are required from such fibers. Existing technologies still display limited performances in these design requirements. Here, achieving highly stretchable and sensitive strain sensors by using a coaxial structure, prepared via coaxial wet spinning of thermoplastic elastomer‐wrapped carbon nanotube fibers, is proposed. The sensors attain high sensitivity (with a gauge factor of 425 at 100% strain), high stretchability, and high linearity. They are also reproducible and durable. Their use as safe sensing components on deformable cable, expandable surfaces, and wearable textiles is demonstrated.     

Wearable and Implantable Devices for Cardiovascular Healthcare: from Monitoring to Therapy Based on Flexible and Stretchable Electronics

Cardiovascular disease is the leading cause of death and has dramatically increased in recent years. Continuous cardiac monitoring is particularly important for early diagnosis and prevention, and flexible and stretchable electronic devices have emerged as effective tools for this purpose. Their thin, soft, and deformable features allow intimate and long‐term integration with biotissues, which enables continuous, high‐fidelity, and sometimes large‐area cardiac monitoring on the skin and/or heart surface. In addition to monitoring, intimate contact is also crucial for high‐precision therapies. Combined with tissue engineering, soft bioelectronics have also demonstrated the capability to repair damaged cardiac tissues. This review highlights the recent advances in wearable and implantable devices based on flexible and stretchable electronics for cardiovascular monitoring and therapy. First, wearable/implantable soft bioelectronics for cardiovascular monitoring (e.g., the electrocardiogram, blood pressure, and oxygen saturation level) are reviewed. Then, advances in cardiovascular therapy based on soft bioelectronics (e.g., mesh pacing, ablation, robotic sleeves, and electronic stents) are discussed. Finally, device‐assisted tissue engineering therapy (e.g., functional electronic scaffolds and in vitro cardiac platforms) is discussed.     

Processing and doping of thick polymer active layers for flexible organic thermoelectric modules

While the majority of research on organic thermoelectric generators has focused on individual devices with organic films having thicknesses of several hundred nanometers (nano-films), films with micrometer-scale thicknesses (micro-films) provide a longer thermal conduction path that results in a larger temperature gradient and higher thermoelectric voltages in modules. In this study, the properties of solution-processed nano- and micro-films of the p-type semiconductor P3HT doped with two different dopants, F₄-TCNQ and Fe³⁺-tos₃·6H₂O, were investigated. While doping with F₄-TCNQ resulted in high electrical conductivity only in nano-films, doping with Fe³⁺-tos₃·6H₂O from a 25 mM solution yielded power factors of up to ∼30 μWm⁻¹ K⁻² with a conductivity of 55.4 Scm⁻¹ in micro-films. Changes in the molecular packing were compared based on X-ray diffraction, and the best operational stability in air was found for the Fe³⁺-tos₃·6H₂O-doped micro-films. Using Fe³⁺-tos₃·6H₂O as dopant, flexible thermoelectric modules with solution-processed micro-films patterned by a photo-etching technique that does not require alignment and assembly of individual devices were demonstrated, exhibiting a maximum power output of 1.94 nWK⁻² for a uni-leg module with 48 elements. Analysis of the flexible module performance showed that the performance is limited by the contact resistance, which must be taken into consideration when optimizing module structure.     

A 5.2 mW Self-Configured Wearable Body Sensor Network Controller and a 12 $mu$ W Wirelessly Powered Sensor for a Continuous Health Monitoring System

A self-configured body sensor network controller and a high efficiency wirelessly powered sensor are presented for a wearable, continuous health monitoring system. The sensor chip harvests its power from the surrounding health monitoring band using an Adaptive Threshold Rectifier (ATR) with 54.9% efficiency, and it consumes 12 ?W to implement an electrocardiogram (ECG) analog front-end and an ADC. The ATR is implemented with a standard CMOS process for low cost. The adhesive bandage type sensor patch is composed of the sensor chip, a Planar-Fashionable Circuit Board (P-FCB) inductor, and a pair of dry P-FCB electrodes. The dry P-FCB electrodes enable long term monitoring without skin irritation. The network controller automatically locates the sensor position, configures the sensor type (self-configuration), wirelessly provides power to the configured sensors, and transacts data with only the selected sensors while dissipating 5.2 mW at a single 1.8 V supply. Both the sensor and the health monitoring band are implemented using P-FCB for enhanced wearability and for lower production cost. The sensor chip and the network controller chip occupy 4.8 mm² and 15.0 mm², respectively, including pads, in standard 0.18 ?m 1P6M CMOS technology.