Skin bioelectronics are considered as an ideal platform for personalised healthcare because of their unique characteristics, such as thinness, light weight, good biocompatibility, excellent mechanical robustness, and great skin conformability. Recent advances in skin-interfaced bioelectronics have promoted various applications in healthcare and precision medicine. Particularly, skin bioelectronics for long-term, continuous health monitoring offer powerful analysis of a broad spectrum of health statuses, providing a route to early disease diagnosis and treatment. In this review, we discuss (1) representative healthcare sensing devices, (2) material and structure selection, device properties, and wireless technologies of skin bioelectronics towards long-term, continuous health monitoring, (3) healthcare applications: acquisition and analysis of electrophysiological, biophysical, and biochemical signals, and comprehensive monitoring, and (4) rational guidelines for the design of future skin bioelectronics for long-term, continuous health monitoring. Long-term, continuous health monitoring of advanced skin bioelectronics will open unprecedented opportunities for timely disease prevention, screening, diagnosis, and treatment, demonstrating great promise to revolutionise traditional medical practices.

Skin bioelectronics towards long-term, continuous health monitoring.

Recent progress on multifunctional electromagnetic interference shielding polymer composites

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

Materials-Driven Soft Wearable Bioelectronics for Connected Healthcare.

A three-dimensional liquid diode for soft, integrated permeable electronics.

Implantable bioelectronics provide unprecedented opportunities for real-time and continuous monitoring of physiological signals of living bodies. Most bioelectronics adopt thin-film substrates such as polyimide and polydimethylsiloxane that exhibit high levels of flexibility and stretchability. However, the low permeability and relatively high modulus of these thin films hamper the long-term biocompatibility. In contrast, devices fabricated on porous substrates show the advantages of high permeability but suffer from low patterning density. Here, we report a wafer-scale patternable strategy for the high-resolution fabrication of supersoft, stretchable, and permeable liquid metal microelectrodes (μLMEs). We demonstrate 2-μm patterning capability, or an ultrahigh density of ~75,500 electrodes/cm2, of μLME arrays on a wafer-size (diameter, 100 mm) elastic fiber mat by photolithography. We implant the μLME array as a neural interface for high spatiotemporal mapping and intervention of electrocorticography signals of living rats. The implanted μLMEs have chronic biocompatibility over a period of eight months.

https://www.science.org/doi/pdf/10.1126/sciadv.adg8602?download=true

Wafer-patterned, permeable, and stretchable liquid metal microelectrodes for implantable bioelectronics with chronic biocompatibility.

Permeable Conductors for Wearable and On‐Skin Electronics

Skin electronics provides remarkable opportunities for non‐invasive and long‐term monitoring of a wide variety of biophysical and physiological signals that are closely related to health, medicine, and human‐machine interactions. Nevertheless, conventional skin electronics fabricated on elastic thin films are difficult to adapt to the wet microenvironments of the skin: Elastic thin films are non‐permeable, which block the skin perspiration; Elastic thin films are difficult to adhere to wet skin; Most skin electronics are difficult to work underwater. Here, a Wet‐Adaptive Electronic Skin (WADE‐skin) is reported, which consists of a next‐to‐skin wet‐adhesive fibrous layer, a next‐to‐air waterproof fibrous layer, and a stretchable and permeable liquid metal electrode layer. While the electronic functionality is determined by the electrode design, this WADE‐skin simultaneously offers superb stretchability, wet adhesion, permeability, biocompatibility, and waterproof property. The WADE‐skin can rapidly adhere to human skin after contact for a few seconds and stably maintain the adhesion over weeks even under wet conditions, without showing any negative effect to the skin health. The use of WADE‐skin is demonstrated for the stable recording of electrocardiogram during intensive sweating as well as underwater activities, and as the strain sensor for the underwater operation of virtual reality‐mediated human‐machine interactions.

Wet-Adaptive Electronic Skin.

Moisture and thermal comfort are critical for long-term wear. In recent years, there is a rapidly growing attention on the importance of comfortability of wearable electronic textiles (e-textiles), particularly in the fields such as health monitoring, sports training, medical diagnostic and treatment, where long-term comfort is crucial. Nonetheless, simultaneously regulating thermal and moisture comfort for the human body without compromising electronic performance remains a significant challenge to date. Herein, we develop a thermal and moisture managing e-textile (TMME-textile) that integrates unidirectional water transport and daytime radiative cooling properties with highly sensitive sensing performance. The TMME-textile is made by patterning sensing electrodes on rationally designed Janus hierarchical gradient honeycombs that offer wetting gradient and optical management. The TMME-textile can unidirectionally pump excessive sweat, providing a dry and comfortable microenvironment for users. Moreover, it possesses high solar reflectivity (98.3%) and mid-infrared emissivity (89.2%), which reduce skin temperature by ∼7.0°C under a solar intensity of 1 kW m-2 . The TMME-textile-based strain sensor displays high sensitivity (0.1749 kPa-1 ) and rapid response rate (170 ms), effectively enabling smooth long-term monitoring, especially during high-intensity outdoor sports where thermal and moisture stresses are prominent challenges to conventional e-textiles. This article is protected by copyright. All rights reserved.

Thermal and Moisture Managing E-Textiles Enabled by Janus Hierarchical Gradient Honeycombs.

Abstract Textile-based wearable electronics have attracted intensive research interest due to their excellent flexibility and breathability inherent in the unique three-dimensional porous structures. However, one of the challenges lies in achieving highly conductive patterns with high precision and robustness without sacrificing the wearing comfort. Herein, we developed a universal and robust in-textile photolithography strategy for precise and uniform metal patterning on porous textile architectures. The as-fabricated metal patterns realized a high precision of sub-100 µm with desirable mechanical stability, washability, and permeability. Moreover, such controllable coating permeated inside the textile scaffold contributes to the significant performance enhancement of miniaturized devices and electronics integration through both sides of the textiles. As a proof-of-concept, a fully integrated in-textiles system for multiplexed sweat sensing was demonstrated. The proposed method opens up new possibilities for constructing multifunctional textile-based flexible electronics with reliable performance and wearing comfort. 

Well-defined in-textile photolithography towards permeable textile electronics

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