Abstract
The increasing demand for minimal to noninvasive in situ analysis of body fluids, such as sweat, interstitial fluid, and tears, has driven rapid development of electrochemically active ...materials and wearable biosensors. The mechanically soft and deformable nature of these biosensors enables them to efficiently adapt to the geometric nonlinearity of a specific part of the human body. The integration of these biosensors with a fully miniaturized wireless telemetry system enables displaying real-time data in a mobile device and/or reporting to an encrypted server for post analysis. These features are essential for the long-term, unobtrusive monitoring of biochemical activity in ambulatory care settings for improved management of many chronic diseases, such as diabetes, gout, and Parkinson’s disease. Herein, we present the latest innovations of wearable electrochemical sensors tailored for human skin or eyes with a focus on their materials, designs, sensing mechanisms, and clinical implications.
Stretchable electronics have recently been extensively investigated for the development of highly advanced human‐interactive devices. Here, a highly stretchable and sensitive strain sensor is ...fabricated based on the composite of fragmentized graphene foam (FGF) and polydimethylsiloxane (PDMS). A graphene foam (GF) is disintegrated into 200–300 μm sized fragments while maintaining its 3D structure by using a vortex mixer, forming a percolation network of the FGFs. The strain sensor shows high sensitivity with a gauge factor of 15 to 29, which is much higher compared to the GF/PDMS strain sensor with a gauge factor of 2.2. It is attributed to the great change in the contact resistance between FGFs over the large contact area, when stretched. In addition to the high sensitivity, the FGF/PDMS strain sensor exhibits high stretchability over 70% and high durability over 10 000 stretching‐releasing cycles. When the sensor is attached to the human body, it functions as a health‐monitoring device by detecting various human motions such as the bending of elbows and fingers in addition to the pulse of radial artery. Finally, by using the FGF, PDMS, and μ‐LEDs, a stretchable touch sensor array is fabricated, thus demonstrating its potential application as an artificial skin.
A highly stretchable and sensitive strain sensor based on a composite of fragmentized graphene foam (FGF) and polydimethylsiloxane (PDMS) is fabricated in a facile process. The FGF/PDMS sensor demonstrates high stretchability up to 70% and high durability over 10 000 stretching cycles with gauge factor in the range of 15–29 depending on the maximum strain applied and the FGF content.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Electroretinogram examinations serve as routine clinical procedures in ophthalmology for the diagnosis and management of many ocular diseases. However, the rigid form factor of current corneal ...sensors produces a mismatch with the soft, curvilinear, and exceptionally sensitive human cornea, which typically requires the use of topical anesthesia and a speculum for pain management and safety. Here we report a design of an all-printed stretchable corneal sensor built on commercially-available disposable soft contact lenses that can intimately and non-invasively interface with the corneal surface of human eyes. The corneal sensor is integrated with soft contact lenses via an electrochemical anchoring mechanism in a seamless manner that ensures its mechanical and chemical reliability. Thus, the resulting device enables the high-fidelity recording of full-field electroretinogram signals in human eyes without the need of topical anesthesia or a speculum. The device, superior to clinical standards in terms of signal quality and comfortability, is expected to address unmet clinical needs in the field of ocular electrodiagnosis.
As part of increased efforts to develop wearable healthcare devices for monitoring and managing physiological and metabolic information, stretchable electrochemical sweat sensors have been ...investigated. In this study, we report on the fabrication of a stretchable and skin-attachable electrochemical sensor for detecting glucose and pH in sweat. A patterned stretchable electrode was fabricated via layer-by-layer deposition of carbon nanotubes (CNTs) on top of patterned Au nanosheets (AuNS) prepared by filtration onto stretchable substrate. For the detection of glucose and pH, CoWO4/CNT and polyaniline/CNT nanocomposites were coated onto the CNT–AuNS electrodes, respectively. A reference electrode was prepared via chlorination of silver nanowires. Encapsulation of the stretchable sensor with sticky silbione led to a skin-attachable sweat sensor. Our sensor showed high performance with sensitivities of 10.89 μA mM–1 cm–2 and 71.44 mV pH–1 for glucose and pH, respectively, with mechanical stability up to 30% stretching and air stability for 10 days. The sensor also showed good adhesion even to wet skin, allowing the detection of glucose and pH in sweat from running while being attached onto the skin. This work suggests the application of our stretchable and skin-attachable electrochemical sensor to health management as a high-performance healthcare wearable device.
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IJS, KILJ, NUK, PNG, UL, UM
A stretchable polyaniline nanofiber temperature sensor array with an active matrix consisting of single‐walled carbon nanotube thin‐film transistors is demonstrated. The integrated temperature sensor ...array gives mechanical stability under biaxial stretching of 30%, and the resultant spatial temperature mapping does not show any mechanical or electrical degradation.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
We report on the facile fabrication of a stretchable array of highly sensitive pressure sensors. The proposed pressure sensor consists of the top layer of Au-deposited polydimethylsiloxane (PDMS) ...micropillars and the bottom layer of conductive polyaniline nanofibers on a polyethylene terephthalate substrate. The sensors are operated by the changes in contact resistance between Au-coated micropillars and polyaniline according to the varying pressure. The fabricated pressure sensor exhibits a sensitivity of 2.0 kPa–1 in the pressure range below 0.22 kPa, a low detection limit of 15 Pa, a fast response time of 50 ms, and high stability over 10000 cycles of pressure loading/unloading with a low operating voltage of 1.0 V. The sensor is also capable of noninvasively detecting human-pulse waveforms from carotid and radial artery. A 5 × 5 array of the pressure sensors on the deformable substrate, which consists of PDMS islands for sensors and the mixed thin film of PDMS and Ecoflex with embedded liquid metal interconnections, shows stable sensing of pressure under biaxial stretching by 15%. The strain distribution obtained by the finite element method confirms that the maximum strain applied to the pressure sensor in the strain-suppressed region is less than 0.04% under a 15% biaxial strain of the unit module. This work demonstrates the potential application of our proposed stretchable pressure sensor array for wearable and artificial electronic skin devices.
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IJS, KILJ, NUK, PNG, UL, UM
This study reports on the fabrication of pressure/temperature/strain sensors and all‐solid‐state flexible supercapacitors using only polydimethylsiloxane coated microporous polypyrrole/graphene foam ...composite (PDMS/PPy/GF) as a common material. A dual‐mode sensor is designed with PDMS/PPy/GF, which measures pressure and temperature with the changes of current and voltage, respectively, without interference to each other. The fabricated dual‐mode sensor shows high sensitivity, fast response/recovery, and high durability during 10 000 cycles of pressure loading. The pressure is estimated using the thermoelectric voltage induced by simultaneous increase in temperature caused by a finger touch on the sensor. Additionally, a resistor‐type strain sensor fabricated using the same PDMS/PPy/GF could detect the strain up to 50%. Flexible, high performance supercapacitor used as a power supply is fabricated with electrodes of PPy/GF for its high surface area and pseudocapacitance. Furthermore, an integrated system of such fabricated multifunctional sensors and a supercapacitor on a skin‐attachable flexible substrate using liquid–metal interconnections operates well, whereas sensors are driven by the power of the supercapacitor. This study clearly demonstrates that the appropriate choice of a single functional material enables fabrication of active multifunctional sensors for pressure, temperature, and strain, as well as the supercapacitor, that could be used in wirelessly powered wearable devices.
High‐performance solid‐state supercapacitors and multifunctional sensors sensitive to pressure, temperature, and strain are fabricated using a single common active material of microporous polydimethylsiloxane coated microporous polypyrrole/graphene foam composite. Furthermore, these sensors could be wirelessly driven with the integrated supercapacitors on a single flexible and skin‐attachable substrate.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
A foldable array of patterned graphene/ZnO nanoparticle UV sensor and asymmetric micro‐supercapacitors (AMSCs) integrated on a paper substrate with patterned liquid metal interconnections is ...reported. The resistor type UV sensor based on graphene/ZnO nanoparticles is patterned to be driven by the stored energy of the integrated AMSCs. The AMSC consists of MnO2 nanoball deposited multiwalled carbon nanotubes (MWNTs) and V2O5 wrapped MWNTs as positive and negative electrodes, respectively. As an electrolyte, propylene carbonate‐poly(methyl methacrylate)‐LiClO4, an organic solvent‐based gel, is used. The UV sensor and AMSCs can be easily integrated on a liquid metal, Galinstan, patterned, waterproof mineral paper and show a mechanically stable UV sensing, regardless of repetitive folding cycles. This work demonstrates a novel foldable nanomaterial based sensor system driven by integrated energy storage devices, applicable to future wearable and portable electronics.
A patterned graphene/ZnO UV sensor driven by integrated asymmetric micro‐supercapacitors (AMSCs) on a liquid metal patterned foldable substrate is demonstrated. With the stored energy of the AMSCs, the integrated UV sensor is operated stable for 1500 s under deformations of folding.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SBCE, SBMB, UL, UM, UPUK
Abstract
Mammographic density (MD) of the breast and body mass index (BMI) are inversely associated with each other, but have inconsistent associations with respect to the risk of breast cancer. ...Skeletal muscle mass index (SMI) has been considered to reflect a relatively accurate fat and muscle percentage in the body. So, we evaluated the relation between SMI and MD. A cross-sectional study was performed in 143,456 women who underwent comprehensive examinations from 2012 to 2016. BMI was adjusted to analyze whether SMI is an independent factor predicting dense breast. After adjustment for confounding factors including BMI, the odds ratios for MD for the dense breasts was between the highest and lowest quartiles of SMI at 2.65 for premenopausal women and at 2.39 for postmenopausal women. SMI was a significant predictor for MD, which could be due to the similar growth mechanism of the skeletal muscle and breast parenchymal tissue. Further studies are needed to understand the causal link between muscularity, MD and breast cancer risk.
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IZUM, KILJ, NUK, PILJ, PNG, SAZU, UL, UM, UPUK
Background
We investigated the prognostic and predictive roles of the hormone receptor (HRc) subtype in patients with ductal carcinoma in situ (DCIS). We focused on identifying the roles of the ...progesterone receptor (PR) independent of estrogen receptor (ER) status.
Methods
Nationwide data of 12,508 female patients diagnosed with DCIS with a mean follow‐up period of 60.7 months were analyzed. HRc subtypes were classified as ER−/PR−, ER−/PR+, ER+/PR−, and ER+/PR+ based on ER and PR statuses. The Cox proportional hazards model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs).
Results
The ER+/PR+ group showed better prognoses than the ER+/PR− and ER−/PR− groups in the patients who received tamoxifen therapy (p = .001 and p = .031, respectively). HRc subtype was an independent prognostic factor (p = .028). The tamoxifen therapy group showed better survival than the patients who did not receive tamoxifen, but only in the ER+/PR+ subgroup (p = .002). Tamoxifen therapy was an independent prognostic factor (HR, 0.619; 95% CI, 0.423 − 0.907; p = .014). PR status was a favorable prognostic factor in patients with DCIS who received tamoxifen therapy (p < .001), and it remained a prognostic factor independent of ER status (HR, 0.576; 95% CI, 0.349 − 0.951; p = .031).
Conclusion
The HRc subtype can be used as both a prognostic and predictive marker in patients with newly diagnosed DCIS. Tamoxifen therapy can improve overall survival in the ER+/PR+ subtype. PR status has significant prognostic and predictive roles independent of ER status. Testing for the PR status in addition to the ER status is routinely recommended in patients with DCIS to determine the HRc subtype in clinical settings.
Implications for Practice
The hormone receptor (HRc) subtype was an independent prognostic factor, and the estrogen receptor (ER)+/progesterone receptor (PR) + subtype showed a better survival in patients with ductal carcinoma in situ (DCIS) who received tamoxifen therapy. PR was an independent prognostic factor independent of ER, and PR was a favorable prognostic factor in patients with DCIS who received tamoxifen therapy. The HRc subtype could be used as both a prognostic and predictive marker in patients with newly diagnosed DCIS. Testing of PR status in addition to ER status is routinely recommended for patients with DCIS to determine the HRc subtype in clinical settings.
This study investigated the prognostic and predictive roles of the hormone receptor subtype in patients with newly diagnosed ductal carcinoma in situ, focusing on the prognostic and predictive values of progesterone receptor status independent of estrogen receptor status. The prognostic effect of tamoxifen therapy was also investigated
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