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Self-powered implantable devices have the potential to extend device operation time inside the body and reduce the necessity for high-risk repeated surgery. Without the technological innovation of in vivo energy harvesters driven by biomechanical energy, energy harvesters are insufficient and inconvenient to power titanium-packaged implantable medical devices. Here, we report on a commercial coin battery-sized high-performance inertia-driven triboelectric nanogenerator (I-TENG) based on body motion and gravity. We demonstrate that the enclosed five-stacked I-TENG converts mechanical energy into electricity at 4.9 μW/cm 3 (root-mean-square output). In a preclinical test, we show that the device successfully harvests energy using real-time output voltage data monitored via Bluetooth and demonstrate the ability to charge a lithium-ion battery. Furthermore, we successfully integrate a cardiac pacemaker with the I-TENG, and confirm the ventricle pacing and sensing operation mode of the self-rechargeable cardiac pacemaker system. This proof-of-concept device may lead to the development of new self-rechargeable implantable medical devices. Self-powered implantable devices have the potential to extend device operation, though current energy harvesters are both insufficient and inconvenient. Here the authors report on a commercial coin battery-sized high-performance inertia-driven triboelectric nanogenerator based on body motion and gravity that can be used to charge a lithium-ion battery and integrated into a cardiac pacemaker.

Nutrients play critical roles in maintaining core physiological functions and in preventing diseases. Technologies for delivering these nutrients and for monitoring their concentrations can help to ensure proper nutritional balance. Eccrine sweat is a potentially attractive class of biofluid for monitoring purposes due to the ability to capture sweat easily and noninvasively from nearly any region of the body using skin‐integrated microfluidic technologies. Here, a miniaturized system of this type is presented that allows simple, rapid colorimetric assessments of the concentrations of multiple essential nutrients in sweat, simultaneously and without any supporting electronics – vitamin C, calcium, zinc, and iron. A transdermal patch integrated directly with the microfluidics supports passive, sustained delivery of these species to the body throughout a period of wear. Comparisons of measurement results to those from traditional lab analysis methods demonstrate the accuracy and reliability of this platform. On‐body tests with human subjects reveal correlations between the time dynamics of concentrations of these nutrients in sweat and those of the corresponding concentrations in blood. Studies conducted before and after consuming certain foods and beverages highlight practical capabilities in monitoring nutritional balance, with strong potential to serve as a basis for guiding personalized dietary choices. This paper introduces a soft, skin‐interfaced microfluidic system that enables nutrient analysis in sweat and delivery of vitamins to the body. Accurate colorimetric sensors can quantify the concentrations of nutrients in sweat, and a transdermal patch integrated directly with the microfluidics supports passive, sustained delivery of nutrients to the body throughout a period of wear.

Soft, wireless physiological sensors that gently adhere to the skin are capable of continuous clinical-grade health monitoring in hospital and/or home settings, of particular value to critically ill infants and other vulnerable patients, but they present risks for injury upon thermal failure. This paper introduces an active materials approach that automatically minimizes such risks, to complement traditional schemes that rely on integrated sensors and electronic control circuits. The strategy exploits thin, flexible bladders that contain small volumes of liquid with boiling points a few degrees above body temperature. When the heat exceeds the safe range, vaporization rapidly forms highly effective, thermally insulating structures and delaminates the device from the skin, thereby eliminating any danger to the skin. Experimental and computational thermomechanical studies and demonstrations in a skin-interfaced mechano-acoustic sensor illustrate the effectiveness of this simple thermal safety system and suggest its applicability to nearly any class of skin-integrated device technology. Minimizing patient risk to thermal failure in wearable electronics typically requires complex circuit control, sensors, or passive materials. Here, Yoo et al. present an active materials system with a self-inflating bladder that delaminates upon excessive heat, mitigating the risk of thermal injury.

Individuals who are unable to walk independently spend most of the day in a wheelchair. This population is at high risk for developing pressure injuries caused by sitting. However, early diagnosis and prevention of these injuries still remain challenging. Herein, we introduce battery-free, wireless, multimodal sensors and a movable system for continuous measurement of pressure, temperature, and hydration at skin interfaces. The device design includes a crack-activated pressure sensor with nanoscale encapsulations for enhanced sensitivity, a temperature sensor for measuring skin temperature, and a galvanic skin response sensor for measuring skin hydration levels. The movable system enables power harvesting, and data communication to multiple wireless devices mounted at skin-cushion interfaces of wheelchair users over full body coverage. Experimental evaluations and numerical simulations of the devices, together with clinical trials for wheelchair patients, demonstrate the feasibility and stability of the sensor system for preventing pressure injuries caused by sitting.

Variations in parameters associated with the ambient environment can introduce noise in soft, body-worn sensors. For example, many piezoresistive pressure sensors exhibit a high degree of sensitivity to fluctuations in temperature, thereby requiring active compensation strategies. The research presented here addresses this challenge with a multilayered 3D microsystem design that integrates four piezoresistive sensors in a full-Wheatstone bridge configuration. An optimized layout of the sensors relative to the neutral mechanical plane leads to both an insensitivity to temperature and an increased sensitivity to pressure, relative to previously reported devices that rely on similar operating principles. Integrating this 3D pressure sensor into a soft, flexible electronics platform yields a system capable of real-time, wireless measurements from the surface of the skin. Placement above the radial and carotid arteries yields high-quality waveforms associated with pulsatile blood flow, with quantitative correlations to blood pressure. The results establish the materials and engineering aspects of a technology with broad potential in remote health monitoring.

Triboelectric nanogenerators (TENGs) that enable the conversion of a given mechanical energy into electrical energy at high efficiency have been very important in practice. Since the given mechanical energy is involuntarily converted to secondary energy sources (light, heat, and sound during triboelectrification), the significant amount of energy being converted is lost. Various studies have thus been continuously carried out to overcome this issue. Since the first TENGs found in 2012, various developments in TENGs have been made: (1) the mechanical-electrical energy conversion characteristics of potential organic/inorganic material groups have been introduced, (2) the integration into the device structure considering the diversity of mechanical energy, and (3) user friendly and industrial application platforms have been aggressively studied. Despite the remarkable progress and improvement of TENGs, their mechanical-electrical conversion efficiency is still quite low. We therefore need to discover and develop materials that can be converted to improve efficiency. Here, we outline the recent progress made in a group of high polarity triboelectric materials that exploit surface charge density and charge transfer properties. We also review the recent boosting powering TENGs. The aim of this work is to provide insight into the future direction and strategies for highly enhanced powering TENGs through material research.

Soft microfluidic systems that capture, store, and perform biomarker analysis of microliter volumes of sweat, in situ, as it emerges from the surface of the skin, represent an emerging class of wearable technology with powerful capabilities that complement those of traditional biophysical sensing devices. Recent work establishes applications in the real-time characterization of sweat dynamics and sweat chemistry in the context of sports performance and healthcare diagnostics. This paper presents a collection of advances in biochemical sensors and microfluidic designs that support multimodal operation in the monitoring of physiological signatures directly correlated to physical and mental stresses. These wireless, battery-free, skin-interfaced devices combine lateral flow immunoassays for cortisol, fluorometric assays for glucose and ascorbic acid (vitamin C), and digital tracking of skin galvanic responses. Systematic benchtop evaluations and field studies on human subjects highlight the key features of this platform for the continuous, noninvasive monitoring of biochemical and biophysical correlates of the stress state.

The standard of clinical care in many pediatric and neonatal neurocritical care units involves continuous monitoring of cerebral hemodynamics using hard-wired devices that physically adhere to the skin and connect to base stations that commonly mount on an adjacent wall or stand. Risks of iatrogenic skin injuries associated with adhesives that bond such systems to the skin and entanglements of the patients and/or the healthcare professionals with the wires can impede clinical procedures and natural movements that are critical to the care, development, and recovery of pediatric patients. This paper presents a wireless, miniaturized, and mechanically soft, flexible device that supports measurements quantitatively comparable to existing clinical standards. The system features a multiphotodiode array and pair of light-emitting diodes for simultaneous monitoring of systemic and cerebral hemodynamics, with ability to measure cerebral oxygenation, heart rate, peripheral oxygenation, and potentially cerebral pulse pressure and vascular tone, through the utilization of multiwavelength reflectance-mode photoplethysmography and functional near-infrared spectroscopy. Monte Carlo optical simulations define the tissue-probing depths for source–detector distances and operating wavelengths of these systems using magnetic resonance images of the head of a representative pediatric patient to define the relevant geometries. Clinical studies on pediatric subjects with and without congenital central hypoventilation syndrome validate the feasibility for using this system in operating hospitals and define its advantages relative to established technologies. This platformhas the potential to substantially enhance the quality of pediatric care across a wide range of conditions and use scenarios, not only in advanced hospital settings but also in clinics of lower- and middle-income countries.

Continuous monitoring of the parameters that define physiological health status is an essential aspect of modern care for critically ill patients, particularly for vulnerable populations. Current hospital-grade systems for such purposes involve sensors taped to the skin, with hard-wired connections to large, expensive data-acquisition and display systems. Soft, wireless, skin-interfaced alternatives reduce associated burdens on the patients, simplify operations in clinical care, minimize risks of adhesive-induced skin injuries and reduce the costs of monitoring, as recently demonstrated in devices designed for maternal, foetal and paediatric health. The implications extend beyond hospital and home settings in well resourced areas of the globe to remote clinics in low and middle-income countries. This Review summarizes the latest progress in this research area, with an emphasis on the growing range of options in device configurations and form factors, sensor modalities and operational features. Examples of technologies capable of monitoring all key vital signs as well as various unconventional metrics of health status highlight the transition from academic prototypes to manufactured systems and scaled deployments.Skin-interfaced wireless biosensors offer great opportunities for inexpensive, burdenless and continuous health monitoring of perinatal and paediatric patients in clinical and home settings. This Review highlights the latest technology developments and deployment activity in this rapidly expanding field.

Capabilities for continuous monitoring of pressures and temperatures at critical skin interfaces can help to guide care strategies that minimize the potential for pressure injuries in hospitalized patients or in individuals confined to the bed. This paper introduces a soft, skin-mountable class of sensor system for this purpose. The design includes a pressure-responsive element based on membrane deflection and a battery-free, wireless mode of operation capable of multi-site measurements at strategic locations across the body. Such devices yield continuous, simultaneous readings of pressure and temperature in a sequential readout scheme from a pair of primary antennas mounted under the bedding and connected to a wireless reader and a multiplexer located at the bedside. Experimental evaluation of the sensor and the complete system includes benchtop measurements and numerical simulations of the key features. Clinical trials involving two hemiplegic patients and a tetraplegic patient demonstrate the feasibility, functionality and long-term stability of this technology in operating hospital settings. Uninterrupted monitoring of pressure and temperature at skin interfaces can help to minimize the potential for pressure injuries in hospitalized or bedridden patients. Here, the authors introduce a soft, skin-mountable sensor that can continuously provide readings via antennas mounted under bedding, and demonstrate the functionality and robustness of the devices on patients.