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Low modulus, compliant systems of sensors, circuits and radios designed to intimately interface with the soft tissues of the human body are of growing interest, due to their emerging applications in continuous, clinical-quality health monitors and advanced, bioelectronic therapeutics. Although recent research establishes various materials and mechanics concepts for such technologies, all existing approaches involve simple, two-dimensional (2D) layouts in the constituent micro-components and interconnects. Here we introduce concepts in three-dimensional (3D) architectures that bypass important engineering constraints and performance limitations set by traditional, 2D designs. Specifically, open-mesh, 3D interconnect networks of helical microcoils formed by deterministic compressive buckling establish the basis for systems that can offer exceptional low modulus, elastic mechanics, in compact geometries, with active components and sophisticated levels of functionality. Coupled mechanical and electrical design approaches enable layout optimization, assembly processes and encapsulation schemes to yield 3D configurations that satisfy requirements in demanding, complex systems, such as wireless, skin-compatible electronic sensors. Many low modulus systems, such as sensors, circuits and radios, are in 2D formats that interface with soft human tissue in order to form health monitors or bioelectronic therapeutics. Here the authors produce 3D architectures, which bypass engineering constraints and performance limitations experienced by their 2D counterparts.

When mounted on the skin, modern sensors, circuits, radios, and power supply systems have the potential to provide clinical-quality health monitoring capabilities for continuous use, beyond the confines of traditional hospital or laboratory facilities. The most well-developed component technologies are, however, broadly available only in hard, planar formats. As a result, existing options in system design are unable to effectively accommodate integration with the soft, textured, curvilinear, and time-dynamic surfaces of the skin. Here, we describe experimental and theoretical approaches for using ideas in soft microfluidics, structured adhesive surfaces, and controlled mechanical buckling to achieve ultralow modulus, highly stretchable systems that incorporate assemblies of high-modulus, rigid, state-of-the-art functional elements. The outcome is a thin, conformable device technology that can softly laminate onto the surface of the skin to enable advanced, multifunctional operation for physiological monitoring in a wireless mode.

For wearable electronics/optoelectronics, thermal management should be provided for accurate signal acquisition as well as thermal comfort. However, outdoor solar energy gain has restricted the efficiency of some wearable devices like oximeters. Herein, wireless/battery‐free and thermally regulated patch‐type tissue oximeter (PTO) with radiative cooling structures are presented, which can measure tissue oxygenation under sunlight in reliable manner and will benefit athlete training. To maximize the radiative cooling performance, a nano/microvoids polymer (NMVP) is introduced by combining two perforated polymers to both reduce sunlight absorption and maximize thermal radiation. The optimized NMVP exhibits sub‐ambient cooling of 6 °C in daytime under various conditions such as scattered/overcast clouds, high humidity, and clear weather. The NMVP‐integrated PTO enables maintaining temperature within ≈1 °C on the skin under sunlight relative to indoor measurement, whereas the normally used, black encapsulated PTO shows over 40 °C owing to solar absorption. The heated PTO exhibits an inaccurate tissue oxygen saturation (StO2) value of ≈67% compared with StO2 in a normal state (i.e., ≈80%). However, the thermally protected PTO presents reliable StO2 of ≈80%. This successful demonstration provides a feasible strategy of thermal management in wearable devices for outdoor applications. This article presents a radiative cooled wireless/battery‐free patch type tissue oximeter with nano/microvoids polymer (NMVP) for eliminating the thermal issue of optoelectronics. The NMVP integrated tissue oximeter serves a temperature within ≈1 °C on the skin under direct sunlight relative to indoor measurement, delivering reliable tissue oxygen saturation, unlike normally black encapsulated devices.

Commercial wearable biosignal sensing technologies encounter challenges associated with irritation or discomfort caused by unwanted objects in direct contact with the skin, which can discourage the widespread adoption of wearable devices. To address this issue, we propose a fabric-based lamina emergent MXene-based electrode, a lightweight and flexible shape-morphing wearable bioelectrode. This work offers an innovative approach to biosignal sensing by harnessing the high electrical conductivity and low skin-to-electrode contact impedance of MXene-based dry electrodes. Its design, inspired by Nesler’s pneumatic interference actuator, ensures stable skin-to-electrode contact, enabling robust biosignal detection in diverse situations. Extensive research is conducted on key design parameters, such as the width and number of multiple semicircular legs, the radius of the anchoring frame, and pneumatic pressure, to accommodate a wide range of applications. Furthermore, a real-time wireless electrophysiological monitoring system has been developed, with a signal-to-noise ratio and accuracy comparable to those of commercial bioelectrodes. This work excels in recognizing various hand gestures through a convolutional neural network, ultimately introducing a shape-morphing electrode that provides reliable, high-performance biosignal sensing for dynamic users. Skin irritation is a common challenge for commercial wearable biosignal sensors due to direct contact with the skin. Here, the authors suggest a lightweight, flexible fabric-based lamina emergent MXene electrode as a solution.

Stretchable wearable devices for the continuous monitoring of physiological signals from deep tissues are constrained by the depth of signal penetration and by difficulties in resolving signals from specific tissues. Here, we report the development and testing of a prototype skin-conformal ultrasonic phased array for the monitoring of haemodynamic signals from tissues up to 14 cm beneath the skin. The device allows for active focusing and steering of ultrasound beams over a range of incident angles so as to target regions of interest. In healthy volunteers, we show that the phased array can be used to monitor Doppler spectra from cardiac tissues, record central blood flow waveforms and estimate cerebral blood supply in real time. Stretchable and conformal skin-worn ultrasonic phased arrays may open up opportunities for wearable diagnostics. A prototype skin-conformal ultrasonic phased array enables the monitoring of physiological signals from deep tissues, as shown for the measurements of cardiac Doppler waveforms and central and cerebral blood flows.

This Protocol Extension describes the low-cost production of rapidly customizable optical neural probes for in vivo optogenetics. We detail the use of a 3D printer to fabricate minimally invasive microscale inorganic light-emitting-diode-based neural probes that can control neural circuit activity in freely behaving animals, thus extending the scope of two previously published protocols describing the fabrication and implementation of optoelectronic devices for studying intact neural systems. The 3D-printing fabrication process does not require extensive training and eliminates the need for expensive materials, specialized cleanroom facilities and time-consuming microfabrication techniques typical of conventional manufacturing processes. As a result, the design of the probes can be quickly optimized, on the basis of experimental need, reducing the cost and turnaround for customization. For example, 3D-printed probes can be customized to target multiple brain regions or scaled up for use in large animal models. This protocol comprises three procedures: (1) probe fabrication, (2) wireless module preparation and (3) implantation for in vivo assays. For experienced researchers, neural probe and wireless module fabrication requires ~2 d, while implantation should take 30–60 min per animal. Time required for behavioral assays will vary depending on the experimental design and should include at least 5 d of animal handling before implantation of the probe, to familiarize each animal to their handler, thus reducing handling stress that may influence the result of the behavioral assays. The implementation of customized probes improves the flexibility in optogenetic experimental design and increases access to wireless probes for in vivo optogenetic research. This Protocol Extension describes the fabrication and implantation of 3D-printed neural probes for tethered or wireless optogenetics in freely moving rodents.

Characterization of temperature and thermal transport properties of the skin can yield important information of relevance to both clinical medicine and basic research in skin physiology. Here we introduce an ultrathin, compliant skin-like, or ‘epidermal’, photonic device that combines colorimetric temperature indicators with wireless stretchable electronics for thermal measurements when softly laminated on the skin surface. The sensors exploit thermochromic liquid crystals patterned into large-scale, pixelated arrays on thin elastomeric substrates; the electronics provide means for controlled, local heating by radio frequency signals. Algorithms for extracting patterns of colour recorded from these devices with a digital camera and computational tools for relating the results to underlying thermal processes near the skin surface lend quantitative value to the resulting data. Application examples include non-invasive spatial mapping of skin temperature with milli-Kelvin precision (±50 mK) and sub-millimetre spatial resolution. Demonstrations in reactive hyperaemia assessments of blood flow and hydration analysis establish relevance to cardiovascular health and skin care, respectively. The determination of skin temperature is an important factor to consider in medical and physiological research. Here, the authors fabricate a thermochromic liquid crystal sensor for the determination of skin temperature and thermal properties.

System-level wearable electronics require to be flexible to ensure conformal contact with the skin, but they also need to integrate rigid and bulky functional components to achieve system-level functionality. As one of integration methods, folding integration offers simplified processing and enhanced functionality through rigid-soft region separation, but so far, it has mainly been applied to modality of electrical sensing and stimulation. This paper introduces a vialess heterogeneous skin patch with multi modalities that separates the soft region and strain-robust region through folded structure. Our system includes electrical and optical modalities for hemodynamic and cardiovascular monitoring, and a force-electrically driven micropump for drug delivery. Each modality is demonstrated through on-demand drug delivery, flexible waveguide-based PPG monitoring, and ECG and body movement monitoring. Wireless data transmission and real-time measurement validate the feedback operation for multi-modalities. This engineered closed-loop platform offers the possibility for broad applications, including cardiovascular monitoring and chronic disease management. For system-level integration of wearable electronics, folding method offers simplified processing and enhanced functionality through rigid-soft region separation. Here, the authors introduce a heterogeneous skin patch with multimodal biosensing and responsive drug delivery through folded structure.

Optogenetic methods to modulate cells and signaling pathways via targeted expression and activation of light-sensitive proteins have greatly accelerated the process of mapping complex neural circuits and defining their roles in physiological and pathological contexts. Recently demonstrated technologies based on injectable, microscale inorganic light-emitting diodes (μ-ILEDs) with wireless control and power delivery strategies offer important functionality in such experiments, by eliminating the external tethers associated with traditional fiber optic approaches. Existing wireless μ-ILED embodiments allow, however, illumination only at a single targeted region of the brain with a single optical wavelength and over spatial ranges of operation that are constrained by the radio frequency power transmission hardware. Here we report stretchable, multiresonance antennas and battery-free schemes for multichannel wireless operation of independently addressable, multicolor μ-ILEDs with fully implantable, miniaturized platforms. This advance, as demonstrated through in vitro and in vivo studies using thin, mechanically soft systems that separately control as many as three different μ-ILEDs, relies on specially designed stretchable antennas in which parallel capacitive coupling circuits yield several independent, well-separated operating frequencies, as verified through experimental and modeling results. When used in combination with active motion-tracking antenna arrays, these devices enable multichannel optogenetic research on complex behavioral responses in groups of animals over large areas at low levels of radio frequency power (<1 W). Studies of the regions of the brain that are involved in sleep arousal (locus coeruleus) and preference/aversion (nucleus accumbens) demonstrate the unique capabilities of these technologies.

Continuous Glucose Monitoring (CGM) systems are revolutionizing the real‐time tracking of blood glucose levels, a cornerstone in effective diabetes management and optimal glycemic control. Transitioning from the “intermittent readings” offered by traditional Blood Glucose Monitoring (BGM) methods, CGM delivers an “uninterrupted flow” of glucose data, enabling a “more detailed” strategy for meeting treatment goals. Initially, the “uptake of CGM faced hurdles due to doubts about its precision, but continuous advancements in technology have not only resolved these concerns but also confirms CGM as a dependable and impactful instrument in diabetes management”. Concurrently, advancements in insulin pump technology have improved their portability and ease of use, greatly increasing patient adoption. The market reflects a growing demand for such innovative healthcare solutions, driven by an increased awareness of diabetes management and bolstered by supportive healthcare policies. Future prospects for CGM and insulin pump technologies are incredibly promising, offering the potential for highly personalized care and sophisticated treatment strategies. This paper aims to explore how the synergy between ongoing technological developments and evolving market dynamics is set to redefine the diabetes care paradigm, positioning CGM and insulin pumps as essential elements in enhancing the quality of life for individuals with diabetes. This paper emphasizes the transition in diabetes management through Continuous Glucose Monitoring(CGM) and insulin pumps, analyzing market growth and academic research. It discusses the interrelationships of these elements and emphasizes the need for integrating these components. Additionally, the paper addresses the need for and prospects of integrating these elements into future research and development systems.