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      Multifunctional wearable devices for diagnosis and therapy of movement disorders

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          Abstract

          Wearable systems that monitor muscle activity, store data and deliver feedback therapy are the next frontier in personalized medicine and healthcare. However, technical challenges, such as the fabrication of high-performance, energy-efficient sensors and memory modules that are in intimate mechanical contact with soft tissues, in conjunction with controlled delivery of therapeutic agents, limit the wide-scale adoption of such systems. Here, we describe materials, mechanics and designs for multifunctional, wearable-on-the-skin systems that address these challenges via monolithic integration of nanomembranes fabricated with a top-down approach, nanoparticles assembled by bottom-up methods, and stretchable electronics on a tissue-like polymeric substrate. Representative examples of such systems include physiological sensors, non-volatile memory and drug-release actuators. Quantitative analyses of the electronics, mechanics, heat-transfer and drug-diffusion characteristics validate the operation of individual components, thereby enabling system-level multifunctionalities.

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          Most cited references 21

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          An ultra-lightweight design for imperceptible plastic electronics.

          Electronic devices have advanced from their heavy, bulky origins to become smart, mobile appliances. Nevertheless, they remain rigid, which precludes their intimate integration into everyday life. Flexible, textile and stretchable electronics are emerging research areas and may yield mainstream technologies. Rollable and unbreakable backplanes with amorphous silicon field-effect transistors on steel substrates only 3 μm thick have been demonstrated. On polymer substrates, bending radii of 0.1 mm have been achieved in flexible electronic devices. Concurrently, the need for compliant electronics that can not only be flexed but also conform to three-dimensional shapes has emerged. Approaches include the transfer of ultrathin polyimide layers encapsulating silicon CMOS circuits onto pre-stretched elastomers, the use of conductive elastomers integrated with organic field-effect transistors (OFETs) on polyimide islands, and fabrication of OFETs and gold interconnects on elastic substrates to realize pressure, temperature and optical sensors. Here we present a platform that makes electronics both virtually unbreakable and imperceptible. Fabricated directly on ultrathin (1 μm) polymer foils, our electronic circuits are light (3 g m(-2)) and ultraflexible and conform to their ambient, dynamic environment. Organic transistors with an ultra-dense oxide gate dielectric a few nanometres thick formed at room temperature enable sophisticated large-area electronic foils with unprecedented mechanical and environmental stability: they withstand repeated bending to radii of 5 μm and less, can be crumpled like paper, accommodate stretching up to 230% on prestrained elastomers, and can be operated at high temperatures and in aqueous environments. Because manufacturing costs of organic electronics are potentially low, imperceptible electronic foils may be as common in the future as plastic wrap is today. Applications include matrix-addressed tactile sensor foils for health care and monitoring, thin-film heaters, temperature and infrared sensors, displays, and organic solar cells.
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            Transdermal drug delivery.

            Transdermal drug delivery has made an important contribution to medical practice, but has yet to fully achieve its potential as an alternative to oral delivery and hypodermic injections. First-generation transdermal delivery systems have continued their steady increase in clinical use for delivery of small, lipophilic, low-dose drugs. Second-generation delivery systems using chemical enhancers, noncavitational ultrasound and iontophoresis have also resulted in clinical products; the ability of iontophoresis to control delivery rates in real time provides added functionality. Third-generation delivery systems target their effects to skin's barrier layer of stratum corneum using microneedles, thermal ablation, microdermabrasion, electroporation and cavitational ultrasound. Microneedles and thermal ablation are currently progressing through clinical trials for delivery of macromolecules and vaccines, such as insulin, parathyroid hormone and influenza vaccine. Using these novel second- and third-generation enhancement strategies, transdermal delivery is poised to significantly increase its impact on medicine.
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              User-interactive electronic skin for instantaneous pressure visualization.

              Electronic skin (e-skin) presents a network of mechanically flexible sensors that can conformally wrap irregular surfaces and spatially map and quantify various stimuli. Previous works on e-skin have focused on the optimization of pressure sensors interfaced with an electronic readout, whereas user interfaces based on a human-readable output were not explored. Here, we report the first user-interactive e-skin that not only spatially maps the applied pressure but also provides an instantaneous visual response through a built-in active-matrix organic light-emitting diode display with red, green and blue pixels. In this system, organic light-emitting diodes (OLEDs) are turned on locally where the surface is touched, and the intensity of the emitted light quantifies the magnitude of the applied pressure. This work represents a system-on-plastic demonstration where three distinct electronic components--thin-film transistor, pressure sensor and OLED arrays--are monolithically integrated over large areas on a single plastic substrate. The reported e-skin may find a wide range of applications in interactive input/control devices, smart wallpapers, robotics and medical/health monitoring devices.
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                Author and article information

                Journal
                Nature Nanotechnology
                Nature Nanotech
                Springer Science and Business Media LLC
                1748-3387
                1748-3395
                May 2014
                March 30 2014
                May 2014
                : 9
                : 5
                : 397-404
                Article
                10.1038/nnano.2014.38
                24681776
                © 2014

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