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Abstract Swallowing is an ensemble of voluntary and autonomic processes key to maintaining our body’s homeostatic balance. Abnormal swallowing (dysphagia) can cause dehydration, malnutrition, aspiration pneumonia, weight loss, anxiety, or even mortality—especially in older adults—by airway obstruction. To prevent or mitigate these outcomes, it is imperative to regularly assess swallowing ability in those who are at risk of developing dysphagia and those already diagnosed with it. However, current diagnostic tools such as endoscopy, manometry, and videofluoroscopy require access to clinical experts to interpret the results. These results are often sampled from a limited examination timeframe of swallowing activity in a controlled environment. Additionally, there is some risk of periprocedural complications associated with these methods. In contrast, the field of epidermal sensors is finding non-invasive and minimally obtrusive ways to examine swallowing function and dysfunction. In this review, we summarize the current state of wearable devices that are aimed at monitoring swallowing function and detecting its abnormalities. We pay particular attention to the materials and design parameters that enable their operation. We examine a compilation of both proof-of-concept studies (which focus mainly on the engineering of the device) and studies whose aims are biomedical (which may involve larger cohorts of subjects, including patients). Furthermore, we briefly discuss the methods of signal acquisition and device assessment in relevant wearable sensors. Finally, we examine the need to increase adherence and engagement of patients with such devices and discuss enhancements to the design of such epidermal sensors that may encourage greater enthusiasm for at-home and long-term monitoring. 

Abstract Epidermal sensors for remote healthcare and performance monitoring require the ability to operate under the effects of bodily motion, heat, and perspiration. Here, the use of purpose‐synthesized polymer‐based dry electrodes and graphene‐based strain gauges to obtain measurements of swallowed volume under typical conditions of exercise is evaluated. The electrodes, composed of the common conductive polymer poly(3,4 ethylenedioxythiophene) (PEDOT) electrostatically bound to poly(styrenesulfonate)‐b‐poly(poly(ethylene glycol) methyl ether acrylate) (PSS‐b‐PPEGMEA), collect surface electromyography (sEMG) signals on the submental muscle group, under the chin. Simultaneously, the deformation of the surface of the skin is measured using strain gauges comprising single‐layer graphene supporting subcontinuous coverage of gold and a highly plasticized composite containing PEDOT:PSS. Together, these materials permit high stretchability, high resolution, and resistance to sweat. A custom printed circuit board (PCB) allows this multicomponent system to acquire strain and sEMG data wirelessly. This sensor platform is tested on the swallowing activity of a cohort of 10 subjects while walking or cycling on a stationary bike. Using a machine learning (ML) model, it is possible to predict swallowed volume with absolute errors of 36% for walking and 43% for cycling. 

Abstract A type of haptic device is described that delivers two modes of stimulation simultaneously and at the same location on the skin. The two modes of stimulation are mechanical (delivered pneumatically by inflatable air pockets embedded within a silicone elastomer) and electrical (delivered by a conductive polymer). The key enabling aspect of this work is the use of a highly plasticized conductive polymer based on poly(3,4‐ethylenedioxythiphene) (PEDOT) blended with elastomeric polyurethane (PU). To fabricate the “electropneumotactile” device, the polymeric electrodes are overlaid directly on top of the elastomeric pneumatic actuator pockets. Co‐placement of the pneumatic actuators and the electrotactile electrodes is enabled by the stretchability of the PEDOT:tosylate/PU blend, allowing the electrotactiles to conform to underlying pneumatic pockets under deformation. The blend of PEDOT and PU has a Young's modulus of ≈150 MPa with little degradation in conductivity following repeated inflation of the air pockets. The ability to perceive simultaneous delivery of two sensations to the same location on the skin is supported by experiments using human subjects. These results show that participants can successfully detect the location of pneumatic stimulation and whether electrotactile stimulation is delivered (yes/no) at a rate significantly above chance (mean accuracy = 94%).