The performance and integration density of silicon integrated circuits (ICs) have progressed at an unprecedented pace in the past 60 years. While silicon ICs thrive at low‐power high‐performance computing, creating flexible and large‐area electronics using silicon remains a challenge. On the other hand, flexible and printed electronics use intrinsically flexible materials and printing techniques to manufacture compliant and large‐area electronics. Nonetheless, flexible electronics are not as efficient as silicon ICs for computation and signal communication. Flexible hybrid electronics (FHE) leverages the strengths of these two dissimilar technologies. It uses flexible and printed electronics where flexibility and scalability are required, i.e., for sensing and actuating, and silicon ICs for computation and communication purposes. Combining flexible electronics and silicon ICs yields a very powerful and versatile technology with a vast range of applications. Here, the fundamental building blocks of an FHE system, printed sensors and circuits, thinned silicon ICs, printed antennas, printed energy harvesting and storage modules, and printed displays, are discussed. Emerging application areas of FHE in wearable health, structural health, industrial, environmental, and agricultural sensing are reviewed. Overall, the recent progress, fabrication, application, and challenges, and an outlook, related to FHE are presented.

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SignificanceThe optical method to determine oxygen saturation in blood is limited to only tissues that can be transilluminated. The status quo provides a single-point measurement and lacks 2D oxygenation mapping capability. We use organic printed optoelectronics in a flexible array configuration that senses reflected light from tissue. Our reflectance oximeter is used beyond conventional sensing locations and accurately measures oxygen saturation on the forehead. In a full system implementation, coupled with a mathematical model, we create 2D oxygenation maps of adult forearms under pressure-cuff–induced ischemia. Our skin-like flexible sensor system has the potential to transform oxygenation monitoring of tissues, wounds, skin grafts, and transplanted organs.

A method to print two materials of different functionality during the same printing step is presented. In printed electronics, devices are built layer by layer and conventionally only one type of material is deposited in one pass. Here, the challenges involving printing of two emissive materials to form polymer light‐emitting diodes (PLEDs) that emit light of different wavelengths without any significant changes in the device characteristics are described. The surface‐energy‐patterning technique is utilized to print materials in regions of interest. This technique proves beneficial in reducing the amount of ink used during blade coating and improving the reproducibility of printed films. A variety of colors (green, red, and near‐infrared) are demonstrated and characterized. This is the first known attempt to print multiple materials by blade coating. These devices are further used in conjunction with a commercially available photodiode to perform blood oxygenation measurements on the wrist, where common accessories are worn. Prior to actual application, the threshold conditions for each color are discussed, in order to acquire a stable and reproducible photoplethysmogram (PPG) signal. Finally, based on the conditions, PPG and oxygenation measurements are successfully performed on the wrist with green and red PLEDs.

Recent progress in printed optoelectronics and their integration in wearable sensors have created new avenues for research in reflectance photoplethysmography (PPG) and oximetry. The reflectionmode sensor, which consists of light emitters and detectors, is a vital component of reflectance oximeters. Here, we report a systematic study of the reflectance oximeter sensor design in terms of component geometry, light emitter and detector spacing, and the use of an optical barrier between the emitter and the detector to maximize sensor performance. Printed red and near-infrared (NIR) organic light-emitting diodes (OLEDs) and organic photodiodes (OPDs) are used to design three sensor geometries: (1) Rectangular geometry, where square OLEDs are placed at each side of the OPD; (2) Bracket geometry, where the OLEDs are shaped as brackets and placed around the square OPD; (3) Circular geometry, where the OLEDs are shaped as block arcs and placed around the circular OPD. Utilizing the bracket geometry, we observe 39.7% and 18.2% improvement in PPG signal magnitude in the red and NIR channels compared to the rectangular geometry, respectively. Using the circular geometry, we observe 48.6% and 9.2% improvements in the red and NIR channels compared to the rectangular geometry. Furthermore, a wearable two-channel PPG sensor is utilized to add redundancy to the measurement. Finally, inverse-variance weighting and template matching algorithms are implemented to improve the detection of heart rate from the multi-channel PPG signals.INDEX TERMS Reflection photoplethysmography sensor, organic optoelectronics, pulse oximetry, wearable sensors, printed electronics, flexible electronics.

EMG-based gesture recognition shows promise for human-machine interaction. Systems are often afflicted by signal and electrode variability which degrades performance over time.We present an end-to-end system combating this variability using a large-area, high-density sensor array and a robust classification algorithm. EMG electrodes are fabricated on a flexible substrate and interfaced to a custom wireless device for 64-channel signal acquisition and streaming. We use braininspired high-dimensional (HD) computing for processing EMG features in one-shot learning. The HD algorithm is tolerant to noise and electrode misplacement and can quickly learn from few gestures without gradient descent or back-propagation. We achieve an average classification accuracy of 96.64% for five gestures, with only 7% degradation when training and testing across different days. Our system maintains this accuracy when trained with only three trials of gestures; it also demonstrates comparable accuracy with the state-of-the-art when trained with one trial.

Light absorption in oxygenated and deoxygenated blood varies appreciably over the visible and nearinfrared spectrum. Pulse oximeters use two distinct wavelengths of light to measure oxygen saturation SpO 2 of blood. Currently, light-emitting diodes (LEDs) are used in oximeters, which need additional components to drive them and negatively impact the overall size of the sensor. In this work, we demonstrate an ambient light oximeter (ALO), which can measure photoplethysmography signals and SpO 2 using various kinds of ambient light, avoiding the use of LEDs. We combine spectral Received: ((will be filled in by the editorial staff)) Revised: ((will be filled in by the editorial staff))

Flexible pressure sensors with high sensitivity, broad working range, and good scalability are highly desired for the next generation of wearable electronic devices. However, manufacturing of such pressure sensors still remains challenging. A large‐area compliant and cost‐effective process to fabricate high‐performance pressure sensors via a combination of mesh‐molded periodic microstructures and printed side‐by‐side electrodes is presented. The sensors exhibit low operating voltage (1 V), high sensitivity (20.9 kPa−1), low detection limit (7.4 Pa), fast response/recovery time (23/18 ms), and excellent reliability (over 10 000 cycles). More importantly, they exhibit ultra‐broad working range (7.4–1 000 000 Pa), high tunability, large‐scale production feasibility, and significant advantage in format miniaturization and creating sensor arrays with self‐defined patterns. The versatility of these devices is demonstrated in various human activity monitoring and spatial pressure mapping as electronic skins. Furthermore, utilizing printing methods, a flexible smart insole with a high level of integration for both foot pressure and temperature mapping is demonstrated. The scalable and cost‐effective manufacturing along with the good comprehensive performance of the pressure sensors makes them very attractive for future development of wearable smart devices and human–machine interfaces.