A Review of Stimuli-Responsive Smart Materials for Wearable Technology in Healthcare: Retrospective, Perspective, and Prospective.

In recent years thanks to the Internet of Things (IoT), the demand for the development of miniaturized and wearable sensors has skyrocketed. Among them, novel sensors for wearable medical devices are mostly needed. The aim of this review is to summarize the advancements in this field from current points of view, focusing on sensors embedded into textile fabrics. Indeed, they are portable, lightweight, and the best candidates for monitoring biometric parameters. The possibility of integrating chemical sensors into textiles has opened new markets in smart clothing. Many examples of these systems are represented by color-changing materials due to their capability of altering optical properties, including absorption, reflectance, and scattering, in response to different external stimuli (temperature, humidity, pH, or chemicals). With the goal of smart health monitoring, nanosized sol-gel precursors, bringing coupling agents into their chemical structure, were used to modify halochromic dyestuffs, both minimizing leaching from the treated surfaces and increasing photostability for the development of stimuli-responsive sensors. The literature about the sensing properties of functionalized halochromic azo dyestuffs applied to textile fabrics is reviewed to understand their potential for achieving remote monitoring of health parameters. Finally, challenges and future perspectives are discussed to envisage the developed strategies for the next generation of functionalized halochromic dyestuffs with biocompatible and real-time stimuli-responsive capabilities.

Synthesis of high payload nanohydrogels for the ecapsulation of hydrophilic molecules via inverse miniemulsion polymerization: caffeine as a case study.

The association of an active principle with a nanocarrier is known to improve its stability and protect it from external factors. Nevertheless, loading of nanoparticles with highly hydrophilic substances like caffeine remains a tricky issue. In the present study, inverse miniemulsion systems were successfully coupled to UV radiation to synthesize polymeric nanohydrogels for drug delivery. The proper choice of the continuous and dispersed phase chemical composition led to the entrapment of active principle into the miniemulsion droplets. Our confinement-based strategy enabled unprecedented caffeine encapsulation efficiency inside 100-nm particles. Dimensional, thermal, and spectroscopic characterizations were carried out to investigate both unloaded and loaded nanohydrogels. Furthermore, in vitro release studies evaluated caffeine release kinetics from nanohydrogels by means of dialysis tests. It was demonstrated that controlled and sustained release occurred within the first 50 hours. Experimental data were found to fit the Higuchi model suggesting that the active principle release is diffusion controlled.

Chitosan⁻Carboxymethylcellulose-Based Polyelectrolyte Complexation and Microcapsule Shell Formulation.

Chitosan (CH)⁻carboxymethyl cellulose sodium salt (NaCMC) microcapsules containing paraffin oil were synthesized by complex formation, and crosslinked with glutaraldehyde (GTA). The electrostatic deposition of NaCMC onto the CH-coated paraffin oil emulsion droplets was demonstrated by zeta potential and optical microscopy. The optimal process conditions were identified in terms of pH of the aqueous solution (5.5) and CH/NaCMC mass ratio (1:1). Encapsulation of paraffin oil and microcapsule morphology were analyzed by ATR-FTIR and SEM, respectively. The effect of GTA crosslinking on paraffin oil latent heat was investigated by DSC and combined with the values of encapsulation efficiency and core content, supporting the compact shell formation.

Cotton fabric functionalisation with menthol/PCL micro- and nano-capsules for comfort improvement.

OBJECTIVE: Cotton functionalisation with poly-ɛ-caprolactone (PCL) micro- and nano-capsules containing menthol was carried out with the aim of introducing a long-lasting refreshing sensation. MATERIALS AND METHODS: The preparation of the polymer micro- and nano-capsules was carried out by solvent displacement technique. A confined impinging jets mixer was used in order to ensure fast mixing and generate a homogeneous environment where PCL and menthol can self-assemble. RESULTS: The micro- and nano-capsules and the functionalised fabrics were characterised by means of DSC, FT-IR spectroscopy and SEM imaging. Micro- and nano-capsules of different size, from about 200 to about 1200 nm, were obtained varying menthol to PCL ratio (from 0.76 to 8), overall concentration and flow rate (i.e. mixing conditions). The inclusion of menthol was confirmed by DSC analysis. DISCUSSION AND CONCLUSION: A patch test was carried out by 10 volunteers. Micro-capsules were found to be effective in conferring the fabric a refreshing sensation without altering skin physiology.

Thermoregulation of feet in cold environments: A study on alpinism.

Thermal comfort plays a crucial role in the performance and well-being of mountaineers, especially in extreme environments. The aim of this study was to develop a reliable protocol to assess the thermal comfort of mountaineering boots, with a specific focus on temperature variations in different regions of the foot and their correlation with physiological factors. Two different models of mountaineering boots were tested at two different environmental temperature (-15°C and -30°C). The mean skin temperature, measured according to International Standards BS EN ISO 9886:2004, was used as an indicator of overall thermal comfort. Physiological factors such as heart rate (HR), body mass index (BMI) and body surface area (BSA) were also measured to understand their relationship to thermoregulation. Kruskal-Wallis and Pearson's ProductMoment correlation tests were performed to investigate whether there was a statistically significant relationship. The results showed significant differences in foot temperature among the Testers, indicating variations in the perception of thermal comfort. The correlation analysis showed a strong positive relationship between mean skin temperature and HR, highlighting the influence of physiological factors on thermal comfort. In addition, the analysis showed that the dorsum and hallux areas had the largest temperature variations, suggesting the occurrence of vasoconstriction and potential discomfort. This study represents a preliminary approach to establishing a reliable protocol for assessing the thermal performance of cold protective footwear.

Impact of Backpacks on Ergonomics: Biomechanical and Physiological Effects: A Narrative Review.

(1) Background: the effects of load carriage packs on human gait biomechanics, physiology and metabolism depend on the weight carried, the design of the pack and its interaction with the user. (2) Methods: An extensive search in the PubMed database was performed to find all the relevant articles using the following keywords: backpack, rucksack, backpack ergonomy and sports backpack; 60 articles were included. (3) Results and significance: Double pack (DP) and T-pack (TP) designs are recommended solutions for school children, compared with backpacks (BP). For soldiers and hikers, a backpack remains the best compromise. A hip belt is recommended for BPs as well as for the back of DPs. Shorter and stiffer shoulder straps combined with a higher and tighter load placement on the back provide the best combination in terms of balance, muscle activation and energy expenditure. It is, therefore, possible to determine guidelines for designing the optimal load carriage system, depending on the application. (4) Conclusions: based on the available evidence, DP and TP are advantageous in terms of posture. DP is better than conventional BPs in terms of balance and muscle activation, but has the disadvantage of limited visibility, thermal sensation and obstructed ventilation. In general, it is desirable not to exceed 40% of body mass (BM).

Effects of Face Masks on Physiological Parameters and Voice Production during Cycling Activity.

This study investigates the effects of face masks on physiological and voice parameters, focusing on cyclists that perform incremental sports activity. Three healthy male subjects were monitored in a climatic chamber wearing three types of masks with different acoustic properties, breathing resistance, and air filtration performance. Masks A and B were surgical masks made of hydrophobic fabric and three layers of non-woven fabric of 100% polypropylene, respectively. Mask S was a multilayer cloth mask designed for sports activity. Mask B and Mask S behave similarly and show lower sound attenuation and sound transmission loss and lower breathing resistance than Mask A, although Mask A exhibits slightly higher filtration efficiency. Similar cheek temperatures were observed for Masks A and B, while a significantly higher temperature was measured with Mask S at incremental physical activity. No differences were found between the masks and the no-mask condition for voice monitoring. Overall, Mask B and Mask S are suitable for sports activities without adverse effects on voice production while ensuring good breathing resistance and filtration efficiency. These outcomes support choosing appropriate masks for sports activities, showing the best trade-off between breathing resistance and filtration efficiency, sound attenuation, and sound transmission loss.

Far-Infrared Emission Properties and Thermogravimetric Analysis of Ceramic-Embedded Polyurethane Films.

The far-infrared ray (FIR) is one kind of electromagnetic wave employed for numerous bio-interactive applications such as body thermoregulation, infrared therapy, etc. Tuning the FIR-emitting property of the functional textile surface can initiate a new horizon to utilize this property in sportswear or even smart textiles. Ceramic particles were studied for their unique ability to constantly emit FIR rays. The purpose of this research is to characterize the FIR emission properties and the thermogravimetric analysis of ceramic-embedded polyurethane films. For this purpose, ceramic particles such as aluminum oxide, silicon dioxide, and titanium dioxide were incorporated (individually) with water-based polyurethane (WPU) binder by a sonication technique to make a thin layer of film. Significant improvement in FIR emissive property of the films was found when using different ceramic particles into the polyurethane films. Reflection and transmission at the FIR range were measured with a gold integrating sphere by Fourier-transform infrared (FTIR) spectrometer. The samples were also characterized by thermogravimetric analysis (TGA). Different physical tests, such as tensile strength and contact angle measurements, were performed to illustrate the mechanical properties of the films. The study suggested that the mechanical properties of the polyurethane films were significantly influenced by the addition of ceramic particles.

Bio-Functional Textiles: Combining Pharmaceutical Nanocarriers with Fibrous Materials for Innovative Dermatological Therapies.

In the field of pharmaceutical technology, significant attention has been paid on exploiting skin as a drug administration route. Considering the structural and chemical complexity of the skin barrier, many research works focused on developing an innovative way to enhance skin drug permeation. In this context, a new class of materials called bio-functional textiles has been developed. Such materials consist of the combination of advanced pharmaceutical carriers with textile materials. Therefore, they own the possibility of providing a wearable platform for continuous and controlled drug release. Notwithstanding the great potential of these materials, their large-scale application still faces some challenges. The present review provides a state-of-the-art perspective on the bio-functional textile technology analyzing the several issues involved. Firstly, the skin physiology, together with the dermatological delivery strategy, is keenly described in order to provide an overview of the problems tackled by bio-functional textiles technology. Secondly, an overview of the main dermatological nanocarriers is provided; thereafter the application of these nanomaterial to textiles is presented. Finally, the bio-functional textile technology is framed in the context of the different dermatological administration strategies; a comparative analysis that also considers how pharmaceutical regulation is conducted.

Relationships between skin properties and environmental parameters.

BACKGROUND/PURPOSE: Many authors have written about skin physiological parameters and their changes according to different environmental conditions. Nevertheless, the literature puts in evidence disagreement among different studies due to the great variability in these parameters and due to the difficulty in comparing the results obtained under different working conditions. Hence, the aim of this work is to attempt to clarify the relationship between some skin properties, such as transepidermal water loss (TEWL), skin hydration and mean skin temperature (T(sk)), and the environmental parameters of ambient temperature (T(a)) and relative humidity (RH), with the help of a climatic chamber to make the environment reliable. This work must be considered as the preliminary step of a wider project dealing with textile engineering: the results will be used in identifying criteria for textile design with the aim of producing more comfortable clothing. METHODS: Experiments were carried out in a climatic chamber with independently controlled T(a) and RH. All the combinations between three levels of T(a) (20 degrees C, 25 degrees C and 30 degrees C) and four levels of RH (25%, 45%, 65% and 85%) were used on a panel of six young female subjects. The assessments made were: skin surface hydration using an electrical capacitance method, TEWL using a Tewameter and T(sk) using a set of thermistors. RESULTS: The results showed a significant correlation between TEWL and T(a), while the RH had a weaker effect on TEWL in the temperature range under investigation. Also, T(sk) showed a higher correlation with T(a) compared with RH. Finally, skin surface hydration was found to be strongly affected by both environmental parameters. CONCLUSIONS: The analysis of experimental data resulted in the elaboration of some easy empirical models useful to evaluate the changes in TEWL, skin hydration and T(sk) in different climatic conditions. These relationships must be considered to be valid only in a restricted range of T(a) (20-30 degrees C) and RH (25-85%) for young female subjects (25-35 years old).

Influence of process parameters on microcapsule formation from chitosan-Type B gelatin complex coacervates.

A series of chitosan/gelatin based microcapsules containing n-hexadecane was synthesized through complex phase coacervation from chitosan (CH) and type-B gelatin (GB), and crosslinked by glutaraldehyde (GTA). This research was conducted to clarify the influence of different parameters on the encapsulation process, i.e., the emulsion formation and the shell formation, using zeta potential and surface tension measurements, attenuated total reflectance (ATR), and thermal analysis such as differential scanning calorimetry (DSC). The optimal values of biopolymer ratios (TBP), crosslinker amount, emulsion time and feeding weight ratio of core/shell polymer (RCS) were identified. The stability of the emulsion was depended on the surface activity and TBP ratio, which also affected the droplet size distribution and the thickness of the shell. Furthermore, core content, encapsulation efficiency and thermal properties of the microcapsules were related to TBP and RCS; with the lowest RCS giving the best microcapsules features.

Overcoming the Limits of Flash Nanoprecipitation: Effective Loading of Hydrophilic Drug into Polymeric Nanoparticles with Controlled Structure.

Flash nanoprecipitation (FNP) is a widely used technique to prepare particulate carriers based on various polymers, and it was proven to be a promising technology for the industrial production of drug loaded nanoparticles. However, up to now, only its application to hydrophobic compounds has been deeply studied and the encapsulation of some strongly hydrophilic compounds, such as caffeine, remains a challenge. Caffeine loaded poly-ε-caprolactone (PCL) nanoparticles were produced in a confined impinging jet mixer using acetone as the solvent and water as the antisolvent. Caffeine was dissolved either in acetone or in water to assess the effects of two different process conditions. Nanoparticles properties were assessed in terms of loading capacity (LC%), encapsulation efficiency (EE%), and in vitro release kinetics. Samples were further characterized by dynamic light scattering, scanning electron microscopy, X-ray photo electron spectroscopy, and infrared spectroscopy to determine the size, morphology, and structure of nanoparticles. FNP was proved an effective technique for entrapping caffeine in PCL and to control its release behavior. The solvent used to solubilize caffeine influences the final structure of the obtained particles. It was observed that the active principle was preferentially adsorbed at the surface when using acetone, while with water, it was embedded in the matrix structure. The present research highlights the possibility of extending the range of applications of FNP to hydrophilic molecules.

Improvement in exercise capacity and delayed anaerobic metabolism induced by far-infrared-emitting garments in active healthy subjects: A pilot study.

Background Far-infrared-emitting garments have several biological properties including the capability to increase blood perfusion in irradiated tissues. Design The aim of the study was to evaluate whether far-infrared radiation increases exercise capacity and delays anaerobic metabolism in healthy subjects. Methods With a double-blind, crossover protocol, a maximal cardiopulmonary exercise test was performed in 20 volunteers, wearing far-infrared or common sport clothes, identical in texture and colour. Results Comparing far-infrared with placebo garments, higher oxygen uptake at peak of exercise and longer endurance time were observed (peak oxygen uptake 38.0 ± 8.9 vs. 36.2 ± 8.5 ml/kg/min, endurance time 592 ± 85 vs. 570 ± 71 seconds; P < 0.01); the anaerobic threshold was significantly delayed (anaerobic threshold time 461 ± 93 vs. 417 ± 103 seconds) and anaerobic threshold oxygen uptake and anaerobic threshold oxygen pulse were significantly higher (25.3 ± 6.4 vs. 20.9 ± 5.4 ml/kg/min and 13.3 ± 3.8 vs. 12.4 ± 3.3 ml/beat, respectively). In 10 subjects the blood lactate concentration was measured every 2 minutes during exercise and at peak; lower values were observed with far-infrared fabrics compared to placebo from the eighth minute of exercise, reaching a significant difference at 10 minutes (3.6 ± 0.83 vs. 4.4 ± 0.96 mmol/l; P = 0.02). Conclusions In healthy subjects, exercising with a far-infrared outfit is associated with an improvement in exercise performance and a delay in anaerobic metabolism. In consideration of the acknowledged non-thermic properties of functionalised clothes, these effects could be mediated by an increase in oxygen peripheral delivery secondary to muscular vasodilation. These data suggest the need for testing far-infrared-emitting garments in patients with exercise limitation or in chronic cardiovascular and respiratory patients engaged in rehabilitation programmes.

Surface behavior and bulk properties of aqueous chitosan and type-B gelatin solutions for effective emulsion formulation.

The behavior of aqueous chitosan (CH), type-B gelatin (GB) and CH-GB coacervate was studied on oil-in-water emulsion formulation at various pH and concentration ratio. The coacervate was formed by phase separation at ratios CH:GB, 1:10 to 1:1 with total biopolymer concentrations of 0.55%-1.0% (w/v) at pH 4.0-5.5. Soluble complexes were formed below pH 5.0 and coacervate formation was confirmed at pH 5.0 and above by zeta potential and UV-spectroscopy measurements. The coacervate formation was found maximum at the CH-GB ratios of 1:10 and 1:5 at pH 5.5. Formulated emulsions (>10µm droplets) using 1% (w/v) chitosan and GB were found stable (+52.5mv and creaming index 86%) and unstable respectively. Emulsion stabilized by mixed CH:GB 1:5 (3%w/v) had no creaming effect. The instability was attributed to the lower surface activity (K=5.0Lg-1) of pure GB compared to CH (K=14.3Lg-1). The formulation and methods can successfully tune the stability of the emulsions.

Functionalization of Cotton Fabrics with Polycaprolactone Nanoparticles for Transdermal Release of Melatonin.

Drug delivery by means of transdermal patches raised great interest as a non-invasive and sustained therapy. The present research aimed to design a patch for transdermal delivery of melatonin, which was encapsulated in polycaprolactone (PCL) nanoparticles (NPs) by employing flash nanoprecipitation (FNP) technique. Melatonin-loaded PCL nanoparticles were successfully prepared with precise control of the particle size by effectively tuning process parameters. The effect of process parameters on the particle size was assessed by dynamic light scattering for producing particles with suitable size for transdermal applications. Quantification of encapsulated melatonin was performed by mean of UV spectrophotometry, obtaining the estimation of encapsulation efficiency (EE%) and loading capacity (LC%). An EE% higher than 80% was obtained. Differential scanning calorimetry (DSC) analysis of NPs was performed to confirm effective encapsulation in the solid phase. Cotton fabrics, functionalized by imbibition with the nano-suspension, were analyzed by scanning electron microscopy to check morphology, adhesion and distribution of the NPs on the surface; melatonin transdermal release from the functionalized fabric was performed via Franz's cells by using a synthetic membrane. NPs were uniformly distributed on cotton fibres, as confirmed by SEM observations; the release test showed a continuous and controlled release whose kinetics were satisfactorily described by Baker-Lonsdale model.

Thermo-physiological comfort of soft-shell back protectors under controlled environmental conditions.

The aim of the study was to investigate thermo-physiological comfort of three back protectors identifying design features affecting heat loss and moisture management. Five volunteers tested the back protectors in a climatic chamber during an intermittent physical activity. Heart rate, average skin temperature, sweat production, microclimate temperature and humidity have been monitored during the test. The sources of heat losses have been identified using infrared thermography and the participants answered a questionnaire to express their subjective sensations associated with their thermo-physiological condition. The results have shown that locally torso skin temperature and microclimate depended on the type of back protector, whose design allowed different extent of perspiration and thermal insulation. Coupling physiological measurements with the questionnaire, it was found that overall comfort was dependent more on skin wetness than skin temperature: the participants preferred the back protector with the highest level of ventilation through the shell and the lowest level of microclimate humidity.

Preparation of functionalized cotton fabrics by means of melatonin loaded ß-cyclodextrin nanosponges.

Biofunctional textiles are a new category of advanced materials which combine conventional textiles with advanced drug delivery systems to obtain fabrics able to release active principles through skin. The work presents the synthesis of hyper cross-linked ß-cyclodextrins nanosponges with the carbonyl group acting as bridge between cyclodextrin molecules. The result of the synthesis is a 3-D porous structure, where melatonin molecules have been complexed. The complex has been characterized by elemental analysis, DSC, SEM, XRD and FT-IR spectroscopy and the results confirm that melatonin interacts with the synthesized nanosponge at molecular level. Melatonin loaded nanosponges have been dispersed on cotton fibres, which have proved to be a suitable substrate for durable nanosponge adsorption. The in vitro release tests from the funtionalized fabrics have shown a zero order kinetics, which is typical of a reservoir diffusion controlled system.

Cotton-made cellulose support for anti-allergic pajamas.

The cotton used to produce an interlock knitted fabric is alkaline boiled, bleached and after drying, it is grafted with monochlorotriazinyl-beta-cyclodextrin (MCT-ß-CD) as a support of an inclusion compound (IC) with natural anti-allergic active principles, in order to improve the curative properties and the comfort. Are used: extract of Viola tricolor Herb (VtH), solution of propolis (P) and of menthol (M), as well as the pharmacologic products: advantan (AD), hydrocortisone (HYD) and pimechrolimus (PI). The dimensions of the active compound molecules were established with software. The textile material grafted with MCT-ß-CD and with active principles absorbed in the cyclodextrin cavity is investigated by EDX. The anti-microbial activity of VtH, P and M was tested. Tactile determinations of softness were performed with human appraisers. By assembling the anti-allergic knitted fabric with untreated fabric, therapeutic pajamas were obtained. The manner to process and manufacture the pajamas for patients with contact and atopic (DA) dermatitis (DC) is presented.