Thin, Soft, Skin-Mounted Microfluidic Networks with Capillary Bursting Valves for Chrono-Sampling of Sweat

Wearable microfluidic patch with integrated capillary valves and pumps for sweat management and multiple biomarker analysis

Wearable sweat sensors are essential for providing insight into human physiological health. The currently developed microfluidic sweat sensors have demonstrated the function of collecting and storing sweat. However, they detect more average concentrations of substances based on time periods, which leads to the fact that in situ real-time measurement for multiple biomarkers remains a grand challenge. Here, we propose a wearable epidermal microfluidic patch with integrated microfluidic pumps and micro-valves for accelerated and continuous collection of the sweat, where the micro-pumps ensure the complete separation of old and new sweat for real-time detection of real concentration of biomarkers in sweat. The biomarker concentration at different time periods is detected by introducing a burst valve, which is used to assist in the analysis of the real-time detection. A quantitative relationship between the minimum burst pressure difference required for sequential collection and the size of the microchannel structure is established to overcome the effects of additional resistance at the gas-liquid interface. Additionally, the sensing modules, including sodium ion, chlorine ion, glucose, and pH level in sweat, are integrated into the patch to realize in situ, real-time detection of multiple biomarkers in the human sweat, decoding the correlation between changes in substance concentrations and physiological conditions. This work provides a unique and simplifying strategy for developing wearable sweat sensors for potential applications in health monitoring and disease diagnostics.

A High-Fidelity Skin-Attachable Acoustic Sensor for Realizing Auditory Electronic Skin

Wearable auditory sensors are critical in user-friendly sound-recognition systems for smart human-machine interaction and the Internet of Things. However, previously reported wearable sensors have limited sound-sensing quality as a consequence of a poor frequency response and a narrow acoustic-pressure range. Here, a skin-attachable acoustic sensor is presented that has higher sensing accuracy in wider auditory field than human ears, with flat frequency response (15-10 000 Hz) and a good range of linearity (29-134 dB_SPL ) as well as high conformality to flexible surfaces and human skin. This high sound-sensing quality is achieved by exploiting the low residual stress and high processability of polymer materials in a diaphragm structure designed using acousto-mechano-electric modeling. Thus, this acoustic sensor shows high acoustic fidelity by sensing human-audible sounds, even loud sounds and low-frequency sounds that human ears cannot detect without distorting them. The polymer-based ultrasmall (<9 mm² ) and thin sensor maintains sound-detection quality on flexible substrates and in a wide temperature range (25 to 90 °C). The acoustic sensor shows a significant potential of auditory electronic skin, by recognizing voice successfully when the sensor attached on human skin is connected to a commercial mobile device running the latest artificial intelligence assistant.

Skin bioelectronics towards long-term, continuous health monitoring

Skin bioelectronics are considered as an ideal platform for personalised healthcare because of their unique characteristics, such as thinness, light weight, good biocompatibility, excellent mechanical robustness, and great skin conformability. Recent advances in skin-interfaced bioelectronics have promoted various applications in healthcare and precision medicine. Particularly, skin bioelectronics for long-term, continuous health monitoring offer powerful analysis of a broad spectrum of health statuses, providing a route to early disease diagnosis and treatment. In this review, we discuss (1) representative healthcare sensing devices, (2) material and structure selection, device properties, and wireless technologies of skin bioelectronics towards long-term, continuous health monitoring, (3) healthcare applications: acquisition and analysis of electrophysiological, biophysical, and biochemical signals, and comprehensive monitoring, and (4) rational guidelines for the design of future skin bioelectronics for long-term, continuous health monitoring. Long-term, continuous health monitoring of advanced skin bioelectronics will open unprecedented opportunities for timely disease prevention, screening, diagnosis, and treatment, demonstrating great promise to revolutionise traditional medical practices.

Dissolvable Polymer Valves for Sweat Chrono-Sampling in Wearable Paper-Based Analytical Devices

Paper sensors with colorimetric signal transduction mechanisms are promising for developing single-use wearable patches that only require a smartphone to quantify signals. However, measuring biomarker fluctuations with colorimetric wearable sensors requires implementing a chrono-sampling method for performing sequential measurements. In this article, we report on a chrono-sampling method that enables the fabrication of wearable devices made entirely of filter paper. It consists of using dried polymers as closed valves that deflect the flow of liquids to different transducers of a multisensor. As time passes by, the polymer dissolves and the valve opens. The sequential opening of the valves results in a succession of measurements that reveals fluctuations in the concentration of the target analyte. This concept was demonstrated with a paper multisensor capable of performing nine consecutive pH measurements. The device was also adapted for developing a urea biosensor that detects pH measurements generated by the hydrolysis of the analyte catalyzed by urease. The proposed analytical platform could monitor the pH of sweat with an accuracy and precision comparable to a laboratory-based method when worn during an exercise routine. The results shown here pave the way for developing colorimetric wearable biosensors that measure variations in the concentration of biomarkers such as glucose, lactate, creatinine, or uric acid over time.

Recent Advances in Electronic Skins with Multiple-Stimuli-Responsive and Self-Healing Abilities

Wearable electronic skin (e-skin) has provided a revolutionized way to intelligently sense environmental stimuli, which shows prospective applications in health monitoring, artificial intelligence and prosthetics fields. Drawn inspiration from biological skins, developing e-skin with multiple stimuli perception and self-healing abilities not only enrich their bionic multifunctionality, but also greatly improve their sensory performance and functional stability. In this review, we highlight recent important developments in the material structure design strategy to imitate the fascinating functionalities of biological skins, including molecular synthesis, physical structure design, and special biomimicry engineering. Moreover, their specific structure-property relationships, multifunctional application, and existing challenges are also critically analyzed with representative examples. Furthermore, a summary and perspective on future directions and challenges of biomimetic electronic skins regarding function construction will be briefly discussed. We believe that this review will provide valuable guidance for readers to fabricate superior e-skin materials or devices with skin-like multifunctionalities and disparate characteristics.

Colorimetric and Electrochemical Screening for Early Detection of Diabetes Mellitus and Diabetic Retinopathy-Application of Sensor Arrays and Machine Learning

In this review, a selection of works on the sensing of biomarkers related to diabetes mellitus (DM) and diabetic retinopathy (DR) are presented, with the scope of helping and encouraging researchers to design sensor-array machine-learning (ML)-supported devices for robust, fast, and cost-effective early detection of these devastating diseases. First, we highlight the social relevance of developing systematic screening programs for such diseases and how sensor-arrays and ML approaches could ease their early diagnosis. Then, we present diverse works related to the colorimetric and electrochemical sensing of biomarkers related to DM and DR with non-invasive sampling (e.g., urine, saliva, breath, tears, and sweat samples), with a special mention to some already-existing sensor arrays and ML approaches. We finally highlight the great potential of the latter approaches for the fast and reliable early diagnosis of DM and DR.

Wearable soft electrochemical microfluidic device integrated with iontophoresis for sweat biosensing

A soft and flexible wearable sweat epidermal microfluidic device capable of simultaneously stimulating, collecting, and electrochemically analyzing sweat is demonstrated. The device represents the first system integrating an iontophoretic pilocarpine delivery system around the inlet channels of epidermal polydimethylsiloxane (PDMS) microfluidic device for sweat collection and analysis. The freshly generated sweat is naturally pumped into the fluidic inlet without the need of exercising. Soft skin-mounted systems, incorporating non-invasive, on-demand sweat sampling/analysis interfaces for tracking target biomarkers, are in urgent need. Existing skin conformal microfluidic-based sensors for continuous monitoring of target sweat biomarkers rely on assays during intense physical exercising. This work demonstrates the first example of combining sweat stimulation, through transdermal pilocarpine delivery, with sample collection through a microfluidic channel for real-time electrochemical monitoring of sweat glucose, in a fully integrated soft and flexible multiplexed device which eliminates the need of exercising. The on-body operational performance and layout of the device were optimized considering the fluid dynamics and evaluated for detecting sweat glucose in several volunteers. Furthermore, the microfluidic monitoring device was integrated with a real-time wireless data transmission system using a flexible electronic board PCB conformal with the body. The new microfluidic platform paves the way to real-time non-invasive monitoring of biomarkers in stimulated sweat samples for diverse healthcare and wellness applications.

Wearable Sweat Loss Measuring Devices: From the Role of Sweat Loss to Advanced Mechanisms and Designs

Wearable sweat sensors have received significant research interest and have become popular as sweat contains considerable health information about physiological and psychological states. However, measured biomarker concentrations vary with sweat rates, which has a significant effect on the accuracy and reliability of sweat biosensors. Wearable sweat loss measuring devices (SLMDs) have recently been proposed to overcome the limitations of biomarker tracking and reduce inter- and intraindividual variability. In addition, they offer substantial potential for monitoring human body homeostasis, because sweat loss plays an indispensable role in thermoregulation and skin hydration. Previous studies have not carried out a comprehensive and systematic review of the principles, importance, and development of wearable SLMDs. This paper reviews wearable SLMDs with a new health perspective from the role of sweat loss to advanced mechanisms and designs. Two types of sweat and their measurement significance for practical applications are highlighted. Then, a comprehensive review of advances in different wearable SLMDs based on hygrometers, absorbent materials, and microfluidics is presented by describing their respective device architectures, present situations, and future directions. Finally, concluding remarks on opportunities for future application fields and challenges for future sweat sensing are presented.

Applications of Advanced Materials for Non-Enzymatic Glucose Monitoring: From Invasive to the Wearable Device

Diabetes mellitus (DM) is a global health problem leading to many complications and disabilities in life adjusting activities and even dead. Monitoring glucose levels is a key factor in diagnosis and management of DM. Conventional glucose sensors consisted of immobilized enzymes, are so susceptible to environmental conditions. In this way, nonenzymatic biosensors have attracted extensive attentions in many clinical diagnostics applications. To date, the finger pricking test is a common enzyme-based glucometer that is an invasive and inconvenient and may lead to infections in the injection sites. So, working on the possibility of cutaneous or subcutaneous insertion of devices as a noninvasive or minimally-invasive systems for continuous glucose controlling approaches through human biofluids (blood, perspiration, tears, saliva, etc.) have stimulated growing interest. This review summarizes recent nonenzymatic and noninvasive biofluids glucose monitoring systems which are highly resilience and stretchable to continuously adapt to body movements during common physical activity. Sensors are based on their constituent materials including carbon-based, metal nanoparticles, polymer, and hydrogel systems are classified for electrochemical, and optical glucose detection. Finally, we address the drawbacks and challenges of enzyme-free sensors which are aroused sustaining research passion to be used in point-of-care medical diagnostics applications.

Osmotically Enabled Wearable Patch for Sweat Harvesting and Lactate Quantification

Lactate is an essential biomarker for determining the health of the muscles and oxidative stress levels in the human body. However, most of the currently available sweat lactate monitoring devices require external power, cannot measure lactate under low sweat rates (such as in humans at rest), and do not provide adequate information about the relationship between sweat and blood lactate levels. Here, we discuss the on-skin operation of our recently developed wearable sweat sampling patch. The patch combines osmosis (using hydrogel discs) and capillary action (using paper microfluidic channel) for long-term sweat withdrawal and management. When subjects are at rest, the hydrogel disc can withdraw fluid from the skin via osmosis and deliver it to the paper. The lactate amount in the fluid is determined using a colorimetric assay. During active sweating (e.g., exercise), the paper can harvest sweat even in the absence of the hydrogel patch. The captured fluid contains lactate, which we quantify using a colorimetric assay. The measurements show the that the total number of moles of lactate in sweat is correlated to sweat rate. Lactate concentrations in sweat and blood correlate well only during high-intensity exercise. Hence, sweat appears to be a suitable biofluid for lactate quantification. Overall, this wearable patch holds the potential of providing a comprehensive analysis of sweat lactate trends in the human body.

A Wearable Autonomous Colorimetric Sweat Induction System for Sweat Analysis

The wearable biochemical sweat sensor's capability to provide insight into molecular information of health dynamics ignites sweat analysis as a promising noninvasive diagnosis scheme for precision medicine. Here, we demonstrate, for the first time, a colorimetric sweat induction microfluidic patch, which facilitates on-demand sweat glands activation by agonist coupled electrode and capillary action-based fluidics to collect microliter volumes (~5 μL) of sweat for monitoring its analytes by digital image analysis. The system's clinical utility demonstrated on a healthy volunteer for sweat pH monitoring flags the way towards other important sweat markers analysis for personalized healthcare.Clinical Relevance- Sweat analysis based on wearable technologies and its correlation with blood analytes pave the way towards non-invasive point-of-care monitoring, as an alternative to blood analysis.

Passively driven microfluidic device with simple operation in the development of nanolitre droplet assay in nucleic acid detection

Since nucleic acid amplification technology has become a vital tool for disease diagnosis, the development of precise applied nucleic acid detection technologies in point-of care testing (POCT) has become more significant. The microfluidic-based nucleic acid detection platform offers a great opportunity for on-site diagnosis efficiency, and the system is aimed at user-friendly access. Herein, we demonstrate a microfluidic system with simple operation that provides reliable nucleic acid results from 18 uniform droplets via LAMP detection. By using only micropipette regulation, users are able to control the nanoliter scale of the droplets in this valve-free and pump-free microfluidic (MF) chip. Based on the oil enclosure method and impermeable fabrication, we successfully preserved the reagent inside the microfluidic system, which significantly reduced the fluid loss and condensation. The relative standard deviation (RSD) of the fluorescence intensity between the droplets and during the heating process was < 5% and 2.0%, respectively. Additionally, for different nucleic acid detection methods, the MF-LAMP chip in this study showed good applicability to both genome detection and gene expression analysis.

A Review of Capillary Pressure Control Valves in Microfluidics

Microfluidics offer microenvironments for reagent delivery, handling, mixing, reaction, and detection, but often demand the affiliated equipment for liquid control for these functions. As a helpful tool, the capillary pressure control valve (CPCV) has become popular to avoid using affiliated equipment. Liquid can be handled in a controlled manner by using the bubble pressure effects. In this paper, we analyze and categorize the CPCVs via three determining parameters: surface tension, contact angle, and microchannel shape. Finally, a few application scenarios and impacts of CPCV are listed, which includes how CPVC simplify automation of microfluidic networks, work with other driving modes; make extensive use of microfluidics by open channel, and sampling and delivery with controlled manners. The authors hope this review will help the development and use of the CPCV in microfluidic fields in both research and industry.

Alginate Bead Biosystem for the Determination of Lactate in Sweat Using Image Analysis

Lactate is present in sweat at high concentrations, being a metabolite of high interest in sport science and medicine. Therefore, the potential to determine lactate concentrations in physiological fluids, at the point of need with minimal invasiveness, is very valuable. In this work, the synthesis and performance of an alginate bead biosystem was investigated. Artificial sweat with different lactate concentrations was used as a proof of concept. The lactate detection was based on a colorimetric assay and an image analysis method using lactate oxidase, horseradish peroxidase and tetramethyl benzidine as the reaction mix. Lactate in artificial sweat was detected with a R² = 0.9907 in a linear range from 10 mM to 100 mM, with a limit of detection of 6.4 mM and a limit of quantification of 21.2 mM. Real sweat samples were used as a proof of concept to test the performance of the biosystem, obtaining a lactate concentration of 48 ± 3 mM. This novel sensing configuration, using alginate beads, gives a fast and reliable method for lactate sensing, which could be integrated into more complex analytical systems.

Cactus-Spine-Inspired Sweat-Collecting Patch for Fast and Continuous Monitoring of Sweat

A sweat sensor is expected to be the most appropriate wearable device for noninvasive healthcare monitoring. However, the practical use of sweat sensors is impeded by irregular and low sweat secretion rates. Here, a sweat-collecting patch that can collect sweat efficiently for fast and continuous healthcare monitoring is demonstrated. The patch uses cactus-spine-inspired wedge-shaped wettability-patterned channels on a hierarchical microstructured/nanostructured surface. The channel shape, in combination with the superhydrophobic/superhydrophilic surface materials, induces a unidirectional Laplace pressure that transports the sweat to the sensing area spontaneously even when the patch is aligned vertically. The patch demonstrates superior sweat-collecting efficiency and reduces the time required to fill the sensing area by transporting sweat almost without leaving it inside the channel. Therefore, a sensor based on the patch responds quickly to biochemicals in sweat, and the patch enables the continuous monitoring of changes in sweat biochemicals according to their changes in the wearer's blood.

E-Skin: The Dawn of a New Era of On-Body Monitoring Systems

Real-time "on-body" monitoring of human physiological signals through wearable systems developed on flexible substrates (e-skin) is the next target in human health control and prevention, while an alternative to bulky diagnostic devices routinely used in clinics. The present work summarizes the recent trends in the development of e-skin systems. Firstly, we revised the material development for e-skin systems. Secondly, aspects related to fabrication techniques were presented. Next, the main applications of e-skin systems in monitoring, such as temperature, pulse, and other bio-electric signals related to health status, were analyzed. Finally, aspects regarding the power supply and signal processing were discussed. The special features of e-skin as identified contribute clearly to the developing potential as in situ diagnostic tool for further implementation in clinical practice at patient personal levels.

Wearable Glucose Monitoring and Implantable Drug Delivery Systems for Diabetes Management

The global cost of diabetes care exceeds $1 trillion each year with more than $327 billion being spent in the United States alone. Despite some of the advances in diabetes care including continuous glucose monitoring systems and insulin pumps, the technology associated with managing diabetes has largely remained unchanged over the past several decades. With the rise of wearable electronics and novel functional materials, the field is well-poised for the next generation of closed-loop diabetes care. Wearable glucose sensors implanted within diverse platforms including skin or on-tooth tattoos, skin-mounted patches, eyeglasses, contact lenses, fabrics, mouthguards, and pacifiers have enabled noninvasive, unobtrusive, and real-time analysis of glucose excursions in ambulatory care settings. These wearable glucose sensors can be integrated with implantable drug delivery systems, including an insulin pump, glucose responsive insulin release implant, and islets transplantation, to form self-regulating closed-loop systems. This review article encompasses the emerging trends and latest innovations of wearable glucose monitoring and implantable insulin delivery technologies for diabetes management with a focus on their advanced materials and construction. Perspectives on the current unmet challenges of these strategies are also discussed to motivate future technological development toward improved patient care in diabetes management.

State of Sweat: Emerging Wearable Systems for Real-Time, Noninvasive Sweat Sensing and Analytics

Skin-interfaced wearable systems with integrated colorimetric assays, microfluidic channels, and electrochemical sensors offer powerful capabilities for noninvasive, real-time sweat analysis. This Perspective details recent progress in the development and translation of novel wearable sensors for personalized assessment of sweat dynamics and biomarkers, with precise sampling and real-time analysis. Sensor accuracy, system ruggedness, and large-scale deployment in remote environments represent key opportunity areas, enabling broad deployment in the context of field studies, clinical trials, and recent commercialization. On-body measurements in these contexts show good agreement compared to conventional laboratory-based sweat analysis approaches. These device demonstrations highlight the utility of biochemical sensing platforms for personalized assessment of performance, wellness, and health across a broad range of applications.

Strain-Tunable Microfluidic Devices with Crack and Wrinkle Microvalves for Microsphere Screening and Fluidic Logic Gates

Mechanical instabilities in soft materials have led to the formation of unique surface patterns such as wrinkles and cracks for a wide range of applications that are related to surface morphologies and their dynamic tuning. Here, we report a simple yet effective strategy to fabricate strain-tunable crack and wrinkle microvalves with dimensions responding to the applied tensile strain. The crack microvalves initially closed before stretching are opened as the tensile strain is applied, whereas the wrinkle microvalves exhibit the opposite trend. Next, the performance of crack and wrinkle microvalves is characterized. The design predictions on the bursting pressure of microvalves and others from the theory agree reasonably well with the experimental measurements. The microfluidic devices with strain-tunable crack and wrinkle microvalves have then been demonstrated for microsphere screening and programmable microfluidic logic devices. The demonstrated microfluidic devices complement the prior studies to open up opportunities in microparticle/cell manipulations, fluidic operations, and biomedicine.

Wearable Biosensors for Non-Invasive Sweat Diagnostics

Recent advances in microfluidics, microelectronics, and electrochemical sensing methods have steered the way for the development of novel and potential wearable biosensors for healthcare monitoring. Wearable bioelectronics has received tremendous attention worldwide due to its great a potential for predictive medical modeling and allowing for personalized point-of-care-testing (POCT). They possess many appealing characteristics, for example, lightweight, flexibility, good stretchability, conformability, and low cost. These characteristics make wearable bioelectronics a promising platform for personalized devices. In this paper, we review recent progress in flexible and wearable sensors for non-invasive biomonitoring using sweat as the bio-fluid. Real-time and molecular-level monitoring of personal health states can be achieved with sweat-based or perspiration-based wearable biosensors. The suitability of sweat and its potential in healthcare monitoring, sweat extraction, and the challenges encountered in sweat-based analysis are summarized. The paper also discusses challenges that still hinder the full-fledged development of sweat-based wearables and presents the areas of future research.

Stretchable and Superwettable Colorimetric Sensing Patch for Epidermal Collection and Analysis of Sweat

Stretchable and wearable sensors allow intimate integration with the human body for health and fitness monitoring. In addition to the acquisition of various physical parameters, quantitative analysis of chemical biomarkers present in sweat may provide vital insights into the physiological state of an individual. A widely investigated system utilizes electrochemical techniques for continuous monitoring of these biomarkers. The required supporting electronics and batteries are often challenging to form a deformable system. In this study, an intrinsically stretchable sensing patch is developed with compliant mechanical properties for conformal attachment to the skin and reliable collection of sweat. In these patches, superhydrophilic colorimetric assays consisting of thermoplastic polyurethane nanofiber textiles decorated with silica nanoparticles are assembled over a styrene-ethylene-butylene-styrene-based superhydrophobic substrate, thereby generating a large wettability contrast to efficiently concentrate the sweat. The system supports multiplexed colorimetric analysis of sweat to quantify pH and ion concentrations with images acquired using smartphones, in which the influence of ambient lighting conditions is largely compensated with a set of reference color markers. Successful demonstrations of in situ analysis of sweat after physical exercises effectively illustrate the practical suitability of the sensing patch, which is attractive for advanced health monitoring, clinical diagnostics, and competitive sports.

A review of wearable biosensors for sweat analysis

Recent advances in the skin-interfaced wearable sweat sensors allow a personalized daily diagnosis and prognosis of the diseases in a form of a non-invasive, portable, and continuous monitoring system. Especially, the soft microfluidic system provides robust quantitative analysis platforms that integrate sweat sampling, storing, and various sensing capabilities. This review systematically introduces the sweat collecting mechanism using soft microfluidic valves, including calculation of sweat storage and loss. In terms of sweat analysis, colorimetric (e.g. enzymatic, chemical, or their mixed reactions), electrochemical (e.g. voltammetric, potentiometric, amperometric, or conductometric), and multiplex measurements of sweat contents facilitate diagnosis of diseases via analysis of combined multiple data, such as vital signals (e.g. ECG, EMG, EEG, etc.) and information from the skin (e.g. temperature, GSR, etc.). The integration of wireless communication with the microfluidic systems enables point-of-care health monitoring for disease and specific physiological status.

Recent progress, challenges, and opportunities for wearable biochemical sensors for sweat analysis

Sweat is a promising, yet relatively unexplored biofluid containing biochemical information that offers broad insights into the underlying dynamic metabolic activity of the human body. The rich composition of electrolytes, metabolites, hormones, proteins, nucleic acids, micronutrients, and exogenous agents found in sweat dynamically vary in response to the state of health, stress, and diet. Emerging classes of skin-interfaced wearable sensors offer powerful capabilities for the real-time, continuous analysis of sweat produced by the eccrine glands in a manner suitable for use in athletics, consumer wellness, military, and healthcare industries. This perspective examines the rapid and continuous progress of wearable sweat sensors through the most advanced embodiments that address the fundamental challenges currently restricting widespread deployment. It concludes with a discussion of efforts to expand the overall utility of wearable sweat sensors and opportunities for commercialization, in which advances in biochemical sensor technologies will be critically important.

Soft, skin-interfaced sweat stickers for cystic fibrosis diagnosis and management

The concentration of chloride in sweat remains the most robust biomarker for confirmatory diagnosis of cystic fibrosis (CF), a common life-shortening genetic disorder. Early diagnosis via quantitative assessment of sweat chloride allows prompt initiation of care and is critically important to extend life expectancy and improve quality of life. The collection and analysis of sweat using conventional wrist-strapped devices and iontophoresis can be cumbersome, particularly for infants with fragile skin, who often have insufficient sweat production. Here, we introduce a soft, epidermal microfluidic device ("sweat sticker") designed for the simple and rapid collection and analysis of sweat. Intimate, conformal coupling with the skin supports nearly perfect efficiency in sweat collection without leakage. Real-time image analysis of chloride reagents allows for quantitative assessment of chloride concentrations using a smartphone camera, without requiring extraction of sweat or external analysis. Clinical validation studies involving patients with CF and healthy subjects, across a spectrum of age groups, support clinical equivalence compared to existing device platforms in terms of accuracy and demonstrate meaningful reductions in rates of leakage. The wearable microfluidic technologies and smartphone-based analytics reported here establish the foundation for diagnosis of CF outside of clinical settings.

Fully Printed Wearable Microfluidic Devices for High-Throughput Sweat Sampling and Multiplexed Electrochemical Analysis

Although the recent advancement in wearable biosensors provides continuous, noninvasive assessment of physiologically relevant chemical markers from human sweat, several bottlenecks still exist for its practical use. There were challenges in developing a multiplexed biosensing system with rapid microfluidic sampling and transport properties, as well as its integration with a portable potentiostat for improved interference-free data collection. Here, we introduce a clean-room free fabrication of wearable microfluidic sensors, using a screen-printed carbon master, for the electrochemical monitoring of sweat biomarkers during exercise activities. The sweat sampling is enhanced by introducing low-dimensional sensing compartments and lowering the hydrophilicity of channel layers via facile silane functionalization. The fluidic channel captures sweat at the inlet and directs the real-time sweat through the active sensing electrodes (within 40 s) for subsequent decoding and selective analyses. For proof of concept, simultaneous amperometric lactate and potentiometric ion sensing (Na⁺, K⁺, and pH) are carried out by a miniature circuit board capable of cross-talk-free signal collection and wireless signal transduction characteristics. All of the sensors demonstrated appreciable sensitivity, selectivity, stability, carryover efficiency, and repeatability. The floating potentiometric circuits eliminate the signal interference from the adjacent amperometric transducers. The fully integrated pumpless microfluidic device is mounted on the epidermis and employed for multiplexed real-time decoding of sweat during stationary biking. The regional variations in sweat composition are analyzed by human trials at the underarm and upperback locations. The presented method offers a large-scale fabrication of inexpensive high-throughput wearable sensors for personalized point-of-care and athletic applications.

Textile Chemical Sensors Based on Conductive Polymers for the Analysis of Sweat

Wearable textile chemical sensors are promising devices due to the potential applications in medicine, sports activities and occupational safety and health. Reaching the maturity required for commercialization is a technology challenge that mainly involves material science because these sensors should be adapted to flexible and light-weight substrates to preserve the comfort of the wearer. Conductive polymers (CPs) are a fascinating solution to meet this demand, as they exhibit the mechanical properties of polymers, with an electrical conductivity typical of semiconductors. Moreover, their biocompatibility makes them promising candidates for effectively interfacing the human body. In particular, sweat analysis is very attractive to wearable technologies as perspiration is a naturally occurring process and sweat can be sampled non-invasively and continuously over time. This review discusses the role of CPs in the development of textile electrochemical sensors specifically designed for real-time sweat monitoring and the main challenges related to this topic.

3D printed smart silk wearable sensors

Wearable sensors play a key role in point-of-care testing (POCT) for their flexible and integration capability for sensitive physiological and biochemical sensing. Here, we present a multifunction wearable silk patch with both electronic channels and microchannels by utilizing matrix-assisted sacrificial 3D printing methods. Owing to the unique properties of a composite silk film (polyvinyl alcohol (PVA) and silk fibroin (SF)), the wearable sensors possess excellent tensile properties, self-healing ability and biocompatibility. Multi-layer channel (microfluidics and microcircuit)-integrated silk wearable sensors were then fabricated for simultaneous sensitive sensing of human cancer markers (carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP)) and motion monitoring. These features of the silk wearable sensors indicate their potential value for sensitive sensing, which will enable them to find broader applications in many fields in POCT, artificial skin and organ-on-a-chip systems.

Wearable Osmotic-Capillary Patch for Prolonged Sweat Harvesting and Sensing

Biomarkers in sweat are a largely untapped source of health information. Most of the currently available sweat harvesting and testing devices are incapable of operating under low-sweat rates such as those experienced by humans at rest. Here we analyze the in vitro and in vivo sampling of sweat through osmosis via the use of a hydrogel interfaced with the skin, without need for active perspiration. The hydrogel also interfaces with paper-based microfluidics to transport the fluid via capillary forces toward a testing zone and then evaporation pad. We show that the hydrogel solute content and area of the evaporation pad regulate the long-term extraction of sweat and its associated biomarkers. The results indicate that the platform can sample biomarkers from a model skin system continuously for approximately 12 h. On-skin testing of the platform on both resting and exercising human subjects confirms that it can sample sweat lactate directly from the surface of skin. The results highlight that lactate in sweat increases with exercise and as a direct result of muscle activity. Implementation of such new principles for sweat fluid harvesting and management via wearable patch devices can contribute toward the advancement of next generation wearables.

Fiber-crafted biofuel cell bracelet for wearable electronics

Wearable devices that generate power using sweat have garnered much attention in the field of skin electronics. These devices require high performance with a small volume and low production rate of sweat by living organisms. Here we demonstrate a high-power biofuel cell bracelet based on the lactate in human sweat. The biofuel cell was developed by using a lactate oxidase/osmium-based mediator/carbon nanotube fiber for lactate oxidation and a bilirubin oxidase/carbon nanotube fiber for oxygen reduction; the fibers were woven into a hydrophilic supportive textile for sweat storage. The storage textile was sandwiched between a hydrophobic textile for sweat absorption from the skin and a hydrophilic textile for water evaporation to improve sweat collection. The performance of the layered cell was 74 μW at 0.39 V in 20 mM artificial sweat lactate, and its performance was maintained at over 80% for 12 h. Furthermore, we demonstrated a series-connection between anode/cathode fibers by tying them up to wrap the bracelet-type biofuel cell on the wrist. The booster six-cell bracelet generated power at 2.0 V that is sufficient for operating digital wrist watches.

Skin-Interfaced Microfluidic Systems that Combine Hard and Soft Materials for Demanding Applications in Sweat Capture and Analysis

Eccrine sweat contains a rich blend of electrolytes, metabolites, proteins, metal ions, and other biomarkers. Changes in the concentrations of these chemical species can indicate alterations in hydration status and they can also reflect health conditions such as cystic fibrosis, schizophrenia, and depression. Recent advances in soft, skin-interfaced microfluidic systems enable real-time measurement of local sweat loss and sweat biomarker concentrations, with a wide range of applications in healthcare. Uses in certain contexts involve, however, physical impacts on the body that can dynamically deform these platforms, with adverse effects on measurement reliability. The work presented here overcomes this limitation through the use of microfluidic structures constructed in relatively high modulus polymers, and designed in geometries that offer soft, system level mechanics when embedded low modulus elastomers. Analytical models and finite element analysis quantitatively define the relevant mechanics of these systems, and serve as the basis for layouts optimized to allow robust operation in demanding, rugged scenarios such as those encountered in football, while preserving mechanical stretchability for comfortable, water-tight bonding to the skin. Benchtop testing and on-body field studies of measurements of sweat loss and chloride concentration under imposed mechanical stresses and impacts demonstrate the key features of these platforms.

Wearable sensors: At the frontier of personalised health monitoring, smart prosthetics and assistive technologies

Wearable sensors have evolved from body-worn fitness tracking devices to multifunctional, highly integrated, compact, and versatile sensors, which can be mounted onto the desired locations of our clothes or body to continuously monitor our body signals, and better interact and communicate with our surrounding environment or equipment. Here, we discuss the latest advances in textile-based and skin-like wearable sensors with a focus on three areas, including (i) personalised health monitoring to facilitate recording physiological signals, body motions, and analysis of body fluids, (ii) smart gloves and prosthetics to realise the sensation of touch and pain, and (iii) assistive technologies to enable disabled people to operate the surrounding motorised equipment using their active organs. We also discuss areas for future research in this emerging field.

Sweat-Based Noninvasive Skin-Patchable Urea Biosensors with Photonic Interpenetrating Polymer Network Films Integrated into PDMS Chips

A wearable noninvasive biosensor for in situ urea detection and quantification was developed using a urease-immobilized photonic interpenetrating polymer network (IPN_urease) film. The photonic IPN film was intertwined with solid-state cholesteric liquid crystals (CLC_solid) and a poly(acrylic acid) (PAA) network on a flexible poly(ethylene terephthalate) substrate adhered to a poly(dimethylsiloxane) (PDMS) chip that was fabricated using an aluminum mold. The presence of urea in the chemical matrix of human sweat red-shifted the reflected color of the photonic IPN_urease film, and quantification was achieved by observing the wavelength at the photonic band gap (λ_PBG) with a limit of detection of 0.4 mM and a linear range of 0.9-50 mM. The color changes observed in the photonic IPN film were digitalized using the CIE 1931 xy coordinates on a cell phone image, thereby enabling fast, direct diagnosis via a downloadable app. This novel PDMS chip can be expanded for use with other biosensors.

A wearable fluidic collection patch and ion chromatography method for sweat electrolyte monitoring during exercise

This paper presents a method to continuously collect and reliably measure sweat analyte concentrations during exercise. The method can be used to validate newly developed sweat sensors and to obtain insight into intraindividual variations of sweat analytes in athletes. First, a novel design of a sweat collection system is created. The sweat collection patch, that is made from hydrophilized foil and a double-sided acrylate adhesive, consists of a reservoir array that collects samples consecutively in time. During a physiological experiment, sweat can be collected from the back of a participant and the filling speed of the collector is monitored by using a camera. After the experiment, Na+, Cl- and K+ levels are measured with ion chromatography. Sweat analyte variations are measured during exercise for an hour at three different locations on the back. The Na+ and Cl- variations show a similar trend and the absolute concentrations vary with the patch location. Na+ and Cl- concentrations increase and K+ concentrations seem to decrease during this exercise. With this new sweat collection system, sweat Na+, Cl- and K+ concentrations can be collected over time during exercise at medium to high intensity, to analyse the trend in electrolyte variations per individual.

Recent Progress in Wearable Biosensors: From Healthcare Monitoring to Sports Analytics

Recent advances in lab-on-a-chip technology establish solid foundations for wearable biosensors. These newly emerging wearable biosensors are capable of non-invasive, continuous monitoring by miniaturization of electronics and integration with microfluidics. The advent of flexible electronics, biochemical sensors, soft microfluidics, and pain-free microneedles have created new generations of wearable biosensors that explore brand-new avenues to interface with the human epidermis for monitoring physiological status. However, these devices are relatively underexplored for sports monitoring and analytics, which may be largely facilitated by the recent emergence of wearable biosensors characterized by real-time, non-invasive, and non-irritating sensing capacities. Here, we present a systematic review of wearable biosensing technologies with a focus on materials and fabrication strategies, sampling modalities, sensing modalities, as well as key analytes and wearable biosensing platforms for healthcare and sports monitoring with an emphasis on sweat and interstitial fluid biosensing. This review concludes with a summary of unresolved challenges and opportunities for future researchers interested in these technologies. With an in-depth understanding of the state-of-the-art wearable biosensing technologies, wearable biosensors for sports analytics would have a significant impact on the rapidly growing field-microfluidics for biosensing.

Soft, skin-interfaced microfluidic systems with integrated immunoassays, fluorometric sensors, and impedance measurement capabilities

Soft microfluidic systems that capture, store, and perform biomarker analysis of microliter volumes of sweat, in situ, as it emerges from the surface of the skin, represent an emerging class of wearable technology with powerful capabilities that complement those of traditional biophysical sensing devices. Recent work establishes applications in the real-time characterization of sweat dynamics and sweat chemistry in the context of sports performance and healthcare diagnostics. This paper presents a collection of advances in biochemical sensors and microfluidic designs that support multimodal operation in the monitoring of physiological signatures directly correlated to physical and mental stresses. These wireless, battery-free, skin-interfaced devices combine lateral flow immunoassays for cortisol, fluorometric assays for glucose and ascorbic acid (vitamin C), and digital tracking of skin galvanic responses. Systematic benchtop evaluations and field studies on human subjects highlight the key features of this platform for the continuous, noninvasive monitoring of biochemical and biophysical correlates of the stress state.

Micro-Nano Hierarchical Structure Enhanced Strong Wet Friction Surface Inspired by Tree Frogs

Superior wet attachment and friction performance without the need of special external or preloaded normal force, similar to the tree frog's toe pad, is highly essential for biomedical engineering, wearable flexible electronics, etc. Although various pillar surfaces are proposed to enhance wet adhesion or friction, their mechanisms remain on micropillar arrays to extrude interfacial liquid via an external force. Here, two-level micropillar arrays with nanocavities on top are discovered on the toe pads of a tree frog, and they exhibit strong boundary friction ≈20 times higher than dry and wet friction without the need of a special external or preloaded normal force. Microscale in situ observations show that the specific micro-nano hierarchical pillars in turn trigger three-level liquid adjusting phenomena, including two-level liquid self-splitting and liquid self-sucking effects. Under these effects, uniform nanometer-thick liquid bridges form spontaneously on all pillars to generate strong boundary friction, which can be ≈2 times higher than for single-level pillar surfaces and ≈3.5 times higher than for smooth surfaces. Finally, theoretical models of boundary friction in terms of self-splitting and self-sucking are built to reveal the importance of liquid behavior induced by micro-nano hierarchical structure.

A programmable epidermal microfluidic valving system for wearable biofluid management and contextual biomarker analysis

Active biofluid management is central to the realization of wearable bioanalytical platforms that are poised to autonomously provide frequent, real-time, and accurate measures of biomarkers in epidermally-retrievable biofluids (e.g., sweat). Accordingly, here, a programmable epidermal microfluidic valving system is devised, which is capable of biofluid sampling, routing, and compartmentalization for biomarker analysis. At its core, the system is a network of individually-addressable microheater-controlled thermo-responsive hydrogel valves, augmented with a pressure regulation mechanism to accommodate pressure built-up, when interfacing sweat glands. The active biofluid control achieved by this system is harnessed to create unprecedented wearable bioanalytical capabilities at both the sensor level (decoupling the confounding influence of flow rate variability on sensor response) and the system level (facilitating context-based sensor selection/protection). Through integration with a wireless flexible printed circuit board and seamless bilateral communication with consumer electronics (e.g., smartwatch), contextually-relevant (scheduled/on-demand) on-body biomarker data acquisition/display was achieved.

Wearable biosensors have been used successfully for biomarker analysis, however, a lack of control over sampling limits applications. Here, the authors report a programmable microfluidic valve to control flow rate, sampling times and allow for biofluid routing and compartmentalisation.

Skin-interfaced microfluidic devices with one-opening chambers and hydrophobic valves for sweat collection and analysis

Soft, skin-interfaced microfluidic platforms are capable of capturing, storing, and assessing sweat chemistry and total sweat loss, which provides essential insight into human physiological health. However, sweat loss from the outlet of the microfluidic devices often leads to deviation of the measured concentration of the biomarker or electrolyte from the actual value. Here, we introduce hydrophobic valves at the junction of the chamber and the microfluidic channel as a new chamber design to reduce sweat evaporation. Because the advancing front of the liquid in the hydrophilic microchannel is blocked by the hydrophobic valve, the fluid flows into the chambers, forms the initial meniscus, and completely fills the chambers along the initial meniscus. Fluid dynamic modeling and numerical simulations provide critical insights into the sweat sampling mechanism into the chambers. With significantly reduced evaporation and contamination, the sweat sample can be easily stored for a long time for later analysis when in situ analysis is limited. Additionally, the design with multiple chambers can allow sequential generation of sweat collection at different times for long-term analysis. The in situ real-time measurements of the sweat loss and pH value analysis from the human subject demonstrate the practical utility of the devices in collecting, storing, and analyzing the sweat generated from sweat glands on the skin.

Microfluidics by Additive Manufacturing for Wearable Biosensors: A Review

Wearable devices are nowadays at the edge-front in both academic research as well as in industry, and several wearable devices have been already introduced in the market. One of the most recent advancements in wearable technologies for biosensing is in the area of the remote monitoring of human health by detection on-the-skin. However, almost all the wearable devices present in the market nowadays are still providing information not related to human ‘metabolites and/or disease’ biomarkers, excluding the well-known case of the continuous monitoring of glucose in diabetic patients. Moreover, even in this last case, the glycaemic level is acquired under-the-skin and not on-the-skin. On the other hand, it has been proven that human sweat is very rich in molecules and other biomarkers (e.g., ions), which makes sweat a quite interesting human liquid with regards to gathering medical information at the molecular level in a totally non-invasive manner. Of course, a proper collection of sweat as it is emerging on top of the skin is required to correctly convey such liquid to the molecular biosensors on board of the wearable system. Microfluidic systems have efficiently come to the aid of wearable sensors, in this case. These devices were originally built using methods such as photolithographic and chemical etching techniques with rigid materials. Nowadays, fabrication methods of microfluidic systems are moving towards three-dimensional (3D) printing methods. These methods overcome some of the limitations of the previous method, including expensiveness and non-flexibility. The 3D printing methods have a high speed and according to the application, can control the textures and mechanical properties of an object by using multiple materials in a cheaper way. Therefore, the aim of this paper is to review all the most recent advancements in the methods for 3D printing to fabricate wearable fluidics and provide a critical frame for the future developments of a wearable device for the remote monitoring of the human metabolism directly on-the-skin.

Advances in Sweat Wearables: Sample Extraction, Real-Time Biosensing, and Flexible Platforms

Wearable biosensors for sweat-based analysis are gaining wide attention due to their potential use in personal health monitoring. Flexible wearable devices enable sweat analysis at the molecular level, facilitating noninvasive monitoring of physiological states via real-time monitoring of chemical biomarkers. Advances in sweat extraction technology, real-time biosensors, stretchable materials, device integration, and wireless digital technologies have led to the development of wearable sweat-biosensing devices that are light, flexible, comfortable, aesthetic, affordable, and informative. Herein, we summarize recent advances of sweat wearables from the aspects of sweat extraction, fabrication of stretchable biomaterials, and design of biosensing modules to enable continuous biochemical monitoring, which are essential for a biosensing device. Key chemical components of sweat, sweat capture methodologies, and considerations of flexible substrates for integrating real-time biosensors with electronics to bring innovations in the art of wearables are elaborated. The strategies and challenges involved in improving the wearable biosensing performance and the perspectives for designing sweat-based wearable biosensing devices are discussed.

A Textile-Based Microfluidic Platform for the Detection of Cytostatic Drug Concentration in Sweat Samples

This work presents a new multilayered microfluidic platform, manufactured using a rapid and cost-effective xurography technique, for the detection of drug concentrations in sweat. Textile fabrics made of cotton and polyester were used as a component of the platform, and they were positioned in the middle of the microfluidic device. In order to obtain a highly conductive textile, the fabrics were in situ coated with different amounts of polyaniline and titanium dioxide nanocomposite. This portable microfluidic platform comprises at least three layers of optically transparent and flexible PVC foils which were stacked one on top of the other. Electrical contacts were provided from the edge of the textile material when a microfluidic variable resistor was actually created. The platform was tested in plain artificial sweat and in artificial sweat with a dissolved cytostatic test drug, cyclophosphamide, of different concentrations. The proposed microfluidic device decreased in resistance when the sweat was applied. In addition, it could successfully detect different concentrations of cytostatic medication in the sweat, which could make it a very useful tool for simple, reliable, and fast diagnostics.

Tear Glucose Measurement by Reflectance Spectrum of a Nanoparticle Embedded Contact Lens

Glucose level is a primary indicator in the diagnosis and treatment of diabetes mellitus. According to the correlation between glucose concentration in blood and tears, measuring tear glucose can be an alternative to traditional strips test for blood glucose. Thus, measuring tear glucose levels could provide noninvasive monitoring of blood glucose. As a biocompatible biosensor, a nanoparticle embedded contact lens (NECL) is developed which is composed of glucose oxidase and cerium oxide (III). Using spectroscopy, we found the detectable changes in reflection spectrum of contact lenses with respect to the glucose concentration, and developed correlation curve of the reflection spectrum with known glucose level. Furthermore, we assessed tear glucose level and compared blood glucose level with the diabetic mouse model to evaluate this approach. Our algorithm for regular monitoring of glucose using contact lens biosensor may lead to noninvasive monitoring of tear glucose level. NECL may provide simple and noninvasive glucose monitoring based on the spectral changes in contact lens biosensor.

Principles of long-term fluids handling in paper-based wearables with capillary-evaporative transport

We construct and investigate paper-based microfluidic devices, which model long-term fluid harvesting, transport, sensing, and analysis in new wearables for sweat analysis. Such devices can continuously wick fluid mimicking sweat and dispose of it on evaporation pads. We characterize and analyze how the action of capillarity and evaporation can cooperatively be used to transport and process sweat mimics containing dissolved salts and model analytes. The results point out that non-invasive osmotic extraction combined with paper microfluidics and evaporative disposal can enable sweat collection and monitoring for durations longer than 10 days. We model the fluid flow in the new capillary-evaporative devices and identify the parameters enabling their long-term operation. We show that the transport rates are sufficiently large to handle natural sweat rates, while we envision that such handling can be interfaced with osmotic harvesting of sweat, a concept that we demonstrated recently. Finally, we illustrate that the salt film deposited at the evaporation pad would eventually lead to cessation of the process but at the same time will preserve a record of analytes that may be used for long-term biomarker monitoring in sweat. These principles can be implemented in future platforms for wearable skin-interfacing assays or electronic biomarker monitors.

Towards practical sample preparation in point-of-care testing: user-friendly microfluidic devices

Microfluidic technologies offer a number of advantages for sample preparation in point-of-care testing (POCT), but the requirement for complicated external pumping systems limits their wide use. To facilitate sample preparation in POCT, various methods have been developed to operate microfluidic devices without complicated external pumping systems. In this review, we introduce an overview of user-friendly microfluidic devices for practical sample preparation in POCT, including self- and hand-operated microfluidic devices. Self-operated microfluidic devices exploit capillary force, vacuum-driven pressure, or gas-generating chemical reactions to apply pressure into microchannels, and hand-operated microfluidic devices utilize human power sources using simple equipment, including a syringe, pipette, or simply by using finger actuation. Furthermore, this review provides future perspectives to realize user-friendly integrated microfluidic circuits for wider applications with the integration of simple microfluidic valves.

Multi-Functional Hydrogel-Interlayer RF/NFC Resonators as a Versatile Platform for Passive and Wireless Biosensing

Wearable sensors promise to transform human understanding of body state. However, despite many wearable sensor modalities that exist, few demonstrate the raw capabilities required for many emerging healthcare applications-passivity (and microelectronics-free), wireless readout, long-term operation, and specificity. Hydrogel-interlayer radio-frequency resonators are demonstrated as a versatile platform for passive and wireless biosensing. Fabricated using a simple vinyl cutter, the base resonator is composed of unanchored, broad-side coupled coils interceded by multifunctional hydrogels-such resonators are tuned to be sensitive to specific analytical or physical signals by modifying hydrogel composition. These resonators are transformed into near-field communication (NFC) sensor circuits through the simple attachment of an LED. These enable direct quantification of sensor state by cellphone and eye with no specialized electronics required. Resonator arrays are finally fused with silicone to form soft, wireless sensor skins that enable co-readout of analytical to physical signals while molded to human subjects. Such low-cost, accessible platforms can integrate with environments in transformative ways, enabling new applications in wireless sensing.

Advanced Soft Materials, Sensor Integrations, and Applications of Wearable Flexible Hybrid Electronics in Healthcare, Energy, and Environment

Recent advances in soft materials and system integration technologies have provided a unique opportunity to design various types of wearable flexible hybrid electronics (WFHE) for advanced human healthcare and human-machine interfaces. The hybrid integration of soft and biocompatible materials with miniaturized wireless wearable systems is undoubtedly an attractive prospect in the sense that the successful device performance requires high degrees of mechanical flexibility, sensing capability, and user-friendly simplicity. Here, the most up-to-date materials, sensors, and system-packaging technologies to develop advanced WFHE are provided. Details of mechanical, electrical, physicochemical, and biocompatible properties are discussed with integrated sensor applications in healthcare, energy, and environment. In addition, limitations of the current materials are discussed, as well as key challenges and the future direction of WFHE. Collectively, an all-inclusive review of the newly developed WFHE along with a summary of imperative requirements of material properties, sensor capabilities, electronics performance, and skin integrations is provided.

O. Microfluidic Point-of-Care Devices: New Trends and Future Prospects for eHealth Diagnostics

Point-of-care (PoC) diagnostics is promising for early detection of a number of diseases, including cancer, diabetes, and cardiovascular diseases, in addition to serving for monitoring health conditions. To be efficient and cost-effective, portable PoC devices are made with microfluidic technologies, with which laboratory analysis can be made with small-volume samples. Recent years have witnessed considerable progress in this area with "epidermal electronics", including miniaturized wearable diagnosis devices. These wearable devices allow for continuous real-time transmission of biological data to the Internet for further processing and transformation into clinical knowledge. Other approaches include bluetooth and WiFi technology for data transmission from portable (non-wearable) diagnosis devices to cellphones or computers, and then to the Internet for communication with centralized healthcare structures. There are, however, considerable challenges to be faced before PoC devices become routine in the clinical practice. For instance, the implementation of this technology requires integration of detection components with other fluid regulatory elements at the microscale, where fluid-flow properties become increasingly controlled by viscous forces rather than inertial forces. Another challenge is to develop new materials for environmentally friendly, cheap, and portable microfluidic devices. In this review paper, we first revisit the progress made in the last few years and discuss trends and strategies for the fabrication of microfluidic devices. Then, we discuss the challenges in lab-on-a-chip biosensing devices, including colorimetric sensors coupled to smartphones, plasmonic sensors, and electronic tongues. The latter ones use statistical and big data analysis for proper classification. The increasing use of big data and artificial intelligence methods is then commented upon in the context of wearable and handled biosensing platforms for the Internet of things and futuristic healthcare systems.