Investigation of cortisol dynamics in human sweat using a graphene-based wireless mHealth system

Wearable Microfluidics for Continuous Assay

The development of wearable devices provides approaches for the realization of self-health care. Easily carried wearable devices allow individual health monitoring at any place whenever necessary. There are various interesting monitoring targets, including body motion, organ pressure, and biomarkers. An efficient use of space in one small device is a promising resolution to increase the functions of wearable devices. Through integration of a microfluidic system into wearable devices, embedding complicated structures in one design becomes possible and can enable multifunction analyses within a limited device volume. This article reviews the reported microfluidic wearable devices, introduces applications to different biofluids, discusses characteristics of the design strategies and sensing principles, and highlights the attractive configurations of each device. This review seeks to provide a detailed summary of recent advanced microfluidic wearable devices. The overview of advanced key components is the basis for the development of future microfluidic wearable devices.

Wearable sensors for telehealth based on emerging materials and nanoarchitectonics

Wearable sensors have made significant progress in sensing physiological and biochemical markers for telehealth. By monitoring vital signs like body temperature, arterial oxygen saturation, and breath rate, wearable sensors provide enormous potential for the early detection of diseases. In recent years, significant advancements have been achieved in the development of wearable sensors based on two-dimensional (2D) materials with flexibility, excellent mechanical stability, high sensitivity, and accuracy introducing a new approach to remote and real-time health monitoring. In this review, we outline 2D materials-based wearable sensors and biosensors for a remote health monitoring system. The review focused on five types of wearable sensors, which were classified according to their sensing mechanism, such as pressure, strain, electrochemical, optoelectronic, and temperature sensors. 2D material capabilities and their impact on the performance and operation of the wearable sensor are outlined. The fundamental sensing principles and mechanism of wearable sensors, as well as their applications are explored. This review concludes by discussing the remaining obstacles and future opportunities for this emerging telehealth field. We hope that this report will be useful to individuals who want to design new wearable sensors based on 2D materials and it will generate new ideas.

One-step hydrothermal synthesis of near-infrared emission carbon quantum dots as fluorescence aptamer sensor for cortisol sensing and imaging

Fluorescence carbon quantum dots (CQDs) have been widely applied to sensing and bioimaging. In this paper, near-infrared carbon quantum dots (NIR-CQDs) were prepared through a simple one-step hydrothermal approach using reduced glutathione and formamide as raw materials. Based on NIR-CQDs, aptamer (Apt) and graphene oxide (GO) has been applied to fluorescence sensing cortisol. NIR-CQDs-Apt adsorbed to the surface of GO through π-π stacking and an inner filter effect (IFE) occurred between NIR-CQDs-Apt and GO leading to NIR-CQDs-Apt fluorescence "off". The IFE process is disrupted in the presence of cortisol, allowing NIR-CQDs-Apt fluorescence "on". This led us to construct a detection method with excellent selectivity over other cortisol sensors. The sensor can detect cortisol from 0.4 to 500 nM and has a detection limit as low as 0.13 nM. Importantly, this sensor can be used to detect intracellular cortisol with excellent biocompatibility and cellular imaging capabilities, which is promising for biosensing.

A wearable sweat electrochemical aptasensor based on the Ni-Co MOF nanosheet-decorated CNTs/PU film for monitoring of stress biomarker

Monitoring cortisol, a hormone released by the adrenal cortex in response to stress, is essential to evaluate the endocrine response to stress stimuli. While the current cortisol sensing methods require large laboratory settings, complex assay, and professional personnel. Herein, a novel flexible and wearable electrochemical aptasensor based on a Ni-Co metal-organic frameworks (MOF) nanosheet-decorated carbon nanotubes (CNTs)/polyurethane (PU) film is developed for rapid and reliable detection of cortisol in sweat. First, the CNTs/PU (CP) film was prepared by a modified wet spinning technology, and the CNTs/polyvinyl alcohol (PVA) solution was thermally deposited on the surface of CP film to form the highly flexible CNTs/PVA/CP (CCP) film with excellent conductivity. Then aminated Ni-Co MOF nanosheet prepared by a facile solvothermal method was conjugated with streptavidin and modified on the CCP film. Biofunctional MOF can effectively capture cortisol aptamer due to its excellent specific surface area. In addition, the MOF with peroxidase activity can catalytic oxidization of hydroquinone (HQ) by hydrogen peroxide (H₂O₂), which could amplify the peak current signal. The catalytic activity of Ni-Co MOF was substantially suppressed in the HQ/H₂O₂ system due to the formation of the aptamer-cortisol complex, which reduced the current signal, thereby realizing highly sensitive and selective detection of cortisol. The sensor has a linear range of 0.1-100 ng/mL and a detection limit of 0.032 ng/mL. Meanwhile, the sensor showed high accuracy for cortisol detection under mechanical deformation conditions. More importantly, the prepared MOF/CCP film based three-electrode was assembled with the polydimethylsiloxane (PDMS) substrate, and the sweat-cloth was used as the sweat collection channel to fabricate a wearable sensor patch for monitoring of cortisol in volunteers' sweat in the morning and evening. This flexible and non-invasive sweat cortisol aptasensor shows great potential for quantitative stress monitoring and management.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Recent Advances in Multiplexed Wearable Sensor Platforms for Real-Time Monitoring Lifetime Stress: A Review

Researchers are interested in measuring mental stress because it is linked to a variety of diseases. Real-time stress monitoring via wearable sensor systems can aid in the prevention of stress-related diseases by allowing stressors to be controlled immediately. Physical tests, such as heart rate or skin conductance, have recently been used to assess stress; however, these methods are easily influenced by daily life activities. As a result, for more accurate stress monitoring, validations requiring two or more stress-related biomarkers are demanded. In this review, the combinations of various types of sensors (hereafter referred to as multiplexed sensor systems) that can be applied to monitor stress are discussed, referring to physical and chemical biomarkers. Multiplexed sensor systems are classified as multiplexed physical sensors, multiplexed physical-chemical sensors, and multiplexed chemical sensors, with the effect of measuring multiple biomarkers and the ability to measure stress being the most important. The working principles of multiplexed sensor systems are subdivided, with advantages in measuring multiple biomarkers. Furthermore, stress-related chemical biomarkers are still limited to cortisol; however, we believe that by developing multiplexed sensor systems, it will be possible to explore new stress-related chemical biomarkers by confirming their correlations to cortisol. As a result, the potential for further development of multiplexed sensor systems, such as the development of wearable electronics for mental health management, is highlighted in this review.

A scoping review of neurodegenerative manifestations in explainable digital phenotyping

Neurologists nowadays no longer view neurodegenerative diseases, like Parkinson's and Alzheimer's disease, as single entities, but rather as a spectrum of multifaceted symptoms with heterogeneous progression courses and treatment responses. The definition of the naturalistic behavioral repertoire of early neurodegenerative manifestations is still elusive, impeding early diagnosis and intervention. Central to this view is the role of artificial intelligence (AI) in reinforcing the depth of phenotypic information, thereby supporting the paradigm shift to precision medicine and personalized healthcare. This suggestion advocates the definition of disease subtypes in a new biomarker-supported nosology framework, yet without empirical consensus on standardization, reliability and interpretability. Although the well-defined neurodegenerative processes, linked to a triad of motor and non-motor preclinical symptoms, are detected by clinical intuition, we undertake an unbiased data-driven approach to identify different patterns of neuropathology distribution based on the naturalistic behavior data inherent to populations in-the-wild. We appraise the role of remote technologies in the definition of digital phenotyping specific to brain-, body- and social-level neurodegenerative subtle symptoms, emphasizing inter- and intra-patient variability powered by deep learning. As such, the present review endeavors to exploit digital technologies and AI to create disease-specific phenotypic explanations, facilitating the understanding of neurodegenerative diseases as "bio-psycho-social" conditions. Not only does this translational effort within explainable digital phenotyping foster the understanding of disease-induced traits, but it also enhances diagnostic and, eventually, treatment personalization.

Dual-signal readout paper-based wearable biosensor with a 3D origami structure for multiplexed analyte detection in sweat

In this research, we design and implement a small, convenient, and noninvasive paper-based microfluidic sweat sensor that can simultaneously detect multiple key biomarkers in human sweat. The origami structure of the chip includes colorimetric and electrochemical sensing regions. Different colorimetric sensing regions are modified with specific chromogenic reagents to selectively identify glucose, lactate, uric acid, and magnesium ions in sweat, as well as the pH value. The regions of electrochemical sensing detect cortisol in sweat by molecular imprinting. The entire chip is composed of hydrophilically and hydrophobically treated filter paper, and 3D microfluidic channels are constructed by using folding paper. The thread-based channels formed after the hydrophilic and hydrophobic modifications are used to control the rate of sweat flow, which in turn can be used to control the sequence of reactions in the differently developing colored regions to ensure that signals of the best color can be captured simultaneously by the colorimetric sensing regions. Finally, the results of on-body experiments verify the reliability of the proposed sweat sensor and its potential for the noninvasive identification of a variety of sweat biomarkers.

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

Universal Fully Integrated Wearable Sensor Arrays for the Multiple Electrolyte and Metabolite Monitoring in Raw Sweat, Saliva, or Urine

Fully integrated wearable sensors are capable of dynamically, directly, and independently tracking biomarkers in raw noninvasive biofluids without any other equipment or accessories by integrating the unique on-body monitoring feature with the special complete functional implementation attribute. Sweat, saliva, and urine are three important noninvasive biofluids, and changes in their biomarkers hold great potential for revealing physiological conditions. However, it is still a challenge to design single fully integrated wearable sensor arrays (FIWSAs) that are universally able to concurrently measure electrolytes and metabolites in three of the most common noninvasive biofluids including sweat, saliva, and urine. Here, we propose the first single universal FIWSAs for wirelessly, noninvasively, and simultaneously measuring various metabolites (i.e., uric acid) and electrolytes (i.e., Na⁺ and H⁺) in raw sweat, saliva, or urine under subjects' exercise by integrating the specifically designed microfluidic, sensing, and electronic modules in a seamless manner. We evaluate its utility for noninvasive gout management in healthy subjects and in gout patients through a purine-rich meal challenge and with a medicine-treatment control, respectively. Noninvasive monitoring of multiple electrolytes and metabolites in a variety of raw noninvasive biofluids via such single universal FIWSAs may enrich the understanding of the biomarkers' levels in the body and would also facilitate self-health management.

Microfabrication of functional polyimide films and microstructures for flexible MEMS applications

Polyimides are widely used in the MEMS and flexible electronics fields due to their combined physicochemical properties, including high thermal stability, mechanical strength, and chemical resistance values. In the past decade, rapid progress has been made in the microfabrication of polyimides. However, enabling technologies, such as laser-induced graphene on polyimide, photosensitive polyimide micropatterning, and 3D polyimide microstructure assembly, have not been reviewed from the perspective of polyimide microfabrication. The aims of this review are to systematically discuss polyimide microfabrication techniques, which cover film formation, material conversion, micropatterning, 3D microfabrication, and their applications. With an emphasis on polyimide-based flexible MEMS devices, we discuss the remaining technological challenges in polyimide fabrication and possible technological innovations in this field.

Recent developments in wearable & non-wearable point-of-care biosensors for cortisol detection

INTRODUCTION

Cortisol is one of the most prominent biomarkers used for the detection of psychological stress and related disorders. It plays an important role in many physiological processes including immunomodulation and fat metabolism. Thus, monitoring of cortisol levels can be used to indicate different pathological conditions including stress disorders. There has been a gradual rise in the development of point of care (PoC) biosensors for continuous cortisol monitoring.

AREAS COVERED

This review discusses recent breakthroughs toward the development of PoC sensors (wearable and non wearable) for cortisol monitoring. Challenges associated with them have also been summarized.

EXPERT OPINION

Electrochemical PoC devices have recently emerged as a powerful tools for continuous monitoring of cortisol that can be utilized for stress management and treatment of related disorders. However, there are many challenges that should be addressed before such devices can be deployed at mass level, such as inter-individual variability, changing the device calibration with the circadian rhythm, interference from other endocrine moieties, etc. [Figure: see text].

Understanding the relationships between physiological and psychosocial stress, cortisol and cognition

Stress is viewed as a state of real or perceived threat to homeostasis, the management of which involves the endocrine, nervous, and immune systems. These systems work independently and interactively as part of the stress response. The scientific stress literature, which spans both animal and human studies, contains heterogeneous findings about the effects of stress on the brain and the body. This review seeks to summarise and integrate literature on the relationships between these systems, examining particularly the roles of physiological and psychosocial stress, the stress hormone cortisol, as controlled by the hypothalamic-pituitary-adrenal (HPA) axis, and the effects of stress on cognitive functioning. Health conditions related to impaired HPA axis functioning and their associated neuropsychiatric symptoms will also be considered. Lastly, this review will provide suggestions of clinical applicability for endocrinologists who are uniquely placed to measure outcomes related to endocrine, nervous and immune system functioning and identify areas of intervention.

MicroSweat: A Wearable Microfluidic Patch for Noninvasive and Reliable Sweat Collection Enables Human Stress Monitoring

Stress affects cognition, behavior, and physiology, leading to lasting physical and mental illness. The ability to detect and measure stress, however, is poor. Increased circulating cortisol during stress is mirrored by cortisol release from sweat glands, providing an opportunity to use it as an external biomarker for monitoring internal emotional state. Despite the attempts at using wearable sensors for monitoring sweat cortisol, there is a lack of reliable wearable sweat collection devices that preserve the concentration and integrity of sweat biomolecules corresponding to stress levels. Here, a flexible, self-powered, evaporation-free, bubble-free, surfactant-free, and scalable capillary microfluidic device, MicroSweat, is fabricated to reliably collect human sweat from different body locations. Cortisol levels are detected corresponding to severe stress ranging from 25 to 125 ng mL^-1 averaged across multiple body regions and 100-1000 ng mL^-1 from the axilla. A positive nonlinear correlation exists between cortisol concentration and stress levels quantified using the perceived stress scale (PSS). Moreover, owing to the sweat variation in response to environmental effects and physiological differences, the longitudinal and personalized profile of sweat cortisol is acquired, for the first time, for various body locations. The obtained sweat cortisol data is crucial for analyzing human stress in personalized and clinical healthcare sectors.

Moving toward smart biomedical sensing

The development of novel biomedical sensors as highly promising devices/tools in early diagnosis and therapy monitoring of many diseases and disorders has recently witnessed unprecedented growth; more and faster than ever. Nonetheless, on the eve of Industry 5.0 and by learning from defects of current sensors in smart diagnostics of pandemics, there is still a long way to go to achieve the ideal biomedical sensors capable of meeting the growing needs and expectations for smart biomedical/diagnostic sensing through eHealth systems. Herein, an overview is provided to highlight the importance and necessity of an inevitable transition in the era of digital health/Healthcare 4.0 towards smart biomedical/diagnostic sensing and how to approach it via new digital technologies including Internet of Things (IoT), artificial intelligence, IoT gateways (smartphones, readers), etc. This review will bring together the different types of smartphone/reader-based biomedical sensors, which have been employing for a wide variety of optical/electrical/electrochemical biosensing applications and paving the way for future eHealth diagnostic devices by moving towards smart biomedical sensing. Here, alongside highlighting the characteristics/criteria that should be met by the developed sensors towards smart biomedical sensing, the challenging issues ahead are delineated along with a comprehensive outlook on this extremely necessary field.

Cortisol Immunosensors: A Literature Review

Cortisol is a steroid hormone that is involved in a broad range of physiological processes in human/animal organisms. Cortisol levels in biological samples are a valuable biomarker, e.g., of stress and stress-related diseases; thus, cortisol determination in biological fluids, such as serum, saliva and urine, is of great clinical value. Although cortisol analysis can be performed with chromatography-based analytical techniques, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS), conventional immunoassays (radioimmunoassays (RIAs), enzyme-linked immunosorbent assays (ELISAs), etc.) are considered the "gold standard" analytical methodology for cortisol, due to their high sensitivity along with a series of practical advantages, such as low-cost instrumentation, an assay protocol that is fast and easy to perform, and high sample throughput. Especially in recent decades, research efforts have focused on the replacement of conventional immunoassays by cortisol immunosensors, which may offer further improvements in the field, such as real-time analysis at the point of care (e.g., continuous cortisol monitoring in sweat through wearable electrochemical sensors). In this review, most of the reported cortisol immunosensors, mainly electrochemical and also optical ones, are presented, focusing on their immunosensing/detection principles. Future prospects are also briefly discussed.

Wearable chemical sensors based on 2D materials for healthcare applications

Chemical sensors worn on the body could make possible the continuous, noninvasive, and accurate monitoring of vital human signals, which is necessary for remote health monitoring and telemedicine. Attractive for creating high-performance, wearable chemical sensors are atomically thin materials with intriguing physical features, abundant chemistry, and high surface-to-volume ratios. These advantages allow for appropriate material-analyte interactions, resulting in a high level of sensitivity even at trace analyte concentrations. Previous review articles covered the material and device elements of 2D material-based wearable devices extensively. In contrast, little research has addressed the existing state, future outlook, and promise of 2D materials for wearable chemical sensors. We provide an overview of recent advances in 2D-material-based wearable chemical sensors to overcome this deficiency. The structure design, manufacturing techniques, and mechanisms of 2D material-based wearable chemical sensors will be evaluated, as well as their applicability in human health monitoring. Importantly, we present a thorough review of the current state of the art and the technological gaps that would enable the future design and nanomanufacturing of 2D materials and wearable chemical sensors. Finally, we explore the challenges and opportunities associated with designing and implementing 2D wearable chemical sensors.

Advances in wearable electrochemical antibody-based sensors for cortisol sensing

Cortisol is a crucial hormone involving many physiological processes. Hence, cortisol detection is essential. This review highlights the key progress made on wearable electrochemical sensors using antibodies. It covers the design, principle, and electroanalytical methodology for detecting cortisol noninvasively. This article also analyzes and collects the analytical performances of electrochemical cortisol sensors. The development of these sensors continues to face challenges such as biofouling, sample management, sensitivity, flexibility, stability, and recognition layer performance. It is also necessary to develop a sensitive electrode and material. This article also presents potential strategies for designing antibody electrodes and provides examples of sensing systems. Additionally, it discusses the challenges in translating research into practical applications.

Off-World Mental Health: Considerations for the Design of Well-being-Supportive Technologies for Deep Space Exploration

During future long-duration space exploration missions, humans will be exposed to combinations of extreme physical, psychological, and interpersonal demands. These demands create risks for the safety, performance, health, and well-being of both individuals and crew. The communication latency in deep space means that explorers will increasingly have to operate independently and take responsibility for their own self-care and self-management. At present, several research programs are focused on developing and testing digital technologies and countermeasures that support the effective functioning of deep space crews. Although promising, these initiatives have been stimulated mostly by technological opportunity rather than cogent theory. In this perspective, we argue that digital technologies developed for spaceflight should be informed by well-being-supportive design principles and be cognizant of broader conversations around the development and use of digital health applications, especially pertaining to issues of autonomy, privacy, and trust. These issues are important for designing potentially mission-critical health technologies and may be determining factors in the safe and successful completion of future off-world endeavors.

A "Two-Part" Resonance Circuit Based Detachable Sweat Patch for Noninvasive Biochemical and Biophysical Sensing

Wearable electronics play important roles in noninvasive, continuous, and personalized monitoring of multiple biosignals generated by the body. To unleash their full potential for next-generation human centered bio-integrated electronics, the wireless sensing capability is a desirable feature. However, state-of-the-art wireless sensing technologies exploit rigid and bulky electronic modules for power supply, signal generation, and data transmission. This study reports a battery-free device technology based on a "two-part" resonance circuit model with modularized, physically separated, and detachable functional units for magnetic coupling and biosensing. The resulting platform combines advantages of electronics and microfluidics with low cost, minimized form factors, and improved performance stability. Demonstration of a detachable sweat patch capable of simultaneous recording of cortisol concentration, pH value, and temperature highlights the potential of the "two-part" circuit for advanced, transformative biosensing. The resulting wireless sensors provide a new engineering solution to monitoring biosignals through intimate and seamless integration with skin surfaces.

Electrochemical-based remote biomarker monitoring: Toward Internet of Wearable Things in telemedicine

Internet of Wearable Things (IoWT) will be a major breakthrough for remote medical monitoring. In this scenario, wearable biomarker sensors have been developing not only to diagnose point-of-care (POC) of diseases, but also to continuously manage them. On-body tracking of biomarkers in biofluids is regarded as a proper substitution of conventional biomarker sensors for dynamic sampling and analyzing due to their high sensitivity, conformability, and affordability, creating ever-rising the market demand for them. In a wireless body area network (WBAN), data is captured from all sensors on the body to a smartphone/laptop, and sent the sensed data to a cloud for storing, processing, and retrieving, and ultimately displayed the data on custom applications (Apps). Wearable IoT biomarker sensors are used for early diseases diagnosis and continuous monitoring in developing countries in which people hardly access to healthcare systems. In this review, we aim to highlight a wide range of wearable electrochemical biomarker sensors, accompanied by microfluidics for continuous sampling, which will pave the way toward developing wearable IoT biomarker sensors to track health status. The current challenges and future perspective in skin-conformal biomarker sensors will be discussing their potential applicability for IoWT in cloud-based telemedicine.

Carbon-Based Flexible Devices for Comprehensive Health Monitoring

Traditional public health systems suffer from incomprehensive, delayed, and inefficient medical services. Convenient and comprehensive health monitoring has been highly sought after recently. Flexible and wearable devices are attracting wide attention due to their potential applications in wearable human health monitoring and care systems. Using carbon materials with overall superiorities can facilitate the development of wearable and flexible devices with various functions and excellent performance, which can comprehensively and real-time monitor human health status and prevent diseases. Herein, the latest advances in the rational design and controlled fabrication of carbon materials for applications in health-related flexible and wearable electronics are reviewed. The fabrication strategies, working mechanism, performance, and applications in health monitoring of carbon-based flexible devices, including electromechanical sensors, temperature/humidity sensors, chemical sensors, and flexible conductive wires/electrodes, are reviewed. Furthermore, integrating multiple carbon-based devices into multifunctional wearable systems is discussed. Finally, the existing challenges and future opportunities in this field are also proposed.

Wearable Localized Surface Plasmon Resonance-Based Biosensor with Highly Sensitive and Direct Detection of Cortisol in Human Sweat

Wearable biosensors have the potential for developing individualized health evaluation and detection systems owing to their ability to provide continuous real-time physiological data. Among various wearable biosensors, localized surface plasmon resonance (LSPR)-based wearable sensors can be versatile in various practical applications owing to their sensitive interactions with specific analytes. Understanding and analyzing endocrine responses to stress is particularly crucial for evaluating human performance, diagnosing stress-related diseases, and monitoring mental health, as stress takes a serious toll on physiological health and psychological well-being. Cortisol is an essential biomarker of stress because of the close relationship between cortisol concentration in the human body and stress level. In this study, a flexible LSPR biosensor was manufactured to detect cortisol levels in the human body by depositing gold nanoparticle (AuNP) layers on a 3-aminopropyltriethoxysilane (APTES)-functionalized poly (dimethylsiloxane) (PDMS) substrate. Subsequently, an aptamer was immobilized on the surface of the LSPR substrate, enabling highly sensitive and selective cortisol capture owing to its specific cortisol recognition. The biosensor exhibited excellent detection ability in cortisol solutions of various concentrations ranging from 0.1 to 1000 nM with a detection limit of 0.1 nM. The flexible LSPR biosensor also demonstrated good stability under various mechanical deformations. Furthermore, the cortisol levels of the flexible LSPR biosensor were also measured in the human epidermis before and after exercise as well as in the morning and afternoon. Our biosensors, which combine easily manufactured flexible sensors with sensitive cortisol-detecting molecules to measure human stress levels, could be versatile candidates for human-friendly products.

Laser-Induced Graphene Arrays-Based Three-Phase Interface Enzyme Electrode for Reliable Bioassays

Electrochemical oxidase biosensors have been widely applied in healthcare, environmental measurements and the biomedical field. However, the low and fluctuant oxygen levels in solution and the high anodic detection potentially restrict the assay accuracy. To address these problems, in this work, we constructed a three-phase interface enzyme electrode by sequentially immobilizing H₂O₂ electrocatalysts and an oxidase layer on a superhydrophobic laser-induced graphene (LIG) array substrate. The LIG-based enzyme electrode possesses a solid-liquid-air three-phase interface where constant and sufficient oxygen can be supplied from the air phase to the enzymatic reaction zone, which enhances and stabilizes the oxidase kinetics. We discovered that the enzymatic reaction rate is 21.2-fold improved over that of a solid-liquid diphase system where oxygen is supplied from the liquid phase, leading to a 60-times wider linear detection range. Moreover, the three-phase enzyme electrode can employ a cathodic measuring principle for oxidase catalytic product H₂O₂ detection, which could minimize interferences arising from oxidizable molecules in biofluids and increase the detection selectivity. This work provides a simple and promising approach to the design and construction of high-performance bioassay systems.

Wearable and flexible electrochemical sensors for sweat analysis: a review

Flexible wearable sweat sensors allow continuous, real-time, noninvasive detection of sweat analytes, provide insight into human physiology at the molecular level, and have received significant attention for their promising applications in personalized health monitoring. Electrochemical sensors are the best choice for wearable sweat sensors due to their high performance, low cost, miniaturization, and wide applicability. Recent developments in soft microfluidics, multiplexed biosensing, energy harvesting devices, and materials have advanced the compatibility of wearable electrochemical sweat-sensing platforms. In this review, we summarize the potential of sweat for medical detection and methods for sweat stimulation and collection. This paper provides an overview of the components of wearable sweat sensors and recent developments in materials and power supply technologies and highlights some typical sensing platforms for different types of analytes. Finally, the paper ends with a discussion of the challenges and a view of the prospective development of this exciting field.

A Wireless, Regeneratable Cocaine Sensing Scheme Enabled by Allosteric Regulation of pH Sensitive Aptamers

A key challenge for achieving continuous biosensing with existing technologies is the poor reusability of the biorecognition interface due to the difficulty in the dissociation of analytes from the bioreceptors upon surface saturation. In this work, we introduce a regeneratable biosensing scheme enabled by allosteric regulation of a re-engineered pH sensitive anti-cocaine aptamer. The aptamer can regain its affinity with target analytes due to proton-promoted duplex-to-triplex transition in DNA configuration followed by the release of adsorbed analytes. A Pd/PdH_x electrode placed next to the sensor can enable the pH regulation of the local chemical environment via electrochemical reactions. Demonstration of a "flower-shaped", stretchable, and inductively coupled electronic system with sensing and energy harvesting capabilities provides a promising route to designing wireless devices in biointegrated forms. These advances have the potential for future development of electronic sensing platforms with on-chip regeneration capability for continuous, quantitative, and real-time monitoring of chemical and biological markers.

Emerging biotransduction strategies on soft interfaces for biosensing

As a lab-on-soft biochip providing accurate and timely biomarker information, wearable biosensors can satisfy the increasing demand for intelligent e-health services, active disease diagnosis/therapy, and huge bioinformation data. As biomolecules generally could not directly produce detectable signals, biotransducers that specifically convert biomolecules to electrical or optical signals are involved, which determines the pivotal sensing performance including 3S (sensitivity, selectivity, and stability), reversibility, etc. The soft interface poses new requirements for biotransducers, especially equipment-free, facile operation, mechanical tolerance, and high sensing performance. In this review, we discussed the emerging electrochemical and optical biotransduction strategies on wearables from the aspects of the transduction mechanism, amplification strategies, biomaterial selection, and device fabrication procedures. Challenges and perspectives regarding future biotransducers for monitoring trace amounts of biomolecules with high fidelity, sensitivity, and multifunctionality are also discussed. It is expected that through fusion with functional electronics, wearable biosensors can provide possibilities to further decentralize the healthcare system and even build biomolecule-based intelligent cyber-physical systems and new modalities of cyborgs.

Masticatory system-inspired microneedle theranostic platform for intelligent and precise diabetic management

Integrated systems for diabetic theranostics present advanced technology to regulate diabetes yet still have critical challenges in terms of accuracy, long-term monitoring, and minimal invasiveness. Inspired by the feature and functions of animal masticatory system, we presented a biomimetic microneedle theranostic platform (MNTP) for intelligent and precise management of diabetes. The MNTP was supported by a miniatured circuit, which used microneedle arrays for on-demand skin penetration, enabling interstitial fluid exudation for simultaneous detection of glucose and physiological ions, and subcutaneous insulin delivery. Interstitial fluid exudation enabled sensing in oxygen-rich environment via the incorporated epidermal sensor functionalized with hybrid carbon nanomaterials. This feature addressed the biosafety issues due to implanted electrodes and the "oxygen-deficit" issues in vivo. The MNTP was demonstrated to accurately detect glucose and ions and deliver insulin to regulate hyperglycemia. The biomimetic and intelligent features of the MNTP endowed it as a highly advanced system for diabetes therapy.

Stress Drivers of Glucose Dynamics during Ozone Exposure Measured Using Radiotelemetry in Rats

BACKGROUND

Inhaled irritant air pollutants may trigger stress-related metabolic dysfunction associated with altered circulating adrenal-derived hormones.

OBJECTIVES

We used implantable telemetry in rats to assess real-time changes in circulating glucose during and after exposure to ozone and mechanistically linked responses to neuroendocrine stress hormones.

METHODS

First, using a cross-over design, we monitored glucose during ozone exposures (0.0, 0.2, 0.4, and 0.8 ppm) and nonexposure periods in male Wistar Kyoto rats implanted with glucose telemeters. A second cohort of unimplanted rats was exposed to ozone (0.0, 0.4 or 0.8 ppm) for 30 min, 1 h, 2 h, or 4 h with hormones measured immediately post exposure. We assessed glucose metabolism in sham and adrenalectomized rats, with or without supplementation of adrenergic/glucocorticoid receptor agonists, and in a separate cohort, antagonists.

RESULTS

Ozone (0.8 ppm) was associated with significantly higher blood glucose and lower core body temperature beginning 90 min into exposure, with reversal of effects 4-6 h post exposure. Glucose monitoring during four daily 4-h ozone exposures revealed duration of glucose increases, adaptation, and diurnal variations. Ozone-induced glucose changes were preceded by higher levels of adrenocorticotropic hormone, corticosterone, and epinephrine but lower levels of thyroid-stimulating hormone, prolactin, and luteinizing hormones. Higher glucose and glucose intolerance were inhibited in rats that were adrenalectomized or treated with adrenergic plus glucocorticoid receptor antagonists but exacerbated by agonists.

DISCUSSION

We demonstrated the temporality of neuroendocrine-stress-mediated biological sequalae responsible for ozone-induced glucose metabolic dysfunction and mechanism in a rodent model. Stress hormones assessment with real-time glucose monitoring may be useful in identifying interactions among irritant pollutants and stress-related illnesses. https://doi.org/10.1289/EHP11088.

Molecularly Imprinted Polymer-Based Sensor for Electrochemical Detection of Cortisol

As a steroid hormone, cortisol has a close relationship with the stress response, and therefore, can be used as a biomarker for early detection of stress. An electrochemical immunosensor is one of the most widely used methods to detect cortisol, with antibodies as its bioreceptor. Apart from conventional laboratory-based methods, the trend for cortisol detection has seemed to be exploiting antibodies and aptamers. Both can provide satisfactory performance with high selectivity and sensitivity, but they still face issues with their short shelf life. Molecularly imprinted polymers (MIPs) have been widely used to detect macro- and micro-molecules by forming artificial antibodies as bioreceptors. MIPs are an alternative to natural antibodies, which despite demonstrating high selectivity and a low degree of cross-reactivity, often also show a high sensitivity to the environment, leading to their denaturation. MIPs can be prepared with convenient and relatively affordable fabrication processes. They also have high durability in ambient conditions, a long shelf life, and the ability to detect cortisol molecules at a concentration as low as 2 ag/mL. By collecting data from the past five years, this review summarizes the antibody and aptamer-based amperometric sensors as well as the latest developments exploiting MIPs rather than antibodies. Lastly, factors that can improve MIPs performance and are expected to be developed in the future are also explained.

Wearable chemical sensors for biomarker discovery in the omics era

Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.

A wearable electrochemical biosensor for the monitoring of metabolites and nutrients

Wearable non-invasive biosensors for the continuous monitoring of metabolites in sweat can detect a few analytes at sufficiently high concentrations, typically during vigorous exercise so as to generate sufficient quantity of the biofluid. Here we report the design and performance of a wearable electrochemical biosensor for the continuous analysis, in sweat during physical exercise and at rest, of trace levels of multiple metabolites and nutrients, including all essential amino acids and vitamins. The biosensor consists of graphene electrodes that can be repeatedly regenerated in situ, functionalized with metabolite-specific antibody-like molecularly imprinted polymers and redox-active reporter nanoparticles, and integrated with modules for iontophoresis-based sweat induction, microfluidic sweat sampling, signal processing and calibration, and wireless communication. In volunteers, the biosensor enabled the real-time monitoring of the intake of amino acids and their levels during physical exercise, as well as the assessment of the risk of metabolic syndrome (by correlating amino acid levels in serum and sweat). The monitoring of metabolites for the early identification of abnormal health conditions could facilitate applications in precision nutrition.

Reversible Immunosensor for the Continuous Monitoring of Cortisol in Blood Plasma Sampled with Microdialysis

Cortisol is a steroid hormone involved in a wide range of medical conditions. The level of the hormone fluctuates over time, but with traditional laboratory-based assays, such dynamics cannot be monitored in real time. Here, a reversible cortisol sensor is reported that allows continuous monitoring of cortisol in blood plasma using sampling by microdialysis. The sensor is based on measuring single-molecule binding and unbinding events of tethered particles. The particles are functionalized with antibodies and the substrate with cortisol-analogues, causing binding and unbinding events to occur between particles and substrate. The frequency of binding events is reduced when cortisol is present in the solution as it blocks the binding sites of the antibodies. The sensor responds to cortisol in the high nanomolar to low micromolar range and can monitor cortisol concentrations over multiple hours. Results are shown for cortisol monitoring in filtered and in microdialysis-sampled human blood plasma.

Highly Stretchable Sensor Based on Fluid Dynamics-Assisted Graphene Inks for Real-Time Monitoring of Sweat

Graphene inks have recently attracted attention for the development of printed wearable and flexible electronics and sensors not only because of their high conductivity and low cost but also because they are suitable for high-speed printing. Although reliable and scalable printing technologies are well established, further improvement in graphene inks in terms of electrical conductivity, stretchability/flexibility, and mass production is necessary for sensors for real-time monitoring. Herein, highly stretchable and conductive graphene inks were prepared by an efficient and scalable fluid dynamics-assisted exfoliation of graphite and a mixing process with elastomeric Ecoflex. After printing inks onto textile substrates, the serpentine-patterned conductors exhibited high conductivity and stable resistance even under a mechanically stretched state (a strain of 150%). Electrochemical sensors that detect sodium ions were fabricated on this conducting platform. These sensors indicated high potentiometric sensing ability under different mechanical deformations. To demonstrate the on-body performance of the developed sensors, real-time monitoring of sodium-ion concentration in the sweat of a human subject was carried out during an indoor stationary cycling exercise.

Graphene and Its Derivatives: Synthesis and Application in the Electrochemical Detection of Analytes in Sweat

Wearable sensors and invasive devices have been studied extensively in recent years as the demand for real-time human healthcare applications and seamless human-machine interaction has risen exponentially. An explosion in sensor research throughout the globe has been ignited by the unique features such as thermal, electrical, and mechanical properties of graphene. This includes wearable sensors and implants, which can detect a wide range of data, including body temperature, pulse oxygenation, blood pressure, glucose, and the other analytes present in sweat. Graphene-based sensors for real-time human health monitoring are also being developed. This review is a comprehensive discussion about the properties of graphene, routes to its synthesis, derivatives of graphene, etc. Moreover, the basic features of a biosensor along with the chemistry of sweat are also discussed in detail. The review mainly focusses on the graphene and its derivative-based wearable sensors for the detection of analytes in sweat. Graphene-based sensors for health monitoring will be examined and explained in this study as an overview of the most current innovations in sensor designs, sensing processes, technological advancements, sensor system components, and potential hurdles. The future holds great opportunities for the development of efficient and advanced graphene-based sensors for the detection of analytes in sweat.

A Wearable, Textile-Based Polyacrylate Imprinted Electrochemical Sensor for Cortisol Detection in Sweat

A wearable, textile-based molecularly imprinted polymer (MIP) electrochemical sensor for cortisol detection in human sweat has been demonstrated. The wearable cortisol sensor was fabricated via layer-by-layer assembly (LbL) on a flexible cotton textile substrate coated with a conductive nanoporous carbon nanotube/cellulose nanocrystal (CNT/CNC) composite suspension, conductive polyaniline (PANI), and a selective cortisol-imprinted poly(glycidylmethacrylate-co-ethylene glycol dimethacrylate) (poly(GMA-co-EGDMA)) decorated with gold nanoparticles (AuNPs), or plated with gold. The cortisol sensor rapidly (<2 min) responded to 9.8−49.5 ng/mL of cortisol, with an average relative standard deviation (%RSD) of 6.4% across the dynamic range, indicating excellent precision. The cortisol sensor yielded an excellent limit of detection (LOD) of 8.00 ng/mL, which is within the typical physiological levels in human sweat. A single cortisol sensor patch could be reused 15 times over a 30-day period with no loss in performance, attesting to excellent reusability. The cortisol sensor patch was successfully verified for use in quantification of cortisol levels in human sweat.

A Comprehensive Review of the Recent Developments in Wearable Sweat-Sensing Devices

Sweat analysis offers non-invasive real-time on-body measurement for wearable sensors. However, there are still gaps in current developed sweat-sensing devices (SSDs) regarding the concerns of mixing fresh and old sweat and real-time measurement, which are the requirements to ensure accurate the measurement of wearable devices. This review paper discusses these limitations by aiding model designs, features, performance, and the device operation for exploring the SSDs used in different sweat collection tools, focusing on continuous and non-continuous flow sweat analysis. In addition, the paper also comprehensively presents various sweat biomarkers that have been explored by earlier works in order to broaden the use of non-invasive sweat samples in healthcare and related applications. This work also discusses the target analyte's response mechanism for different sweat compositions, categories of sweat collection devices, and recent advances in SSDs regarding optimal design, functionality, and performance.

Antibody-Coated Wearable Organic Electrochemical Transistors for Cortisol Detection in Human Sweat

The dysregulation of the hormone cortisol is related to several pathological states, and its monitoring could help prevent severe stress, fatigue, and mental diseases. While wearable antibody-based biosensors could allow real-time and simple monitoring of antigens, an accurate and low-cost antibody-based cortisol detection through electrochemical methods is considerably challenging due to its low concentration and the high ionic strength of real biofluids. Here, a label-free and fast sensor for cortisol detection is proposed based on antibody-coated organic electrochemical transistors. The developed devices show unprecedented high sensitivities of 50 μA/dec for cortisol sensing in high-ionic-strength solutions with effective cortisol detection demonstrated with real human sweat. The sensing mechanism is analyzed through impedance spectroscopy and confirmed with electrical models. Compared to existing methods requiring bulky and expensive laboratory equipment, these wearable devices enable point-of-care cortisol detection in 5 min with direct sweat collection for personalized well-being monitoring.

Feasibility and value of salivary cortisol sampling to reflect distress in head and neck cancer patients undergoing chemoradiation: A proof-of-concept study

BACKGROUND

Head and neck cancer (HNC) patients undergoing chemo/radiation commonly experience severe and persistent distress associated with treatment related fear and physical side effects such as xerostomia, dysphagia, and dryness of mouth. Cortisol, a stress sensitive hormone, can be easily measured in saliva to reflect biobehavioral responses to such stressors. Unfortunately, it has not been used in this population due to concerns associated with chemoradiation (C/RT) related xerostomia.

METHODS

In a proof-of-concept study, we explored the feasibility of collecting salivary cortisol as a marker of fear and distress in HNC patients. Ten HNC subjects undergoing C/RT provided saliva samples for 3 consecutive days across three timepoints (pre-treatment, 3-weeks and 1-month post-treatment) and completed concurrent depression, anxiety and swallowing related fear measures.

RESULTS

Salivary cortisol collection adherence was between 80-60%. It was not impacted by xerostomia. Diurnal cortisol pattern demonstrated dysregulation at pretreatment in 62%, and flattened aberrant slopes continued at 3-weeks and beyond in 50% of subjects.

CONCLUSIONS

Our study supports the feasibility and utility of salivary cortisol measurement in HNC patients across the treatment trajectory. Diurnal cortisol measures may be a valuable tool to detect and monitor treatment distress during C/RT in this population.

Utilizing Gradient Porous Graphene Substrate as the Solid-Contact Layer To Enhance Wearable Electrochemical Sweat Sensor Sensitivity

Wearable sweat monitoring represents an attractive opportunity for personalized healthcare and for evaluating sports performance. One of the limitations with such monitoring, however, is water layer formation upon cycling of ion-selective sensors, leading to degraded sensitivity and long-term instability. Our report is the first to use chemical vapor deposition-grown, three-dimensional, graphene-based, gradient porous electrodes to minimize such water layer formation. The proposed design reduces the ion diffusion path within the polymeric ion-selective membrane and enhances the electroactive surface for highly sensitive, real-time detection of Na⁺ ions in human sweat with high selectivity. We obtained a 7-fold enhancement in electroactive surface against 2D electrodes (e.g., carbon, gold), yielding a sensitivity of 65.1 ± 0.25 mV decade^-1 (n = 3, RSD = 0.39%), the highest to date for wearable Na⁺ sweat sensors. The on-body sweat sensing performance is comparable to that of ICP-MS, suggesting its feasibility for health evaluation through sweat.

Skin Electronics from Biocompatible In Situ Welding Enabled By Intrinsically Sticky Conductors

Welding usually involves high temperatures, toxic solvents, or conditions not compatible with human bodies, which severely limit the fusion of electronics and human tissues. To achieve direct welding of electronics on human skin, the intrinsically sticky conductors that can simultaneously achieve metal-grade electrical conductivity (≈41 7000 S m^-1 ), hydrogel-grade stretchability (>900% strain), and self-adhesiveness (1.8 N cm^-1 ) are reported. The sticky conductors composed of gallium indium alloy and acrylate polymer adhesives have a surface-enriched structure, which can form instant mechanical and electrical connections with different surfaces through gentle pressure without involving conditions that may damage human tissues. Based on the sticky conductors, the in situ welding of electronics on the skin is realized. To demonstrate the feasibility of in situ welding, electronic tattoos are achieved for movement monitoring. Intrinsically sticky electrodes that can resist drying and simultaneously deform with the skin for electrophysiological measurement are also developed.

Surface Engineering of Laser-Induced Graphene Enables Long-Term Monitoring of On-Body Uric Acid and pH Simultaneously

Laser-induced graphene (LIG) suffers from serious decay in long-term biosensing, which greatly restricts its practical applications. Herein, we report a new strategy to engineer the LIG surface with Au clusters and chitosan sequentially to form a C-Au-LIG electrode with a superhydrophilic and highly conductive 3D graphene surface, which demonstrates superior performance and negligible decay in both long-term storage and practical usage in vitro and in vivo environments. Moreover, the C-Au-LIG electrode can be used for detecting uric acid (UA) and pH simultaneously from a single differential pulse voltammetry curve with low-detection limitation, high accuracy, and negligible interference with other sweat biomarkers. The integrated C-Au-LIG wearable biosensor was employed to continuously monitor the UA content in human sweat, which can well reflect the daily intake of purines for at least 10 days. Therefore, the C-Au-LIG electrode demonstrates significant application potential and provides inspiration for surface engineering of other biosensor materials and electrodes.

Wearable Sensor for Continuous Sweat Biomarker Monitoring

In recent years, wearable sensors have enabled the unique mode of real-time and noninvasive monitoring to develop rapidly in medical care, sports, and other fields. Sweat contains a wide range of biomarkers such as metabolites, electrolytes, and various hormones. Combined with wearable technology, sweat can reflect human fatigue, disease, mental stress, dehydration, and so on. This paper comprehensively describes the analysis of sweat components such as glucose, lactic acid, electrolytes, pH, cortisol, vitamins, ethanol, and drugs by wearable sensing technology, and the application of sweat wearable devices in glasses, patches, fabrics, tattoos, and paper. The development trend of sweat wearable devices is prospected. It is believed that if the sweat collection, air permeability, biocompatibility, sensing array construction, continuous monitoring, self-healing technology, power consumption, real-time data transmission, specific recognition, and other problems of the wearable sweat sensor are solved, we can provide the wearer with important information about their health level in the true sense.

Battery-free, tuning circuit-inspired wireless sensor systems for detection of multiple biomarkers in bodily fluids

Tracking the concentration of biomarkers in biofluids can provide crucial information about health status. However, the complexity and nonideal form factors of conventional digital wireless schemes impose challenges in realizing biointegrated, lightweight, and miniaturized sensors. Inspired by the working principle of tuning circuits in radio frequency electronics, this study reports a class of battery-free wireless biochemical sensors: In a resonance circuit, the coupling between a sensing interface and an inductor-capacitor oscillator through a pair of varactor diodes converts a change in electric potential into a modulation in capacitance, resulting in a quantifiable shift of the resonance circuit. Proper design of sensing interfaces with biorecognition elements enables the detection of various biomarkers, including ions, neurotransmitters, and metabolites. Demonstrations of "smart accessories" and miniaturized probes suggest the broad utility of this circuit model. The design concepts and sensing strategies provide a realistic pathway to building biointegrated electronics for wireless biochemical sensing.

Research Progress on the Preparation and Applications of Laser-Induced Graphene Technology

Graphene has been regarded as a potential application material in the field of new energy conversion and storage because of its unique two-dimensional structure and excellent physical and chemical properties. However, traditional graphene preparation methods are complicated in-process and difficult to form patterned structures. In recent years, laser-induced graphene (LIG) technology has received a large amount of attention from scholars and has a wide range of applications in supercapacitors, batteries, sensors, air filters, water treatment, etc. In this paper, we summarized a variety of preparation methods for graphene. The effects of laser processing parameters, laser type, precursor materials, and process atmosphere on the properties of the prepared LIG were reviewed. Then, two strategies for large-scale production of LIG were briefly described. We also discussed the wide applications of LIG in the fields of signal sensing, environmental protection, and energy storage. Finally, we briefly outlined the future trends of this research direction.

Eccrine Sweat Molecular Model for Development of de novo Biosensors

In this paper, we present a validated, novel, in silico molecular dynamics (MD) model of eccrine sweat with approx. 35k atoms developed using Large-scale Atomic/Molecular Massively Parallel Simulator (LAMMPS) program. CHARMMS36m force field for constituent atoms and SPC/E water model are used to develop this model. The model outputs transport properties such as self-diffusivity computed using mean squared displacement and bulk viscosity computed via Green-Kubo correlations, which are compared with existing literature values and experimental studies and presented. This validated model is intended to serve as a tool to develop eccrine sweat based biosensors.

The era of nano-bionic: 2D materials for wearable and implantable body sensors

Nano-bionics have the potential of revolutionizing modern medicine. Among nano-bionic devices, body sensors allow to monitor in real-time the health of patients, to achieve personalized medicine, and even to restore or enhance human functions. The advent of two-dimensional (2D) materials is facilitating the manufacturing of miniaturized and ultrathin bioelectronics, that can be easily integrated in the human body. Their unique electronic properties allow to efficiently transduce physical and chemical stimuli into electric current. Their flexibility and nanometric thickness facilitate the adaption and adhesion to human body. The low opacity permits to obtain transparent devices. The good cellular adhesion and reduced cytotoxicity are advantageous for the integration of the devices in vivo. Herein we review the latest and more significant examples of 2D material-based sensors for health monitoring, describing their architectures, sensing mechanisms, advantages and, as well, the challenges and drawbacks that hampers their translation into commercial clinical devices.

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.