Wearable Woven Electrochemical Biosensor Patch for Non-invasive Diagnostics

Eco-Friendly Textile-Based Wearable Humidity Sensor with Multinode Wireless Connectivity for Healthcare Applications

Textile-based wearable humidity sensors are of great interest for human healthcare monitoring as they can provide critical human-physiology information. The demand for wearable and sustainable sensing technology has significantly promoted the development of eco-friendly sensing solutions for potential real-world applications. Herein, a biodegradable cotton (textile)-based wearable humidity sensor has been developed using fabsil-treated cotton fabric coated with a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) sensing layer. The structural, chemical composition, hygroscopicity, and morphological properties are examined using X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), contact angle measurement, and scanning electron microscopy (SEM) analysis. The developed sensor exhibited a nearly linear response (Adj. R-square value observed as 0.95035) over a broad relative humidity (RH) range from 25 to 91.5%RH displaying high sensitivity (26.1%/%RH). The sensor shows excellent reproducibility (on replica sensors with a margin of error ±1.98%) and appreciable stability/aging with time (>4.5 months), high flexibility (studied at bending angles 30°, 70°, 120°, and 150°), substantial response/recovery durations (suitable for multiple applications), and highly repeatable (multicyclic analysis) sensing performance. The prospective relevance of the developed humidity sensor toward healthcare applications is demonstrated via breathing rate monitoring (via a sensor attached to a face mask), distinguishing different breathing patterns (normal, deep, and fast), skin moisture monitoring, and neonatal care (diaper wetting). The multinode wireless connectivity is demonstrated using a Raspberry Pi Pico-based system for demonstrating the potential applicability of the developed sensor as a real-time humidity monitoring system for the healthcare sector. Further, the biodegradability analysis of the used textile is evaluated using the soil burial degradation test. The work suggests the potential applicability of the developed flexible and eco-friendly humidity sensor in wearable healthcare devices and other humidity sensing applications.

Electrochemical sensing fibers for wearable health monitoring devices

Real-time monitoring of health conditions is an emerging strong issue in health care, internet information, and other strongly evolving areas. Wearable electronics are versatile platforms for non-invasive sensing. Among a variety of wearable device principles, fiber electronics represent cutting-edge development of flexible electronics. Enabled by electrochemical sensing, fiber electronics have found a wide range of applications, providing new opportunities for real-time monitoring of health conditions by daily wearing, and electrochemical fiber sensors as explored in the present report are a promising emerging field. In consideration of the key challenges and corresponding solutions for electrochemical sensing fibers, we offer here a timely and comprehensive review. We discuss the principles and advantages of electrochemical sensing fibers and fabrics. Our review also highlights the importance of electrochemical sensing fibers in the fabrication of "smart" fabric designs, focusing on strategies to address key issues in fiber-based electrochemical sensors, and we provide an overview of smart clothing systems and their cutting-edge applications in therapeutic care. Our report offers a comprehensive overview of current developments in electrochemical sensing fibers to researchers in the fields of wearables, flexible electronics, and electrochemical sensing, stimulating forthcoming development of next-generation "smart" fabrics-based electrochemical sensing.

Fabric-Based Electrochemical Glucose Sensor with Integrated Millifluidic Path from a Hydrophobic Batik Wax

In recent years, measuring and monitoring analyte concentrations continuously, frequently, and periodically has been a vital necessity for certain individuals. We developed a cotton-based millifluidic fabric-based electrochemical device (mFED) to monitor glucose continuously and evaluate the effects of mechanical deformation on the device's electrochemical performance. The mFED was fabricated using stencil printing (thick film method) for patterning the electrodes and wax-patterning to make the reaction zone. The analytical performance of the device was carried out using the chronoamperometry method at a detection potential of -0.2 V. The mFED has a linear working range of 0-20 mM of glucose, with LOD and LOQ of 0.98 mM and 3.26 mM. The 3D mFED shows the potential to be integrated as a wearable sensor that can continuously measure glucose under mechanical deformation.

Recent Advances in Wearable Biosensors for Non-Invasive Detection of Human Lactate

Lactate, a crucial product of the anaerobic metabolism of carbohydrates in the human body, is of enormous significance in the diagnosis and treatment of diseases and scientific exercise management. The level of lactate in the bio-fluid is a crucial health indicator because it is related to diseases, such as hypoxia, metabolic disorders, renal failure, heart failure, and respiratory failure. For critically ill patients and those who need to regularly control lactate levels, it is vital to develop a non-invasive wearable sensor to detect lactate levels in matrices other than blood. Due to its high sensitivity, high selectivity, low detection limit, simplicity of use, and ability to identify target molecules in the presence of interfering chemicals, biosensing is a potential analytical approach for lactate detection that has received increasing attention. Various types of wearable lactate biosensors are reviewed in this paper, along with their preparation, key properties, and commonly used flexible substrate materials including polydimethylsiloxane (PDMS), polyethylene terephthalate (PET), paper, and textiles. Key performance indicators, including sensitivity, linear detection range, and detection limit, are also compared. The challenges for future development are also summarized, along with some recommendations for the future development of lactate biosensors.

Textile-based electrochemical sensors and their applications

Textile and their composite-based functional sensors are extensively acknowledged and preferred detection platforms in recent times. Developing suitable methodologies for fabricating textile sensors can be achieved either by integration of conductive fibers and yarns into textiles using technologies such as weaving, knitting and embroidery; or by functionalization of textile materials with conductive nanomaterials/inks using printing or coating methods. Textile materials are gaining enormous attention for fabricating soft lab-on-fabric devices due to their unique features such as high flexibility, wear and wash resistance, mechanical strength and promising sensing performances. Owing to these collective properties, textile-based electrochemical transducers are now showcasing rapid and accurate electrical measurements towards real time point-of-care diagnostics and environmental monitoring applications. The present review provides a brief overview of key progress made in the field of developing textile materials and their composites-based electrochemical sensors and biosensors in recent years where electrode configurations are specifically based on either natural or synthetic fabrics. Different ways to fabricate and functionalize textiles for their application in electrochemical analysis are briefly discussed. The review ends with a conclusive note focusing on the current challenges in the fabrication of textile-based stable electrochemical sensors and biosensors.

A novel cloth-based supersandwich electrochemical aptasensor for direct, sensitive detection of pathogens

Traditional detection methods for food-borne pathogens are usually expensive and laborious, so there is an urgent need for an economical, facile and sensitive method. In this work, a novel cloth-based supersandwich electrochemical aptasensor (CSEA) is firstly developed for direct detection of pathogens. Carbon ink- and wax-based screen-printing is used to make cloth-based electrodes and hydrophilic/hydrophobic regions respectively to fabricate the sensing devices. Two well-designed, specific single-stranded DNA sequences arise a cascade hybridization reaction to form the DNA supersandwich (DSS) whose grooves can be inserted by methylene blue (MB), which effectively amplifies the current signal to greatly improve the detection sensitivity. Taking the detection of Salmonella typhimurium (S. typhimurium) as an example, the aptamers bind to S. typhimurium to form the target-aptamers complex, which can simultaneously bind to the capture probe and DSS, resulting in detection of S. typhimurium. Moreover, the addition of tail sequences of aptamer makes the proposed CSEA versatile. Under optimized conditions, the electrochemical signal increases linearly with the logarithm of S. typhimurium concentration over the range from 10² to 10⁸ CFU mL^-1, with a limit of detection of 16 CFU mL^-1. Additionally, the CSEA efficiently determined the levels of S. typhimurium in milk samples. Experimental results illustrate that the fabricated CSEA is sensitive, specific, reproducible and stable. Moreover, when Ru(bpy)₃²⁺ replaces MB, the electrochemiluminescence (ECL) can be performed. Thus, for the proposed sensing strategy, the dual-mode detection of electrochemistry and ECL is easily realized.

Wearable chem-biosensing devices: from basic research to commercial market

Wearable chem-biosensors have been garnering tremendous interest due to the significant potential in tailored healthcare diagnostics and therapeutics. With the development of the medical diagnostics revolution, wearable chem-biosensors as a rapidly emerging wave allow individuals to perform on-demand detection and obtain the required in-depth information. In contrast to commercial wearables, which tend to be miniaturized for measuring physical activities, the recent progressive wearable chem-biosensing device have mainly focused on non-invasive or minimally invasive monitoring biomarkers at the molecular level. Wearables is a multidisciplinary subject, and chem-biosensing is one of the most significant technologies. In this review, the currently basic academic research of wearable chem-biosensing devices and its commercial transformation were summarized and highlighted. Moreover, some representative wearable products on the market for individual health managements are presented. Strategies for the identification and sensing of biomarkers are discussed to further promote the development of wearable chem-biosensing devices. We also shared the limitations and breakthroughs of the next generation of chemo-biosensor wearables, from home use to clinical diagnosis.

A thread-based wearable sweat nanobiosensor

Non-invasive wearable biosensors provide an efficient way of continuously quantifying a person's biochemical parameters, and are highly valuable for predicting human physiological status and flagging risks and illness. Commercial wearable sensors are available for tracking a user's physical activities, but few could monitor user's health conditions through sweat analysis. Electronic textile (e-textile) biosensors enable new applications in this scenario because of its high flexibility/wearability, low cost, high level of electronic integration, and unobtrusiveness. However, challenges in developing e-textile sweat biosensors remain in the production of textile-based biosensing materials, skin interfacing design, and embedded data acquisition/transmission. Here, we propose a novel wearable electrochemical sweat biosensor based on conductive threads decorated with zinc-oxide nanowires (ZnO NWs) and apply it to detecting lactate and sodium in perspiration during physical exercise. The sweat biosensor is fully integrated with signal readout and data communication circuits in a wearable headband and is capable of monitoring human sweat accurately and wirelessly. We achieved the detection of lactate and sodium in linear ranges of 0-25 mM and 0.1-100 mM and limits of detection of 3.61 mM and 0.16 mM, respectively, which cover the clinically-relevant ranges of lactate and sodium in human sweat. We demonstrated accurate lactate and sodium measurements in human sweat from a healthy volunteer, and the results are in good agreement with standard test results. We also conducted on-body measurements on the same human volunteer during exercise and confirmed the robustness of the signal readout during body movements and the excellent accuracy of the testing results.

Evaluating the Possibility of Translating Technological Advances in Non-Invasive Continuous Lactate Monitoring into Critical Care

Lactate is widely measured in critically ill patients as a robust indicator of patient deterioration and response to treatment. Plasma concentrations represent a balance between lactate production and clearance. Analysis has typically been performed with the aim of detecting tissue hypoxia. However, there is a diverse range of processes unrelated to increased anaerobic metabolism that result in the accumulation of lactate, complicating clinical interpretation. Further, lactate levels can change rapidly over short spaces of time, and even subtle changes can reflect a profound change in the patient's condition. Hence, there is a significant need for frequent lactate monitoring in critical care. Lactate monitoring is commonplace in sports performance monitoring, given the elevation of lactate during anaerobic exercise. The desire to continuously monitor lactate in athletes has led to the development of various technological approaches for non-invasive, continuous lactate measurements. This review aims firstly to reflect on the potential benefits of non-invasive continuous monitoring technology within the critical care setting. Secondly, we review the current devices used to measure lactate non-invasively outside of this setting and consider the challenges that must be overcome to allow for the translation of this technology into intensive care medicine. This review will be of interest to those developing continuous monitoring sensors, opening up a new field of research.

High-Sensitivity Wearable and Flexible Humidity Sensor Based on Graphene Oxide/Non-Woven Fabric for Respiration Monitoring

The popularity of humidity sensing for respiratory analysis of patients is gradually increasing because of its portability and cost-effectiveness. However, current flexible humidity sensors are mainly made of polymer films, whose poor hygroscopicity and breathability reduce their sensitivity and comfort. In this study, a highly sensitive humidity sensor was developed using non-woven fabric (NWF) coated with graphene oxide (GO). Bovine serum albumin was used to improve the adsorption of GO onto the NWF, and its effect on sensitivity was investigated by adjusting its concentration. High-humidity sensitivity was experimentally validated by testing different relative humidity levels, and its fast response and excellent feasibility under diverse breathing conditions were verified by successful monitoring of fast and deep breathing, differentiating nose and mouth breathing, and even identifying simple spoken words. This study developed a breathable and skin-friendly humidity sensor based on GO/NWF, which is a promising device for human healthcare.

Microfluidic cloth-based analytical devices: Emerging technologies and applications

Cloth (or fabric) is an omnipresent material that has various applications in everyday life, and has become one of the things people are most familiar with. It has some attractive properties such as low cost, ability to transport fluid by capillary force, high tensile strength and durability, good wet strength, and great biocompatibility and biodegradability. Hence, cloth is an ideal material for the development of economical and user-friendly diagnostic devices for many applications including food detection, environmental monitoring, disease diagnosis and public health. Microfluidic cloth-based analytical devices (μCADs) (or microfluidic fabric-based analytical devices (μFADs)) first emerged in 2011 as a low-cost alternative to conventional laboratory testing, with the goal of improving point of care testing and disease screening in the developing world. In this review, we examine the advances in the development of μCADs from 2011 to 2020, especially highlighting emerging technologies and applications related to the μCADs. First, different fabrication methods for μCADs are introduced and compared. Second, a series of cloth-based microfluidic functional components are discussed, including microvalves, fluid velocity control elements, micromixers, and microfilters. Then, electroanalytical μCADs are described, especially focusing on the use of cloth-based electrodes. Next, various detection methods for μCADs, together with their corresponding applications, are compared and categorized. In addition, the current development of wearable μCADs is also demonstrated. Finally, the future outlook and trends in this field are discussed.

Recent Developments of Flexible and Stretchable Electrochemical Biosensors

The skyrocketing popularity of health monitoring has spurred increasing interest in wearable electrochemical biosensors. Compared with the traditionally rigid and bulky electrochemical biosensors, flexible and stretchable devices render a unique capability to conform to the complex, hierarchically textured surfaces of the human body. With a recognition element (e.g., enzymes, antibodies, nucleic acids, ions) to selectively react with the target analyte, wearable electrochemical biosensors can convert the types and concentrations of chemical changes in the body into electrical signals for easy readout. Initial exploration of wearable electrochemical biosensors integrates electrodes on textile and flexible thin-film substrate materials. A stretchable property is needed for the thin-film device to form an intimate contact with the textured skin surface and to deform with various natural skin motions. Thus, stretchable materials and structures have been exploited to ensure the effective function of a wearable electrochemical biosensor. In this mini-review, we summarize the recent development of flexible and stretchable electrochemical biosensors, including their principles, representative application scenarios (e.g., saliva, tear, sweat, and interstitial fluid), and materials and structures. While great strides have been made in the wearable electrochemical biosensors, challenges still exist, which represents a small fraction of opportunities for the future development of this burgeoning field.

Bio-Integrated Wearable Systems: A Comprehensive Review

Bio-integrated wearable systems can measure a broad range of biophysical, biochemical, and environmental signals to provide critical insights into overall health status and to quantify human performance. Recent advances in material science, chemical analysis techniques, device designs, and assembly methods form the foundations for a uniquely differentiated type of wearable technology, characterized by noninvasive, intimate integration with the soft, curved, time-dynamic surfaces of the body. This review summarizes the latest advances in this emerging field of "bio-integrated" technologies in a comprehensive manner that connects fundamental developments in chemistry, material science, and engineering with sensing technologies that have the potential for widespread deployment and societal benefit in human health care. An introduction to the chemistries and materials for the active components of these systems contextualizes essential design considerations for sensors and associated platforms that appear in following sections. The subsequent content highlights the most advanced biosensors, classified according to their ability to capture biophysical, biochemical, and environmental information. Additional sections feature schemes for electrically powering these sensors and strategies for achieving fully integrated, wireless systems. The review concludes with an overview of key remaining challenges and a summary of opportunities where advances in materials chemistry will be critically important for continued progress.

The design, fabrication, and applications of flexible biosensing devices

Flexible biosensors form part of a rapidly growing research field that take advantage of a multidisciplinary approach involving materials, fabrication and design strategies to be able to function at biological interfaces that may be soft, intrinsically curvy, irregular, or elastic. Numerous exciting advancements are being proposed and developed each year towards applications in healthcare, fundamental biomedical research, food safety and environmental monitoring. In order to place these developments in perspective, this review is intended to present an overview on field of flexible biosensor development. We endeavor to show how this subset of the broader field of flexible and wearable devices presents unique characteristics inherent in their design. Initially, a discussion on the structure of flexible biosensors is presented to address the critical issues specific to their design. We then summarize the different materials as substrates that can resist mechanical deformation while retaining their function of the bioreceptors and active elements. Several examples of flexible biosensors are presented based on the different environments in which they may be deployed or on the basis of targeted biological analytes. Challenges and future perspectives pertinent to the current and future stages of development are presented. Through these summaries and discussion, this review is expected to provide insights towards a systematic and fundamental understanding for the fabrication and utilization of flexible biosensors, as well as inspire and improve designs for smart and effective devices in the future.

A Hand-Held Point-of-Care Biosensor Device for Detection of Multiple Cancer and Cardiac Disease Biomarkers Using Interdigitated Capacitive Arrays

This paper presents a hand-held point-of-care device that incorporates a lab-on-a-chip module with interdigitated capacitive biosensors for label-free detection of multiple cancer and cardiovascular disease biomarkers. The developed prototype is comprised of a cartridge incorporating capacitive biodetection sensors, a sensitive capacitive readout electronics enclosed in a hand-held unit, and data analysis software calculating the concentration of biomarkers using previously stored reference database. The capacitive biodetection sensors are made of interdigitated circular electrodes, which are preactivated with single (for detecting one biomarker) or multiple specific antibodies (for detecting multiple disease biomarkers). Detection principle of capacitive biosensor is based on measuring the level of capacitance change between interdigitated electrode pairs induced by the change in dielectric constant due to affinity-based electron exchange in between antibodies/antigens and electrodes. The more antibody-antigens binding occurs, the more capacitance change is measured due to the change in dielectric constant of the capacitance media. The device uses preactivated ready-to-use cartridges embedded with capacitive biosensors with shelf-life of three months under optimal conditions, and is capable of onsite diagnosis and can report the result in less than 30 min. The device is verified with real patient blood samples for six different disease biomarkers.

Infectious pathogens meet point-of-care diagnostics

The field of point-of-care (POC) diagnostics provides the rapid diagnosis of infectious diseases which is essential and critical for improving the general public health in resource-limited settings. POC platforms offer many advantages for detection of various pathogens including portability, automation, speed, cost, and efficiency. In this review, we provide an overview of the recent trends for POC diagnostics of infectious diseases with focus on portable platforms. We review here the present status of POC platforms, emphasizing in period of the past three years, then extrapolate their advance into the future applications for diagnosis of infectious pathogens.

Skin-interfaced systems for sweat collection and analytics

Recent interdisciplinary advances in materials, mechanics, and microsystem designs for biocompatible electronics, soft microfluidics, and electrochemical biosensors establish the foundations for emerging classes of thin, skin-interfaced platforms capable of capturing, storing, and performing quantitative, spatiotemporal measurements of sweat chemistry, instantaneous local sweat rate, and total sweat loss. This review summarizes scientific and technical progress in this area and highlights the implications in real time and ambulatory modes of deployment during physical activities across a broad range of contexts in clinical health, physiology research, fitness/wellness, and athletic performance.

Wearable Flexible and Stretchable Glove Biosensor for On-Site Detection of Organophosphorus Chemical Threats

A flexible glove-based electrochemical biosensor with highly stretchable printed electrode system has been developed as a wearable point-of-use screening tool for defense and food security applications. This disposable-mechanically robust "lab-on-a-glove" integrates a stretchable printable enzyme-based biosensing system and active surface for swipe sampling on different fingers, and is coupled with a compact electronic interface for electrochemical detection and real-time wireless data transmission to a smartphone device. Stress-enduring inks are used to print the electrode system and the long serpentine connections to the wireless electronic interface. Dynamic mechanical deformation, bending, and stretching studies illustrate the resilience and compliance of the printed traces against extreme mechanical deformations expected for such on-glove sampling/sensing operation. An organophosphorus hydrolase (OPH)-based biosensor system on the index finger enables rapid on-site detection of organophosphate (OP) nerve-agent compounds on suspicious surfaces and agricultural products following their swipe collection on the thumb finger. The new wireless glove-based biosensor system offers considerable promise for field screening of OP nerve-agents and pesticides in defense and food-safety applications, with significant speed and cost advantages. Such "lab-on-a-glove" demonstration opens the area of flexible wearable sensors to future on-the-hand multiplexed chemical detection in diverse fields.