Wearable sweat sensing for prolonged, semicontinuous, and nonobtrusive health monitoring

The correlation of urea and creatinine concentrations in sweat and saliva with plasma during hemodialysis: an observational cohort study

OBJECTIVES

Urea and creatinine concentrations in plasma are used to guide hemodialysis (HD) in patients with end-stage renal disease (ESRD). To support individualized HD treatment in a home situation, there is a clinical need for a non-invasive and continuous alternative to plasma for biomarker monitoring during and between cycles of HD. In this observational study, we therefore established the correlation of urea and creatinine concentrations between sweat, saliva and plasma in a cohort of ESRD patients on HD.

METHODS

Forty HD patients were recruited at the Dialysis Department of the Catharina Hospital Eindhoven. Sweat and salivary urea and creatinine concentrations were analyzed at the start and at the end of one HD cycle and compared to the corresponding plasma concentrations.

RESULTS

A decrease of urea concentrations during HD was observed in sweat, from 27.86 mmol/L to 12.60 mmol/L, and saliva, from 24.70 mmol/L to 5.64 mmol/L. Urea concentrations in sweat and saliva strongly correlated with the concentrations in plasma (ρ 0.92 [p<0.001] and 0.94 [p<0.001], respectively). Creatinine concentrations also decreased in sweat from 43.39 μmol/L to 19.69 μmol/L, and saliva, from 59.00 μmol/L to 13.70 μmol/L. However, for creatinine, correlation coefficients were lower than for urea for both sweat and saliva compared to plasma (ρ: 0.58 [p<0.001] and 0.77 [p<0.001], respectively).

CONCLUSIONS

The results illustrate a proof of principle of urea measurements in sweat and saliva to monitor HD adequacy in a non-invasive and continuous manner. Biosensors enabling urea monitoring in sweat or saliva could fill in a clinical need to enable at-home HD for more patients and thereby decrease patient burden.

Nanoarchitectonics-based electrochemical aptasensors for highly efficient exosome detection

Exosomes, a type of extracellular vesicles, have attracted considerable attention due to their ability to provide valuable insights into the pathophysiological microenvironment of the cells from which they originate. This characteristic implicates their potential use as diagnostic disease biomarkers clinically, including cancer, infectious diseases, neurodegenerative disorders, and cardiovascular diseases. Aptasensors, which are electrochemical aptamers based biosensing devices, have emerged as a new class of powerful detection technology to conventional methods like ELISA and Western analysis, primarily because of their capability for high-performance bioanalysis. This review covers the current research landscape on the detection of exosomes utilizing nanoarchitectonics strategy for the development of electrochemical aptasensors. Strategies involving signal amplification and biofouling prevention are discussed, with an emphasis on nanoarchitectonics-based bio-interfaces, showcasing their potential to enhance sensitivity and selectivity through optimal conduction and mass transport properties. The ongoing challenges to broaden the clinical applications of these biosensors are also highlighted.

Metal oxide nanomaterials based electrochemical and optical biosensors for biomedical applications: Recent advances and future prospectives

The amalgamation of nanostructures with modern electrochemical and optical techniques gave rise to interesting devices, so-called biosensors. A biosensor is an analytical tool that incorporates various biomolecules with an appropriate physicochemical transducer. Over the past few years, metal oxide nanomaterials (MONMs) have significantly stimulated biosensing research due to their desired functionalities, versatile chemical stability, and low cost along with their unique optical, catalytic, electrical, and adsorption properties that provide an attractive platform for linking the biomolecules, for example, antibodies, nucleic acids, enzymes, and receptor proteins as sensing elements with the transducer for the detection of signals or signal amplifications. The signals to be measured are in direct proportionate to the concentration of the bioanalyte. Because of their simplicity, cost-effectiveness, portability, quick analysis, higher sensitivity, and selectivity against a broad range of biosamples, MONMs-based electrochemical and optical biosensing platforms are exhaustively explored as powerful early-diagnosis tools for point of care applications. Herein, we made a bibliometric analysis of past twenty years (2004-2023) on the application of MONMs as electrochemical and optical biosensing units using Web of Science database and the results of which clearly reveal the increasing number of publications since 2004. Geographical area distribution analysis of these publications shows that China tops the list followed by the United States of America and India. In this review, we first describe the electrochemical and optical properties of MONMs that are crucial for the creation of extremely stable, specific, and sensitive sensors with desirable characteristics. Then, the biomedical applications of MONMs-based bare and hybrid electrochemical and optical biosensing frameworks are highlighted in the light of recent literature. Finally, current limitations and future challenges in the field of biosensing technology are addressed.

Skin-Interfaced Bifluidic Paper-Based Device for Quantitative Sweat Analysis

The erratic, intermittent, and unpredictable nature of sweat production, resulting from physiological or psychological fluctuations, poses intricacies to consistently and accurately sample and evaluate sweat biomarkers. Skin-interfaced microfluidic devices that rely on colorimetric mechanisms for semi-quantitative detection are particularly susceptible to these inaccuracies due to variations in sweat secretion rate or instantaneous volume. This work introduces a skin-interfaced colorimetric bifluidic sweat device with two synchronous channels to quantify sweat rate and biomarkers in real-time, even during uncertain sweat activities. In the proposed bifluidic-distance metric approach, with one channel to measure sweat rate and quantify collected sweat volume, the other channel can provide an accurate analysis of the biomarkers based on the collected sweat volume. The closed channel design also reduces evaporation and resists contamination from the external environment. The feasibility of the device is highlighted in a proof-of-the-concept demonstration to analyze sweat chloride for evaluating hydration status and sweat glucose for assessing glucose levels. The low-cost yet highly accurate device provides opportunities for clinical sweat analysis and disease screening in remote and low-resource settings. The developed device platform can be facilely adapted for the other biomarkers when corresponding colorimetric reagents are exploited.

Recent Advances in Bioelectronics for Localized Drug Delivery

The last decade has witnessed remarkable advancements in bioelectronics, ushering in a new era of wearable and implantable devices for drug delivery. By utilizing miniaturized system design and/or flexible materials, bioelectronics illustrates ideal integration with target organs and tissues, making them ideal platforms for localized drug delivery. Furthermore, the development of electrically assisted drug delivery systems has enhanced the efficiency and safety of therapeutic administration, particularly for the macromolecules that encounter additional challenges in penetrating biological barriers. In this review, a concise overview of recent progress in bioelectronic devices for in vivo localized drug delivery, with highlights on the latest trends in device design, working principles, and their corresponding functionalities, is provided. The reported systems based on their targeted delivery locations as wearable systems, ingestible systems, and implantable systems are categorized. Each category is introduced in detail by highlighting the special requirements for devices and the corresponding solutions. The remaining challenges in this field and future directions are also discussed.

Passive sweat wearable: A new paradigm in the wearable landscape toward enabling "detect to treat" opportunities

Growing interest over recent years in personalized health monitoring coupled with the skyrocketing popularity of wearable smart devices has led to the increased relevance of wearable sweat-based sensors for biomarker detection. From optimizing workouts to risk management of cardiovascular diseases and monitoring prediabetes, the ability of sweat sensors to continuously and noninvasively measure biomarkers in real-time has a wide range of applications. Conventional sweat sensors utilize external stimulation of sweat glands to obtain samples, however; this stimulation influences the expression profile of the biomarkers and reduces the accuracy of the detection method. To address this limitation, our laboratory pioneered the development of the passive sweat sensor subfield, which allowed for our progress in developing a sweat chemistry panel. Passive sweat sensors utilize nanoporous structures to confine and detect biomarkers in ultra-low sweat volumes. The ability of passive sweat sensors to use smaller samples than conventional sensors enable users with sedentary lifestyles who perspire less to benefit from sweat sensor technology not previously afforded to them. Herein, the mechanisms and strategies of current sweat sensors are summarized with an emphasis on the emerging subfield of passive sweat-based diagnostics. Prospects for this technology include discovering new biomarkers expressed in sweat and expanding the list of relevant detectable biomarkers. Moreover, the accuracy of biomarker detection can be enhanced with machine learning using prediction algorithms trained on clinical data. Applying this machine learning in conjunction with multiplex biomarker detection will allow for a more holistic approach to trend predictions. This article is categorized under: Diagnostic Tools > Diagnostic Nanodevices Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Diagnostic Tools > Biosensing.

Advances in Non-Electrochemical Sensing of Human Sweat Biomarkers: From Sweat Sampling to Signal Reading

Sweat, commonly referred to as the ultrafiltrate of blood plasma, is an essential physiological fluid in the human body. It contains a wide range of metabolites, electrolytes, and other biologically significant markers that are closely linked to human health. Compared to other bodily fluids, such as blood, sweat offers distinct advantages in terms of ease of collection and non-invasive detection. In recent years, considerable attention has been focused on wearable sweat sensors due to their potential for continuous monitoring of biomarkers. Electrochemical methods have been extensively used for in situ sweat biomarker analysis, as thoroughly reviewed by various researchers. This comprehensive review aims to provide an overview of recent advances in non-electrochemical methods for analyzing sweat, including colorimetric methods, fluorescence techniques, surface-enhanced Raman spectroscopy, and more. The review covers multiple aspects of non-electrochemical sweat analysis, encompassing sweat sampling methodologies, detection techniques, signal processing, and diverse applications. Furthermore, it highlights the current bottlenecks and challenges faced by non-electrochemical sensors, such as limitations and interference issues. Finally, the review concludes by offering insights into the prospects for non-electrochemical sensing technologies. By providing a valuable reference and inspiring researchers engaged in the field of sweat sensor development, this paper aspires to foster the creation of innovative and practical advancements in this domain.

Signal Amplification Strategy Design in Nanozyme-Based Biosensors for Highly Sensitive Detection of Trace Biomarkers

Nanozymes show great promise in enhancing disease biomarker sensing by leveraging their physicochemical properties and enzymatic activities. These qualities facilitate signal amplification and matrix effects reduction, thus boosting biomarker sensing performance. In this review, recent studies from the last five years, concentrating on disease biomarker detection improvement through nanozyme-based biosensing are examined. This enhancement primarily involves the modulations of the size, morphology, doping, modification, electromagnetic mechanisms, electron conduction efficiency, and surface plasmon resonance effects of nanozymes for increased sensitivity. In addition, a comprehensive description of the synthesis and tuning strategies employed for nanozymes has been provided. This includes a detailed elucidation of their catalytic mechanisms in alignment with the fundamental principles of enhanced sensing technology, accompanied by the presentation of quantitatively analyzed results. Moreover, the diverse applications of nanozymes in strip sensing, colorimetric sensing, electrochemical sensing, and surface-enhanced Raman scattering have been outlined. Additionally, the limitations, challenges, and corresponding recommendations concerning the application of nanozymes in biosensing have been summarized. Furthermore, insights have been offered into the future development and outlook of nanozymes for biosensing. This review aims to serve not only as a reference for enhancing the sensitivity of nanozyme-based biosensors but also as a catalyst for exploring nanozyme properties and their broader applications in biosensing.

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Recent advances in skin-interfaced wearable sweat sensors enable the noninvasive, real-time monitoring of biochemical signals associated with health and wellness. These wearable platforms leverage microfluidic channels, biochemical sensors, and flexible electronics to enable the continuous analysis of sweat-based biomarkers such as electrolytes, metabolites, and hormones. As this field continues to mature, the potential of low-cost, continuous personalized health monitoring enabled by such wearable sensors holds significant promise for addressing some of the formidable obstacles to delivering comprehensive medical care in under-resourced settings. This Perspective highlights the transformative potential of wearable sweat sensing for providing equitable access to cutting-edge healthcare diagnostics, especially in remote or geographically isolated areas. It examines the current understanding of sweat composition as well as recent innovations in microfluidic device architectures and sensing strategies by showcasing emerging applications and opportunities for innovation. It concludes with a discussion on expanding the utility of wearable sweat sensors for clinically relevant health applications and opportunities for enabling equitable access to innovation to address existing health disparities.

Sweat analysis for urea sensing: trends and challenges

With increasing population there is a rise in pathological diseases that the healthcare facilities are grappling with. Sweat-based wearable technologies for continuous monitoring have overcome the demerits associated with sweat sampling and sensing. Hence, sweat as an alternative biofluid holds great promise for the quantification of a host of biomarkers and understanding the functioning of the body, thereby deducing ailments quickly and economically. This comprehensive review accounts for recent advances in sweat-based LOCs (Lab-On-Chips), which are a likely alternative to the existing blood-urea sample testing that is invasive and time-consuming. The present review is focused on the advancements in sweat-based Lab-On-Chips (LOCs) as an alternative to invasive and time-consuming blood-urea sample testing. In addition, different sweat collection methods (direct skin, near skin and microfluidic) and their mechanism for urea sensing are explained in detail. The mechanism of urea in biofluids in protein metabolism, balancing nitrogen levels and a crucial factor of kidney function is described. In the end, research and technological advancements are explained to address current challenges and enable its widespread implementation.

The Evolving Role of Proteins in Wearable Sweat Biosensors

Sweat is an increasingly popular biological medium for fitness monitoring and clinical diagnostics. It contains an abundance of biological information and is available continuously and noninvasively. Sweat-sensing devices often employ proteins in various capacities to create skin-friendly matrices that accurately extract valuable and time-sensitive information from sweat. Proteins were first used in sensors as biorecognition elements in the form of enzymes and antibodies, which are now being tuned to operate at ranges relevant for sweat. In addition, a range of structural proteins, sometimes assembled in conjunction with polymers, can provide flexible and compatible matrices for skin sensors. Other proteins also naturally possess a range of functionalities─as adhesives, charge conductors, fluorescence emitters, and power generators─that can make them useful components in wearable devices. Here, we examine the four main components of wearable sweat sensors─the biorecognition element, the transducer, the scaffold, and the adhesive─and the roles that proteins have played so far, or promise to play in the future, in each component. On a case-by-case basis, we analyze the performance characteristics of existing protein-based devices, their applicable ranges of detection, their transduction mechanism and their mechanical properties. Thereby, we review and compare proteins that can readily be used in sweat sensors and others that will require further efforts to overcome design, stability or scalability challenges. Incorporating proteins in one or multiple components of sweat sensors could lead to the development and deployment of tunable, greener, and safer biosourced devices.

A versatile artificial skin platform for sweat sensor development

Research targeting the development of on-body sensors has been significantly growing in recent years - an example is on-skin sweat sensing. However, the wide inter and intra person variability of skin characteristics make in vivo testing of these sensors and included materials such as skin adhesives difficult, which hampers especially the initial development phase of such wearables. Besides the development of wearable sweat sensors, companies developing deodorants, cosmetics, medical adhesives and wearable textiles now need to perform expensive human subjects testing with little control over the exact sweat mechanisms. Hence, there is a need for a realistic, adaptable and stable test platform, or artificial skin. We present a versatile artificial skin platform that faithfully recapitulates skin topography, active sweat pores, skin wetting behaviour and sweat rate, and that can be tuned to mimic the specifications of the targeted body location and sweating characteristics. The developed artificial skin is capable of generating sweat rates as low as 0.1 nL min^-1 pore^-1 and as high as 100 nL min^-1 pore^-1, spanning the whole range of physiological sweat rates. Specifically, the platform can be used for the development of sweat sensors for sedentary persons whose sweat rates are commonly lower than currently delivered by any other artificial skin platform.

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.

Smartphone-based platforms implementing microfluidic detection with image-based artificial intelligence

The frequent outbreak of global infectious diseases has prompted the development of rapid and effective diagnostic tools for the early screening of potential patients in point-of-care testing scenarios. With advances in mobile computing power and microfluidic technology, the smartphone-based mobile health platform has drawn significant attention from researchers developing point-of-care testing devices that integrate microfluidic optical detection with artificial intelligence analysis. In this article, we summarize recent progress in these mobile health platforms, including the aspects of microfluidic chips, imaging modalities, supporting components, and the development of software algorithms. We document the application of mobile health platforms in terms of the detection objects, including molecules, viruses, cells, and parasites. Finally, we discuss the prospects for future development of mobile health platforms.

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.

Self-Powered Biosensors for Monitoring Human Physiological Changes

Human physiological signals have an important role in the guidance of human health or exercise training and can usually be divided into physical signals (electrical signals, blood pressure, temperature, etc.) and chemical signals (saliva, blood, tears, sweat). With the development and upgrading of biosensors, many sensors for monitoring human signals have appeared. These sensors are characterized by softness and stretching and are self-powered. This article summarizes the progress in self-powered biosensors in the past five years. Most of these biosensors are used as nanogenerators and biofuel batteries to obtain energy. A nanogenerator is a kind of generator that collects energy at the nanoscale. Due to its characteristics, it is very suitable for bioenergy harvesting and sensing of the human body. With the development of biological sensing devices, the combination of nanogenerators and classical sensors so that they can more accurately monitor the physiological state of the human body and provide energy for biosensor devices has played a great role in long-range medical care and sports health. A biofuel cell has a small volume and good biocompatibility. It is a device in which electrochemical reactions convert chemical energy into electrical energy and is mostly used for monitoring chemical signals. This review analyzes different classifications of human signals and different forms of biosensors (implanted and wearable) and summarizes the sources of self-powered biosensor devices. Self-powered biosensor devices based on nanogenerators and biofuel cells are also summarized and presented. Finally, some representative applications of self-powered biosensors based on nanogenerators are introduced.

A Step Forward for Smart Clothes─Fabric-Based Microfluidic Sensors for Wearable Health Monitoring

We report the first demonstration of fabric-based microfluidics for wearable sensing. A new technology to develop microfluidics on fabrics, as a part of an undergarment, is described here. Compared to conventional microfluidics from polydimethylsiloxane, fabric-based microfluidics are simple to make, robust, and suitable for efficient sweat delivery. Specifically, acrylonitrile butadiene styrene (ABS) films with precut microfluidic patterns were infused through fabrics to form hydrophobic areas in a specially controlled sandwich structure. Experimental tests and simulations confirmed the sweat delivery efficiency of the microfluidics. Electrodes were screen-printed onto the fabric-based microfluidic. A novel wearable potentiometer based on Arduino was also developed as the transducer and signal readouts, which was low-cost, standardized, open-source, and capable of wireless data transfer. We applied the sensor system as a standalone or as a module of a T-shirt to quantify [Ca²⁺] in a wearer's sweat, with physiological and accurate results generated. Overall, this work represents a critical step in turning regular undergarments into biochemically smart platforms for health monitoring, which will broadly benefit human healthcare.

Wearable Healthcare Monitoring Based on a Microfluidic Electrochemical Integrated Device for Sensing Glucose in Natural Sweat

Wearable sweat sensors offer the possibility of continuous real-time health monitoring of an individual at a low cost without invasion. A variety of sweat glucose sensors have been developed thus far to help diabetes patients frequently monitor blood glucose levels through sweat glucose as a surrogate marker. The present study demonstrates the development and characterization of a three-dimensional paper-based microfluidic electrochemical integrated device (3D PMED) for measuring glucose concentration in sweat in real-time via simple, non-invasive, capillary-action-based sample collection. The device was selective for glucose, and it detected glucose accurately in the clinically relevant range (0~2 mM) in an off-body setup. To the best of our knowledge, this is the first time NEXAR™ has been used for biosensing applications. Further, the developed glucose sensor has acceptable sensitivity of 16.8 µA/mM/cm². Importantly, in an on-body setup, the device achieved a significant amperometric response to sweat glucose in a very short amount of time (a few seconds). With detailed investigations, this proof-of-concept study could help further the development of sensitive and selective sweat-based glucose sensing devices for real-time glucose monitoring in diabetes patients.

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.

A Self-Powered Wearable Sensor for Continuous Wireless Sweat Monitoring

Wireless wearable sweat analysis devices can monitor biomarkers at the molecular level continuously and in situ, which is highly desired for personalized health care. The miniaturization, integration, and wireless operation of sweat sensors improve the comfort and convenience while also bringing forward new challenges for power supply technology. Herein, a wireless self-powered wearable sweat analysis system (SWSAS) is designed that effectively converts the mechanical energy of human motion into electricity through hybrid nanogenerator modules (HNGMs). The HNGM shows stable output characteristics at low frequency with a current of 15 mA and a voltage of 60 V. Through real-time on-body sweat analysis powered by HNGM, the SWSAS is demonstrated to selectively monitor biomarkers (Na⁺ and K⁺ ) in sweat and wirelessly transmit the sensing data to the user interface via Bluetooth.

DNA Antiadhesive Layer for Reusable Plasmonic Sensors: Nanostructure Pitch Effect

A long-term reusable sensor that provides the opportunity to easily regenerate the active surface and minimize the occurrence of undesired absorption events is an appealing solution that helps to cut down the costs and improve the device performances. Impressive advances have been made in the past years concerning the development of novel cutting-edge sensors, but the reusability can currently represent a challenge. Direct shielding of the sensor surface is not always applicable, because it can impact the device performance. This study reports an antiadhesive layer (AAL) made of 90 mg/mL DNA sodium salt from salmon testes (ssstDNA) for passivating gold plasmonic sensor surfaces. Our gold two-dimensional (2D) nanostructured plasmonic metasurfaces modified with AAL were used for DNA quantification. AAL is thin enough that the plasmonic sensor remains sensitive to subsequent deposition of DNA, which serves as an analyte. AAL protects the gold surface from unwanted nonspecific adsorption by enabling wash-off of the deposited analyte after analysis and thus recovery of the LSPR peak position (rLSPR). The calibration curve obtained on a single nanostructure (Achiral Octupolar, 100 nm pitch) gave an LOD = 105 ng/mL and an extraordinary dynamic range, performances comparable or superior to those of commercial UV-vis spectrometers for acid nucleic dosage. Two different analytes were tested: ssstDNA (∼2000 bp) in deionized water and double-strand DNA (dsDNA) of 546-1614 bp in 100 mM Tris buffer and 10 mM MgCl₂. The two nanostructures (Achiral Octupolar 25 and 100) were found to have the same sensitivity to DNA in deionized water but different sensitivity to DNA in a salt/buffer solution, opening a potential for solute discrimination. To the best of our knowledge, this is the first report on the use of AAL made of several kilobase-pairs-long dsDNA to produce a reusable plasmonic sensor. The working principle and limitations are drawn based on the LSPR and SERS study.

Low-Cost Wearable Fluidic Sweat Collection Patch for Continuous Analyte Monitoring and Offline Analysis

Sweat sensors allow for new unobtrusive ways to continuously monitor an athlete's performance and health status. Significant advances have been made in the optimization of sensitivity, selectivity, and durability of electrochemical sweat sensors. However, comparing the in situ performance of these sensors in detail remains challenging because standardized sweat measurement methods to validate sweat sensors in a physiological setting do not yet exist. Current collection methods, such as the absorbent patch technique, are prone to contamination and are labor-intensive, which limits the number of samples that can be collected over time for offline reference measurements. We present an easy-to-fabricate sweat collection system that allows for continuous electrochemical monitoring, as well as chronological sampling of sweat for offline analysis. The patch consists of an analysis chamber hosting a conductivity sensor and a sequence of 5 to 10 reservoirs that contain level indicators that monitor the filling speed. After testing the performance of the patch in the laboratory, elaborate physiological validation experiments (3 patch locations, 6 participants) were executed. The continuous sweat conductivity measurements were compared with laboratory [Na⁺] and [Cl^-] measurements of the samples, and a strong linear relationship (R² = 0.97) was found. Furthermore, sweat rate derived from ventilated capsule measurement at the three locations was compared with patch filling speed and continuous conductivity readings. As expected from the literature, sweat conductivity was linearly related to sweat rate as well. In short, a successfully validated sweat collection patch is presented that enables sensor developers to systematically validate novel sweat sensors in a physiological setting.

Screen-Printed Carbon Black/Recycled Sericin@Fabrics for Wearable Sensors to Monitor Sweat Loss

Wearable sensors to monitor human sweat loss are important for real-time health monitoring, requiring electrically conductive, mechanically flexible fabrics as working electrodes. Here, a textile-based sweat monitor was fabricated by screen printing of carbon black and recycled sericin on cotton fabrics. The obtained fabric with excellent flexibility, good hydrophilicity (86°), and proper resistivity (61.7 Ω/cm²) can be used as a working electrode for a wearable sweat monitor. A wearable sweat monitor is highly sensitive (42.7% in acidic sweat), flexible, and can be washed (99.1% retention after 30 washes). This work offers a promising approach for the fabrication of wearable sensors and promotes the widespread applications of personalized health-monitoring devices.

How to Assess the Measurement Performance of Mobile/Wearable Point-of-Care Testing Devices? A Systematic Review Addressing Sweat Analysis

Recent advances in technologies for biosensor integration in mobile or wearable devices have highlighted the need for the definition of proper validation procedures and technical standards that enable testing, verification and validation of the overall performance of these solutions. Thus, reliable assessment—in terms of limits of detection/quantitation, linearity, range, analytical and diagnostic sensitivity/specificity, accuracy, repeatability, reproducibility, cross-reactivity, diagnostic efficiency, and positive/negative prediction—still represents the most critical and challenging aspect required to progress beyond the status of feasibility studies. Considering this picture, this work aims to review and discuss the literature referring to the available methods and criteria reported in the assessment of the performance of point-of-care testing (PoCT) devices within their specific applications. In particular, without losing generality, we focused on mobile or wearable systems able to analyze human sweat. In performing this review, the focus was on the main challenges and trends underlined in the literature, in order to provide specific hints that can be used to set shared procedures and improve the overall reliability of the identified solutions, addressing the importance of sample management, the sensing components, and the electronics. This review can contribute to supporting an effective validation of mobile or wearable PoCT devices and thus to spreading the use of reliable approaches outside hospitals and clinical laboratories.

Comprehensive Review on Wearable Sweat-Glucose Sensors for Continuous Glucose Monitoring

The incidence of diabetes is increasing at an alarming rate, and regular glucose monitoring is critical in order to manage diabetes. Currently, glucose in the body is measured by an invasive method of blood sugar testing. Blood glucose (BG) monitoring devices measure the amount of sugar in a small sample of blood, usually drawn from pricking the fingertip, and placed on a disposable test strip. Therefore, there is a need for non-invasive continuous glucose monitoring, which is possible using a sweat sensor-based approach. As sweat sensors have garnered much interest in recent years, this study attempts to summarize recent developments in non-invasive continuous glucose monitoring using sweat sensors based on different approaches with an emphasis on the devices that can potentially be integrated into a wearable platform. Numerous research entities have been developing wearable sensors for continuous blood glucose monitoring, however, there are no commercially viable, non-invasive glucose monitors on the market at the moment. This review article provides the state-of-the-art in sweat glucose monitoring, particularly keeping in sight the prospect of its commercialization. The challenges relating to sweat collection, sweat sample degradation, person to person sweat amount variation, various detection methods, and their glucose detection sensitivity, and also the commercial viability are thoroughly covered.

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

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

Smartphone-integrated colorimetric sensor array-based reader system and fluorometric detection of dopamine in male and female geriatric plasma by bluish-green fluorescent carbon quantum dots

A simple, cost-effective system was developed for dopamine (DA) detection using green synthesized 1-6 ​nm honey-based carbon quantum dots (H-CQDs) exhibiting bluish green fluorescence. The H-CQDs exhibited emission at 445 ​nm, with a quantum yield of ∼44%. The H-CQDs were used as a probe for electron transfer based DA detection and changes in H-CQD color in the presence of DA. The H-CQDs were formed with polar functional groups and were highly soluble in aqueous media. In the fluorometric mode, the proposed system demonstrated high specificity toward DA and effective limit of detection (LOD) values of 6, 8.5, and 8 ​nM in deionized (DI) water, male geriatric plasma, and female geriatric plasma, respectively, in the linear range 100 ​nM-1000 μM. In the colorimetric mode, the color changed within 5 ​min, and the LOD was 163 ​μM. A colorimetric sensor array system was used to precisely detect DA with a smartphone-integrated platform using an in house built imaging application and an analyzer app. Additionally, no additives were required, and the H-CQDs were not functionalized. More importantly, the H-CQDs were morphologically and analytically characterized before and after DA detection. Because the sensor array-based system allows high specificity DA detection in both DI water and geriatric plasma, it will play an important role in biomedical applications.

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

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

Material-assisted mass spectrometric analysis of low molecular weight compounds for biomedical applications

Low molecular weight compounds play an important role in encoding the current physiological state of an individual. Laser desorption/ionization mass spectrometry (LDI MS) offers high sensitivity with low cost for molecular detection, but it is not able to cover small molecules due to the drawbacks of the conventional matrix. Advanced materials are better alternatives, showing little background interference and high LDI efficiency. Herein, we first classify the current materials with a summary of compositions and structures. Matrix preparation protocols are then reviewed, to enhance the selectivity and reproducibility of MS data better. Finally, we highlight the biomedical applications of material-assisted LDI MS, at the tissue, bio-fluid, and cellular levels. We foresee that the advanced materials will bring far-reaching implications in LDI MS towards real-case applications, especially in clinical settings.

Epidermal Sensor for Potentiometric Analysis of Metabolite and Electrolyte

Wearable epidermal sensors that can provide noninvasive and continuous analysis of metabolites and electrolytes in sweat have great significance for healthcare monitoring. This study reports an epidermal sensor that can wirelessly, noninvasively, and potentiometrically analyze metabolites and electrolytes. Potentiometry-based ion-selective electrodes (ISE) are most widely used for detecting electrolytes, such as Na⁺ and K⁺. We develop an enzyme-based glucose ISE for potentiometric analysis of sweat glucose. The glucose ISE sensor is obtained by modifying a glucose oxidase layer (GOD) on an H⁺ ISE sensor. GOD catalyzes glucose to generate H⁺. The generated H⁺ passes through the H⁺ selective membrane to change the potential of the electrode. We have fully examined the limit of detection, detecting range, and stability of our epidermal sensor. Meanwhile, using this epidermal sensor, we can easily analyze the relationship between blood glucose and sweat glucose. The concentration curve of sweat glucose can represent blood glucose concentration, significantly contributing to sports and chronic disease monitoring.

Design of Multi-Shelled Hollow Cr2 O3 Spheres for Metabolic Fingerprinting

Schizophrenia (SZ) detection enables effective treatment to improve the clinical outcome, but objective and reliable SZ diagnostics are still limited. An ideal diagnosis of SZ suited for robust clinical screening must address detection throughput, low invasiveness, and diagnosis accuracy. Herein, we built a multi-shelled hollow Cr₂ O₃ spheres (MHCSs) assisted laser desorption/ionization mass spectrometry (LDI MS) platform for the direct metabolic profiling of biofluids towards SZ diagnostics. The MHCSs displayed strong light absorption for enhanced ionization and microscale surface roughness with stability for the effective LDI of metabolites. We profiled urine and serum metabolites (≈1 μL) with the enhanced LDI efficacy in seconds. We discriminated SZ patients (SZs) from healthy controls (HCs) with the highest area under the curve (AUC) value of 1.000 for the blind test. We identified four compounds with optimal diagnostic power as a simplified metabolite panel for SZ and demonstrated the metabolite quantification for clinic use. Our approach accelerates the growth of new platforms toward a precision diagnosis in the near future.