Emerging wearable flexible sensors for sweat analysis

A photonic crystal-hydrogel sensor for the monitoring of potassium ions in sweat

Sweat contains abundant physiological information critical for health monitoring, making wearable sweat sensors increasingly popular in exercise and training surveillance. Most of the existing sensors are designed to measure physical parameters such as heart rate, blood pressure, and respiration, relying on electronic instruments for biochemical analysis of body fluids. In this study, we present a wearable hydrogel band integrated with a photonic crystal array, for visual, non-invasive and in situ analysis of sweat for sports practitioners. The hydrogel sensor, inspired by the biological properties of onions, demonstrates excellent skin adhesion for efficient sweat collection. This innovative design allows for the development of a simple, reliable, and low-cost sensor capable of detecting potassium ion concentrations and pH levels in sweat. Under optimized conditions, the developed sensor can respond to potassium ion concentrations ranging from 1 mM to 150 mM, with a pH response range of 3 to 9 for human sweat. The dynamic cycling tests of potassium ion concentration and pH in sweat demonstrated that this sensor can effectively monitor electrolyte balance and dehydration during outdoor exercise.

Synergistic color-changing and conductive photonic cellulose nanocrystal patches for sweat sensing with biodegradability and biocompatibility

Given the ongoing requirements for versatility, sustainability, and biocompatibility in wearable applications, cellulose nanocrystal (CNC) photonic materials emerge as excellent candidates for multi-responsive wearable devices due to their tunable structural color, strong electron-donating capacity, and renewable nature. Nonetheless, most CNC-derived materials struggle to incorporate color-changing and electrical sensing into one system since the self-assembly of CNCs is incompatible with conventional conductive mediums. Here we report the design of a conductive photonic patch through constructing a CNC/polyvinyl alcohol hydrogel modulated by phytic acid (PA). The introduction of PA significantly enhances the hydrogen bonding interaction, resulting in the composite film with impressive flexibility (1.4 MJ m-3) and progressive color changes from blue, green, yellow, to ultimately red upon sweat wetting. Interestingly, this system simultaneously demonstrates selective and sensitive electrical sensing functions, as well as satisfactory biocompatibility, biodegradability, and breathability. Importantly, a proof-of-concept demonstration of a skin-adhesive patch is presented, where the optical and electrical dual-signal sweat sensing allows for intuitive visual and multimode electric localization of sweat accumulation during physical exercises. This innovative interactive strategy for monitoring human metabolites could offer a fresh perspective into the design of wearable health-sensing devices, while greatly expanding the applications of CNC-based photonic materials in medicine-related fields.

Recent Progress and Opportunities of Wearable Non-Invasive Epidermal Sensors for Skin Disease Diagnosis

With deteriorating environment and increased stress in modern life, skin diseases have become the fourth leading cause of nonfatal and chronic diseases. An early diagnosis might improve the chances of a successful treatment. Wearable epidermal sensors have been emerged as new non-invasive tools for clinical practice and research in dermatology, which can act as a complement to the otherwise mostly visual and tactile judgments. This review discusses the recent progress and opportunities of wearable epidermal sensors for skin disease diagnosis. The configuration, material choice, and fundamental platforms of wearable epidermal sensors are first summarized. Then, their emerging application in monitoring skin diseases is demonstrated by detecting skin hardness, skin hydration, and biomakers. With the advances highlighted here and the ongoing research efforts, the continuous breakthrough in wearable epidermal sensors and their attractive application in skin disease management is foreseeable in the future.

Stretchable Sweat Lactate Sensor with Dual-Signal Read-Outs

Innovations in wearable sweat sensors hold great promise to provide deeper insights into molecular level health information non-invasively. Lactate, a key metabolite present in sweat, holds immense significance in assessing physiological conditions and performance in sports physiology and health sensing. This paper presents the development and characterization of stretchable electrodes with ultrahigh active surface area of 648 % for lactate sensing. The as-printed stretchable electrodes were functionalized with an electron transfer layer comprising Toluidine Blue O and multi-walled carbon nanotubes (MWCNTs), and an enzymatic layer consisting of lactate dehydrogenase with β-Nicotinamide adenine dinucleotide as the cofactor for lactate selectivity. This sensor achieves a dual-signal read-out in which both electrochemical and fluorescence signals were obtained during lactate detection, demonstrating promising sensor performance in terms of sensitivity and reliability. We demonstrate the robustness of the dual-signal sensor under simulated conditions of physical deformation and shifted excitation. Under these compromised conditions, the performance of the stretchable electrodes remained largely unaffected, showcasing their potential for robust and adaptable sensing platforms in wearable health monitoring applications.

Toward Integrated Multifunctional Laser-Induced Graphene-Based Skin-Like Flexible Sensor Systems

The burgeoning demands for health care and human-machine interfaces call for the next generation of multifunctional integrated sensor systems with facile fabrication processes and reliable performances. Laser-induced graphene (LIG) with highly tunable physical and chemical characteristics plays vital roles in developing versatile skin-like flexible or stretchable sensor systems. This Progress Report presents an in-depth overview of the latest advances in LIG-based techniques in the applications of flexible sensors. First, the merits of the LIG technique are highlighted especially as the building blocks for flexible sensors, followed by the description of various fabrication methods of LIG and its variants. Then, the focus is moved to diverse LIG-based flexible sensors, including physical sensors, chemical sensors, and electrophysiological sensors. Mechanisms and advantages of LIG in these scenarios are described in detail. Furthermore, various representative paradigms of integrated LIG-based sensor systems are presented to show the capabilities of LIG technique for multipurpose applications. The signal cross-talk issues are discussed with possible strategies. The LIG technology with versatile functionalities coupled with other fabrication strategies will enable high-performance integrated sensor systems for next-generation skin electronics.

Recent Trends of Bioanalytical Sensors with Smart Health Monitoring Systems: From Materials to Applications

Smart biosensors attract significant interest due to real-time monitoring of user health status, where bioanalytical electronic devices designed to detect various activities and biomarkers in the human body have potential applications in physical sign monitoring and health care. Bioelectronics can be well integrated by output signals with wireless communication modules for transferring data to portable devices used as smart biosensors in performing real-time diagnosis and analysis. In this review, the scientific keys of biosensing devices and the current trends in the field of smart biosensors, (functional materials, technological approaches, sensing mechanisms, main roles, potential applications and challenges in health monitoring) will be summarized. Recent advances in the design and manufacturing of bioanalytical sensors with smarter capabilities and enhanced reliability indicate a forthcoming expansion of these smart devices from laboratory to clinical analysis. Therefore, a general description of functional materials and technological approaches used in bioelectronics will be presented after the sections of scientific keys to bioanalytical sensors. A careful introduction to the established systems of smart monitoring and prediction analysis using bioelectronics, regarding the integration of machine-learning-based basic algorithms, will be discussed. Afterward, applications and challenges in development using these smart bioelectronics in biological, clinical, and medical diagnostics will also be analyzed. Finally, the review will conclude with outlooks of smart biosensing devices assisted by machine learning algorithms, wireless communications, or smartphone-based systems on current trends and challenges for future works in wearable health monitoring.

Innovative Material-Based Wearable Non-Invasive Electrochemical Sweat Sensors towards Biomedical Applications

Sweat is an accessible biofluid that provides useful physiological information about the body's biomolecular state and systemic health. Wearable sensors possess various advantageous features, such as lightweight design, wireless connectivity, and compatibility with human skin, that make them suitable for continuous monitoring. Wearable electrochemical sweat sensors can diagnose diseases and monitor health conditions by detecting biomedical signal changes in sweat. This paper discusses the state-of-the-art research in the field of wearable sweat sensors and the materials used in their construction. It covers biomarkers present in sweat, sensing modalities, techniques for sweat collection, and ways to power these sensors. Innovative materials are categorized into three subcategories: sweat collection, sweat detection, and self-powering. These include substrates for sensor fabrication, analyte detection electrodes, absorbent patches, microfluidic devices, and self-powered devices. This paper concludes by forecasting future research trends and prospects in material-based wearable non-invasive sweat sensors.

A wearable flexible electrochemical biosensor with CuNi-MOF@rGO modification for simultaneous detection of uric acid and dopamine in sweat

BACKGROUND

In health assessment and personalized medical services, accurate detection of biological markers such as dopamine (DA) and uric acid (UA) in sweat is crucial for providing valuable physiological information. However, there are challenges in detecting sweat biomarkers due to their low concentrations, variations in sweat yield among individuals, and the need for efficient sweat collection.

RESULTS

We synthesized CuNi-MOF@rGO as a high-activity electrocatalyst and investigated its feasibility and electrochemical mechanism for simultaneously detecting low-concentration biomarkers UA and DA. Interaction between the non-coordinating carboxylate group and the sample produces effective separation signals for DA and UA. The wearable biomimetic biosensor has a wide linear range of 1-500 μM, with a detection limit of 9.41 μM and sensitivity of 0.019 μA μM-1 cm-2 for DA, and 10-1000 μM, with a detection limit of 9.09 μM and sensitivity of 0.026 μA μM-1 cm-2 for UA. Thus, our sensor performs excellently in detecting low-concentration biomarkers. To improve sweat collection, we designed a microfluidic-controlled device with hydrophilic modification in the microchannel. Experimental results show optimal ink flow at 2% concentration. Overall, we developed an innovative and highly active electrocatalyst, successfully enabling simultaneous detection of low-concentration biomarkers UA and DA.

SIGNIFICANCE

This study provides a strategy for sweat analysis and health monitoring. Moreover, the sensor also showed good performance in detecting real sweat samples. This study has shown great potential in future advances in sweat analysis and health monitoring.

Triboelectric Nanogenerator Enabled Sweat Extraction and Power Activation for Sweat Monitoring

Wearable sweat sensors can detect and monitor various substances in sweat, providing valuable information for healthcare monitoring and clinical diagnostics. Recent advances in flexible electronic technologies have enabled the development of wearable sweat sensors that can measure sweat rate and biochemical substances in real time, although several challenges remain, such as power management and sweat extraction issues. Here, a passive sweat extraction strategy as well as a self‐powered monitoring system (SEMS) is reported to be designed for sedentary individuals, i.e., elders. The SEMS system comprises a wearable triboelectric nanogenerator (TENG) for sweat extraction, a sweat‐activated battery (SAB) as the integrated power source, carbachol‐loaded iontophoresis electrodes for sweat extraction, microfluidics with biosensors for detecting physiological information in sweat, and near field communication (NFC)‐based wireless microelectronics for data communication, processing, and collection. By tapping the TENG, sedentary people can passively extract sweat based on the iontophoresis process, allowing the sensors to detect biological information in sweat. The good flexibility of the SEMS device enables real‐time and non‐invasive detection of sweat analytes in a wearable format. This system offers a new strategy of sweat collection and analysis for the elderly group, and therefore can help to understand human physiology and personalize health monitoring deeply.

An integrated wearable sticker based on extended-gate AlGaN/GaN high electron mobility transistors for real-time cortisol detection in human sweat

Cortisol hormone imbalances can be detected through non-invasive sweat monitoring using field-effect transistor (FET) biosensors, which provide rapid and sensitive detection. However, challenges like skin compatibility and integration with sweat collection have hindered FET biosensors as wearable sensing platforms. In this study, we present an integrated wearable sticker for real-time cortisol detection based on an extended-gate AlGaN/GaN high electron mobility transistor (HEMT) combined with a soft bottom substrate and flexible channel for sweat collection. The developed devices exhibit excellent linearity (R2 = 0.990) and a high sensitivity of 1.245 μA dec-1 for cortisol sensing from 1 nM to 100 μM in high-ionic-strength solution, with successful cortisol detection demonstrated using authentic human sweat samples. Additionally, the chip's microminiature design effectively reduces bending impact during the wearable process of traditional soft binding sweat sensors. The extendedgate structure design of the HEMT chip enhances both width-to-length ratio and active sensing area, resulting in an exceptionally low detection limit of 100 fM. Futhermore, due to GaN material's inherent stability, this device exhibits long-term stability with sustained performance within a certain attenuation range even after 60 days. These stickers possess small, lightweight, and portable features that enable real-time cortisol detection within 5 minutes through direct sweat collection. The application of this technology holds great potential in the field of personal health management, facilitating users to conveniently monitor their mental and physical conditions.

Tunable Periodic Nanopillar Array for MAPbI3 Perovskite Photodetectors with Improved Light Absorption

In the field of optoelectronic applications, the vigorous development of organic-inorganic hybrid perovskite materials, such as methylammonium lead triiodide (MAPbI3), has spurred continuous research on methods to enhance the photodetection performance. Periodic nanoarrays can effectively improve the light absorption of perovskite thin films. However, there are still challenges in fabricating tunable periodic patterned and large-area perovskite nanoarrays. In this study, we present a cost-effective and facile approach utilizing nanosphere lithography and dry etching techniques to create a large-area Si nanopillar array, which is employed for patterning MAPbI3 thin films. The scanning electron microscopy (SEM) and X-ray diffraction (XRD) results reveal that the introduction of nanopillar structures did not have a significant adverse effect on the crystallinity of the MAPbI3 thin film. Light absorption tests and optical simulations indicate that the nanopillar array enhances the light intensity within the perovskite films, leading to photodetectors with a responsivity of 11.2 A/W and a detectivity of 7.3 × 1010 Jones at 450 nm in wavelength. Compared with photodetectors without nanostructures, these photodetectors exhibit better visible light absorption. Finally, we demonstrate the application of these photodetector arrays in a prototype image sensor.

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.

Recent Advances in Batteryless NFC Sensors for Chemical Sensing and Biosensing

This article reviews the recent advances in the field of batteryless near-field communication (NFC) sensors for chemical sensing and biosensing. The commercial availability of low-cost commercial NFC integrated circuits (ICs) and their massive integration in smartphones, used as readers and cloud interfaces, have aroused great interest in new batteryless NFC sensors. The fact that coil antennas are not importantly affected by the body compared with other wireless sensors based on far-field communications makes this technology suitable for future wearable point-of-care testing (PoCT) devices. This review first compares energy harvesting based on NFC to other energy-harvesting technologies. Next, some practical recommendations for designing and tuning NFC-based tags are described. Power transfer is key because in most cases, the energy harvested has to be stable for several seconds and not contaminated by undesired signals. For this reason, the effect of the dimensions of the coils and the conductivity on the wireless power transfer is thoroughly discussed. In the last part of the review, the state of the art in NFC-based chemical and biosensors is presented. NFC-based tags (or sensor tags) are mainly based on commercial or custom NFC ICs, which are used to harvest the energy from the RF field generated by the smartphone to power the electronics. Low-consumption colorimeters and potentiostats can be integrated into these NFC tags, opening the door to the integration of chemical sensors and biosensors, which can be harvested and read from a smartphone. The smartphone is also used to upload the acquired information to the cloud to facilitate the internet of medical things (IoMT) paradigm. Finally, several chipless sensors recently proposed in the literature as a low-cost alternative for chemical applications are discussed.

An End-to-End Dynamic Posture Perception Method for Soft Actuators Based on Distributed Thin Flexible Porous Piezoresistive Sensors

This paper proposes a method for accurate 3D posture sensing of the soft actuators, which could be applied to the closed-loop control of soft robots. To achieve this, the method employs an array of miniaturized sponge resistive materials along the soft actuator, which uses long short-term memory (LSTM) neural networks to solve the end-to-end 3D posture for the soft actuators. The method takes into account the hysteresis of the soft robot and non-linear sensing signals from the flexible bending sensors. The proposed approach uses a flexible bending sensor made from a thin layer of conductive sponge material designed for posture sensing. The LSTM network is used to model the posture of the soft actuator. The effectiveness of the method has been demonstrated on a finger-size 3 degree of freedom (DOF) pneumatic bellow-shaped actuator, with nine flexible sponge resistive sensors placed on the soft actuator's outer surface. The sensor-characterizing results show that the maximum bending torque of the sensor installed on the actuator is 4.7 Nm, which has an insignificant impact on the actuator motion based on the working space test of the actuator. Moreover, the sensors exhibit a relatively low error rate in predicting the actuator tip position, with error percentages of 0.37%, 2.38%, and 1.58% along the x-, y-, and z-axes, respectively. This work is expected to contribute to the advancement of soft robot dynamic posture perception by using thin sponge sensors and LSTM or other machine learning methods for control.

All fabric and flexible wearable sensors for simultaneous sweat metabolite detection and high-efficiency collection

Wearable sweat electrochemical sensors have attracted wide attention due to their advantages of non-invasive, portable, real-time monitoring, etc. However, existing sensors still have some problems with efficient sweat collection. Microfluidic channel technology and electrospinning technology are commonly used to collect sweat efficiently, but there are some limitations such as complex channel design and multiple spinning parameters. Besides, existing sensors are mostly based on flexible polymers, such as, PET, PDMS, PI and PI, which have limited wearability and permeability. Based on the above, all fabric and dual-function flexible wearable sweat electrochemical sensor is proposed in this paper. This sensor uses fabric as the raw material to implement the directional transport of sweat and the multi-component integrated detection dual functions. Meanwhile, the high-efficiency collection of sweat is obtained by a Janus fabric, wherein one side of the selected silk is superhydrophobic graft treated and the other side is hydrophilic plasma treated. Therefore, the resulting Janus fabric can effectively transfer sweat from the skin side to the electrode, and the minimum sweat droplet can reach 0.2 μL to achieve micro-volume collection. Besides, the patterned sensor, made of silk-based carbon cloth, is fabricated using a simple laser engraving, which could detect Na⁺, pH, and glucose instantaneously. As a result, these proposed sensors can achieve good sensing performance and high-efficiency sweat collection dual functionality; moreover, it has good flexibility and comfortable wearability.

Miniaturized Microfluidic Electrochemical Biosensors Powered by Enzymatic Biofuel Cell

Electrochemical biosensors, in which enzymatic biofuel cells simultaneously work as energy power and signal generators, have become a research hotspot. They display the merits of power self-support, a simplified structure, in vivo operational feasibility, online and timely monitoring, etc. Since the concept of enzymatic biofuel cell-powered biosensors (EBFC-SPBs) was first proposed, its applications in health monitoring have scored tremendous achievements. However, the creation and practical application of portable EBFC-SPBs are still impeded by the difficulty in their miniaturization. In recent years, the booming microfluidic technology has powerfully pushed forward the progress made in miniaturized and portable EBFC-SPBs. This brief review recalls and summarizes the achievements and progress made in miniaturized EBFC-SPBs. In addition, we also discuss the advantages and challenges that microfluidic and screen-printing technologies provide to wearable and disposable EBFC-SPBs.

Flexible Wearable Sensors in Medical Monitoring

The popularity of health concepts and the wave of digitalization have driven the innovation of sensors in the medical field. Such continual development has made sensors progress in the direction of safety, flexibility, and intelligence for continuous monitoring of vital signs, which holds considerable promise for changing the way humans live and even treat diseases. To this end, flexible wearable devices with high performance, such as high sensitivity, high stability, and excellent biodegradability, have attracted strong interest from scientists. Herein, a review of flexible wearable sensors for temperature, heart rate, human motion, respiratory rate, glucose, and pH is highlighted. In addition, engineering issues are also presented, focusing on material selection, sensor fabrication, and power supply. Finally, potential challenges facing current technology and future directions of wearable sensors are also discussed.

Multifunctional Flexible Humidity Sensor Systems Towards Noncontact Wearable Electronics

In the past decade, the global industry and research attentions on intelligent skin-like electronics have boosted their applications in diverse fields including human healthcare, Internet of Things, human-machine interfaces, artificial intelligence and soft robotics. Among them, flexible humidity sensors play a vital role in noncontact measurements relying on the unique property of rapid response to humidity change. This work presents an overview of recent advances in flexible humidity sensors using various active functional materials for contactless monitoring. Four categories of humidity sensors are highlighted based on resistive, capacitive, impedance-type and voltage-type working mechanisms. Furthermore, typical strategies including chemical doping, structural design and Joule heating are introduced to enhance the performance of humidity sensors. Drawing on the noncontact perception capability, human/plant healthcare management, human-machine interactions as well as integrated humidity sensor-based feedback systems are presented. The burgeoning innovations in this research field will benefit human society, especially during the COVID-19 epidemic, where cross-infection should be averted and contactless sensation is highly desired.

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.