Towards smart personalized perspiration analysis: An IoT-integrated cellulose-based microfluidic wearable patch for smartphone fluorimetric multi-sensing of sweat biomarkers

Optical sensors for transdermal biomarker detection: A review

This review has explored optical sensors and their important role in non-invasive transdermal biomarker detection. While electrochemical sensors have been thoroughly studied for biomarker tracking, optical sensors present a compelling alternative due to their high sensitivity and selectivity, multiplex capabilities, cost-efficiency, and small form factor. This review examines the latest advancements in optical sensing technologies for transdermal biomarker detection, such as colorimetry, fluorescence, surface plasmon resonance (SPR), fiber optics, photonic crystals, and Raman spectroscopy. These technologies have been applied in the analysis of biomarkers present in sweat and skin gases, which are essential for non-invasive health monitoring. Furthermore, the review has discussed the challenges and future perspectives of optical sensors in in transdermal biomarker detection. The analysis of various sensor types and their applications highlights the transformative potential of optical sensors in enhancing disease diagnostics and promoting proactive health management.

Ratiometric fluorescent capillary sensor for real-time dual-monitoring of pH and O2 fluctuation

The pH and O2 are the two important parameters to evaluate environmental conditions, healthcare, and industrial processes. Herein, we developed a ratiometric fluorescent capillary-based dual-functional sensor for simultaneous monitoring of pH and O2 fluctuations. The fluorescent sensor consists of a pH sensing unit and an O2 sensing unit on both ends of the capillary inner wall. The ratiometric fluorescent pH sensing unit includes pH-sensitive probe HPTS and the reference dye Ce6, while the O2 sensing unit is composed of O2-sensitive probe RuDP and the reference dye C6. Under single-wavelength excitation at 430 nm, the ratiometric fluorescent dual-functional sensor exhibits highly sensitive, selective and reproducible responses to both pH and O2. As for practical aqueous samples, the results about pH and O2 levels obtained by our sensor are considerable consistent with commercial devices. Meanwhile, the dynamic changes of pH and O2 levels during glucose catalysis by glucose oxidase can be detected in real-time and accurately. The dual-functional ratiometric fluorescent capillary transducer provides a significant potential platform for environmental monitoring and medical diagnosis.

A sensor platform based on SERS detection/janus textile for sweat glucose and lactate analysis toward portable monitoring of wellness status

Herein we report a wearable sweat sensor of a Janus fabric based on surface enhanced Raman scattering (SERS) technology, mainly detecting the two important metabolites glucose and lactate. Janus fabric is composed of electrospinning PU on a piece of medical gauze (cotton), working as the unidirectional moisture transport component (R = 1305%) to collect and transfer sweat efficiently. SERS tags with different structures act as the probe to recognize and detect the glucose and lactate in high sensitivity. Core-shell structured gold nanorods with DTNB inside (AuNRs@DTNB@Au) are used to detect lactate, while gold nanorods with MPBA (AuNRs@MPBA) are used to detect glucose. Through the characteristic SERS information, two calibration functions were established for the concentration determination of glucose and lactate. The concentrations of glucose and lactate in sweat of a 23 years volunteer during three-stage interval running are tested to be 95.5, 53.2, 30.5 μM and 4.9, 13.9, 10.8 mM, indicating the glucose (energy) consumption during exercise and the rapid accumulation of lactate at the early stage accompanied by the subsequent relief. As expected, this sensing system is able to provide a novel strategy for effective acquisition and rapid detection of essential biomarkers in sweat.

Skin-attachable Tb-MOF ratio fluorescent sensor for real-time detection of human sweat pH

The pH of human sweat is highly related with a variety of diseases, whereas the monitoring of sweat pH still remains challenging for ordinary families. In this study, we developed a novel dual-emission Tb-MOF using DPA as the ligand and further designed and constructed a skin-attachable Tb-MOF ratio fluorescent sensor for real-time detection of human sweat pH. With the increased concentration of H+, the interaction of H+ with carbonyl organic ligand leads to the collapse of the Tb-MOF crystal structure, resulting in the interruption of antenna effect, and correspondingly increasing the emission of the ligand at 380 nm and decreasing the emission of the central ion Tb3+ at 544 nm. This Tb-MOF nanoprobe has a good linear response in the pH range of 4.12-7.05 (R2 = 0.9914) with excellent anti-interference ability. Based on the merits of fast pH response and high sensitivity, the nanoprobe was further used to prepare flexible wearable sensor. The wearable sensor can detect pH in the linear range of 3.50-6.70, which covers the pH range of normal human sweat (4.50-6.50). Subsequently, the storage stability and detection accuracy of the sensors were evaluated. Finally, the sensor has been successfully applied for the detection of pH in actual sweat samples from 21 volunteer and the real-time monitoring of pH variation during movement processing. This skin-attachable Tb-MOF sensor, with the advantages of low cost, visible color change and long shelf-life, is appealing for sweat pH monitoring especially for ordinary families.

From Lab to Life: Self-Powered Sweat Sensors and Their Future in Personal Health Monitoring

The rapid development of wearable sweat sensors has demonstrated their potential for continuous, non-invasive disease diagnosis and health monitoring. Emerging energy harvesters capable of converting various environmental energy sources-biomechanical, thermal, biochemical, and solar-into electrical energy are revolutionizing power solutions for wearable devices. Based on self-powered technology, the integration of the energy harvesters with wearable sweat sensors can drive the device for biosensing, signal processing, and data transmission. As a result, self-powered sweat sensors are able to operate continuously without external power or charging, greatly facilitating the development of wearable electronics and personalized healthcare. This review focuses on the recent advances in self-powered sweat sensors for personalized healthcare, covering sweat sensors, energy harvesters, energy management, and applications. The review begins with the foundations of wearable sweat sensors, providing an overview of their detection methods, materials, and wearable devices. Then, the working mechanism, structure, and a characteristic of different types of energy harvesters are discussed. The features and challenges of different energy harvesters in energy supply and energy management of sweat sensors are emphasized. The review concludes with a look at the future prospects of self-powered sweat sensors, outlining the trajectory of the field and its potential to flourish.

Recent advances in nonenzymatic electrochemical biosensors for sports biomarkers: focusing on antibodies, aptamers and molecularly imprinted polymers

Nonenzymatic electrochemical biosensors, renowned for their high sensitivity, multi-target analysis capabilities, and miniaturized integration, align well with the requirements of non-invasive, multi-index integrated, continuous monitoring, and user-friendly wearable biosensors in sports science. In the past three years, novel strategies targeting specific responses to sports biomarkers have opened new avenues for applications in sports science. However, these advancements also pose challenges in achieving adequate sensitivity and specificity for online analysis of complex sweat bio-samples. Our article focuses on three key nonenzymatic electrochemical biosensing strategies: antigen-antibody reactions, nucleic acid aptamer recognition, and molecular imprinting capture. We delve into strategies to enhance specificity and sensitivity in the application of biosensors in sports science, including shortening signal transduction paths through built-in signal probes, increasing reaction sites through increased surface area and the introduction of nanostructures, multi-target analyses, and microfluidic techniques.

TinyML-Raman: A novel IoT based field-deployable spectra analysis for accurate identification of pharmaceuticals and trace dye-pesticide mixtures from facile SERS method

BACKGROUND

Upcoming inexpensive, compact Internet of Things (IoT) microcontrollers i.e., tiny-machine learning (TinyML) takes the ML driven Raman spectroscopy one step ahead for realization of more affordable and highly compact field deployable instruments. Further, lack of large spectral datasets and need for numerous specialized SERS substrates impede the development of various ML-based surface enhanced Raman spectroscopy (SERS) applications. The aim is to introduce TinyML analysis on wide range of spectra classes using customized dataset obtained with low-cost SERS. In this regard, it is vital to establish an optimum ML model and efficient data handling methodology for low memory TinyML units.

RESULTS

We introduce a novel TinyML methodology for accurate classification of large spectra classes with smartphone assistance for data communication and results visualization. To generate large customized spectral dataset, we present a facile, micro-drop SERS using Au colloids and reusable grooved Al substrates. The results demonstrated that memory efficient 8-bit data quantization based convolutional neural network is effective for accurate identification of 22 different spectra classes of trace dye-pesticide mixtures and pharmaceuticals. In this novel quantized data analysis on significantly varied intensity and complex variation spectra classes i.e., many individual, binary-mixtures and some with varied compositions, data normalization is shown to be powerful for improving ML classification accuracy from about 55 % to >99.5 %. Its robustness is demonstrated using inter-instrument driven data variations such as spectral shifts, high noise, and abscissa-flip, with five-fold cross validation of model performance. In addition, on-site quantification of analyte through spectral intensity is also demonstrated.

SIGNIFICANCE

This study opens up a new approach of ML analysis towards realization of next generation field deployable analytical instruments maintaining data privacy. It presents a detailed procedure of quantized spectral data analysis and its implementation in TinyML, attractive for various users and instrument manufacturers. The presented innovative computer-free ML analysis can be employed in all types of spectrometers, meeting the common goal of Raman spectroscopy i.e., accurate identification of complex spectra classes.

Luminescence Probes in Bio-Applications: From Principle to Practice

Bioanalysis based on optical imaging has gained significant progress in the last few decades. Luminescence probes are capable of detecting, monitoring, and tracing particular biomolecules in complex biological systems to figure out the roles of these molecules in organisms. Considering the rapid development of luminescence probes for bio-applications and their promising future, we have attempted to explore the working principles and recent advances in bio-applications of luminescence probes, in the hope of helping readers gain a detailed understanding of luminescence probes developed in recent years. In this review, we first focus on the current widely used luminescence probes, including fluorescence probes, bioluminescence probes, chemiluminescence probes, afterglow probes, photoacoustic probes, and Cerenkov luminescence probes. The working principles for each type of luminescence probe are concisely described and the bio-application of the luminescence probes is summarized by category, including metal ions detection, secretion detection, imaging, and therapy.

Human Activity Recording Based on Skin-Strain-Actuated Microfluidic Pumping in Asymmetrically Designed Micro-Channels

The capability to record data in passive, image-based wearable sensors can simplify data readouts and eliminate the requirement for the integration of electronic components on the skin. Here, we developed a skin-strain-actuated microfluidic pump (SAMP) that utilizes asymmetric aspect ratio channels for the recording of human activity in the fluidic domain. An analytical model describing the SAMP's operation mechanism as a wearable microfluidic device was established. Fabrication of the SAMP was achieved using soft lithography from polydimethylsiloxane (PDMS). Benchtop experimental results and theoretical predictions were shown to be in good agreement. The SAMP was mounted on human skin and experiments conducted on volunteer subjects demonstrated the SAMP's capability to record human activity for hundreds of cycles in the fluidic domain through the observation of a stable liquid meniscus. Proof-of-concept experiments further revealed that the SAMP could quantify a single wrist activity repetition or distinguish between three different shoulder activities.

Spicy Recipe for At-Home Diagnostics: Smart Salivary Sensors for Point-of-Care Diagnosis of Jaundice

Even though significant advances have been made, there is still a lack of reliable sensors capable of noninvasively monitoring bilirubin and diagnosing jaundice as the most common neonatal disease, particularly at the point-of-care (POC) where blood sampling from infants is accompanied by serious challenges and concerns. Herein, for the first time, using an easy-to-fabricate/use assay, we demonstrate the capability of curcumin embedded within paper for noninvasive optical monitoring of bilirubin in saliva. The highly selective sensing of the developed sensor toward bilirubin is attributed to bilirubin photoisomerization under blue light exposure, which can selectively restore the bilirubin-induced quenched fluorescence of curcumin. We also fabricated an IoT-enabled hand-held optoelectronic reader to measure and quantify the fluorescence and color signals of our sensor. Clinical analysis on the saliva of 18 jaundiced infants by using our developed smart salivary sensor proved that it is amenable to be widely exploited in POC applications for bilirubin monitoring as there are good correlations between its results with those of reference methods in saliva and blood. Meeting all WHO's REASSURED criteria by our developed sensor makes it a highly promising sensor for smart noninvasive diagnosis and therapeutic monitoring of jaundice, hepatitis, and other bilirubin-induced neurologic diseases at the POC.

Microfluidics in smart food safety

The evolution of food safety practices is crucial in addressing the challenges posed by a growing global population and increasingly complex food supply chains. Traditional methods are often labor-intensive, time-consuming, and susceptible to human error. This chapter explores the transformative potential of integrating microfluidics into smart food safety protocols. Microfluidics, involving the manipulation of small fluid volumes within microscale channels, offers a sophisticated platform for developing miniaturized devices capable of complex tasks. Combined with sensors, actuators, big data analytics, artificial intelligence, and the Internet of Things, smart microfluidic systems enable real-time data acquisition, analysis, and decision-making. These systems enhance control, automation, and adaptability, making them ideal for detecting contaminants, pathogens, and chemical residues in food products. The chapter covers the fundamentals of microfluidics, its integration with smart technologies, and its applications in food safety, addressing the challenges and future directions in this field.

Application of non-contact sensors for health monitoring in hospitals: a narrative review

The continuous monitoring of the health status of patients is essential for the effective monitoring of disease progression and the management of symptoms. Recently, health monitoring using non-contact sensors has gained interest. Therefore, this study aimed to investigate the use of non-contact sensors for health monitoring in hospital settings and evaluate their potential clinical applications. A comprehensive literature search was conducted using PubMed to identify relevant studies published up to February 26, 2024. The search terms included "hospital," "monitoring," "sensor," and "non-contact." Studies that used non-contact sensors to monitor health status in hospital settings were included in this review. Of the 38 search results, five studies met the inclusion criteria. The non-contact sensors described in the studies were radar, infrared, and microwave sensors. These non-contact sensors were used to obtain vital signs, such as respiratory rate, heart rate, and body temperature, and were then compared with the results from conventional measurement methods (polysomnography, nursing records, and electrocardiography). In all the included studies, non-contact sensors demonstrated a performance similar to that of conventional health-related parameter measurement methods. Non-contact sensors are expected to be a promising solution for health monitoring in hospital settings.

Seamless integration of Internet of Things, miniaturization, and environmental chemical surveillance

IoT is a game-changer across all fields, including chemistry. Embracing sustainable practices and green chemistry, the miniaturization and automation of systems, and their integration into IoT is key to achieving these principles, as a rising trend with momentum. Particularly, IoT and analytical chemistry are linked in the rapid exchange of analytical data for environmental, industrial, healthcare, and educational applications. Meanwhile, cooperation with other fields of science is evident, and there is a prompt and subjective analysis of information related to analytical systems and methodologies. This paper will review the concepts, requirements, and architecture of IoT and its role in the miniaturization and automation of analytical tools using electronic modules and sensors. The aim is to explore the standards and perspectives of IoT and its interaction with different aspects of analytical chemistry. Additionally, it aimed to explain the basics and applications of IoT for chemists, and its relevance to different subfields of analytical chemistry, particularly in the field of environmental chemical surveillance. The article also covers updating IoT devices and creating DIY-based degradation devices to enhance the educational aspect of chemistry and reduce barriers to lab facilities and equipment. Lastly, it will explore how IoT is really important and how it's going to significantly impact analytical chemistry.

SPEED: an integrated, smartphone-operated, handheld digital PCR Device for point-of-care testing

This study elaborates on the design, fabrication, and data analysis details of SPEED, a recently proposed smartphone-based digital polymerase chain reaction (dPCR) device. The dPCR chips incorporate partition diameters ranging from 50 μm to 5 μm, and these partitions are organized into six distinct blocks to facilitate image processing. Due to the superior thermal conductivity of Si and its potential for mass production, the dPCR chips were fabricated on a Si substrate. A temperature control system based on a high-power density Peltier element and a preheating/cooling PCR protocol user interface shortening the thermal cycle time. The optical design employs four 470 nm light-emitting diodes as light sources, with filters and mirrors effectively managing the light emitted during PCR. An algorithm is utilized for image processing and illumination nonuniformity correction including conversion to a monochromatic format, partition identification, skew correction, and the generation of an image correction mask. We validated the device using a range of deoxyribonucleic acid targets, demonstrating its potential applicability across multiple fields. Therefore, we provide guidance and verification of the design and testing of the recently proposed SPEED device.

Recent developments and future perspectives of microfluidics and smart technologies in wearable devices

Wearable devices are gaining popularity in the fields of health monitoring, diagnosis, and drug delivery. Recent advances in wearable technology have enabled real-time analysis of biofluids such as sweat, interstitial fluid, tears, saliva, wound fluid, and urine. The integration of microfluidics and emerging smart technologies, such as artificial intelligence (AI), machine learning (ML), and Internet of Things (IoT), into wearable devices offers great potential for accurate and non-invasive monitoring and diagnosis. This paper provides an overview of current trends and developments in microfluidics and smart technologies in wearable devices for analyzing body fluids. The paper discusses common microfluidic technologies in wearable devices and the challenges associated with analyzing each type of biofluid. The paper emphasizes the importance of combining smart technologies with microfluidics in wearable devices, and how they can aid diagnosis and therapy. Finally, the paper covers recent applications, trends, and future developments in the context of intelligent microfluidic wearable devices.

Wearable sweat chloride sensors: materials, fabrication and their applications

Chloride is a crucial anion required for multiple functions in the human body including maintaining acid-base balance, fluid balance, electrical neutrality and supporting muscles and nerve cells. Low-chloride levels can cause nausea, diarrhoea, etc. Chloride levels are measured in different body fluids such as urine, serum, sweat and saliva. Sweat chloride measurements are used for multiple applications including disease diagnosis, sports monitoring, and geriatric care. For instance, a sweat chloride test is performed for cystic fibrosis screening. Further, sweat also offers continuous non-invasive access to body fluids for real-time monitoring of chloride that could be used for sports and geriatric care. This review focuses on wearable chloride sensors that are used for periodic and continuous chloride monitoring. The multiple sections in the paper discuss the clinical significance of chloride, detection methods, sensor fabrication methods and their application in cystic fibrosis screening, sports and geriatric care. Finally, the last section discusses the limitation of current sensors and future directions for wearable chloride sensors.

Microfluidic-Based Non-Invasive Wearable Biosensors for Real-Time Monitoring of Sweat Biomarkers

Wearable biosensors are attracting great interest thanks to their high potential for providing clinical-diagnostic information in real time, exploiting non-invasive sampling of biofluids. In this context, sweat has been demonstrated to contain physiologically relevant biomarkers, even if it has not been exhaustively exploited till now. This biofluid has started to gain attention thanks to the applications offered by wearable biosensors, as it is easily collectable and can be used for continuous monitoring of some parameters. Several studies have reported electrochemical and optical biosensing strategies integrated with flexible, biocompatible, and innovative materials as platforms for biospecific recognition reactions. Furthermore, sampling systems as well as the transport of fluids by microfluidics have been implemented into portable and compact biosensors to improve the wearability of the overall analytical device. In this review, we report and discuss recent pioneering works about the development of sweat sensing technologies, focusing on opportunities and open issues that can be decisive for their applications in routine-personalized healthcare practices.

Skin-Attachable Ink-Dispenser-Printed Paper Fluidic Sensor Patch for Colorimetric Sweat Analysis

In situ analysis of sweat biomarkers potentially provides noninvasive lifestyle monitoring and early diagnosis. Quantitative detection of sweat rate is crucial for thermoregulation and preventing heat injuries. Here, a skin-attachable paper fluidic patch is reported for in situ colorimetric sensing of multiple sweat markers (pH, glucose, lactate, and uric acid) with concurrent sweat rate tracking. Two sets of fluidic patterns-multiplexed detection zones and a longitudinal sweat rate channel-are directly printed by an automated ink dispenser from a specially developed ceramic-based ink. The ceramic ink thermal-cures into an impervious barrier, confining sweat within the channels. The ceramic-ink-printed boundary achieves higher pattern resolution, prevents fluid leakage, attains pattern thermal stability, and resistant to organic solvents. The cellulose matrix of the detection zones is modified with nanoparticles to improve the color homogeneity and sweat sensor sensitivity. The sweat rate channel is made moisture sensitive by incorporating a metal-salt-based dye. The change in saturation/color of the detection zones and/or channels upon sweat addition can be visually detected or quantified by a smartphone camera. A cost-effective way is provided to fabricate paper fluidic sensor patches, successfully demonstrating on-body multiplexed evaluation of sweat analytes. Such skin wearables offer on-site analysis, meaningful to an increasingly health-conscious population.

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.

Recent Advances in Nanowire-Based Wearable Physical Sensors

Wearable electronics is a technology that closely integrates electronic devices with the human body or clothing, which can realize human-computer interaction, health monitoring, smart medical, and other functions. Wearable physical sensors are an important part of wearable electronics. They can sense various physical signals from the human body or the surrounding environment and convert them into electrical signals for processing and analysis. Nanowires (NW) have unique properties such as a high surface-to-volume ratio, high flexibility, high carrier mobility, a tunable bandgap, a large piezoresistive coefficient, and a strong light-matter interaction. They are one of the ideal candidates for the fabrication of wearable physical sensors with high sensitivity, fast response, and low power consumption. In this review, we summarize recent advances in various types of NW-based wearable physical sensors, specifically including mechanical, photoelectric, temperature, and multifunctional sensors. The discussion revolves around the structural design, sensing mechanisms, manufacture, and practical applications of these sensors, highlighting the positive role that NWs play in the sensing process. Finally, we present the conclusions with perspectives on current challenges and future opportunities in this field.

Next-Generation Microfluidics for Biomedical Research and Healthcare Applications

Microfluidic systems offer versatile biomedical tools and methods to enhance human convenience and health. Advances in these systems enables next-generation microfluidics that integrates automation, manipulation, and smart readout systems, as well as design and three-dimensional (3D) printing for precise production of microchannels and other microstructures rapidly and with great flexibility. These 3D-printed microfluidic platforms not only control the complex fluid behavior for various biomedical applications, but also serve as microconduits for building 3D tissue constructs-an integral component of advanced drug development, toxicity assessment, and accurate disease modeling. Furthermore, the integration of other emerging technologies, such as advanced microscopy and robotics, enables the spatiotemporal manipulation and high-throughput screening of cell physiology within precisely controlled microenvironments. Notably, the portability and high precision automation capabilities in these integrated systems facilitate rapid experimentation and data acquisition to help deepen our understanding of complex biological systems and their behaviors. While certain challenges, including material compatibility, scaling, and standardization still exist, the integration with artificial intelligence, the Internet of Things, smart materials, and miniaturization holds tremendous promise in reshaping traditional microfluidic approaches. This transformative potential, when integrated with advanced technologies, has the potential to revolutionize biomedical research and healthcare applications, ultimately benefiting human health. This review highlights the advances in the field and emphasizes the critical role of the next generation microfluidic systems in advancing biomedical research, point-of-care diagnostics, and healthcare systems.

Smart Wearable Nanopaper Patch for Continuous Multiplexed Optical Monitoring of Sweat Parameters

Notwithstanding the substantial progress in optical wearable sensing devices, developing wearable optical sensors for simultaneous, real-time, and continuous monitoring of multiple biomarkers is still an important, yet unmet, demand. Aiming to address this need, we introduced for the first time a smart wearable optical sensor (SWOS) platform combining a multiplexed sweat sensor sticker with its IoT-enabled readout module. We employed our SWOS system for on-body continuous, real-time, and simultaneous fluorimetric monitoring of sweat volume (physical parameter) and pH (chemical marker). Herein, a variation in moisture (5-45 μL) or pH (4.0-7.0) causes a color/fluorescence change in the copper chloride/fluorescein immobilized within a transparent chitin nanopaper (ChNP) in a selective and reversible manner. Human experiments conducted on athletic volunteers during exercise confirm that our developed SWOS platform can be efficiently exploited for smart perspiration analysis toward personalized health monitoring. Moreover, our system can be further extended for the continuous and real-time multiplexed monitoring of various biomarkers (metabolites, proteins, or drugs) of sweat or other biofluids (for example, analyzing exhaled breath by integrating onto a facemask).

3D-printed epidermal sweat microfluidic systems with integrated microcuvettes for precise spectroscopic and fluorometric biochemical assays

Systems for capture, storage and analysis of eccrine sweat can provide insights into physiological health status, quantify losses of water, electrolytes, amino acids and/or other essential species, and identify exposures to adverse environmental species or illicit drugs. Recent advances in materials and device designs serve as the basis for skin-compatible classes of microfluidic platforms and in situ colorimetric assays for precise assessments of sweat rate, sweat loss and concentrations of wide-ranging types of biomarkers in sweat. This paper presents a set of findings that enhances the performance of these systems through the use of microfluidic networks, integrated valves and microscale optical cuvettes formed by three dimensional printing in hard/soft hybrid materials systems, for accurate spectroscopic and fluorometric assays. Field studies demonstrate the capability of these microcuvette systems to evaluate the concentrations of copper, chloride, and glucose in sweat, along with the pH of sweat, with laboratory-grade accuracy and sensitivity.

Microfluidic Wearable Devices for Sports Applications

This study aimed to systematically review the application and research progress of flexible microfluidic wearable devices in the field of sports. The research team thoroughly investigated the use of life signal-monitoring technology for flexible wearable devices in the domain of sports. In addition, the classification of applications, the current status, and the developmental trends of similar products and equipment were evaluated. Scholars expect the provision of valuable references and guidance for related research and the development of the sports industry. The use of microfluidic detection for collecting biomarkers can mitigate the impact of sweat on movements that are common in sports and can also address the issue of discomfort after prolonged use. Flexible wearable gadgets are normally utilized to monitor athletic performance, rehabilitation, and training. Nevertheless, the research and development of such devices is limited, mostly catering to professional athletes. Devices for those who are inexperienced in sports and disabled populations are lacking. Conclusions: Upgrading microfluidic chip technology can lead to accurate and safe sports monitoring. Moreover, the development of multi-functional and multi-site devices can provide technical support to athletes during their training and competitions while also fostering technological innovation in the field of sports science.

Opportunities and challenges for sweat-based monitoring of metabolic syndrome via wearable technologies

Metabolic syndrome is a prevalent condition in adults over the age of 65 and is a risk factor for developing cardiovascular disease and type II diabetes. Thus, methods to track the condition, prevent complications and assess symptoms and risk factors are needed. Here we discuss sweat-based wearable technologies as a potential monitoring tool for patients with metabolic syndrome. We describe several key symptoms that can be evaluated that could employ sweat patches to assess inflammatory markers, glucose, sodium, and cortisol. We then discuss the challenges with material property, sensor integration, and sensor placement and provide feasible solutions to optimize them. Together with a list of recommendations, we propose a pathway toward successfully developing and implementing reliable sweat-based technologies to monitor metabolic syndrome.

Metabolic syndrome is a risk factor for developing cardiovascular disease and type II diabetes. Lyzwinski, Elgendi and colleagues discuss the potential role of sweat-based wearable technologies for monitoring metabolic syndrome along with engineering challenges towards implementation and optimization

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.

Skin-interfaced electronics: A promising and intelligent paradigm for personalized healthcare

Skin-interfaced electronics (skintronics) have received considerable attention due to their thinness, skin-like mechanical softness, excellent conformability, and multifunctional integration. Current advancements in skintronics have enabled health monitoring and digital medicine. Particularly, skintronics offer a personalized platform for early-stage disease diagnosis and treatment. In this comprehensive review, we discuss (1) the state-of-the-art skintronic devices, (2) material selections and platform considerations of future skintronics toward intelligent healthcare, (3) device fabrication and system integrations of skintronics, (4) an overview of the skintronic platform for personalized healthcare applications, including biosensing as well as wound healing, sleep monitoring, the assessment of SARS-CoV-2, and the augmented reality-/virtual reality-enhanced human-machine interfaces, and (5) current challenges and future opportunities of skintronics and their potentials in clinical translation and commercialization. The field of skintronics will not only minimize physical and physiological mismatches with the skin but also shift the paradigm in intelligent and personalized healthcare and offer unprecedented promise to revolutionize conventional medical practices.

Smart Janus fabrics for one-way sweat sampling and skin-friendly colorimetric detection

Functionalized textiles with biofluid management capability have attracted tremendous attention in recent years due to their significant roles in health monitoring and dehydration prevention. Here we propose a one-way colorimetric sweat sampling and sensing system based on a Janus fabric using interfacial modification techniques. The opposite wettability of Janus fabric enables sweat to be quickly moved from the skin surface to the hydrophilic side and colorimetric patches. The unidirectional sweat-wicking performance of Janus fabric not only facilitates adequate sweat sampling but also inhibits the backflow of hydrated colorimetric regent from the assay patch toward the skin, eliminating potential epidermal contaminations. On this basis, visual and portable detection of sweat biomarkers including chloride, pH, and urea is also achieved. The results show that the true concentrations of chloride, pH, and urea in sweat are ∼10 mM, ∼7.2, and ∼10 mM, respectively. The detection limits of chloride and urea are 1.06 mM and 3.05 mM. This work bridges the gap between sweat sampling and a friendly epidermal microenvironment, providing a promising way for multifunctional textiles.

Reshaping healthcare with wearable biosensors

Wearable health sensors could monitor the wearer's health and surrounding environment in real-time. With the development of sensor and operating system hardware technology, the functions of wearable devices have been gradually enriched with more diversified forms and more accurate physiological indicators. These sensors are moving towards high precision, continuity, and comfort, making great contributions to improving personalized health care. At the same time, in the context of the rapid development of the Internet of Things, the ubiquitous regulatory capabilities have been released. Some sensor chips are equipped with data readout and signal conditioning circuits, and a wireless communication module for transmitting data to computer equipment. At the same time, for data analysis of wearable health sensors, most companies use artificial neural networks (ANN). In addition, artificial neural networks could help users effectively get relevant health feedback. Through the physiological response of the human body, various sensors worn could effectively transmit data to the control unit, which analyzes the data and provides feedback of the health value to the user through the computer. This is the working principle of wearable sensors for health. This article focuses on wearable biosensors used for healthcare monitoring in different situations, as well as the development, technology, business, ethics, and future of wearable sensors for health monitoring.

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.

Moving toward smart biomedical sensing

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

Flexible Sweat Sensors: From Films to Textiles

Flexible sweat sensors have found widespread potential applications for long-term wear and tracking and real-time monitoring of human health. However, the main substrate currently used in common flexible sweat sensors is thin film, which has disadvantages such as poor air permeability and the need for additional wearables. In this Review, the recent progress of sweat sensors has been systematically summarized by the types of monitoring methods of sweat sensors. In addition, this Review introduces and compares the performance of sweat sensors based on thin film and textile substrates such as fiber/yarn. Finally, opportunities and suggestions for the development of flexible sweat sensors are presented by summarizing the integration methods of sensors and human body monitoring sites.

Epidermal Wearable Biosensors for Monitoring Biomarkers of Chronic Disease in Sweat

Biological information detection technology is mainly used for the detection of physiological and biochemical parameters closely related to human tissues and organ lesions, such as biomarkers. This technology has important value in the clinical diagnosis and treatment of chronic diseases in their early stages. Wearable biosensors can be integrated with the Internet of Things and Big Data to realize the detection, transmission, storage, and comprehensive analysis of human physiological and biochemical information. This technology has extremely wide applications and considerable market prospects in frontier fields including personal health monitoring, chronic disease diagnosis and management, and home medical care. In this review, we systematically summarized the sweat biomarkers, introduced the sweat extraction and collection methods, and discussed the application and development of epidermal wearable biosensors for monitoring biomarkers in sweat in preclinical research in recent years. In addition, the current challenges and development prospects in this field were discussed.

Novel Wearable Optical Sensors for Vital Health Monitoring Systems-A Review

Wearable sensors are pioneering devices to monitor health issues that allow the constant monitoring of physical and biological parameters. The immunity towards electromagnetic interference, miniaturization, detection of nano-volumes, integration with fiber, high sensitivity, low cost, usable in harsh environments and corrosion-resistant have made optical wearable sensor an emerging sensing technology in the recent year. This review presents the progress made in the development of novel wearable optical sensors for vital health monitoring systems. The details of different substrates, sensing platforms, and biofluids used for the detection of target molecules are discussed in detail. Wearable technologies could increase the quality of health monitoring systems at a nominal cost and enable continuous and early disease diagnosis. Various optical sensing principles, including surface-enhanced Raman scattering, colorimetric, fluorescence, plasmonic, photoplethysmography, and interferometric-based sensors, are discussed in detail for health monitoring applications. The performance of optical wearable sensors utilizing two-dimensional materials is also discussed. Future challenges associated with the development of optical wearable sensors for point-of-care applications and clinical diagnosis have been thoroughly discussed.

Wearable artificial intelligence biosensor networks

The demand for high-quality healthcare and well-being services is remarkably increasing due to the ageing global population and modern lifestyles. Recently, the integration of wearables and artificial intelligence (AI) has attracted extensive academic and technological attention for its powerful high-dimensional data processing of wearable biosensing networks. This work reviews the recent developments in AI-assisted wearable biosensing devices in disease diagnostics and fatigue monitoring demonstrating the trend towards personalised medicine with highly efficient, cost-effective, and accurate point-of-care diagnosis by finding hidden patterns in biosensing data and detecting abnormalities. The reliability of adaptive learning and synthetic data and data privacy still need further investigation to realise personalised medicine in the next decade. Due to the worldwide popularity of smartphones, they have been utilised for sensor readout, wireless data transfer, data processing and storage, result display, and cloud server communication leading to the development of smartphone-based biosensing systems. The recent advances have demonstrated a promising future for the healthcare system because of the increasing data processing power, transfer efficiency and storage capacity and diversifying functionalities.

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.

Paper based microfluidic devices: a review of fabrication techniques and applications

A wide range of applications are possible with paper-based analytical devices, which are low priced, easy to fabricate and operate, and require no specialized equipment. Paper-based microfluidics offers the design of miniaturized POC devices to be applied in the health, environment, food, and energy sector employing the ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment free and Deliverable to end users) principle of WHO. Therefore, this field is growing very rapidly and ample research is being done. This review focuses on fabrication and detection techniques reported to date. Additionally, this review emphasises on the application of this technology in the area of medical diagnosis, energy generation, environmental monitoring, and food quality control. This review also presents the theoretical analysis of fluid flow in porous media for the efficient handling and control of fluids. The limitations of PAD have also been discussed with an emphasis to concern on the transformation of such devices from laboratory to the consumer.

Microfluidic assessment of nutritional biomarkers: Concepts, approaches and advances

Among various approaches to understand the health status of an individual, nutritional biomarkers can provide valuable information, particularly in terms of deficiencies, if any, and their severity. Commonly, the approach revolves around molecular sciences, and the information gained can support prognosis, diagnosis, remediation, and impact assessment of therapies. Microfluidic platforms can offer benefits of low sample and reagent requirements, low cost, high precision, and lower detection limits, with simplicity in handling and the provision for complete automation and integration with information and communication technologies (ICTs). While several advances are being made, this work details the underlying concepts, with emphasis on different point-of-care devices for the analysis of macro and micronutrient biomarkers. In addition, the scope of using different wearable microfluidic sensors for real-time and noninvasive determination of biomarkers is detailed. While several challenges remain, a strong focus is given on recent advances, presenting the state-of-the-art of this field. With more such biomarkers being discovered and commercialization-driven research, trends indicate the wide prospects of this advancing field in supporting clinicians, food technologists, nutritionists, and others.

Computational Portable Microscopes for Point-of-Care-Test and Tele-Diagnosis

In bio-medical mobile workstations, e.g., the prevention of epidemic viruses/bacteria, outdoor field medical treatment and bio-chemical pollution monitoring, the conventional bench-top microscopic imaging equipment is limited. The comprehensive multi-mode (bright/dark field imaging, fluorescence excitation imaging, polarized light imaging, and differential interference microscopy imaging, etc.) biomedical microscopy imaging systems are generally large in size and expensive. They also require professional operation, which means high labor-cost, money-cost and time-cost. These characteristics prevent them from being applied in bio-medical mobile workstations. The bio-medical mobile workstations need microscopy systems which are inexpensive and able to handle fast, timely and large-scale deployment. The development of lightweight, low-cost and portable microscopic imaging devices can meet these demands. Presently, for the increasing needs of point-of-care-test and tele-diagnosis, high-performance computational portable microscopes are widely developed. Bluetooth modules, WLAN modules and 3G/4G/5G modules generally feature very small sizes and low prices. And industrial imaging lens, microscopy objective lens, and CMOS/CCD photoelectric image sensors are also available in small sizes and at low prices. Here we review and discuss these typical computational, portable and low-cost microscopes by refined specifications and schematics, from the aspect of optics, electronic, algorithms principle and typical bio-medical applications.

A Soft Wearable Microfluidic Patch with Finger-Actuated Pumps and Valves for On-Demand, Longitudinal, and Multianalyte Sweat Sensing

Easy sample collection, physiological relevance, and ability to noninvasively and longitudinally monitor the human body are some of the key attributes of wearable sweat sensors. Examples typically include reversible sensors or an array of single-use sensors embedded in specialized microfluidics for temporal analysis of sweat. However, evolving this field to a level that truly represents "lab-on-skin" technology will require the incorporation of advanced functionalities that give the user the freedom to (1) choose the precise time for performing sample analysis and (2) select sensors from an array embedded within the device for performing condition-specific sample analysis. Here, we introduce new concepts in wearable microfluidic platforms that offer such capabilities. The described technology involves a series of finger-actuated pumps, valves, and sensors incorporated within soft, wearable microfluidics. The incoming sweat collects in the inlet chamber and can be analyzed by the user at the time of their choosing. On-demand sweat analyte assessment is achieved by pulling a thin tab to activate a pump which opens a valve and allows the pooled sweat to enter a chamber embedded with sensors for the desired analytes. The article describes a thorough characterization of the platform that demonstrates the robustness of the pumping, valving, and sensing aspects of the device under conditions mimicking real-life scenarios. A two-day-long human pilot study validates the system and illustrates the device's ability to offer on-demand, longitudinal, and multianalyte sensing. Our work represents the first example of a wearable system with such on-demand sensing capabilities and opens exciting avenues in sweat sensing for acquiring new insights into human physiology.

A Review of Recent Advances in Vital Signals Monitoring of Sports and Health via Flexible Wearable Sensors

In recent years, vital signals monitoring in sports and health have been considered the research focus in the field of wearable sensing technologies. Typical signals include bioelectrical signals, biophysical signals, and biochemical signals, which have applications in the fields of athletic training, medical diagnosis and prevention, and rehabilitation. In particular, since the COVID-19 pandemic, there has been a dramatic increase in real-time interest in personal health. This has created an urgent need for flexible, wearable, portable, and real-time monitoring sensors to remotely monitor these signals in response to health management. To this end, the paper reviews recent advances in flexible wearable sensors for monitoring vital signals in sports and health. More precisely, emerging wearable devices and systems for health and exercise-related vital signals (e.g., ECG, EEG, EMG, inertia, body movements, heart rate, blood, sweat, and interstitial fluid) are reviewed first. Then, the paper creatively presents multidimensional and multimodal wearable sensors and systems. The paper also summarizes the current challenges and limitations and future directions of wearable sensors for vital typical signal detection. Through the review, the paper finds that these signals can be effectively monitored and used for health management (e.g., disease prediction) thanks to advanced manufacturing, flexible electronics, IoT, and artificial intelligence algorithms; however, wearable sensors and systems with multidimensional and multimodal are more compliant.

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 Review of Digital Health and Biotelemetry: Modern Approaches towards Personalized Medicine and Remote Health Assessment

With the prevalence of digitalization in all aspects of modern society, health assessment is becoming digital too. Taking advantage of the most recent technological advances and approaching medicine from an interdisciplinary perspective has allowed for important progress in healthcare services. Digital health technologies and biotelemetry devices have been more extensively employed for preventing, detecting, diagnosing, monitoring, and predicting the evolution of various diseases, without requiring wires, invasive procedures, or face-to-face interaction with medical personnel. This paper aims to review the concepts correlated to digital health, classify and describe biotelemetry devices, and present the potential of digitalization for remote health assessment, the transition to personalized medicine, and the streamlining of clinical trials.

A Review of Stimuli-Responsive Smart Materials for Wearable Technology in Healthcare: Retrospective, Perspective, and Prospective

In recent years thanks to the Internet of Things (IoT), the demand for the development of miniaturized and wearable sensors has skyrocketed. Among them, novel sensors for wearable medical devices are mostly needed. The aim of this review is to summarize the advancements in this field from current points of view, focusing on sensors embedded into textile fabrics. Indeed, they are portable, lightweight, and the best candidates for monitoring biometric parameters. The possibility of integrating chemical sensors into textiles has opened new markets in smart clothing. Many examples of these systems are represented by color-changing materials due to their capability of altering optical properties, including absorption, reflectance, and scattering, in response to different external stimuli (temperature, humidity, pH, or chemicals). With the goal of smart health monitoring, nanosized sol-gel precursors, bringing coupling agents into their chemical structure, were used to modify halochromic dyestuffs, both minimizing leaching from the treated surfaces and increasing photostability for the development of stimuli-responsive sensors. The literature about the sensing properties of functionalized halochromic azo dyestuffs applied to textile fabrics is reviewed to understand their potential for achieving remote monitoring of health parameters. Finally, challenges and future perspectives are discussed to envisage the developed strategies for the next generation of functionalized halochromic dyestuffs with biocompatible and real-time stimuli-responsive capabilities.

Microfluidic wearable electrochemical sweat sensors for health monitoring

Research on remote health monitoring through wearable sensors has attained popularity in recent decades mainly due to aging population and expensive health care services. Microfluidic wearable sweat sensors provide economical, non-invasive mode of sample collection, important physiological information, and continuous tracking of human health. Recent advances in wearable sensors focus on electrochemical monitoring of biomarkers in sweat and can be applicable in various fields like fitness monitoring, nutrition, and medical diagnosis. This review focuses on the evolution of wearable devices from benchtop electrochemical systems to microfluidic-based wearable sensors. Major classification of wearable sensors like skin contact-based and biofluidic-based sensors are discussed. Furthermore, sweat chemistry and related biomarkers are explained in addition to integration of microfluidic systems in wearable sweat sensors. At last, recent advances in wearable electrochemical sweat sensors are discussed, which includes tattoo-based, paper microfluidics, patches, wrist band, and belt-based wearable sensors.