Non-invasive textile based colorimetric sensor for the simultaneous detection of sweat pH and lactate

Multifunctional laser-induced graphene circuits and laser-printed nanomaterials toward non-invasive human kidney function monitoring

Faced with the increasing prevalence of chronic kidney disease (CKD), portable monitoring of CKD-related biomarkers such as potassium ion (K+), creatinine (Cre), and lactic acid (Lac) levels in sweat has shown tremendous potential for early diagnosis. However, a rapidly manufacturable portable device integrating multiple CKD-related biomarker sensors for ease of sweat testing use has yet to be reported. Here, a portable electrochemical sensor integrated with multifunctional laser-induced graphene (LIG) circuits and laser-printed nanomaterials based working electrodes fabricated by fully automatic laser manufacturing is proposed for non-invasive human kidney function monitoring. The sensor comprises a two-electrode LIG circuit for K+ sensing, a three-electrode LIG circuit with a Kelvin compensating connection for Cre and Lac sensing, and a printed circuit board based portable electrochemical workstation. The working electrodes containing Cu and Cu2O nanoparticles fabricated by two-step laser printing show good sensitivity and selectivity toward Cre and Lac sensing. The sensor circuits are fabricated by generating a hydrophilic-hydrophobic interface on a patterned LIG through laser. This sensor recruited rapid laser manufacturing and integrated with multifunctional LIG circuits and laser-printed nanomaterials based working electrodes, which is a potential kidney function monitoring solution for healthy people and kidney disease patients.

Disposable Zirconium trisulfide-Reduced graphene oxide modified conducting thread based electrochemical biosensor for lung cancer diagnosis

Flexible technology in sensors have received much attention in monitoring of human health through various physiological indicators. Thus, it drawn a lot of interest in the development of flexible substrate for the diagnosis of various diseases via analysis of analytes. Present work focusses on the development of ecofriendly, portable, flexible, conducting thread (Th) and used as smart substrate for fabrication of biosensor towards ultrasensitive detection of the lung cancer biomarker (cytoskeleton-associated protein 4; CKAP4). The zirconium trisulfide-reduced graphene oxide nanocomposite and poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) modified cotton thread based biosensor was fabricated via dip coating method. Next, successive immobilization of monoclonal antibodies of CKAP4 (anti-CKAP4) and bovine serum albumin (BSA) was performed via drop cast approach using fabricated electrode [nZrS3@rGO/PEDOT:PSS/Th]. The response of fabricated electrode (BSA/anti-CKAP4/ZrS3@rGO/PEDOT:PSS/Th) was recorded electrochemically versus CKAP4 concentration via chronoamperometry (CA). The results showed wider linear detection range of 6.25-800 pg mL-1, excellent sensitivity of 85.2 µA[log(pg mL-1)]-1cm-2 with good stability up to 42 days. The response of fabricated biosensor was supported by investigating response of CKAP4 biomarker present in patients of lung cancer (concentration as determined through enzyme-linked immunosorbent assay) and obtained results exhibited excellent correlation with that of standard samples.

Surface-engineered natural fibers: Emerging alternative substrates for chemical sensor applications: A review

Natural fiber has become one of the most widely used alternative materials for chemical sensor fabrication due to its advantages, such as biocompatibility, flexibility, and self-microfluidic properties. Enhanced natural fiber surface has been used as a substrate in colorimetric and electrochemical sensors. This review focuses on improving the natural fiber properties for preparation as a substrate for chemical sensors. Various methods for natural fiber extraction are discussed and compared. Bleaching and decolorization is important for preparation of colorimetric sensors, while carbonization and nanoparticle doping are favorable for increasing their electrical conductivity for electrochemical sensor fabrication. Also, example fabrications and applications of natural fiber-based chemical sensors for chemical and biomarker detection are discussed. The selectivity of the sensors can be introduced and improved by surface modification of natural fiber, such as enzyme immobilization and biorecognition element functionalization, illustrating the adaptability of natural fiber as a smart sensing device, e.g., wearable and portable sensors. Ultimately, the high performances of natural fiber-based chemical sensors indicate the potential uses of natural fiber as a renewable and eco-friendly substrate material in the field of chemical sensors and biosensors for clinical diagnosis and environmental monitoring.

Smart salt-responsive thread for highly sensitive microfluidic glucose detection in sweat

Thread-based microfluidic colorimetric sensors have been deemed a potential tool that may be incorporated into textiles for non-invasive sweat analysis. Nevertheless, their poor performance significantly limits their practical uses in sweat glucose detection down to 20 μM. Herein, a microfluidic glucose sensing device containing a salt-responsive thread is developed for the highly sensitive detection of glucose in human sweat. By grafting a zwitterionic polymer brush-which could react to ionic strength by changing the conformation of the polymer chains from the collapsing state to the stretching state-onto the cotton thread, the salt-responsive thread was created. Compared to the pristine cotton thread, the modified thread has better ion-capture capabilities, a more noticeable swelling effect, and a higher ability to absorb water. These enable a significant enrichment of glucose when the saline solution passes through it. The salt-responsive thread was employed to construct a thread/paper-based microfluidic sensing device for the monitoring of glucose in artificial sweat, exhibiting a sensitivity of -0.255 μM-1 and a detection limit of 14.7 μM. In comparison to the pristine cotton thread-based device, the performance is significantly superior. Using a hydrophobic fabric and salt-responsive threads, a glucose-sensing headband was prepared for on-body sweat glucose monitoring. With the use of a smartphone-based image analysis system, the headband can detect the concentration of glucose in a volunteer's perspiration. Using the thread-based salt-responsive zwitterionic polymer brush might offer a novel approach to creating wearable sweat sensors with extremely high sensitivity.

Recent Advances in Electrochemical Detection of Cell Energy Metabolism

Cell energy metabolism is a complex and multifaceted process by which some of the most important nutrients, particularly glucose and other sugars, are transformed into energy. This complexity is a result of dynamic interactions between multiple components, including ions, metabolic intermediates, and products that arise from biochemical reactions, such as glycolysis and mitochondrial oxidative phosphorylation (OXPHOS), the two main metabolic pathways that provide adenosine triphosphate (ATP), the main source of chemical energy driving various physiological activities. Impaired cell energy metabolism and perturbations or dysfunctions in associated metabolites are frequently implicated in numerous diseases, such as diabetes, cancer, and neurodegenerative and cardiovascular disorders. As a result, altered metabolites hold value as potential disease biomarkers. Electrochemical biosensors are attractive devices for the early diagnosis of many diseases and disorders based on biomarkers due to their advantages of efficiency, simplicity, low cost, high sensitivity, and high selectivity in the detection of anomalies in cellular energy metabolism, including key metabolites involved in glycolysis and mitochondrial processes, such as glucose, lactate, nicotinamide adenine dinucleotide (NADH), reactive oxygen species (ROS), glutamate, and ATP, both in vivo and in vitro. This paper offers a detailed examination of electrochemical biosensors for the detection of glycolytic and mitochondrial metabolites, along with their many applications in cell chips and wearable sensors.

Wearable Sensors as a Preoperative Assessment Tool: A Review

Surgery is a common first-line treatment for many types of disease, including cancer. Mortality rates after general elective surgery have seen significant decreases whilst postoperative complications remain a frequent occurrence. Preoperative assessment tools are used to support patient risk stratification but do not always provide a precise and accessible assessment. Wearable sensors (WS) provide an accessible alternative that offers continuous monitoring in a non-clinical setting. They have shown consistent uptake across the perioperative period but there has been no review of WS as a preoperative assessment tool. This paper reviews the developments in WS research that have application to the preoperative period. Accelerometers were consistently employed as sensors in research and were frequently combined with photoplethysmography or electrocardiography sensors. Pre-processing methods were discussed and missing data was a common theme; this was dealt with in several ways, commonly by employing an extraction threshold or using imputation techniques. Research rarely processed raw data; commercial devices that employ internal proprietary algorithms with pre-calculated heart rate and step count were most commonly employed limiting further feature extraction. A range of machine learning models were used to predict outcomes including support vector machines, random forests and regression models. No individual model clearly outperformed others. Deep learning proved successful for predicting exercise testing outcomes but only within large sample-size studies. This review outlines the challenges of WS and provides recommendations for future research to develop WS as a viable preoperative assessment tool.

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.

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.

Nanodot zirconium trisulfide modified conducting thread: A smart substrate for fabrication of next generation biosensor

In present work, we report an eco-friendly, flexible and highly conducting cotton thread (CT) as a smart substrate for the development of biosensing platform towards ultrasensitive detection of swine flu serum amyloid A (SAA) biomarker. The biosensor was fabricated by optimized coating of CT with poly(3,4-ethylenedioxythiophene): poly(styrenesulfonate) (PEDOT:PSS) conductive ink followed by incorporation of nanodot zirconium trisulfide (nZrS3) which helped in enhancing the electrochemical properties and improving stability of PEDOT:PSS polymeric film. The fabricated nZrS3/PEDOT:PSS/CT electrode was then used for sequential immobilization of monoclonal antibodies of SAA (anti-SAA) and bovine serum albumin (BSA). The synthesized nanomaterials and fabricated electrodes were characterized through X-ray diffraction, Fourier-transform infrared spectroscopy, transmission electron microscopy, scanning electron microscopy and contact angle analyser techniques. The electrochemical response of the fabricated smart thread based biosensor (BSA/anti-SAA/ZrS3/PEDOT:PSS/CT) was recorded against SAA using chronoamperometry technique which revealed superior sensitivity {30.2 μA [log (μg mL-1)]-1 cm-2}, excellent lower detection limit (0.72 ng mL-1) and prolonged shelf life up to 48 days. The response of the biosensor was also validated by analysing the electrochemical response of SAA spiked serum samples and the obtained results showed good correlation with that of standard samples.

Advanced Textile-Based Wearable Biosensors for Healthcare Monitoring

With the innovation of wearable technology and the rapid development of biosensors, wearable biosensors based on flexible textile materials have become a hot topic. Such textile-based wearable biosensors promote the development of health monitoring, motion detection and medical management, and they have become an important support tool for human healthcare monitoring. Textile-based wearable biosensors not only non-invasively monitor various physiological indicators of the human body in real time, but they also provide accurate feedback of individual health information. This review examines the recent research progress of fabric-based wearable biosensors. Moreover, materials, detection principles and fabrication methods for textile-based wearable biosensors are introduced. In addition, the applications of biosensors in monitoring vital signs and detecting body fluids are also presented. Finally, we also discuss several challenges faced by textile-based wearable biosensors and the direction of future development.

Fabrication of an electrospun polycaprolactone substrate for colorimetric bioassays

Colorimetric assays rely on detecting colour changes to measure the concentration of target molecules. Paper substrates are commonly used for the detection of biomarkers due to their availability, porous structure, and capillarity. However, the morphological and mechanical properties of paper, such as fibre diameter, pore size, and tensile strength, cannot be easily tuned to meet the specific requirements of colorimetric sensors, including liquid capacity and reagent immobilisation. As an alternative to paper materials, biodegradable polymeric membranes made of electrospun polycaprolactone (PCL) fibres can provide various tunable properties related to fibre diameter and pore size.We aimed to obtain a glucose sensor substrate for colorimetric sensing using electrospinning with PCL. A feeding solution was created by mixing PCL/chloroform and 3,3',5',5'-tetramethylbenzidine (TMB)/ethanol solutions. This solution was electrospun to fabricate a porous membrane composed of microfibres consist of PCL and TMB. The central area of the membrane was made hydrophilic through air plasma treatment, and it was subsequently functionalized with a solution containing glucose oxidase, horseradish peroxidase, and trehalose.The sensing areas were evaluated by measuring colour changes in glucose solutions of varying concentrations. The oxidation reactions of glucose and TMB in sensor substrates were recorded and analysed to establish the correlation between different glucose concentrations and colour changes. For comparison, conventional paper substrates prepared with same parameters were evaluated alongside the electrospun PCL substrates. As a result, better immobilization of reagents and higher sensitivity of glucose were achieved with PCL substrates, indicating their potential usage as a new sensing substrate for bioassays.

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

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

Alternative platform for COVID-19 diagnosis based on AuNP-modified lab-on-paper

COVID-19 has caused global health problems, and so rapid diagnosis is crucial to slow spread of the disease. Herein, a novel lab-on-paper screening method for SARS-CoV-2 Omicron BA.2 variant was developed using a gold nanoparticle-based colorimetric biosensor along with sensitive detection of SARS-CoV-2 antigen using laser desorption ionization-mass spectrometry (LDI-MS). As a result of antigen-antibody interaction, in the presence of SARS-CoV-2 antigen the gold nanoparticles undergo aggregation and change color from red to light purple, allowing for rapid determination of SARS-CoV-2 antigen with the naked eye. Furthermore, the lab-on-paper method can be directly applied as a substrate for sensitive quantitation of SARS-CoV-2 antigen in saliva using LDI-MS without the use of a conventional organic matrix and sample preparation. LDI-MS offers early diagnosis with high sensitivity, rapidity without sample preparation and lower cost per test compared with reverse transcriptase-PCR, which is crucial for preventing mortality in patients with underlying conditions. This method showed linearity over 0.01-1 μg mL^-1 covering the cut-off value of 0.048 μg mL^-1 for COVID-19 detection in human saliva. Moreover, a colorimetric sensor for urea was also fabricated in-parallel, for prediction of COVID-19 severity in patients with chronic kidney disease. The color change upon increasing urea concentration directly reflected kidney damage, which is related to increasing risk of mortality among patients with COVID-19. Hence, this platform might be a potential device for non-invasive diagnosis of SARS-CoV-2 Omicron BA.2 variant, which is the variant of most concern because it is transmitted more rapidly than the original SARS-CoV-2 virus and the Delta variant.

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.

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

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

Wearable potentiometric biosensor for analysis of urea in sweat

Herein, we introduce wearable potentiometric biosensors on screen-printed carbon electrodes (SPCEs) for on-body and on-site monitoring of urea in sweat. The biosensor architecture was judiciously designed to detect urea at different pHs and incorporate a pH sensor, thus containing polyaniline ink, urease bioink and a polyvinylchloride membrane. Urea detection could be performed in the wide range from 5 to 200 mM at pH 7.0, encompassing urea levels in human sweat. The biosensor response was fast (incubation time 5 min), with no interference from other substances in sweat. Reliable urea detection could be done in undiluted human sweat with a skin-worn flexible device using the pH correction strategy afforded by the pH sensor. The performance of the epidermal biosensor was not affected by severe bending strains. The feasibility of mass production was demonstrated by fabricating epidermal flexible biosensors using slot-die coating with a roll-to-roll technique.

Polylactic acid/tapioca starch/banana peel-based material for colorimetric and electrochemical biosensing applications

The rapidly growing electronic and plastic waste has become a global environmental concern. Developing advanced and environmentally safe agro-based materials is an emerging field with an enormous potential for applications in sensors and devices. Here, an agro-based material as membrane has been developed by incorporating tapioca starch and banana peel powder in polylactic acid, with uniform dispersibility and amorphous nature. The material was used for the development of electrochemical sensor for S-gene of SARS-CoV-2. Further, the membrane was used for the development of a non-invasive, colorimetric skin patch for the detection of glucose and a sensor for the assessment of fruit juice quality. Using OECD-recommended model systems, the developed membrane was found to be non-toxic towards aquatic and terrestrial non-target organisms. The developed conductive material opens new avenues in various electrochemical, analytical, and biological applications.

Flexible Textile-Based Sweat Sensors for Wearable Applications

The current physical health care system has gradually evolved into a form of virtual hospitals communicating with sensors, which can not only save time but can also diagnose a patient's physical condition in real time. Textile-based wearable sensors have recently been identified as detection platforms with high potential. They are developed for the real-time noninvasive detection of human physiological information to comprehensively analyze the health status of the human body. Sweat comprises various chemical compositions, which can be used as biomarkers to reflect the relevant information of the human physiology, thus providing references for health conditions. Combined together, textile-based sweat sensors are more flexible and comfortable than other conventional sensors, making them easily integrated into the wearable field. In this short review, the research progress of textile-based flexible sweat sensors was reviewed. Three mechanisms commonly used for textile-based sweat sensors were firstly contrasted with an introduction to their materials and preparation processes. The components of textile-based sweat sensors, which mainly consist of a sweat transportation channel and collector, a signal-selection unit, sensing elements and sensor integration and communication technologies, were reviewed. The applications of textile-based sweat sensors with different mechanisms were also presented. Finally, the existing problems and challenges of sweat sensors were summarized, which may contribute to promote their further development.

Nanomaterial Gas Sensors for Biosensing Applications: A Review

BACKGROUND

Nanomaterial is one of the most used materials for various gas sensing applications to detect toxic gases, human breath, and other specific gas sensing. One of the most important applications of nanomaterial based gas sensors is biosensing applications. In this review article, the gas sensors for biosensing are discussed on the basis of crystalline structure and different categories of nanomaterial.

METHODS

In this paper, firstly, rigorous efforts have been made to find out research questions by going through a structured and systematic survey of available peer reviewed high quality articles in this field. The papers related to nanomaterial based biosensors are then reviewed qualitatively to provide substantive findings from the recent developments in this field.

RESULTS

In this mini-review article, firstly, classifications of nanomaterial gas sensors have been presented on the basis of the crystalline structure of nanomaterial and different types of nanomaterial available for biosensing applications. Further, the gas sensors based on nanomaterial for biosensing applications are collected and reviewed in terms of their performance parameters such as sensing material used, target gas component, detection ranges (ppm-ppb), response time, operating temperature and method of detection, etc. The different nanomaterials possess slightly different sensing and morphological properties due to their structure; therefore, it can be said that a nanomaterial must be selected carefully for a particular application. The 1D nanomaterials show the best selectivity and sensitivity for gases available in low concentration ranges due to their miniaturised structure compared to 2D and 3D nanomaterials. However, these 2D and 3D nanomaterials also so good sensing properties compared to bulk semiconductor materials. The polymer and nanocomposites which are also discussed in this patent article have opened the door for future research and have great potential for new generation gas sensors for detecting biomolecules.

CONCLUSION

These nanomaterials extend great properties towards sensing the application of different gases for a lower concentration of particular gas particles. Nano polymer and nanocomposites have great potential to be used as gas sensors for the detection of biomolecules.

Flexible biochemical sensors for point-of-care management of diseases: a review

Health problems have been widely concerned by all mankind. Real-time monitoring of disease-related biomarkers can feedback the physiological status of human body in time, which is very helpful to the diseases management of healthcare. However, conventional non-flexible/rigid biochemical sensors possess low fit and comfort with the human body, hence hindering the accurate and comfortable long-time health monitoring. Flexible and stretchable materials make it possible for sensors to be continuously attached to the human body with good fit, and more precise and higher quality results can be obtained. Thus, tremendous attention has been paid to flexible biochemical sensors in point-of-care (POC) for real-time monitoring the entire disease process. Here, recent progress on flexible biochemical sensors for management of various diseases, focusing on chronic and communicable diseases, is reviewed, and the detection principle and performance of these flexible biochemical sensors are discussed. Finally, some directions and challenges are proposed for further development of flexible biochemical sensors.

Simplifying the complex: accessible microfluidic solutions for contemporary processes within in vitro diagnostics

In vitro diagnostics (IVDs) form the cornerstone of modern medicine. They are routinely employed throughout the entire treatment pathway, from initial diagnosis through to prognosis, treatment planning, and post-treatment surveillance. Given the proven links between high quality diagnostic testing and overall health, ensuring broad access to IVDs has long been a focus of both researchers and medical professionals. Unfortunately, the current diagnostic paradigm relies heavily on centralized laboratories, complex and expensive equipment, and highly trained personnel. It is commonly assumed that this level of complexity is required to achieve the performance necessary for sensitive and specific disease diagnosis, and that making something affordable and accessible entails significant compromises in test performance. However, recent work in the field of microfluidics is challenging this notion. By exploiting the unique features of microfluidic systems, researchers have been able to create progressively simple devices that can perform increasingly complex diagnostic assays. This review details how microfluidic technologies are disrupting the status quo, and facilitating the development of simple, affordable, and accessible integrated IVDs. Importantly, we discuss the advantages and limitations of various approaches, and highlight the remaining challenges within the field.

γ-Irradiation crosslinking of graphene oxide/cellulose nanofiber/poly (acrylic acid) hydrogel as a urea sensing patch

Poly (acrylic acid) (PAA) nanocomposite hydrogel was fabricated as a sensing patch for non-invasive dual detection of urea in sweat. The hydrogel was prepared by γ-irradiation crosslinking of PAA solution incorporated with graphene oxide (GO) and cellulose nanofiber (CNF). With high water-sorption capacity and transparency, the hydrogel was suitable to accommodate coloring reagents and enzymes for colorimetric sensing of urea in sweat. The colorimetric sensor exhibited vivid color change towards the increase of urea concentration in a linear range of 40-80 mM covering a cut-off value (60 mM) for chronic kidney disease (CKD) indication. Furthermore, the hydrogel could be directly applied as a substrate for direct quantitation of urea in sweat by laser desorption ionization mass spectroscopy (LDI-MS). While CNF improved the mechanical properties of the hydrogel, GO played a key role in enhancing laser desorption ionization of urea in LDI-MS and increased the hydrogel functionalities. LDI-MS verified that GO/CNF/PAA hydrogel could act as a direct matrix for promoting urea ionization and these results corresponded well with the colorimetric sensor. Hence, this hydrogel patch might be a potential material to be applied in non-invasive and dual-detection of CKD in medical diagnosis.

End-to-end design of wearable sensors

Wearable devices provide an alternative pathway to clinical diagnostics by exploiting various physical, chemical and biological sensors to mine physiological (biophysical and/or biochemical) information in real time (preferably, continuously) and in a non-invasive or minimally invasive manner. These sensors can be worn in the form of glasses, jewellery, face masks, wristwatches, fitness bands, tattoo-like devices, bandages or other patches, and textiles. Wearables such as smartwatches have already proved their capability for the early detection and monitoring of the progression and treatment of various diseases, such as COVID-19 and Parkinson disease, through biophysical signals. Next-generation wearable sensors that enable the multimodal and/or multiplexed measurement of physical parameters and biochemical markers in real time and continuously could be a transformative technology for diagnostics, allowing for high-resolution and time-resolved historical recording of the health status of an individual. In this Review, we examine the building blocks of such wearable sensors, including the substrate materials, sensing mechanisms, power modules and decision-making units, by reflecting on the recent developments in the materials, engineering and data science of these components. Finally, we synthesize current trends in the field to provide predictions for the future trajectory of wearable sensors.

Advanced wearable biosensors for the detection of body fluids and exhaled breath by graphene

Given the huge economic burden caused by chronic and acute diseases on human beings, it is an urgent requirement of a cost-effective diagnosis and monitoring process to treat and cure the disease in their preliminary stage to avoid severe complications. Wearable biosensors have been developed by using numerous materials for non-invasive, wireless, and consistent human health monitoring. Graphene, a 2D nanomaterial, has received considerable attention for the development of wearable biosensors due to its outstanding physical, chemical, and structural properties. Moreover, the extremely flexible, foldable, and biocompatible nature of graphene provide a wide scope for developing wearable biosensor devices. Therefore, graphene and its derivatives could be trending materials to fabricate wearable biosensor devices for remote human health management in the near future. Various biofluids and exhaled breath contain many relevant biomarkers which can be exploited by wearable biosensors non-invasively to identify diseases. In this article, we have discussed various methodologies and strategies for synthesizing and pattering graphene. Furthermore, general sensing mechanism of biosensors, and graphene-based biosensing devices for tear, sweat, interstitial fluid (ISF), saliva, and exhaled breath have also been explored and discussed thoroughly. Finally, current challenges and future prospective of graphene-based wearable biosensors have been evaluated with conclusion. Graphene is a promising 2D material for the development of wearable sensors. Various biofluids (sweat, tears, saliva and ISF) and exhaled breath contains many relevant biomarkers which facilitate in identify diseases. Biosensor is made up of biological recognition element such as enzyme, antibody, nucleic acid, hormone, organelle, or complete cell and physical (transducer, amplifier), provide fast response without causing organ harm.

"Listen to Your Immune System When It's Calling for You": Monitoring Autoimmune Diseases Using the iShU App

The immune system plays a key role in protecting living beings against bacteria, viruses, and fungi, among other pathogens, which may be harmful and represent a threat to our own health. However, for reasons that are not fully understood, in some people this protective mechanism accidentally attacks the organs and tissues, thus causing inflammation and leads to the development of autoimmune diseases. Remote monitoring of human health involves the use of sensor network technology as a means of capturing patient data, and wearable devices, such as smartwatches, have lately been considered good collectors of biofeedback data, owing to their easy connectivity with a mHealth system. Moreover, the use of gamification may encourage the frequent usage of such devices and behavior changes to improve self-care for autoimmune diseases. This study reports on the use of wearable sensors for inflammation surveillance and autoimmune disease management based on a literature search and evaluation of an app prototype with fifteen stakeholders, in which eight participants were diagnosed with autoimmune or inflammatory diseases and four were healthcare professionals. Of these, six were experts in human–computer interaction to assess critical aspects of user experience. The developed prototype allows the monitoring of autoimmune diseases in pre-, during-, and post-inflammatory crises, meeting the personal needs of people with this health condition. The findings suggest that the proposed prototype—iShU—achieves its purpose and the overall experience may serve as a foundation for designing inflammation surveillance and autoimmune disease management monitoring solutions.

Excellent physicochemical and sensing characteristics of a Re x O y based pH sensor at low post-deposition annealing temperature

pH monitoring in clinical assessment is pivotal as pH imbalance significantly influences the physiological and extracellular functions of the human body. Metal oxide based pH sensors, a promising alternative to bulky pH electrodes, mostly require complex fabrication, high-temperature post-deposition treatment, and high expenses that inhibit their practical applicability. So, there is still room to develop a straightforward and cost-effective metal oxide based pH sensor comprising high sensitivity and reliability. In this report, a novel solution-processed and low-temperature annealed (220 °C) mixed-valence (vii/vi) oxide of rhenium (Re x O y ) was applied in an electrolyte-insulator-semiconductor (EIS) structure. The annealing effect on morphological, structural, and compositional properties was scrutinized by physical and chemical characterizations. The post-annealed Re x O y exhibited a high pH sensitivity (57.3 mV pH-1, R 2 = 0.99), a lower hysteresis (4.7 mV), and a reduced drift rate (1.7 mV h-1) compared to the as-prepared sample for an analytically acceptable pH range (2-12) along with good stability and reproducibility. The magnified sensing performance originated due to the valence state of Re from Re6+ to Re7+ attributed to each electron transfer for a single H+ ion. The device showed high selectivity for H+ ions, which was confirmed by the interference study with other relevant ions. The feasibility of the sensor was verified by measuring the device in real samples. Hence, the ease-of-fabrication and notable sensing performance of the proposed sensor endorsed its implementation for diagnosing pH-related diseases.

Hybrid Janus Membrane with Dual-Asymmetry Integration of Wettability and Conductivity for Ultra-Low-Volume Sweat Sensing

Highly sensitive and selective analysis of sweat at ultra-low sample volume remains a major challenge in the field of biosensing. Manipulation of small volumes of liquid for efficient sampling is essential to address this challenge. A hybrid Janus membrane with dual-asymmetry integration of wettability and conductivity is developed for regulated micro-volume liquid transport in wearable sweat biosensing. Unlike the uncontrollable liquid diffusion in a conventional porous membrane, the asymmetric wettability of porous Janus membrane leads to unique unidirectional liquid transport with high breakthrough pressure (1737.66 Pa) and fast self-pumping rate (35.94 μL/min) for micro-volume liquid sampling. The asymmetric conductive layer shows excellent flexible conductivity, anti-interference of friction, and efficient electrochemical interface due to the in situ generation of gold nanoparticles on one side of the membrane. The fabricated Pt-enzyme electrodes on the membrane promises effective testing range, great selectivity, and high sensitivity and accuracy (correlation efficiency, glucose: R² = 0.999, lactate: R² = 0.997), enabling ultra-low volume (∼0.15 μL) real time measurements on the skin surface. The innovative Janus membrane with unidirectional, self-pumping, and anti-interference performance provides a new strategy for miniaturized wearable microfluidic sweat electrochemical biosensor preparation in athletic performance evaluation, health monitoring, disease diagnosis, intelligent medicine, and so forth.

Skin Patchable Sensor Surveillance for Continuous Glucose Monitoring

Diabetes mellitus is a physiological and metabolic disorder affecting millions of people worldwide, associated with global morbidity, mortality, and financial expenses. Long-term complications can be avoided by frequent, continuous self-monitoring of blood glucose. Therefore, this review summarizes the current state-of-art glycemic control regimes involving measurement approaches and basic concepts. Following an introduction to the significance of continuous glucose sensing, we have tracked the evolution of glucose monitoring devices from minimally invasive to non-invasive methods to present an overview of the spectrum of continuous glucose monitoring (CGM) technologies. The conveniences, accuracy, and cost-effectiveness of the real-time CGM systems (rt-CGMs) are the factors considered for discussion. Transdermal biosensing and drug delivery routes have recently emerged as an innovative approach to substitute hypodermal needles. This work reviews skin-patchable glucose monitoring sensors for the first time, providing specifics of all the major findings in the past 6 years. Skin patch sensors and their progressive form, i.e., microneedle (MN) array sensory and delivery systems, are elaborated, covering self-powered, enzymatic, and non-enzymatic devices. The critical aspects reviewed are material design and assembly techniques focusing on flexibility, sensitivity, selectivity, biocompatibility, and user-end comfort. The review highlights the advantages of patchable MNs' multi-sensor technology designed to maintain precise blood glucose levels and administer diabetes drugs or insulin through a "sense and act" feedback loop. Subsequently, the limitations and potential challenges encountered from the MN array as rt-CGMs are listed. Furthermore, the current statuses of working prototype glucose-responsive "closed-loop" insulin delivery systems are discussed. Finally, the expected future developments and outlooks in clinical applications are discussed.

The Role of Soft Robotic Micromachines in the Future of Medical Devices and Personalized Medicine

Developments in medical device design result in advances in wearable technologies, minimally invasive surgical techniques, and patient-specific approaches to medicine. In this review, we analyze the trajectory of biomedical and engineering approaches to soft robotics for healthcare applications. We review current literature across spatial scales and biocompatibility, focusing on engineering done at the biotic-abiotic interface. From traditional techniques for robot design to advances in tunable material chemistry, we look broadly at the field for opportunities to advance healthcare solutions in the future. We present an extracellular matrix-based robotic actuator and propose how biomaterials and proteins may influence the future of medical device design.

Smart Materials Enabled with Artificial Intelligence for Healthcare Wearables

Contemporary medicine suffers from many shortcomings in terms of successful disease diagnosis and treatment, both of which rely on detection capacity and timing. The lack of effective, reliable, and affordable detection and real‐time monitoring limits the affordability of timely diagnosis and treatment. A new frontier that overcomes these challenges relies on smart health monitoring systems that combine wearable sensors and an analytical modulus. This review presents the latest advances in smart materials for the development of multifunctional wearable sensors while providing a bird's eye‐view of their characteristics, functions, and applications. The review also presents the state‐of‐the‐art on wearables fitted with artificial intelligence (AI) and support systems for clinical decision in early detection and accurate diagnosis of disorders. The ongoing challenges and future prospects for providing personal healthcare with AI‐assisted support systems relating to clinical decisions are presented and discussed.

Microfluidic devices based on textile threads for analytical applications: state of the art and prospects

Microfluidic devices based on textile threads have interesting advantages when compared to systems made with traditional materials, such as polymers and inorganic substrates (especially silicon and glass). One of these significant advantages is the device fabrication process, made more cheap and simple, with little or no microfabrication apparatus. This review describes the fundamentals, applications, challenges, and prospects of microfluidic devices fabricated with textile threads. A wide range of applications is discussed, integrated with several analysis methods, such as electrochemical, colorimetric, electrophoretic, chromatographic, and fluorescence. Additionally, the integration of these devices with different substrates (e.g., 3D printed components or fabrics), other devices (e.g., smartphones), and microelectronics is described. These combinations have allowed the construction of fully portable devices and consequently the development of point-of-care and wearable analytical systems.

Non-invasive wearable chemical sensors in real-life applications

Over the past decade, non-invasive wearable chemical sensors have gained tremendous attention in the field of personal health monitoring and medical diagnosis. These sensors provide non-invasive, real-time, and continuous monitoring of targeted biomarkers with more simplicity than the conventional diagnostic approaches. This review primarily describes the substrate materials used for sensor fabrication, sample collection and handling, and analytical detection techniques that are utilized to detect biomarkers in different biofluids. Common substrates including paper, textile, and hydrogel for wearable sensor fabrication are discussed. Principles and applications of colorimetric and electrochemical detection in wearable chemical sensors are illustrated. Data transmission systems enabling wireless communication between the sensor and output devices are also discussed. Finally, examples of different designs of wearable chemical sensors including tattoos, garments, and accessories are shown. Successful development of non-invasive wearable chemical sensors will effectively help users to manage their personal health, predict the potential diseases, and eventually improve the overall quality of life.

Trending Technology of Glucose Monitoring during COVID-19 Pandemic: Challenges in Personalized Healthcare

The COVID-19 pandemic has continued to spread rapidly, and patients with diabetes are at risk of experiencing rapid progression and poor prognosis for appropriate treatment. Continuous glucose monitoring (CGM), which includes accurately tracking fluctuations in glucose levels without raising the risk of coronavirus exposure, becomes an important strategy for the self-management of diabetes during this pandemic, efficiently contributing to the diabetes care and the fight against COVID-19. Despite being less accurate than direct blood glucose monitoring, wearable noninvasive systems can encourage patient adherence by guaranteeing reliable results through high correlation between blood glucose levels and glucose concentrations in various other biofluids. This review highlights the trending technologies of glucose sensors during the ongoing COVID-19 pandemic (2019-2020) that have been developed to make a significant contribution to effective management of diabetes and prevention of coronavirus spread, from off-body systems to wearable on-body CGM devices, including nanostructure and sensor performance in various biofluids. The advantages and disadvantages of various human biofluids for use in glucose sensors are also discussed. Furthermore, the challenges faced by wearable CGM sensors with respect to personalized healthcare during and after the pandemic are deliberated to emphasize the potential future directions of CGM devices for diabetes management.

Glucose determination behaviour of gold microspheres-electrodeposited carbon cloth flexible electrodes in neutral media

Despite numerous advances in the field of nonenzymatic glucose detection, monitoring glucose in physiological applications is still a challenge and is mostly limited to electrode surface modification. This study proposes a simple method for electrodepositing cotton-like gold microspheres (CGMs) on a carbon cloth (CC) flexible electrode, with the potential for the functional supporting substrate to monitor glucose in a neutral environment. It was demonstrated that the voltammetric response of glucose oxidation increased with increases in glucose concentration in the 3D functional flexible substrate; moreover, the amperometric response of glucose oxidation increased over time. The results indicate that the functional flexible electrode-made of gold microspheres-based carbon cloth with a predefined geometry and pore-architecture network to promote the medium-permeation and synergetic effects between CGMs and CC-can be a suitable platform for measuring glucose variation in environments with neutral pH. This is particularly relevant because the oxygen-containing functional groups on the CC surface increase the dehydrogenation rate of glucose oxidation in neutral phosphate-buffered saline.

3D printed smart silk wearable sensors

Wearable sensors play a key role in point-of-care testing (POCT) for their flexible and integration capability for sensitive physiological and biochemical sensing. Here, we present a multifunction wearable silk patch with both electronic channels and microchannels by utilizing matrix-assisted sacrificial 3D printing methods. Owing to the unique properties of a composite silk film (polyvinyl alcohol (PVA) and silk fibroin (SF)), the wearable sensors possess excellent tensile properties, self-healing ability and biocompatibility. Multi-layer channel (microfluidics and microcircuit)-integrated silk wearable sensors were then fabricated for simultaneous sensitive sensing of human cancer markers (carcinoembryonic antigen (CEA) and alpha-fetoprotein (AFP)) and motion monitoring. These features of the silk wearable sensors indicate their potential value for sensitive sensing, which will enable them to find broader applications in many fields in POCT, artificial skin and organ-on-a-chip systems.

Wearable Sweat Biosensors Refresh Personalized Health/Medical Diagnostics

Sweat contains a broad range of critical biomarkers including ions, small molecules, and macromolecules that may indirectly or directly reflect the health status of the human body and thereby help track disease progression. Wearable sweat biosensors enable the collection and analysis of sweat in situ, achieving real-time, continuous, and noninvasive monitoring of human biochemical parameters at the molecular level. This review summarizes the physiological/pathological information of sweat and wearable sweat biosensors. First, the production of sweat pertaining to various electrolytes, metabolites, and proteins is described. Then, the compositions of the wearable sweat biosensors are summarized, and the design of each subsystem is introduced in detail. The latest applications of wearable sweat biosensors for outdoor, hospital, and family monitoring are highlighted. Finally, the review provides a summary and an outlook on the future developments and challenges of wearable sweat biosensors with the aim of advancing the field of wearable sweat monitoring technology.

Advanced materials-integrated electrochemical sensors as promising medical diagnostics tools: A review

Electrochemical sensors have increasingly been linked with terms as modern biomedically effective highly selective and sensitive devices, wearable and wireless technology, portable electronics, smart textiles, energy storage, communication and user-friendly operating systems. The work brings the overview of the current advanced materials and their application strategies for improving performance, miniaturization and portability of sensing devices. It provides the extensive information on recently developed (bio)sensing platforms based on voltammetric, amperometric, potentiometric and impedimetric detection modes including portable, non-invasive, wireless, and self-driven miniaturized devices for monitoring human and animal health. Diagnostics of selected free radical precursors, low molecular biomarkers, nucleic acids and protein-based biomarkers, bacteria and viruses of today's interest is demonstrated.

Applying Nanomaterials to Modern Biomedical Electrochemical Detection of Metabolites, Electrolytes, and Pathogens

Personal biosensors and bioelectronics have been demonstrated for use in out-of-clinic biomedical devices. Such modern devices have the potential to transform traditional clinical analysis into a new approach, allowing patients or users to screen their own health or warning of diseases. Researchers aim to explore the opportunities of easy-to-wear and easy-to-carry sensors that would empower users to detect biomarkers, electrolytes, or pathogens at home in a rapid and easy way. This mobility would open the door for early diagnosis and personalized healthcare management to a wide audience. In this review, we focus on the recent progress made in modern electrochemical sensors, which holds promising potential to support point-of-care technologies. Key original research articles covered in this review are mainly experimental reports published from 2018 to 2020. Strategies for the detection of metabolites, ions, and viruses are updated in this article. The relevant challenges and opportunities of applying nanomaterials to support the fabrication of new electrochemical biosensors are also discussed. Finally, perspectives regarding potential benefits and current challenges of the technology are included. The growing area of personal biosensors is expected to push their application closer to a new phase of biomedical advancement.