Medium-distance affordable, flexible and wireless epidermal sensor for pH monitoring in sweat

Paper-Based Electrochemical (Bio)Sensors for the Detection of Target Analytes in Liquid, Aerosol, and Solid Samples

The last decade has been incredibly fruitful in proving the multifunctionality of paper for delivering innovative electrochemical (bio)sensors. The paper material exhibits unprecedented versatility to deal with complex liquid matrices and facilitate analytical detection in aerosol and solid phases. Such remarkable capabilities are feasible by exploiting the intrinsic features of paper, including porosity, capillary forces, and its easy modification, which allow for the fine designing of a paper device. In this review, we shed light on the most relevant paper-based electrochemical (bio)sensors published in the literature so far to identify the smart functional roles that paper can play to bridge the gap between academic research and real-world applications in the biomedical, environmental, agrifood, and security fields. Our analysis aims to highlight how paper's multifarious properties can be artfully harnessed for breaking the boundaries of the most classical applications of electrochemical (bio)sensors.

Long-term stable pH sensor array with synergistic bilayer structure for 2D real-time mapping in cell culture monitoring

Pursuing accurate, swift, and durable pH sensors is important across numerous fields, encompassing healthcare, environmental surveillance, and agriculture. In particular, the emphasis on real-time pH monitoring during cell cultivation has become increasingly pronounced in the current scientific environment-a crucial element being diligently researched to ensure optimal cell production. Both polyaniline (PANi) and iridium oxide (IrOx) show their worth in pH sensing, yet they come with challenges. Single-PANi-layered pH sensors often grapple with diminished sensitivity and lagging responses, while electrodeposited IrOx structures exhibit poor adhesion, leading to their separation from metallic substrates-a trait undesirable for a consistently stable, long-term pH sensor. This paper introduces a bi-layered PANi-IrOx pH sensor, strategically leveraging the advantages of both materials. The results presented here underscore the sensitivity enhancement of binary-phased framework, faster response time, and more robust structure than prior work. Through this synergistic strategy, we demonstrate the potential of integrating different phases to overcome the inherent constraints of individual materials, setting the stage for advanced pH-sensing solutions.

Functionalized orthopaedic implant as pH electrochemical sensing tool for smart diagnosis of hardware infection

In the orthopaedic surgery field, the use of medical implants to treat a patient's bone fracture is nowadays a common practice, nevertheless, it is associated with possible cases of infection. The consequent hardware infection can lead to implant failure and systemic infections, with prolonged hospitalization, time-consuming rehabilitation treatments, and extended antibiotic therapy. Hardware infections are strictly related to bacterial adhesion to the implant, leading to infection occurrence and consequent pH decreasing from physiological level to acid pH. Here, we demonstrate the new strategy to use an orthopaedic implant functionalized with iridium oxide film as the working electrode for the potentiometric monitoring of pH in hardware infection diagnosis. A functional investigation was focused on selecting the implant material, namely titanium, titanium alloy, and stainless steel, and the component, namely screws and implants. After selecting the titanium-based implant as the working electrode and a silver wire as the reference electrode in the final configuration of the smart sensing orthopaedic implant, a calibration curve was performed in standard solutions. An equation equal to y = (0.76 ± 0.02) - (0.068 ± 0.002) x, R2 = 0.996, was obtained in the pH range of 4-8. Subsequently, hysteresis, interference, matrix effect, recovery study, and storage stability were investigated to test the overall performance of the sensing device, demonstrating the tremendous potential of electrochemical sensors to deliver the next generation of smart orthopaedic implants.

A paper-based dual functional biosensor for safe and user-friendly point-of-care urine analysis

Safe, accurate, and reliable analysis of urinary biomarkers is clinically important for early detection and monitoring of the progression of chronic kidney disease (CKD), as it has become one of the world's most prevalent non-communicable diseases. However, current technologies for measuring urinary biomarkers are either time-consuming and limited to well-equipped hospitals or lack the necessary sensitivity for quantitative analysis and post a health risk to frontline practitioners. Here we report a robust paper-based dual functional biosensor, which is integrated with the clinical urine sampling vial, for the simultaneous and quantitative analysis of pH and glucose in urine. The pH sensor was fabricated by electrochemically depositing IrOx onto a paper substrate using optimised parameters, which enabled an ultrahigh sensitivity of 71.58 mV pH-1. Glucose oxidase (GOx) was used in combination with an electrochemically deposited Prussian blue layer for the detection of glucose, and its performance was enhanced by gold nanoparticles (AuNPs), chitosan, and graphite composites, achieving a sensitivity of 1.5 μA mM-1. This dual function biosensor was validated using clinical urine samples, where a correlation coefficient of 0.96 for pH and 0.98 for glucose detection was achieved with commercial methods as references. More importantly, the urine sampling vial was kept sealed throughout the sample-to-result process, which minimised the health risk to frontline practitioners and simplified the diagnostic procedures. This diagnostic platform, therefore, holds high promise as a rapid, accurate, safe, and user-friendly point-of-care (POC) technology for the analysis of urinary biomarkers in frontline clinical settings.

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.

A high-performance, all-solid-state Na+ selective sensor printed with eco-friendly conductive ink

In recent years, the integration of flexible printed electronics and electrochemical sensors has emerged as a new approach for developing wearable biochemical detecting devices. Among the materials utilized in flexible printed electronics, carbon-based conductive inks are considered to be crucial. In this study, we propose a cost-effective, highly conductive, and environmentally friendly ink formulation utilizing graphite and carbon black (CB) as conductive fillers, resulting in a very low sheet resistance of 15.99 Ω sq^-1 (conductivity of 2.5 × 10³ S m^-1) and a printed film thickness of 25 μm. The unique "sandwich" structure of the working electrode (WE) printed with this ink enhances its electrical conductivity, leading to high sensitivity, selectivity, and stability, with almost no water film generated between the WE and the ion-selective membrane (ISM), strong ion selectivity, long-term stability, and anti-interference. The lower detection limit of the sensor for Na⁺ is 0.16 mM with a slope of 75.72 mV per decade. To validate the sensor's usability, we analyzed three sweat samples collected during physical activity, with Na⁺ concentrations within the typical range for human sweat (51 ± 4 mM, 39 ± 5 mM, and 46 ± 2 mM).

Paper card-like electrochemical platform as a smart point-of-care device for reagent-free glucose measurement in tears

This communication describes the development of polyvinyl chloride electrochemical system in which a paper layer loaded with reagents is inserted into the device, demonstrating a new concept of a paper card-like pad for a reagent-free and easy measurement of the target analyte in solution. This device detects glucose in artificial tears in the range of 0.2-2 mM with a detection limit of 50 μM by simply adding the artificial tears to the paper card-like pad. The novel configuration goes beyond the state of the art, widening the application range of paper in the design of smart analytical devices.

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.

Electrochemical-based remote biomarker monitoring: Toward Internet of Wearable Things in telemedicine

Internet of Wearable Things (IoWT) will be a major breakthrough for remote medical monitoring. In this scenario, wearable biomarker sensors have been developing not only to diagnose point-of-care (POC) of diseases, but also to continuously manage them. On-body tracking of biomarkers in biofluids is regarded as a proper substitution of conventional biomarker sensors for dynamic sampling and analyzing due to their high sensitivity, conformability, and affordability, creating ever-rising the market demand for them. In a wireless body area network (WBAN), data is captured from all sensors on the body to a smartphone/laptop, and sent the sensed data to a cloud for storing, processing, and retrieving, and ultimately displayed the data on custom applications (Apps). Wearable IoT biomarker sensors are used for early diseases diagnosis and continuous monitoring in developing countries in which people hardly access to healthcare systems. In this review, we aim to highlight a wide range of wearable electrochemical biomarker sensors, accompanied by microfluidics for continuous sampling, which will pave the way toward developing wearable IoT biomarker sensors to track health status. The current challenges and future perspective in skin-conformal biomarker sensors will be discussing their potential applicability for IoWT in cloud-based telemedicine.

Privacy-Aware Architectures for NFC and RFID Sensors in Healthcare Applications

World population and life expectancy have increased steadily in recent years, raising issues regarding access to medical treatments and related expenses. Through last-generation medical sensors, NFC (Near Field Communication) and radio frequency identification (RFID) technologies can enable healthcare internet of things (H-IoT) systems to improve the quality of care while reducing costs. Moreover, the adoption of point-of-care (PoC) testing, performed whenever care is needed to return prompt feedback to the patient, can generate great synergy with NFC/RFID H-IoT systems. However, medical data are extremely sensitive and require careful management and storage to protect patients from malicious actors, so secure system architectures must be conceived for real scenarios. Existing studies do not analyze the security of raw data from the radiofrequency link to cloud-based sharing. Therefore, two novel cloud-based system architectures for data collected from NFC/RFID medical sensors are proposed in this paper. Privacy during data collection is ensured using a set of classical countermeasures selected based on the scientific literature. Then, data can be shared with the medical team using one of two architectures: in the first one, the medical system manages all data accesses, whereas in the second one, the patient defines the access policies. Comprehensive analysis of the H-IoT system can be useful for fostering research on the security of wearable wireless sensors. Moreover, the proposed architectures can be implemented for deploying and testing NFC/RFID-based healthcare applications, such as, for instance, domestic PoCs.

Surface Wrinkling for Flexible and Stretchable Sensors

Recent advances in nanolithography, miniaturization, and material science, along with developments in wearable electronics, are pushing the frontiers of sensor technology into the large-scale fabrication of highly sensitive, flexible, stretchable, and multimodal detection systems. Various strategies, including surface engineering, have been developed to control the electrical and mechanical characteristics of sensors. In particular, surface wrinkling provides an effective alternative for improving both the sensing performance and mechanical deformability of flexible and stretchable sensors by releasing interfacial stress, preventing electrical failure, and enlarging surface areas. In this study, recent developments in the fabrication strategies of wrinkling structures for sensor applications are discussed. The fundamental mechanics, geometry control strategies, and various fabricating methods for wrinkling patterns are summarized. Furthermore, the current state of wrinkling approaches and their impacts on the development of various types of sensors, including strain, pressure, temperature, chemical, photodetectors, and multimodal sensors, are reviewed. Finally, existing wrinkling approaches, designs, and sensing strategies are extrapolated into future applications.

Sweat analysis with a wearable sensing platform based on laser-induced graphene

The scientific community has shown increasing interest in laser scribing for the direct fabrication of conductive graphene-based tracks on different substrates. This can enable novel routes for the noninvasive analysis of biofluids (such as sweat or other noninvasive matrices), whose results can provide the rapid evaluation of a person's health status. Here, we present a wearable sensing platform based on laser induced graphene (LIG) porous electrodes scribed on a flexible polyimide sheet, which samples sweat through a paper sampler. The device is fully laser manufactured and features a two layer design with LIG-based vertical interconnect accesses. A detailed characterization of the LIG electrodes including pore size, surface groups, surface area in comparison to electroactive surface area, and the reduction behavior of different LIG types was performed. The bare LIG electrodes can detect the electrochemical oxidation of both uric acid and tyrosine. Further modification of the surface of the LIG working electrode with an indoaniline derivative [4-((4-aminophenyl)imino)-2,6-dimethoxycyclohexa-2,5-dien-1-one] enables the voltammetric measurement of pH with an almost ideal sensitivity and without interference from other analytes. Finally, electrochemical impedance spectroscopy was used to measure the concentrations of ions through the analysis of the sweat impedance. The device was successfully tested in a real case scenario, worn on the skin during a sports session. In vitro tests proved the non-cytotoxic effect of the device on the A549 cell line.

ZnO and AZO Film Potentiometric pH Sensors Based on Flexible Printed Circuit Board

In this study, we deposited zinc oxide (ZnO) and aluminum-doped zinc oxide (AZO) on the electroless nickel immersion gold (ENIG) of a flexible printed circuit board (FPCB) as a potentiometric pH sensor. The sensing films of the pH sensor were fabricated by a radio frequency (RF) sputtering system and analyzed by field emission scanning electron microscope (FE-SEM) and X-ray photoelectron spectroscopy (XPS). In the pH 2 to 10 buffer solutions, it was observed that the characteristics of the pH sensor through the voltage–time (V-T) measurement system include average sensitivity and linearity, drift effect, and repeatability. According to the experimental results, the pH sensors in this study could exhibit good characteristics.

Laser-Induced Graphene-Based Wearable Epidermal Ion-Selective Sensors for Noninvasive Multiplexed Sweat Analysis

Wearable sweat sensors are a rapidly rising research area owing to their convenience for personal healthcare and disease diagnosis in a real-time and noninvasive manner. However, the fast and scalable fabrication of flexible electrodes remains a major challenge. Here, we develop a wearable epidermal sensor for multiplexed sweat analysis based on the laser-induced graphene (LIG) technique. This simple and mask-free technique allows the direct manufacturing of graphene electrode patterns on commercial polyimide foils. The resulting LIG devices can simultaneously monitor the pH, Na⁺, and K⁺ levels in sweat with the sensitivities of 51.5 mV/decade (pH), 45.4 mV/decade (Na⁺), and 43.3 mV/decade (K⁺), respectively. Good reproducibility, stability, and selectivity are also observed. On-body testing of the LIG-based sensor integrated with a flexible printed circuit board during stationary cycling demonstrates its capability for real-time sweat analysis. The concentrations of ions can be remotely and wirelessly transmitted to a custom-developed smartphone application during the period in which the sensor user performs physical activities. Owing to the unique advantages of LIG technique, including facile fabrication, mass production, and versatile, more physiological signals (glucose, uric acid, tyrosine, etc.) could be easily expanded into the LIG-based wearable sensors to reflect the health status or clinical needs of individuals.

Wearable Ball-Impact Piezoelectric Multi-Converters for Low-Frequency Energy Harvesting from Human Motion

Multi-converter piezoelectric harvesters based on mono-axial and bi-axial configurations are proposed. The harvesters exploit two and four piezoelectric converters (PCs) and adopt an impinging spherical steel ball to harvest electrical energy from human motion. When the harvester undergoes a shake, a tilt, or a combination of the two, the ball hits one PC, inducing an impact-based frequency-up conversion. Prototypes of the harvesters have been designed, fabricated, fastened to the wrist of a person by means of a wristband and watchband, and experimentally tested for different motion levels. The PCs of the harvesters have been fed to passive diode-based voltage-doubler rectifiers connected in parallel to a storage capacitor, C_s = 220 nF. By employing the mono-axial harvester, after 8.5 s of consecutive impacts induced by rotations of the wrist, a voltage v_cs(t) of 40.2 V across the capacitor was obtained, which corresponded to a stored energy of 178 μJ. By employing the bi-axial harvester, the peak instantaneous power provided by the PCs to an optimal resistive load was 1.58 mW, with an average power of 9.65 μW over 0.7 s. The proposed harvesters are suitable to scavenge electrical energy from low-frequency nonperiodical mechanical movements, such as human motion.

Smartphone-assisted electrochemical sensor for reliable detection of tyrosine in serum

Point-of-care devices have attracted a huge interest by the scientific community because of the valuable potentiality for rapid diagnosis and precision medicine through cost-effective and easy-to-use devices for on-site measurement by unskilled personnel. Herein, we reported a smartphone-assisted electrochemical device consisted of a screen-printed electrode modified with carbon black nanomaterial and a commercially available smartphone potentiostat i.e. EmStat3 Blue, for sensitive detection of tyrosine. Once optimized the conditions, tyrosine was detected in standard solutions by square wave voltammetry, achieving a linear range comprised between 30 and 500 μM, with a detection limit equal to 4.4 μM. To detect tyrosine in serum, the interference of another amino acid i.e. tryptophan was hindered using a sample treatment with an extraction cartridge. The agreement of results analyzing serum samples with HPLC reference method and with the developed smart sensing system demonstrated the suitability of this smartphone-assisted sensing tool for cost-effective and rapid analyses of tyrosine in serum samples.

Iridium Oxide Enabled Sensors Applications

There have been numerous studies applying iridium oxides in different applications to explore their proton-change-based reactions since the 1980s. Iridium oxide can be fabricated directly by applying electrodeposition, sputter-coating method, or oxidation of iridium wire. Generally, there have been currently two approaches in applying iridium oxide to enable its sensing applications. One was to improve or create different electrolytes with (non-)electrodeposition method for better performance of Nernst Constant with the temperature-related system. The mechanism behind the scenes were summarized herein. The other was to change the structure of iridium oxide through different kinds of templates such as photolithography patterns, or template-assisted direct growth methods, etc. to improve the sensing performance. The detection targets varied widely from intracellular cell pH, glucose in an artificial sample or actual urine sample, and the hydrogen peroxide, glutamate or organophosphate pesticides, metal-ions, etc. This review paper has focused on the mechanism of electrodeposition of iridium oxide in aqueous conditions and the sensing applications towards different biomolecules compounds. Finally, we summarize future trends on Iridium oxide based sensing and predict future work that could be further explored.

Energy Autonomous Sweat-Based Wearable Systems

The continuous operation of wearable electronics demands reliable sources of energy, currently met through Li-ion batteries and various energy harvesters. These solutions are being used out of necessity despite potential safety issues and unsustainable environmental impact. Safe and sustainable energy sources can boost the use of wearables systems in diverse applications such as health monitoring, prosthetics, and sports. In this regard, sweat- and sweat-equivalent-based studies have attracted tremendous attention through the demonstration of energy-generating biofuel cells, promising power densities as high as 3.5 mW cm-2 , storage using sweat-electrolyte-based supercapacitors with energy and power densities of 1.36 Wh kg-1 and 329.70 W kg-1 , respectively, and sweat-activated batteries with an impressive energy density of 67 Ah kg-1 . A combination of these energy generating, and storage devices can lead to fully energy-autonomous wearables capable of providing sustainable power in the µW to mW range, which is sufficient to operate both sensing and communication devices. Here, a comprehensive review covering these advances, addressing future challenges and potential solutions related to fully energy-autonomous wearables is presented, with emphasis on sweat-based energy storage and energy generation elements along with sweat-based sensors as applications.

PANI-Based Wearable Electrochemical Sensor for pH Sweat Monitoring

Nowadays, we are assisting in the exceptional growth in research relating to the development of wearable devices for sweat analysis. Sweat is a biofluid that contains useful health information and allows a non-invasive, continuous and comfortable collection. For this reason, it is an excellent biofluid for the detection of different analytes. In this work, electrochemical sensors based on polyaniline thin films deposited on the flexible substrate polyethylene terephthalate coated with indium tin oxide were studied. Polyaniline thin films were abstained by the potentiostatic deposition technique, applying a potential of +2 V vs. SCE for 90 s. To improve the sensor performance, the electronic substrate was modified with reduced graphene oxide, obtained at a constant potential of −0.8 V vs. SCE for 200 s, and then polyaniline thin films were electrodeposited on top of the as-deposited substrate. All samples were characterized by XRD, SEM, EDS, static contact angle and FT-IR/ATR analysis to correlate the physical-chemical features with the performance of the sensors. The obtained electrodes were tested as pH sensors in the range from 2 to 8, showing good behavior, with a sensitivity of 62.3 mV/pH, very close to a Nernstian response, and a reproducibility of 3.8%. Interference tests, in the presence of competing ions, aimed to verify the selectivity, were also performed. Finally, a real sweat sample was collected, and the sweat pH was quantified with both the proposed sensor and a commercial pH meter, showing an excellent concordance.

Advanced Wound Dressing for Real-Time pH Monitoring

The rapid evolution of wearable technologies is giving rise to a strong push for textile chemical sensors design targeting the real-time collection of vital parameters for improved healthcare. Among the most promising applications, monitoring of nonhealing wounds is a scarcely explored medical field that still lacks quantitative tools for the management of the healing process. In this work, a smart bandage is developed for the real-time monitoring of wound pH, which has been reported to correlate with the healing stages, thus potentially giving direct access to the wound status without disturbing the wound bed. The fully textile device is realized by integrating a sensing layer, including the two-terminal pH sensor made of a semiconducting polymer and iridium oxide particles, and an absorbent layer ensuring the delivery of a continuous wound exudate flow across the sensor area. The two-terminal sensor exhibits a reversible response with a sensitivity of (59 ± 4) μA pH-1 in the medically relevant pH range for wound monitoring (pH 6-9), and its performance is not substantially affected either by the presence of the most common chemical interferents or by temperature gradients from 22 to 40 °C. Thanks to the robust sensing mechanism based on potentiometric transduction and the simple device geometry, the fully assembled smart bandage was successfully validated in flow analysis using synthetic wound exudate.

Wireless and battery-free platforms for collection of biosignals

Recent progress in biosensors have quantitively expanded current capabilities in exploratory research tools, diagnostics and therapeutics. This rapid pace in sensor development has been accentuated by vast improvements in data analysis methods in the form of machine learning and artificial intelligence that, together, promise fantastic opportunities in chronic sensing of biosignals to enable preventative screening, automated diagnosis, and tools for personalized treatment strategies. At the same time, the importance of widely accessible personal monitoring has become evident by recent events such as the COVID-19 pandemic. Progress in fully integrated and chronic sensing solutions is therefore increasingly important. Chronic operation, however, is not truly possible with tethered approaches or bulky, battery-powered systems that require frequent user interaction. A solution for this integration challenge is offered by wireless and battery-free platforms that enable continuous collection of biosignals. This review summarizes current approaches to realize such device architectures and discusses their building blocks. Specifically, power supplies, wireless communication methods and compatible sensing modalities in the context of most prevalent implementations in target organ systems. Additionally, we highlight examples of current embodiments that quantitively expand sensing capabilities because of their use of wireless and battery-free architectures.

A Versatile Aggregation-induced Emission Fluorescent Probe for Visible Detection of pH

By tactfully structuring a luminescent molecule as an accurate pH probe with aggregation-induced emission (AIE) feature, it is significant to overcome aggregation-caused quenching of emitted light in practice. Herein, we present a simple AIE-active fluorescence probe for pH detection on the basis of intramolecular charge transfer (ICT) with wide response range and high sensitivity reaction. The donor-acceptor-donor (D-A-D) style probe utilized a conjugated structural hybrid of the electron-withdrawing nitrile group and electron-donating hydroxyl as well as dimethylamino groups for fluorescent platform. The AIE-active probe possesses good fluorescence under water fraction up to 90% in mixed MeOH/water system. Furthermore, it can be used in profiling and visualization of pH detection in MeOH/water system at f_w = 90% under UV 365 nm lamp. What's more, the probe can be employed to be a broad range test paper of pH detection, paving the way for low-cost practical applications.