Body-Interfaced Chemical Sensors for Noninvasive Monitoring and Analysis of Biofluids

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.

Wearing the Lab: Advances and Challenges in Skin-Interfaced Systems for Continuous Biochemical Sensing

Continuous, on-demand, and, most importantly, contextual data regarding individual biomarker concentrations exemplify the holy grail for personalized health and performance monitoring. This is well-illustrated for continuous glucose monitoring, which has drastically improved outcomes and quality of life for diabetic patients over the past 2 decades. Recent advances in wearable biosensing technologies (biorecognition elements, transduction mechanisms, materials, and integration schemes) have begun to make monitoring of other clinically relevant analytes a reality via minimally invasive skin-interfaced devices. However, several challenges concerning sensitivity, specificity, calibration, sensor longevity, and overall device lifetime must be addressed before these systems can be made commercially viable. In this chapter, a logical framework for developing a wearable skin-interfaced device for a desired application is proposed with careful consideration of the feasibility of monitoring certain analytes in sweat and interstitial fluid and the current development of the tools available to do so. Specifically, we focus on recent advancements in the engineering of biorecognition elements, the development of more robust signal transduction mechanisms, and novel integration schemes that allow for continuous quantitative analysis. Furthermore, we highlight the most compelling and promising prospects in the field of wearable biosensing and the challenges that remain in translating these technologies into useful products for disease management and for optimizing human performance.

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.

Bioadhesive Technology Platforms

Bioadhesives have emerged as transformative and versatile tools in healthcare, offering the ability to attach tissues with ease and minimal damage. These materials present numerous opportunities for tissue repair and biomedical device integration, creating a broad landscape of applications that have captivated clinical and scientific interest alike. However, fully unlocking their potential requires multifaceted design strategies involving optimal adhesion, suitable biological interactions, and efficient signal communication. In this Review, we delve into these pivotal aspects of bioadhesive design, highlight the latest advances in their biomedical applications, and identify potential opportunities that lie ahead for bioadhesives as multifunctional technology platforms.

Wearable Sensor Patch with Hydrogel Microneedles for In Situ Analysis of Interstitial Fluid

Continuous real-time monitoring of biomarkers in interstitial fluid is essential for tracking metabolic changes and facilitating the early detection and management of chronic diseases such as diabetes. However, developing minimally invasive sensors for the in situ analysis of interstitial fluid and addressing signal delays remain a challenge. Here, we introduce a wearable sensor patch incorporating hydrogel microneedles for rapid, minimally invasive collection of interstitial fluid from the skin while simultaneously measuring biomarker levels in situ. The sensor patch is stretchable to accommodate the swelling of the hydrogel microneedles upon extracting interstitial fluid and adapts to skin deformation during measurements, ensuring consistent sensing performance in detecting model biomarker concentrations, such as glucose and lactate, in a mouse model. The sensor patch exhibits in vitro sensitivities of 0.024 ± 0.002 μA mM-1 for glucose and 0.0030 ± 0.0004 μA mM-1 for lactate, with corresponding linear ranges of 0.1-3 and 0.1-12 mM, respectively. For in vivo glucose sensing, the sensor patch demonstrates a sensitivity of 0.020 ± 0.001 μA mM-1 and a detection range of 1-8 mM. By integrating a predictive model, the sensor patch can analyze and compensate for signal delays, improving calibration reliability and providing guidance for potential optimization in sensing performance. The sensor patch is expected to serve as a minimally invasive platform for the in situ analysis of multiple biomarkers in interstitial fluid, offering a promising solution for continuous health monitoring and disease management.

Mobile sensing to advance tumor modeling in cancer patients: A conceptual framework

As mobile and wearable devices continue to grow in popularity, there is strong yet unrealized potential to harness people's mobile sensing data to improve our understanding of their cellular and biologically-based diseases. Breakthrough technical innovations in tumor modeling, such as the three dimensional tumor microenvironment system (TMES), allow researchers to study the behavior of tumor cells in a controlled environment that closely mimics the human body. Although patients' health behaviors are known to impact their tumor growth through circulating hormones (cortisol, melatonin), capturing this process is a challenge to rendering realistic tumor models in the TMES or similar tumor modeling systems. The goal of this paper is to propose a conceptual framework that unifies researchers from digital health, data science, oncology, and cellular signaling, in a common cause to improve cancer patients' treatment outcomes through mobile sensing. In support of our framework, existing studies indicate that it is feasible to use people's mobile sensing data to approximate their underlying hormone levels. Further, it was found that when cortisol is cycled through the TMES based on actual patients' cortisol levels, there is a significant increase in pancreatic tumor cell growth compared to when cortisol levels are at normal healthy levels. Taken together, findings from these studies indicate that continuous monitoring of people's hormone levels through mobile sensing may improve experimentation in the TMES, by informing how hormones should be introduced. We hope our framework inspires digital health researchers in the psychosocial sciences to consider how their expertise can be applied to advancing outcomes across levels of inquiry, from behavioral to cellular.

Application of Intelligent Medical Sensing Technology

With the popularization of intelligent sensing and the improvement of modern medical technology, intelligent medical sensing technology has emerged as the times require. This technology combines basic disciplines such as physics, mathematics, and materials with modern technologies such as semiconductors, integrated circuits, and artificial intelligence, and has become one of the most promising in the medical field. The core of intelligent medical sensor technology is to make existing medical sensors intelligent, portable, and wearable with full consideration of ergonomics and sensor power consumption issues in order to conform to the current trends in cloud medicine, personalized medicine, and health monitoring. With the development of automation and intelligence in measurement and control systems, it is required that sensors have high accuracy, reliability, and stability, as well as certain data processing capabilities, self-checking, self-calibration, and self-compensation, while traditional medical sensors cannot meet such requirements. In addition, to manufacture high-performance sensors, it is also difficult to improve the material process alone, and it is necessary to combine computer technology with sensor technology to make up for its performance shortcomings. Intelligent medical sensing technology combines medical sensors with microprocessors to produce powerful intelligent medical sensors. Based on the original sensor functions, intelligent medical sensors also have functions such as self-compensation, self-calibration, self-diagnosis, numerical processing, two-way communication, information storage, and digital output. This review focuses on the application of intelligent medical sensing technology in biomedical sensing detection from three aspects: physical sensor, chemical sensor, and biosensor.

A flexible optoacoustic blood 'stethoscope' for noninvasive multiparametric cardiovascular monitoring

Quantitative and multiparametric blood analysis is of great clinical importance in cardiovascular disease diagnosis. Although there are various methods to extract blood information, they often require invasive procedures, lack continuity, involve bulky instruments, or have complicated testing procedures. Flexible sensors can realize on-skin assessment of several vital signals, but generally exhibit limited function to monitor blood characteristics. Here, we report a flexible optoacoustic blood 'stethoscope' for noninvasive, multiparametric, and continuous cardiovascular monitoring, without requiring complicated procedures. The optoacoustic blood 'stethoscope' features the light delivery elements to illuminate blood and the piezoelectric acoustic elements to capture light-induced acoustic waves. We show that the optoacoustic blood 'stethoscope' can adhere to the skin for continuous and non-invasive in-situ monitoring of multiple cardiovascular biomarkers, including hypoxia, intravascular exogenous agent concentration decay, and hemodynamics, which can be further visualized with a tailored 3D algorithm. Demonstrations on both in-vivo animal trials and human subjects highlight the optoacoustic blood 'stethoscope''s potential for cardiovascular disease diagnosis and prediction.

Epidermal Wearable Biosensors for the Continuous Monitoring of Biomarkers of Chronic Disease in Interstitial Fluid

Healthcare technology has allowed individuals to monitor and track various physiological and biological parameters. With the growing trend of the use of the internet of things and big data, wearable biosensors have shown great potential in gaining access to the human body, and providing additional functionality to analyze physiological and biochemical information, which has led to a better personalized and more efficient healthcare. In this review, we summarize the biomarkers in interstitial fluid, introduce and explain the extraction methods for interstitial fluid, and discuss the application of epidermal wearable biosensors for the continuous monitoring of markers in clinical biology. In addition, the current needs, development prospects and challenges are briefly discussed.

Wearable Microfluidics for Continuous Assay

The development of wearable devices provides approaches for the realization of self-health care. Easily carried wearable devices allow individual health monitoring at any place whenever necessary. There are various interesting monitoring targets, including body motion, organ pressure, and biomarkers. An efficient use of space in one small device is a promising resolution to increase the functions of wearable devices. Through integration of a microfluidic system into wearable devices, embedding complicated structures in one design becomes possible and can enable multifunction analyses within a limited device volume. This article reviews the reported microfluidic wearable devices, introduces applications to different biofluids, discusses characteristics of the design strategies and sensing principles, and highlights the attractive configurations of each device. This review seeks to provide a detailed summary of recent advanced microfluidic wearable devices. The overview of advanced key components is the basis for the development of future microfluidic wearable devices.

Flexible and Wearable Biosensors for Monitoring Health Conditions

Flexible and wearable biosensors have received tremendous attention over the past decade owing to their great potential applications in the field of health and medicine. Wearable biosensors serve as an ideal platform for real-time and continuous health monitoring, which exhibit unique properties such as self-powered, lightweight, low cost, high flexibility, detection convenience, and great conformability. This review introduces the recent research progress in wearable biosensors. First of all, the biological fluids often detected by wearable biosensors are proposed. Then, the existing micro-nanofabrication technologies and basic characteristics of wearable biosensors are summarized. Then, their application manners and information processing are also highlighted in the paper. Massive cutting-edge research examples are introduced such as wearable physiological pressure sensors, wearable sweat sensors, and wearable self-powered biosensors. As a significant content, the detection mechanism of these sensors was detailed with examples to help readers understand this area. Finally, the current challenges and future perspectives are proposed to push this research area forward and expand practical applications in the future.

Universal Fully Integrated Wearable Sensor Arrays for the Multiple Electrolyte and Metabolite Monitoring in Raw Sweat, Saliva, or Urine

Fully integrated wearable sensors are capable of dynamically, directly, and independently tracking biomarkers in raw noninvasive biofluids without any other equipment or accessories by integrating the unique on-body monitoring feature with the special complete functional implementation attribute. Sweat, saliva, and urine are three important noninvasive biofluids, and changes in their biomarkers hold great potential for revealing physiological conditions. However, it is still a challenge to design single fully integrated wearable sensor arrays (FIWSAs) that are universally able to concurrently measure electrolytes and metabolites in three of the most common noninvasive biofluids including sweat, saliva, and urine. Here, we propose the first single universal FIWSAs for wirelessly, noninvasively, and simultaneously measuring various metabolites (i.e., uric acid) and electrolytes (i.e., Na⁺ and H⁺) in raw sweat, saliva, or urine under subjects' exercise by integrating the specifically designed microfluidic, sensing, and electronic modules in a seamless manner. We evaluate its utility for noninvasive gout management in healthy subjects and in gout patients through a purine-rich meal challenge and with a medicine-treatment control, respectively. Noninvasive monitoring of multiple electrolytes and metabolites in a variety of raw noninvasive biofluids via such single universal FIWSAs may enrich the understanding of the biomarkers' levels in the body and would also facilitate self-health management.

Fluorescent Probes as a Tool in Diagnostic and Drug Delivery Systems

Over the last few years, the development of fluorescent probes has received considerable attention. Fluorescence signaling allows noninvasive and harmless real-time imaging with great spectral resolution in living objects, which is extremely useful for modern biomedical applications. This review presents the basic photophysical principles and strategies for the rational design of fluorescent probes as visualization agents in medical diagnosis and drug delivery systems. Common photophysical phenomena, such as Intramolecular Charge Transfer (ICT), Twisted Intramolecular Charge Transfer (TICT), Photoinduced Electron Transfer (PET), Excited-State Intramolecular Proton Transfer (ESIPT), Fluorescent Resonance Energy Transfer (FRET), and Aggregation-Induced Emission (AIE), are described as platforms for fluorescence sensing and imaging in vivo and in vitro. The presented examples are focused on the visualization of pH, biologically important cations and anions, reactive oxygen species (ROS), viscosity, biomolecules, and enzymes that find application for diagnostic purposes. The general strategies regarding fluorescence probes as molecular logic devices and fluorescence–drug conjugates for theranostic and drug delivery systems are discussed. This work could be of help for researchers working in the field of fluorescence sensing compounds, molecular logic gates, and drug delivery.

Wearable chemical sensors for biomarker discovery in the omics era

Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.

A Bifunctional Fully Integrated Wearable Tracker for Epidermal Sweat and Wound Exudate Multiple Biomarkers Monitoring

Fully integrated wearable electronics that combine the extraordinary feature of incessant and on-body operation with the distinctive external equipment-free trait are the ultimate goal of modern wearables. Epidermal sweat and wound exudate, as two noninvasively accessible biofluids on/surrounding the skin, reflect underlying health conditions. However, the design of universal wearable sensors with the bifunctional capability to monitor both epidermal secretions is still a challenge. Here, a single bifunctional fully integrated wearable tracker for wirelessly, simultaneously, and dynamically in situ measuring multiple epidermal sweat or wound exudate biomarkers is propos. Considering the electrolytes (e.g., Na⁺ , K⁺ , and H⁺ ) and metabolites (e.g., uric acid (UA)) levels in sweat or wound exudate may correlate with health or wound conditions, the dynamic and skin-on tracking of the biomarkers of Na⁺ , K⁺ , pH, and UA levels in sweat under subjects' exercise and in wound exudate during subjects' wound healing are performed through the seamless integration of microfluidic, sensing, and electronic modules. Its applicability is evaluated for noninvasive hyperuricemia management in hyperuricemia/healthy subjects through a purine-rich intake test and for wound management in subjects' infected wounds through a control medical treatment.

Bioresorbable Nanostructured Chemical Sensor for Monitoring of pH Level In Vivo

Here, the authors report on the manufacturing and in vivo assessment of a bioresorbable nanostructured pH sensor. The sensor consists of a micrometer-thick porous silica membrane conformably coated layer-by-layer with a nanometer-thick multilayer stack of two polyelectrolytes labeled with a pH-insensitive fluorophore. The sensor fluorescence changes linearly with the pH value in the range 4 to 7.5 upon swelling/shrinking of the polymer multilayer and enables performing real-time measurements of the pH level with high stability, reproducibility, and accuracy, over 100 h of continuous operation. In vivo studies carried out implanting the sensor in the subcutis on the back of mice confirm real-time monitoring of the local pH level through skin. Full degradation of the pH sensor occurs in one week from implant in the animal model, and its biocompatibility after 2 months is confirmed by histological and fluorescence analyses. The proposed approach can be extended to the detection of other (bio)markers in vivo by engineering the functionality of one (at least) of the polyelectrolytes with suitable receptors, thus paving the way to implantable bioresorbable chemical sensors.

Upcycling Compact Discs for Flexible and Stretchable Bioelectronic Applications

Electronic waste is a global issue brought about by the short lifespan of electronics. Viable methods to relieve the inundated disposal system by repurposing the enormous amount of electronic waste remain elusive. Inspired by the need for sustainable solutions, this study resulted in a multifaceted approach to upcycling compact discs. The once-ubiquitous plates can be transformed into stretchable and flexible biosensors. Our experiments and advanced prototypes show that effective, innovative biosensors can be developed at a low-cost. An affordable craft-based mechanical cutter allows pre-determined patterns to be scored on the recycled metal, an essential first step for producing stretchable, wearable electronics. The active metal harvested from the compact discs was inert, cytocompatible, and capable of vital biopotential measurements. Additional studies examined the material’s resistive emittance, temperature sensing, real-time metabolite monitoring performance, and moisture-triggered transience. This sustainable approach for upcycling electronic waste provides an advantageous research-based waste stream that does not require cutting-edge microfabrication facilities, expensive materials, and high-caliber engineering skills.

Electronic waste is a global issue brought about by the short lifespan of electronics. Here, the authors report a process to upcycle compact discs into flexible and stretchable bio-electronics.

S-Nitrosothiol-Impregnated Silicone Catheter for Colorimetric Sensing of Indole and E. coli: Toward On-Body Detection of Urinary Tract Infections

Although there are many techniques to detect pathogenic bacteria, most of them are only suited for in vitro diagnostics. We report a urinary catheter-based colorimetric sensor for potential on-body detection of E. coli, the most prevalent bacterial species in urinary tract infections associated with the use of urinary catheters. In urine, indole is secreted by E. coli and reacts with a nitrosating agent incorporated in a silicone catheter. A red dimeric product, indoxyl red, is generated within silicone rubber to allow for color-based indole sensing with high sensitivity, linearity, and specificity. This reaction is initiated by the nitrosation reaction of indole at its C-3 position via reagents like sodium nitrite or S-nitroso-N-acetyl-penicillamine under aerobic conditions. The generated 3-nitrosoindole undergoes tautomerization, dimerization, and deoximation to form indoxyl red with high absorbance at 537 nm. In contrast to other indole sensors, the presented method can be applied in real catheters to detect indole and E. coli in biofluids such as urine. The is because (1) S-nitroso-N-acetyl-penicillamine, the nitrosating agent, can be impregnated into silicone elastomers, (2) indole from urine is extracted into silicone due to its hydrophobicity, and (3) the high acidity and oxygen solubility of silicone facilitates the sensing reaction within the silicone matrix. This silicone-based colorimetric sensor clearly differentiates E. coli below and above 10⁵ CFU/mL, which is the threshold concentration of bacteriuria. We expect that early diagnosis of urinary tract infections using the naked eye is possible by functionalizing an exposed section of urinary catheters with the proposed molecular probe.

Flexible microstructured pressure sensors: design, fabrication and applications

In recent years, flexible pressure sensors have caused widespread concern for their extensive applications in human activity and health monitoring, robotics and prosthesis, as well as human-machine interface. Flexible pressure sensors in these applications are required to have a high sensitivity, large detective limit, linear response, fast response time, and mechanical stability. The mechanisms of capacitive, piezoresistive, and piezoelectric pressure sensors and the strategies to improve their performance are introduced. Sensing layers with microstructures have shown capability to significantly improve the performances of pressure sensors. Various fabrication methods for these structures are reviewed in terms of their pros and cons. Besides, the interference caused by environmental stimuli and internal stress from different directions leads to the infidelity of the signal transmission. Therefore, the anti-interference ability of flexible pressure sensors is highly desired. Several potential applications for flexible pressure sensors are also briefly discussed. Last, we conclude the future challenges for facilely fabricating flexible pressure sensors with high performance and anti-interference ability.

Benefits of a Skull-Interfaced Flexible and Implantable Multilight Emitting Diode Array for Photobiomodulation in Ischemic Stroke

Photobiomodulation (PBM) has received attention due to its potential for improving tissue function and enhancing regeneration in stroke. A lightweight, compact, and simple system of miniaturized electronic devices consisting of packaged light-emitting diodes (LEDs) that incorporates a flexible substrate for in vivo brain PBM in a mouse model is developed. Using this device platform, the preventive and therapeutic effects of PBM affixed to the exposed skull of mice in the photothrombosis and middle cerebral artery occlusion stroke model are evaluated. Among the wavelength range of 630, 850, and 940 nm LED array, the PBM with 630-nm LED array is proved to be the most effective for reducing the infarction volume and neurological impairment after ischemic stroke. Moreover, the PBM with 630 nm LED array remarkably improves the capability of spatial learning and memory in the chronic poststroke phase, attenuates AIM2 inflammasome activation and inflammasome-mediated pyroptosis, and modulates microglial polarization in the hippocampus and cortex 7 days following ischemic stroke. Thus, PBM may prevent tissue and functional damage in acute ischemic injury, thereby attenuating the development of cognitive impairment after stroke.

Molecularly imprinted polymers via reversible addition-fragmentation chain-transfer synthesis in sensing and environmental applications

Molecularly imprinted polymers (MIP) have shown their potential as artificial and selective receptors for environmental monitoring. These materials can be tailor-made to achieve a specific binding event with a template through a chosen mechanism. They are capable of emulating the recognition capacity of biological receptors with superior stability and versatility of integration in sensing platforms. Commonly, these polymers are produced by traditional free radical bulk polymerization (FRP) which may not be the most suitable for enhancing the intended properties due to the poor imprinting performance. To improve the imprinting technique and the polymer capabilities, controlled/living radical polymerization (CRP) has been used to overcome the main drawbacks of FRP. Combining CRP techniques such as RAFT (reversible addition-fragmentation chain transfer) with MIP has achieved higher selectivity, sensitivity, and sorption capacity of these polymers when implemented as the transductor element in sensors. The present work focuses on RAFT-MIP design and synthesis strategies to enhance the binding affinities and their implementation in environmental contaminant sensing applications.

Wearable hydrogel patch with noninvasive, electrochemical glucose sensor for natural sweat detection

Recent advances in microelectronics and electrochemical sensing platforms have preceded the development of devices for personal monitoring and managing physiological and metabolic information that exploit sweat as a noninvasive, convenient approach for providing information about underlying health conditions, such as glucose level monitoring. Although most sweat glucose sensors have targeted applications during exercise and other active stimulation induced-sweat, natural sweating offers an attractive alternative with minimal effect on users that can be accessed during routine and sedentary activities without impeding personal lifestyle and preserves the correlation between blood and sweat glucose. Here, we present a noninvasive sweat glucose sensor with convenient hydrogel patches for rapid sampling of natural perspiration without external activities that stimulate sweating. The wearable hydrogel patch rapidly takes up natural sweat from the hand and serves as a medium for electrochemical sensing. A prussian blue-doped poly(3,4-ethylenedioxythiophene nanocomposite (PB-PEDOT NC) electrode provides cost-effective, stable and excellent electrocatalytic activity in sweat glucose measurements. We demonstrated sweat glucose sensor functionality by long-term measurements of glucose in sweat from human subjects consuming food and drinks. By enabling the analysis of sweat glucose during routine and sedentary activities, the sweat glucose sensor shows great promise for clinical-grade glucose management and enlarges the scope of next-generation noninvasive sensing systems.

Highly integrated watch for noninvasive continual glucose monitoring

This article reports a highly integrated watch for noninvasive continual blood glucose monitoring. The watch employs a Nafion-coated flexible electrochemical sensor patch fixed on the watchband to obtain interstitial fluid (ISF) transdermally at the wrist. This reverse iontophoresis-based extraction method eliminates the pain and inconvenience that traditional fingerstick blood tests pose in diabetic patients' lives, making continual blood glucose monitoring practical and easy. All electronic modules, including a rechargeable power source and other modules for signal processing and wireless transmission, are integrated onto a watch face-sized printed circuit board (PCB), enabling comfortable wearing of this continual glucose monitor. Real-time blood glucose levels are displayed on the LED screen of the watch and can also be checked with the smartphone user interface. With 23 volunteers, the watch demonstrated 84.34% clinical accuracy in the Clarke error grid analysis (zones A + B). In the near future, commercial products could be developed based on this lab-made prototype to provide the public with noninvasive continual glucose monitoring.

Progress of Wearable and Flexible Electrochemical Biosensors With the Aid of Conductive Nanomaterials

Conductive nanomaterials have recently gained a lot of interest due to their excellent physical, chemical, and electrical properties, as well as their numerous nanoscale morphologies, which enable them to be fabricated into a wide range of modern chemical and biological sensors. This study focuses mainly on current applications based on conductive nanostructured materials. They are the key elements in preparing wearable electrochemical Biosensors, including electrochemical immunosensors and DNA biosensors. Conductive nanomaterials such as carbon (Carbon Nanotubes, Graphene), metals and conductive polymers, which provide a large effective surface area, fast electron transfer rate and high electrical conductivity, are summarized in detail. Conductive polymer nanocomposites in combination with carbon and metal nanoparticles have also been addressed to increase sensor performance. In conclusion, a section on current challenges and opportunities in this growing field is forecasted at the end.

Recent advances in polymeric nanostructured ion selective membranes for biomedical applications

Nano structured ion-selective membranes (ISMs) are very attractive materials for a wide range of sensing and ion separation applications. The present review focuses on the design principles of various ISMs; nanostructured and ionophore/ion acceptor doped ISMs, and their use in biomedical engineering. Applications of ISMs in the biomedical field have been well-known for more than half a century in potentiometric analysis of biological fluids and pharmaceutical products. However, the emergence of nanotechnology and sophisticated sensing methods assisted in miniaturising ion-selective electrodes to needle-like sensors that can be designed in the form of implantable or wearable devices (smartwatch, tattoo, sweatband, fabric patch) for health monitoring. This article provides a critical review of recent advances in miniaturization, sensing and construction of new devices over last decade (2011-2021). The designing of tunable ISM with biomimetic artificial ion channels offered intensive opportunities and innovative clinical analysis applications, including precise biosensing, controlled drug delivery and early disease diagnosis. This paper will also address the future perspective on potential applications and challenges in the widespread use of ISM for clinical use. Finally, this review details some recommendations and future directions to improve the accuracy and robustness of ISMs for biomedical applications.

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

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

Development of sponge-like cellulose colorimetric swab immobilized with anthocyanin from red-cabbage for sweat monitoring

Novel sponge-like biochromic swab was developed via immobilization of natural anthocyanin (Cy) biomolecular probe into microporous cellulose aerogel. The current biosensor is characterized with simple preparation, environmentally-friendly, biocompatibility, biodegradability, flexibility, portability and reversibility. This biochromic sponge-like aerogel detector displayed a color change from pink to green-yellow in response to the biochemical changes occurs to sweat. This could be ascribed to intramolecular charge transfer occurs to the molecular system of Cy. Thus, the anthocyanin probe displayed colorimetric variations in UV-Vis absorption spectra via a blue shifting from 620 to 529 nm when raising the pH value of the prepared mimic sweat solution. Natural pH sensitive anthocyanin spectroscopic probe was extracted from red-cabbage plant, characterized by HPLC, and encapsulated into microporous cellulose. The microporous sponge-like cellulose swab was prepared by activating wood pulp utilizing phosphoric acid, and then subjected to freeze-drying. This anthocyanin probe is highly soluble in water. Thus, it was encapsulated as a direct dye into cellulose substrate during the freeze-drying process. To allow a better fixation of this water-soluble anthocyanin probe to the cellulose substrate, potash alum was added to the freeze-dried mixture to act as a fixing agent or mordant (M) generating Cy/M coordination complex. The produced Cy/M nanoparticles (NPs) were explored by transmission electron microscopy (TEM). The morphological features of the generated aerogels were investigated by scan electron microscope (SEM), energy-dispersive X-ray (EDX) spectra, and Fourier-transform infrared spectra (FT-IR). The cytotoxicity of the prepared aerogel-based biosensor was also evaluated. The naked-eye colorimetric changes were studied by exploring color strength, UV-Vis spectra and CIE Lab colorimetric coordinates.

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.

Recent progress, challenges, and opportunities for wearable biochemical sensors for sweat analysis

Sweat is a promising, yet relatively unexplored biofluid containing biochemical information that offers broad insights into the underlying dynamic metabolic activity of the human body. The rich composition of electrolytes, metabolites, hormones, proteins, nucleic acids, micronutrients, and exogenous agents found in sweat dynamically vary in response to the state of health, stress, and diet. Emerging classes of skin-interfaced wearable sensors offer powerful capabilities for the real-time, continuous analysis of sweat produced by the eccrine glands in a manner suitable for use in athletics, consumer wellness, military, and healthcare industries. This perspective examines the rapid and continuous progress of wearable sweat sensors through the most advanced embodiments that address the fundamental challenges currently restricting widespread deployment. It concludes with a discussion of efforts to expand the overall utility of wearable sweat sensors and opportunities for commercialization, in which advances in biochemical sensor technologies will be critically important.

Doubly Photopolymerized Holographic Sensors

Holographic sensors are two-dimensional (2D) photonic crystals that diffract narrow-band light in the visible spectrum to quantify analytes in aqueous solutions. Here, a holographic fabrication setup was developed to produce holographic sensors through a doubly polymerization system of a poly-2-hydroxyethyl methacrylate hydrogel film using a pulsed Nd:YAG laser (λ = 355 nm, 5 ns, 100 mJ). Wavelength shifts of holographic Bragg peak in response to alcohol species (0-100 vol %) were characterized. Diffraction spectra showed that the holographic sensors could be used for short-chain alcohols at concentrations up to 60 vol %. The reversibility of the sensor was demonstrated, exhibiting a response time of 7.5 min for signal saturation. After 30 cycles, the Bragg peak and color remained the same in both 20 and 60 vol %. The fabrication parameters were simulated in MATLAB using a 2D finite-difference time-domain algorithm to model the interference pattern and energy flux profile of laser beam recording in the hydrogel medium. This work demonstrates a particle-free holographic sensor that offers continuous, reversible, and rapid colorimetric readouts for the real-time quantification of alcohols.

ANTIGONE: A Programmable Energy-Efficient Current Digitizer for an ISFET Wearable Sweat Sensing System

This article describes the design and the characterization of the ANTIGONE (ANalog To dIGital cONvErter) ASIC (Application Specific Integrated Circuit) built in AMS 0.35 m technology for low dc-current sensing. This energy-efficient ASIC was specifically designed to interface with multiple Ion-Sensitive Field-Effect Transistors (ISFETs) and detect biomarkers like pH, Na+, K+ and Ca2+ in human sweat. The ISFET-ASIC system can allow real-time noninvasive and continuous health monitoring. The ANTIGONE ASIC architecture is based on the current-to-frequency converter through the charge balancing principle. The same front-end can digitize multiple currents produced by four sweat ISFET sensors in time multiplexing. The front-end demonstrates good linearity over a dynamic range that spans from 1 pA up to 500 nA. The consumed energy per conversion is less than 1 J. The chip is programmable and works in eight different modes of operation. The system uses a standard Serial Peripheral Interface (SPI) to configure, control and read the digitally converted sensor data. The chip is controlled by a portable device over Bluetooth Low Energy (BLE) through a Microcontroller Unit (MCU). The sweat sensing system is part of a bigger wearable platform that exploits the convergence of multiparameter biosensors and environmental sensors for personalized and preventive healthcare.

Recent advances in biofluid detection with micro/nanostructured bioelectronic devices

Most biofluids contain a wide variety of biochemical components that are closely related to human health. Analyzing biofluids, such as sweat and tears, may deepen our understanding in pathophysiologic conditions associated with human body, while providing a variety of useful information for the diagnosis and treatment of disorders and disease. Emerging classes of micro/nanostructured bioelectronic devices for biofluid detection represent a recent breakthrough development of critical importance in this context, including traditional biosensors (TBS) and micro/nanostructured biosensors (MNBS). Related biosensors are not restricted to flexible and wearable devices; solid devices are also involved here. This article is a timely overview of recent technical advances in this field, with an emphasis on the new insights of constituent materials, design architectures and detection methods of MNBS that support the necessary levels of biocompatibility, device functionality, and stable operation for component analysis. An additional section discusses and analyzes the existing challenges, possible solutions and future development of MNBS for detecting biofluids.

Role of soft-gel substrates on bouncing-merging transition in drop impact on a liquid film

Liquid droplets impacting on liquid films is common in many industrial and natural processes. It is crucial to understand the impact of droplets on a liquid film resting on soft deformable substrates in some of the applications including 3D printing of engineering structures, prosthetic implants and tissue engineering. By recognizing the practical relevance of soft-substrates, we present an experimental investigation to assess the role of deformable substrates on bouncing-to-merging transition in droplet impact on the liquid film. First, we prepared polyacrylamide (PAAm) soft-gel substrates with various "softness" (i.e., Young's modulus) by modulating the concentration of a crosslinker, N,N-methylene-bis-acrylamide (BIS). We found that the Young's modulus of PAAm initially increases with the concentration of crosslinker, and subsequently becomes almost constant due to inhomogeneity of crosslinking. Next, through the experiments of droplet impact on the liquid film resting on soft substrates with different Young's moduli, we observe that the early merging and corresponding bouncing-to-merging transitional boundaries remain unaffected by the "softness" since such merging occurs further away from the substrate. However, the late merging, which appears during the retraction process of the deformed droplet, occurs relatively close to the substrate, and hence is found to be significantly affected by its "softness". A scaling analysis is presented to quantify the role of change in Young's modulus of the substrate on late merging, which is supported by the experimental data.

Reusable Surface-Enhanced Raman Spectroscopy Membranes and Textiles via Template-Assisted Self-Assembly and Micro/Nanoimprinting

Surface-enhanced Raman spectroscopy (SERS) has emerged as a powerful tool for ultrasensitive fingerprint recognition of molecules with considerable potential in wearable biochemical sensing. However, previous efforts to fabricate wearable SERS devices by directly treating fabrics with plasmonic nanoparticles have generated a nonuniform assembly of nanoparticles, weakly adsorbed on fabrics via van der Waals forces. Here, we report the creation of washing reusable SERS membranes and textiles via template-assisted self-assembly and micro/nanoimprinting approaches. Uniquely, we employ the capillary force driven self-assembly process to generate micropatch arrays of Au nanoparticle (NP) aggregates within hydrophobic microstructured templates, which are then robustly bonded onto semipermeable transparent membranes and stretchable textiles using the UV-resist based micro/nanoimprinting technique. A mild reactive ion etching (RIE) treatment of SERS membranes and textiles can physically expose the SERS hotspots of Au NP-aggregates embedded within the polymer UV resist for further improvement of their SERS performance. Also, we demonstrate that the semipermeable transparent SERS membranes can keep the moisture content of meat from evaporating to enable stable in situ SERS monitoring of biochemical environments at the fresh meat surface. By contrast, stretchable SERS textiles can allow the spreading, soaking, and evaporation of solution analyte samples on the fabric matrix for continuous enrichment of analyte molecules at the hotspots in biochemical SERS detection. Due to the mechanical robustness of the UV-resist immobilized Au NP aggregates, simple detergent-water washing with ultrasound sonication or mechanical stirring can noninvasively clean contaminated hot spots to reuse SERS textiles. Therefore, we envision that washing reusable SERS membranes and textiles by template-assisted self-assembly and micro/nanoimprinting fabrication are promising for wearable biochemical sensing applications, such as wound monitoring and body fluid monitoring.

Non-Invasive Electrochemical Biosensors Operating in Human Physiological Fluids

Non-invasive healthcare technologies are an important part of research and development nowadays due to the low cost and convenience offered to both healthcare receivers and providers. This work overviews the recent advances in the field of non-invasive electrochemical biosensors operating in secreted human physiological fluids, viz. tears, sweat, saliva, and urine. Described electrochemical devices are based on different electrochemical techniques, viz. amperometry, coulometry, cyclic voltammetry, and impedance spectroscopy. Challenges that confront researchers in this exciting area and key requirements for biodevices are discussed. It is concluded that the field of non-invasive sensing of biomarkers in bodily fluid is highly convoluted. Nonetheless, if the drawbacks are appropriately addressed, and the pitfalls are adroitly circumvented, the approach will most certainly disrupt current clinical and self-monitoring practices.

Electrochemical Hybrid Methods and Sensors for Antioxidant/Oxidant Activity Monitoring and Their Use as a Diagnostic Tool of Oxidative Stress: Future Perspectives and Challenges

The terminology used in electrochemical methods which are used to generate the measured signal in antioxidant/oxidant activity (AOA/OA) sensors is briefly considered. The review presents a hybrid version of electrochemical methods for the determination of AOA/OA. Invasive electrochemical methods/sensors for AOA/OA of blood/serum/plasma, and non-invasive ones for semen, sweat, saliva and skin determination are described. AOA/OA sensors application in health estimation, cosmetology, food and nutrients is presented. Attention is paid to widely described approaches and technologies used in chemical/biochemical sensors. It will be considered as base/prototypes for developing sensors of the kind for AOA/OA determination. Prospects for the development of wearable, written sensors and biosensors are considered. Miniature and wireless sensors will allow for the monitoring of the patient’s state, both at the bedside and far beyond the hospital. The development of wearable self-powered written and printed sensors is an important step towards personalized medicine.

Towards wearable and implantable continuous drug monitoring: A review

Continuous drug monitoring is a promising alternative to current therapeutic drug monitoring strategies and has a strong potential to reshape our understanding of pharmacokinetic variability and to improve individualised therapy. This review highlights recent advances in biosensing technologies that support continuous drug monitoring in real time. We focus primarily on aptamer-based biosensors, wearable and implantable devices. Emphasis is given to the approaches employed in constructing biosensors. We pay attention to sensors' biocompatibility, calibration performance, long-term characteristics stability and measurement quality. Last, we discuss the current challenges and issues to be addressed in continuous drug monitoring to make it a promising, future tool for individualised therapy. The ongoing efforts are expected to result in fully integrated implantable drug biosensing technology. Thus, we may anticipate an era of advanced healthcare in which wearable and implantable biochips will automatically adjust drug dosing in response to patient health conditions, thus enabling the management of diseases and enhancing individualised therapy.

Comparison of Colorimetric Analyses to Determine Cortisol in Human Sweat

Colorimetric analysis, which relies on a chemical reaction to facilitate a change in visible color, is a great strategy for detecting cortisol, which is necessary to diagnose and manage the wide variety of diseases related to the hormone, because it is simple in design, inexpensive, and reliable as a standard cortisol analysis technique. In this study, four different colorimetric cortisol analyses that use various chromogens, which include sulfuric acid, Porter-Silber reagent, Prussian blue, and blue tetrazolium, are studied. Modifications to the classic Porter-Silber method are made by increasing the carbon content of the alcohol and adding gold nanoparticles, which result in a twofold increase in reaction rate and a slight decrease in the limit of detection (LoD). After a comparison of the reaction rate, LoD, dynamic range, characteristic peaks, and color stability of all methods, blue tetrazolium demonstrates a low LoD (97 ng/mL), broad dynamic range (0.05-2 μg/mL), and quick reaction rate (color development as fast as 10 min), which are well within the requirements for human biofluids. Cortisol in artificial saliva and sweat and in human sweat was determined while confirming that no excipients or other biomarkers interfered with the reactions. Twenty-one human sweat samples were tested using blue tetrazolium and revealed a significant difference between male and female apocrine cortisol concentrations and showed a highly significant difference between apocrine and eccrine cortisol concentrations. Colorimetric methods of cortisol can compete with existing electrochemical sensors because of their similar accuracy and detection range in certain wearable biosensor applications. The simplicity of colorimetric methods advances potential applications in skin-interfaced bio-electronics and point-of-care devices.

A wearable lab-on-a-patch platform with stretchable nanostructured biosensor for non-invasive immunodetection of biomarker in sweat

Conformable, wearable biosensor-integrated systems are a promising approach to non-invasive and quantitative on-body detection of biomarkers in body fluids. However, realizing such a system has been slowed by the difficulty of fabricating a soft affinity-based biosensor patch capable of precise on-body fluid handling with minimal wearer intervention and a simple measurement protocol. Herein, we demonstrate a conformable, wearable lab-on-a-patch (LOP) platform composed of a stretchable, label-free, impedimetric biosensor and a stretchable microfluidic device for on-body detection of the hormone biomarker, cortisol. The all-in-one, stretchable microfluidic device can precisely collect and deliver sweat for cortisol quantitation and offers one-touch operation of reagent delivery for simultaneous electrochemical signal generation and washing. Three-dimensional nanostructuring of the Au working electrode enables the high sensitivity required to detect the pM-levels of cortisol in sweat. Our integrated LOP detected sweat cortisol quantitatively and accurately during exercise. This LOP will open a new horizon for non-invasive, highly sensitive, and quantitative on-body immunodetection for wearable personal diagnostics.

Flexible potentiometric pH sensors for wearable systems

There is a growing demand for developing wearable sensors that can non-invasively detect the signs of chronic diseases early on to possibly enable self-health management. Among these the flexible and stretchable electrochemical pH sensors are particularly important as the pH levels influence most chemical and biological reactions in materials, life and environmental sciences. In this review, we discuss the most recent developments in wearable electrochemical potentiometric pH sensors, covering the key topics such as (i) suitability of potentiometric pH sensors in wearable systems; (ii) designs of flexible potentiometric pH sensors, which may vary with target applications; (iii) materials for various components of the sensor such as substrates, reference and sensitive electrode; (iv) applications of flexible potentiometric pH sensors, and (v) the challenges relating to flexible potentiometric pH sensors.

Glutamate sensing in biofluids: recent advances and research challenges of electrochemical sensors

Electrochemical sensing guidelines for glutamate in biofluids, associated with different diseases, providing knowledge translation among science, engineering, and medical professionals.