Uric Acid Monitoring with a Smartphone as the Electrochemical Analyzer

Secure and privacy-preserving automated machine learning operations into end-to-end integrated IoT-edge-artificial intelligence-blockchain monitoring system for diabetes mellitus prediction

Diabetes Mellitus, one of the leading causes of death worldwide, has no cure to date and can lead to severe health complications, such as retinopathy, limb amputation, cardiovascular diseases, and neuronal disease, if left untreated. Consequently, it becomes crucial to be able to monitor and predict the incidence of diabetes. Machine learning approaches have been proposed and evaluated in the literature for diabetes prediction. This paper proposes an IoT-edge-Artificial Intelligence (AI)-blockchain system for diabetes prediction based on risk factors. The proposed system is underpinned by blockchain to obtain a cohesive view of the risk factors data from patients across different hospitals and ensure security and privacy of the user's data. We provide a comparative analysis of different medical sensors, devices, and methods to measure and collect the risk factors values in the system. Numerical experiments and comparative analysis were carried out within our proposed system, using the most accurate random forest (RF) model, and the two most used state-of-the-art machine learning approaches, Logistic Regression (LR) and Support Vector Machine (SVM), using three real-life diabetes datasets. The results show that the proposed system predicts diabetes using RF with 4.57% more accuracy on average in comparison with the other models LR and SVM, with 2.87 times more execution time. Data balancing without feature selection does not show significant improvement. When using feature selection, the performance is improved by 1.14% for PIMA Indian and 0.02% for Sylhet datasets, while it is reduced by 0.89% for MIMIC III.

Recent advancements of smartphone-based sensing technology for diagnosis, food safety analysis, and environmental monitoring

The emergence of computationally powerful smartphones, relatively affordable high-resolution camera, drones, and robotic sensors have ushered in a new age of advanced sensible monitoring tools. The present review article investigates the burgeoning smartphone-based sensing paradigms, including surface plasmon resonance (SPR) biosensors, electrochemical biosensors, colorimetric biosensors, and other innovations for modern healthcare. Despite the significant advancements, there are still scarcity of commercially available smart biosensors and hence need to accelerate the rates of technology transfer, application, and user acceptability. The application/necessity of smartphone-based biosensors for Point of Care (POC) testing, such as prognosis, self-diagnosis, monitoring, and treatment selection, have brought remarkable innovations which eventually eliminate sample transportation, sample processing time, and result in rapid findings. Additionally, it articulates recent advances in various smartphone-based multiplexed bio sensors as affordable and portable sensing platforms for point-of-care devices, together with statistics for point-of-care health monitoring and their prospective commercial viability.

Two-dimensional glass/p-ATP/Ag NPs as multifunctional SERS substrates for label-free quantification of uric acid in sweat

Abnormal uric acid (UA) content in body fluids can fully reflect the status of metabolism and immunity in the body. We have developed a simple, efficient and label-free surface enhanced Raman scattering (SERS) method for UA detection. Briefly, p-aminothiophenol (p-ATP) was used as the internal standard molecule and linking molecule to prepare a glass/p-ATP/Ag NPs SERS substrate. The Raman characteristic peak of p-ATP at 1076 cm^-1 can be used as an internal standard molecule to correct the signal fluctuation of UA detection. The results show that the SERS method owns a linear response with a ranging from 5 × 10^-6 to 10^-3 M of UA characteristic peak of both 693 cm^-1 and 493 cm^-1 with a determination coefficient (R²) of 0.9878 and 0.9649, respectively. Additionally, the SERS sensor has been further used for the analysis of UA in sweat and good recoveries were obtained for the sensing of sweat. We believe that the developed SERS substrate has potential for applications in healthcare monitoring.

A new microfluidic-chip device followed by sensitive image analysis of smart phone for simultaneous determination of dyes with different acidic-basic properties

In this study, a new microfluidic-chip coupled with micro solid phase extraction (μ-SPE) and a RGB detection system was designed. The method was used for extraction and simultaneous determination of trace amounts of dyes with different acidic-basic properties. Erythrosine (Ery) and Crystal Violet (CV) were selected as acidic and basic model analytes, respectively. The first step of this method is based on the on-chip electromembrane extraction (CEME) of analytes from aqueous solution. The utilized microfluidic system is a single compartment that composed of three polymethyl metacrylate plates (with sandwiched structures) patterned with palm shaped helix channels. The device consisted one pair of platinum electrodes that were embedded in the acceptor phase channels in each side. The middle part was cut and used as the path of the sample. The extracted analytes by CEME were passed through the micro-packed column containing strong cation and anion exchanger sorbents respectively. Two adsorbents were separated by a polypropylene frit and sealed on each side by two polypropylene frites. Following dye adsorption on the sorbents, the colors that emerged were promptly evaluated using RGB colorimetry on a smartphone. Central composite design was used to analyze and optimize the effective parameters on extraction efficiency. The relative standard deviations (RSDs%) based on five replicate measurements were less than 7.8% for RGB and 8.6% for the spectrophotometry technique under ideal conditions. Image analysis using a smartphone yielded LOD values of 15.0 and 10.5 μg L^-1 for Ery and CV, respectively. The CEME- μ-SPE -RGB approach produced findings that were equivalent to those obtained by spectrophotometry. Finally, the approach was used to accurately determine Ery and CV in water samples, yielding good relative recoveries (recovery ≥94.0).

Moving toward smart biomedical sensing

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

Efficient Point-of-Care Detection of Uric Acid in the Human Blood Sample with an Enhanced Electrocatalytic Response Using Nanocomposites of Cobalt and Mixed-Valent Molybdenum Sulfide

This work efficiently detects uric acid (UA) in a human blood sample using cobalt nanoparticle-immobilized mixed-valent molybdenum sulfide on the copper substrate in a point-of-care (PoC) device. The sensor electrode was fabricated by micromachining of Cu clad boards employing an engraver to generate a three-electrode system consisting of working electrode (WE), reference electrode (RE), and counter electrode (CE). The WE was subjected to physical vapor deposition of mixed-valent MoSx layers by a reaction between Mo(CO)6 and H2S at ∼200 °C using a simple setup following which CoNPs were electrochemically deposited. The RE and CE were covered with Ag/AgCl and Ag paste, respectively. A plasma separation membrane acted as the medium of UA/blood serum delivery to the electrodes. The material and electrochemical characterization confirmed that CoNPs over MoSx provided an enlarged electroactive surface for the direct electron transfer to achieve an enhanced electrocatalytic response. The binary combination of CoNPs and MoSx layers over the Cu electrode reduced the charge-transfer resistance by two times, enhanced the surface adsorption by more than two times, and yielded a high diffusion coefficient of 3.46 × 10-3 cm2/s. These interfacial effects facilitated the UA oxidation, leading to unprecedented mA range current density for UA sensing for the PoC device. The electrochemical detection tests in the PoC device revealed a sensitivity of 64.7 μA/μM cm-2, which is ∼50 times higher compared to the latest reported value (1.23 μA/μM cm-2), a high limit of detection of 5 nM, and shelf life of 6 months, confirming the synergistic effect-mediated high sensitivity under PoC settings. Interference tests confirmed no intervention of similar analytes. Tests on blood samples demonstrated a recovery percentage close to 100% in human serum UA, signifying the suitability of the nanocomposite-based sensor and the PoC device for clinical sensing applications.

A Novel Turn-On Fluorescence Probe Based on Cu(II) Functionalized Metal–Organic Frameworks for Visual Detection of Uric Acid

As an important biomarker in urine, the level of uric acid is of importance for human health. In this work, a Cu(II) functionalized metal–organic framework (Cu²⁺@Tb-MOFs) is designed and developed as a novel fluorescence probe for wide-range uric acid detection in human urine. The study shows that this fluorescence platform demonstrated excellent pH-independent stability, high water tolerance, and good thermal stability. Based on the strong interaction between metal ions and uric acid, the designed Cu²⁺@Tb-MOFs can be employed as efficient turn-on fluorescent probes for the detection of uric acid with wide detection range (0~10⁴ µM) and high sensitivity (LOD = 0.65 µM). This probe also demonstrates an anti-interference property, as other species coexisted, and the possibility for recycling. The sensing mechanisms are further discussed at length. More importantly, we experimentally constructed a molecular logic gate operation based on this fluorescence probe for intelligent detection of uric acid. These results suggest the Cu(II) functionalized metal–organic framework can act as a prominent candidate for personalized monitoring of the concentration of uric acid in the human urine system.

Recent Advancements in Electrochemical Biosensors for Monitoring the Water Quality

The release of chemicals and microorganisms from various sources, such as industry, agriculture, animal farming, wastewater treatment plants, and flooding, into water systems have caused water pollution in several parts of our world, endangering aquatic ecosystems and individual health. World Health Organization (WHO) has introduced strict standards for the maximum concentration limits for nutrients and chemicals in drinking water, surface water, and groundwater. It is crucial to have rapid, sensitive, and reliable analytical detection systems to monitor the pollution level regularly and meet the standard limit. Electrochemical biosensors are advantageous analytical devices or tools that convert a bio-signal by biorecognition elements into a significant electrical response. Thanks to the micro/nano fabrication techniques, electrochemical biosensors for sensitive, continuous, and real-time detection have attracted increasing attention among researchers and users worldwide. These devices take advantage of easy operation, portability, and rapid response. They can also be miniaturized, have a long-life span and a quick response time, and possess high sensitivity and selectivity and can be considered as portable biosensing assays. They are of special importance due to their great advantages such as affordability, simplicity, portability, and ability to detect at on-site. This review paper is concerned with the basic concepts of electrochemical biosensors and their applications in various water quality monitoring, such as inorganic chemicals, nutrients, microorganisms' pollution, and organic pollutants, especially for developing real-time/online detection systems. The basic concepts of electrochemical biosensors, different surface modification techniques, bio-recognition elements (BRE), detection methods, and specific real-time water quality monitoring applications are reviewed thoroughly in this article.

Electrochemiluminescent sensor based on an aggregation-induced emission probe for bioanalytical detection

In recent years, with the rapid development of electrochemiluminescence (ECL) sensors, more luminophores have been designed to achieve high-throughput and reliable analysis. Impressively, after the proposed fantastic concept of "aggregation-induced electrochemiluminescence (AIECL)" by Cola, the application of AIECL emitters provides more abundant choices for the further improvement of ECL sensors. In this review, we briefly report the phenomenon, principle and representative applications of aggregation-induced emission (AIE) and AIECL emitters. Moreover, it is noteworthy that the cases of AIECL sensors for bioanalytical detection are summarized in detail, from 2017 to now. Finally, inspired by the applications of AIECL emitters, relevant prospects and challenges for AIECL sensors are proposed, which is of great significance for exploring more advanced bioanalytical detection technology.

CRISPR-Cas12a-Derived Photoelectrochemical Biosensor for Point-Of-Care Diagnosis of Nucleic Acid

This work presented a point-of-care (POC) photoelectrochemical (PEC) biosensing for the detection of human papillomavirus-16 (HPV-16) on a portable electrochemical detection system by using CRISPR-Cas12a trans-cleaving the G-quadruplex for the biorecognition/amplification and a hollow In₂O₃-In₂S₃-modified screen-printed electrode (In₂O₃-In₂S₃/SPE) as the photoactive material. G-quadruplexes were capable of biocatalytic precipitation (H₂O₂-mediated 4-chloro-1-naphthol oxidation) on the In₂O₃-In₂S₃/SPE surface, resulting in a weakened photocurrent, but suffered from trans-cleavage when the CRISPR-Cas12a system specifically recognized the analyte. The photocurrent results could be directly observed with the card-sized electrochemical device via a smartphone, which displayed a high-value photocurrent for these positive samples, while a low-value photocurrent for the target-free samples. Such a system exhibited satisfying photocurrent responses toward HPV-16 within a wide working range from 5.0 to 5000 pM and allowed for detection of HPV-16 at a concentration as low as 1.2 pM. The proposed assay provided a smartphone signal readout to enable the rapid screening PEC determination of HPV-16 concentration without sophisticated instruments, thus meeting the requirements of remote areas and resource-limited settings. We envision that combining an efficient biometric PEC sensing platform with a wireless card-sized electrochemical device will enable high-throughput POC diagnostic analysis.

Electrochemical Sensor Nanoarchitectonics for Sensitive Detection of Uric Acid in Human Whole Blood Based on Screen-Printed Carbon Electrode Equipped with Vertically-Ordered Mesoporous Silica-Nanochannel Film

Screen-printed carbon electrodes (SPCEs) bear great potential in the detection of biomarker in clinical samples with low sample consumption. However, modification of electrode surfaces to improve the anti-interference ability and sensitivity is highly desirable for direct electroanalysis of whole blood samples. Here, a reliable and miniaturized electrochemical sensor is demonstrated based on SPCE equipped with vertically-ordered mesoporous silica-nanochannel film (VMSF). To achieve stable binding of VMSF and improve the electrocatalytic performance, electrochemically reduced graphene oxide (ErGO) is applied as a conductive adhesion layer, that is in situ reduced from GO nanosheets during fast growth (less than 10 s) of amino groups modified VMSF (NH2-VMSF) using electrochemically assisted self-assembly (EASA). In comparison with bare SPCE, NH2-VMSF/ErGO/SPCE exhibits decreased oxidation potential of uric acid (UA) by 147 mV owing to significant electrocatalytic ability of ErGO. The dual signal amplification based on electrocatalysis of ErGO and enrichment of nanochannels leads to enhanced peak current by 3.9 times. Thus, the developed NH2-VMSF/ErGO/SPCE sensor enables sensitive detection of UA in the range from 0.5 μM to 180 μM with a low limit of detection (LOD, 129 nM, S/N = 3). Owing to good anti-fouling ability and high selectivity of the sensor, direct and rapid detection of UA in human whole blood is realized with very low sample consumption (50 μL).

Smartphone-Based Biosensor Devices for Healthcare: Technologies, Trends, and Adoption by End-Users

Smart biosensors are becoming an important support for modern healthcare, even more so in the current context. Numerous smartphone-based biosensor developments were published in recent years, some highly effective and sensitive. However, when patents and patent applications related to smart biosensors for healthcare applications are analyzed, it is surprising to note that, after significant growth in the first half of the decade, the number of applications filed has decreased considerably in recent years. There can be many causes of this effect. In this review, we present the state of the art of different types of smartphone-based biosensors, considering their stages of development. In the second part, a critical analysis of the possible reasons why many technologies do not reach the market is presented. Both technical and end-user adoption limitations were addressed. It was observed that smart biosensors on the commercial stage are still scarce despite the great evolution that these technologies have experienced, which shows the need to strengthen the stages of transfer, application, and adoption of technologies by end-users.

Electrochemical quantification of biomarker myeloperoxidase

Point of care testing (PoCT) devices permit precise and rapid detection of disease-related biomarkers contributing to an early disease diagnosis and administration of an appropriate treatment. The enzyme myeloperoxidase (MPO) is a relevant biomarker for infection and inflammation events assessment; however its direct electrochemical quantification is hindered by the limited accessibility to the iron atom in its active center. Herein, such hindrance of the MPO biomolecule is overcome using the redox mediator 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS). The charge involved in the electrochemical reduction of the MPO-oxidized ABTS is correlated with the concentration of MPO. The use of ABTS allowed for the electrochemical assessment of a wide range of MPO concentrations (10-1000 nM) including those reported for wound infections, chronic obstructive pulmonary disease and early adverse cardiac events. The developed electroanalytical approach is rapid and inexpensive, and thus suitable for implementation in PoCT devices.

Recent advances in flexible and wearable sensors for monitoring chemical molecules

In recent years, real-time health management has received increasing attention, benefiting from the rapid development of flexible and wearable devices. Conventionally, flexible and wearable devices are used for collecting health data such as electrophysiological signals, blood pressure, heart rate, etc. The monitoring of chemical factors has shown growing significance, providing the basis for the screening, diagnosis, and treatment of many diseases. Nowadays, in order to understand the health status of the human body more comprehensively and accurately, researchers in the community have started putting effort into developing wearable devices for monitoring chemical factors. Progressively, more flexible chemical sensors with wearable real-time health-monitoring functionality have been developed thanks to advances relating to wireless communications and flexible electronics. In this review, we describe the variety of chemical molecules and information that can currently be monitored, including pH levels, glucose, lactate, uric acid, ion levels, cytokines, nutrients, and other biomarkers. This review analyzes the pros and cons of the most advanced wearable chemical sensors in terms of wearability. At the end of this review, we discuss the current challenges and development trends relating to flexible and wearable chemical sensors from the aspects of materials, electrode designs, and soft-hard interface connections.

Smartphone-Based Electrochemical System for Biosensors and Biodetection

With the advantages of high popularity, convenient operation, open-source operation systems, high resolution imaging, and excellent computing capabilities, smartphones have been widely used as the core of detection system for calculation, control, and real-time display. Hence, smartphones play an important role in electrochemical detection and optical detection. Smartphone-based electrochemical systems were combined with screen-printed electrode and interdigital electrodes for in situ detection. The electrodes were modified with biomaterials, chemical materials, and nanomaterials for biosensors and biodetection, such as 3-amino phenylboronic acid nanocomposites, graphene, gold nanoparticles, zinc oxide nanoparticles, carbon nanotubes, proteins, peptides, and antibodies. With the modified electrodes, the smartphone-based impedance system was used to detect acetone, bovine serum albumin, human serum albumin, and trinitrotoluene, while smartphone-based amperometric system was employed to monitor glucose, ascorbic acid, dopamine, uric acid, and levodopa. The smartphone-based electrochemical system for biosensors and biodetection has provided miniaturized and portable alternative for diagnosis, which is promising to find application in point-of-care testing (POCT).

Microfluidic paper-based analytical device by using Pt nanoparticles as highly active peroxidase mimic for simultaneous detection of glucose and uric acid with use of a smartphone

Herein, a simple microfluidic paper-based analytical device (μPAD) by using platinum nanoparticles (Pt NPs) as highly active peroxidase mimic for simultaneous determination of glucose and uric acid was fabricated. The μPAD consisted of one sample transportation layer, four paper-based detection chips, and two layers of hydrophobic polyethylene terephthalate (PET) films. The four detection chips were immobilized with various chromogenic reagents, Pt NPs, and specific oxidase (glucose oxidase or uricase). H₂O₂ generated by specific enzymatic reactions could oxidize co-immobilized chromogenic reagents to produce colored products by using Pt NPs as efficient catalyst. The multi-layered structure of μPAD could effectively improve the color uniformity and color intensity. Total color intensity from each two detection chips modified with distinct chromogenic reagents were used for quantitative analysis of glucose and uric acid, respectively, resulting in significantly improved sensitivity. The linear range for glucose and uric acid detection was 0.01-5.0 mM and 0.01-2.5 mM, respectively. Satisfied results were obtained for glucose and uric acid detection in real serum samples. An easy-to-use smartphone APP was developed for convenient and intelligent detection. The developed μPAD integrated with smartphone as detector holds great applicability for simple and portable on-site analysis.

Smartphone-based photochemical sensor for multiplex determination of glucose, uric acid, and total cholesterol in fingertip blood

The physical picture of the proposed system, which consists of a photochemical dongle, a cloud-enabled smartphone, and disposable test strips.

Testing and diagnosis of SARS-CoV-2 infection

The recent outbreak of the coronavirus disease 2019 (COVID-19) has rapidly spread around the world since its discovery in China, in December 2019. The current standard method for determining whether a patient is infected with the SARS-CoV-2 virus involves taking a nasal or throat swab sample, which is then sent to laboratories for testing. The laboratories then use polymerase chain reaction (PCR)-based technology on respiratory specimens remain the gold standard to determine if the genetic material of the virus is present in the sample and use this information to diagnose the patient. However, serologic immunoassays and point-of-care technologies are rapidly emerging with high specificity and sensitivity as well. Even if there are excellent techniques for diagnosing symptomatic patients with COVID-19 in equipped laboratories, critical gaps still exist in the screening of asymptomatic individuals who are in the incubation phase of the virus, as well as in the accurate determination of live virus shedding during convalescence to inform decisions for ending isolation.

5G-Enabled intelligent construction of a chest pain center with up-conversion lateral flow immunoassay

Acute myocardial infarction (AMI) has become a worldwide health problem because of its rapid onset and high mortality. Cardiac troponin I (cTnI) is the gold standard for diagnosis of AMI, and its rapid and accurate detection is critical for early diagnosis and management of AMI. Using a lateral flow immunoassay with upconverting nanoparticles as fluorescent probes, we developed an up-conversion fluorescence reader capable of rapidly quantifying the cTnI concentration in serum based upon the fluorescence intensity of the test and control lines on the test strip. Reliable detection of cTnI in the range 0.1-50 ng mL^-1 could be achieved in 15 min, with a lower detection limit of 0.1 ng mL^-1. The reader was also adapted for use on a 5th generation (5G) mobile network enabled intelligent chest pain center. Through Bluetooth wireless communication, the results achieved using the reader on an ambulance heading to a central hospital could be transmitted to a 5G smartphone and uploaded for real-time edge computing and cloud storage. An application in the 5G smartphone allows users to upload their medical information to establish dedicated electronic health records and doctors to monitor patients' health status and provide remote medical services. Combined with mobile internet and big data, the 5G-enabled intelligent chest pain center with up-conversion lateral flow immunoassay may predict the onset of AMI and save valuable time for patients suffering an AMI.

Point-of-Care Quantification of Serum Alpha-Fetoprotein for Screening Birth Defects in Resource-Limited Settings: Proof-of-Concept Study

Background:

Maternal serum alpha-fetoprotein (MSAFP) concentration typically increases during pregnancy and is routinely measured during the second trimester as a part of screening for fetal neural tube defects and Down syndrome. However, most pregnancy screening tests are not available in the settings they are needed the most. A mobile device–enabled technology based on MSAFP for screening birth defects could enable the rapid screening and triage of high-risk pregnancies, especially where maternal serum screening and fetal ultrasound scan facilities are not easily accessible. Shifting the approach from clinic- and laboratory-dependent care to a mobile platform based on our point-of-care approach will enable translation to resource-limited settings and the global health care market.

Objective:

The objective of this study is to develop and perform proof-of-concept testing of a lateral flow immunoassay on a mobile platform for rapid, point-of-care quantification of serum alpha-fetoprotein (AFP) levels, from a drop of human serum, within a few minutes.

Methods:

The development of the immunoassay involved the selection of commercially available antibodies and optimization of their concentrations by an iterative method to achieve the required detection limits. We compared the performance of our method with that of commercially obtained human serum samples, with known AFP concentrations quantified by the Abbott ARCHITECT chemiluminescent magnetic microparticle immunoassay (CMIA).

Results:

We tested commercially obtained serum samples (N=20) with concentrations ranging from 2.2 to 446 ng/mL to compare the results of our point-of-care assay with results from the Abbott ARCHITECT CMIA. A correlation of 0.98 (P<.001) was observed on preliminary testing and comparison with the CMIA. The detection range of our point-of-care assay covers the range of maternal serum AFP levels observed during pregnancy.

Conclusions:

The preliminary test results from the AFP test on the mobile platform performed in this study represent a proof of concept that will pave the way for our future work focused on developing a mobile device–enabled quad-screen point-of-care testing with the potential to enable the screening of high-risk pregnancies in various settings. The AFP test on the mobile platform can be applied to enable screening for high-risk pregnancies, within a few minutes, at the point of care even in remote areas where maternal serum tests and fetal ultrasound scans are not easily accessible; assessment of whether clinical follow-up and diagnostic testing may be needed after a positive initial screening evaluation; and development of surveillance tools for birth defects.

Soft Wearable Healthcare Materials and Devices

In spite of advances in electronics and internet technologies, current healthcare remains hospital-centred. Disruptive technologies are required to translate state-of-art wearable devices into next-generation patient-centered diagnosis and therapy. In this review, recent advances in the emerging field of soft wearable materials and devices are summarized. A prerequisite for such future healthcare devices is the need of novel materials to be mechanically compliant, electrically conductive, and biologically compatible. It is begun with an overview of the two viable design strategies reported in the literatures, which is followed by description of state-of-the-art wearable healthcare devices for monitoring physical, electrophysiological, chemical, and biological signals. Self-powered wearable bioenergy devices are also covered and sensing systems, as well as feedback-controlled wearable closed-loop biodiagnostic and therapy systems. Finally, it is concluded with an overall summary and future perspective.

Metal-organic frameworks for chemical sensing devices

Metal-organic frameworks (MOFs) are exceptionally large surface area materials with organized porous cages that have been investigated for nearly three decades. Due to the flexibility in their design and predisposition toward functionalization, they have shown promise in many areas of application, including chemical sensing. Consequently, they are identified as advanced materials with potential for deployment in analytical devices for chemical and biochemical sensing applications, where high sensitivity is desirable, for example, in environmental monitoring and to advance personal diagnostics. To keep abreast of new research, which signposts the future directions in the development of MOF-based chemical sensors, this review examines studies since 2015 that focus on the applications of MOF films and devices in chemical sensing. Various examples that use MOF films in solid-state sensing applications were drawn from recent studies based on electronic, electrochemical, electromechanical and optical sensing methods. These examples underscore the readiness of MOFs to be integrated in optical and electronic analytical devices. Also, preliminary demonstrations of future sensors are indicated in the performances of MOF-based wearables and smartphone sensors. This review will inspire collaborative efforts between scientists and engineers working within the field of MOFs, leading to greater innovations and accelerating the development of MOF-based analytical devices for chemical and biochemical sensing applications.

β-Cyclodextrin functionalized 3D reduced graphene oxide composite-based electrochemical sensor for the sensitive detection of dopamine

A three-dimensional reduced graphene oxide nanomaterial with β-cyclodextrin modified glassy carbon electrode (3D-rGO/β-CD/GCE) was constructed and used to detect the electrochemical behavior of dopamine (DA). The nanocomposite materials were characterized by scanning electron microscopy (SEM), infrared spectrometry (FT-IR), Raman spectrogram and thermogravimetric analysis (TGA), which showed that β-CD was well modified on 3D graphene with a porous structure. The electrochemical properties of different modified electrodes were investigated by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS), proving the highest electron transfer rate of the 3D-rGO/β-CD modified electrode. The experimental conditions such as scan rate, pH, enrichment time and layer thickness were optimized. Under the best experimental conditions, DA was detected by differential pulse voltammetry (DPV) by 3D-rGO/β-CD/GCE with excellent electrocatalytic ability and satisfactory recognition ability, resulting in a wide linear range of 0.5-100 μM and a low detection limit (LOD) of 0.013 μM. The modified electrode based on 3D-rGO/β-CD nanocomposites is promising in the field of electrochemical sensors due to its high sensitivity and other excellent properties.

Integrated hand-held electrochemical sensor for multicomponent detection in urine

Electrochemical sensors have shown great advantage and application potential in point-of-care testing (POCT) related scenarios. However, some fatal problems plague its widespread utilization, which include the susceptibility of sensors to interference in real samples (e.g. pH), the contradiction between the limited objects detectable for most sensors and the requirement of multi-target analysis in most cases, and the complicated procedures in sensor preparation as well as in routine use. This paper contributed a tip-like electrochemical sensor prototype. By integrated with a commercial pipettor, it fulfilled semi-automatic assay procedure of sampling, detection and rinsing, thus saving operational time and manual work. The tip sensor owns the property of simple fabrication and is free from any modification of extra bio/chem materials. Moreover, built on multiple electrochemical signal outputs including open circuit potential, peak current and potential of specific electrochemical reaction, this work established a novel multi-component sensing strategy, wherein detection of uric acid (UA), urea and pH in urine samples was realized by using one single working electrode. The detection range for the above targets is 5.0~600 μM for UA, 4.0~8.0 for pH and 0.5~7.0 mM for urea with the detection limits (S/N = 3) of 0.05 μM for UA and 5.4 μM for urea, and the sensitivity of pH assay is 73 mV/pH. Notably, as variation of sample pH has impact on electrochemical analysis, the pH-related parameter was introduced for calibration to diminish such interference. The developed tip sensor and the novel sensing strategy may open a new window for electrochemical technology and broaden its application in POCT.

Validation of Electrochemical Sensor for Determination of Manganese in Drinking Water

Manganese (Mn) is an essential nutrient for metabolic functions, yet excessive exposure can lead to neurological disease in adults and neurodevelopmental deficits in children. Drinking water represents one of the routes of excessive Mn exposure. Both natural enrichment from rocks and soil, and man-made contamination can pollute groundwater that supplies drinking water for a substantial fraction of the U.S. population. Conventional methods for Mn monitoring in drinking water are costly and involve a long turn-around time. Recent advancements in electrochemical sensing, however, have led to the development of miniature sensors for Mn determination. These sensors rely on a cathodic stripping voltammetry electroanalytical technique on a miniaturized platinum working electrode. In this study, we validate these electrochemical sensors for the determination of Mn concentrations in drinking water against the standard method using inductively coupled plasma mass spectrometry (ICP-MS). Drinking water samples (n = 78) in the 0.03 ppb to 5.3 ppm range were analyzed. Comparisons with ICP-MS yielded 100% agreement, ∼70% accuracy, and ∼91% precision. We envision the use of our system for rapid and inexpensive point-of-use identification of Mn levels in drinking water, which is especially valuable for frequent monitoring where contamination is present.

Smartphone-Enabled Paper-Based Hemoglobin Sensor for Extreme Point-of-Care Diagnostics

We report a simple, affordable (∼0.02 US $/test), rapid (within 5 min), and quantitative paper-based sensor integrated with smartphone application for on-spot detection of hemoglobin (Hgb) concentration using approximately 10 μL of finger-pricked blood. Quantitative analytical colorimetry is achieved via an Android-based application (Sens-Hb), integrating key operational steps of image acquisition, real-time analysis, and result dissemination. Further, feedback from the machine learning algorithm for adaptation of calibration data offers consistent dynamic improvement for precise predictions of the test results. Our study reveals a successful deployment of the extreme point-of-care test in rural settings where no infrastructural facilities for diagnostics are available. The Hgb test device is validated both in the controlled laboratory environment (n = 200) and on the field experiments (n = 142) executed in four different Indian villages. Validation results are well correlated with the pathological gold standard results (r = 0.9583) with high sensitivity and specificity for the healthy (n = 136) (>11 g/dL) (specificity: 97.2%), mildly anemic (n = 55) (<11 g/dL) (sensitivity: 87.5%, specificity: 100%), and severely anemic (n = 9) (<7 g/dL) (sensitivity: 100%, specificity: 100%) samples. Results from field trials reveal that only below 5% cases of the results are interpreted erroneously by classifying mildly anemic patients as healthy ones. On-field deployment has unveiled the test kit to be extremely user friendly that can be handled by minimally trained frontline workers for catering the needs of the underserved communities.

A highly sensitive uric acid biosensor based on vertically arranged ZnO nanorods on a ZnO nanoparticle-seeded electrode

Vertically-arranged ZnO nanorods grown on a ZnO nanoparticle-seeded FTO electrode using a hydrothermal method for highly sensitive uric acid biosensor fabrication.

IoT-Enabled Fluorescence Sensor for Quantitative KET Detection and Anti-Drug Situational Awareness

Recently, drug abuse has become a worldwide concern. Among varieties of drugs, KET is found to be favorite in drug addicts, especially teenagers, for recreational purposes. KET is a kind of analgesic and anesthetic drug which can induce hallucinogenic and dissociative effects after high-dose abuse. Hence, it is critical to develop a rapid and sensitive detection method for strict drug control. In this study, we proposed a cloud-enabled smartphone based fluorescence sensor for quantitative detection of KET from human hair sample. The lateral flow immunoassay (LFIA) was used as the detecting strategy where UCNPs were introduced as fluorescent labels. The sensor was capable of identifying the up-converted fluorescence and calculating the signal intensities on TL and CL to obtain a T/C value, which was corresponding to the KET concentration. The sensor transmitted the test data to the cloud-enabled smartphone through Type-C interface, and the data were further uploaded to the edge of the network for cloud-edge computing and storage. The entire detection took only 5 minutes with high stability and reliability. The detection limit of KET was 1 ng/mL and a quantitative detection range from 1 to 150 ng/mL. Furthermore, based on the huge development of Internet of Things (IoT), an App was developed on the smartphone for anti-drug situational awareness. Based on this system, it was convenient for Police Department to perform on-site KET detection. Moreover, it was critical for prediction of the development trend of future events, benefiting much to constructing a harmonious society.

Measurement of serum phosphate levels using a mobile sensor

The measurement of serum phosphate concentration is crucial for patients with advanced chronic kidney disease (CKD) and those on maintenance dialysis, as abnormal phosphate levels may be associated with severe health risks. It is important to monitor serum phosphate levels on a regular basis in these patients; however, such measurements are generally limited to every 0.5-3 months, depending on the severity of CKD. This is due to the fact that serum phosphate measurements can only be performed at regular clinic visits, in addition to cost considerations. Here we present a portable and cost-effective point-of-care device capable of measuring serum phosphate levels using a single drop of blood (<60 μl). This is achieved by integrating a paper-based microfluidic platform with a custom-designed smartphone reader. This mobile sensor was tested on patients undergoing dialysis, where whole blood samples were acquired before starting the hemodialysis and during the three-hour treatment. This sampling during the hemodialysis, under patient consent, allowed us to test blood samples with a wide range of phosphate concentrations, and our results showed a strong correlation with the ground truth laboratory tests performed on the same patient samples (Pearson coefficient r = 0.95 and p < 0.001). Our 3D-printed smartphone attachment weighs about 400 g and costs less than 80 USD, whereas the material cost for the disposable test is <3.5 USD (under low volume manufacturing). This low-cost and easy-to-operate system can be used to measure serum phosphate levels at the point-of-care in about 45 min and can potentially be used on a daily basis by patients at home.

Development of micropillar array electrodes for highly sensitive detection of biomarkers

Micropillar array electrodes (μAEs) have been widely applied in electrochemical detection owing to their advantages of increased mass transport, lower detection limit, and potential to be miniaturized. This paper reports the fabrication, simulation, surface modification, and characterization of PDMS-based μAEs coated with gold films. The μAEs consist of 9 × 10 micropillars with a height of either 100 μm, 300 μm, or 500 μm in a 0.09 cm2 region. Numerical simulation was employed to study the influence of geometrical parameters on the current density. The μAEs were fabricated by soft lithography and characterized using both SEM and cyclic voltammetry. Experiments revealed that high pillars enabled enhanced voltammetric current density regardless of the scan rates. The platinum-palladium/multi-walled carbon nanotubes (Pt-Pd/MWCNTs) were coated on the μAEs to improve their electrochemical detection capability. The μAEs demonstrated 1.5 times larger sensitivity compared with the planar electrode when hydrogen peroxide was detected. Furthermore, μAE500 with Pt-Pd/MWCNTs was employed to detect sarcosine, a potential biomarker for prostate cancer. The linear range and limit of detection for sarcosine were from 5 to 60 μM and 1.28 μM, respectively. This detection range covers the concentration of sarcosine in human tissues (0-60 μM). These results suggest that the μAEs have better detection performance in comparison to planar electrodes due to their large surface area and pillar height. This paper provides essential guidelines for the application of μAEs in high sensitivity electrochemical detection of low abundance analytes.

Single-Atom Cobalt-Based Electrochemical Biomimetic Uric Acid Sensor with Wide Linear Range and Ultralow Detection Limit

Uric acid (UA) detection is essential in diagnosis of arthritis, preeclampsia, renal disorder, and cardiovascular diseases, but it is very challenging to realize the required wide detection range and low detection limit. We present here a single-atom catalyst consisting of Co^(II) atoms coordinated by an average of 3.4 N atoms on an N-doped graphene matrix (A-Co-NG) to build an electrochemical biomimetic sensor for UA detection. The A-Co-NG sensor achieves a wide detection range over 0.4-41,950 μM and an extremely low detection limit of 33.3 ± 0.024 nM, which are much better than previously reported sensors based on various nanostructured materials. Besides, the A-Co-NG sensor also demonstrates its accurate serum diagnosis for UA for its practical application. Combination of experimental and theoretical calculation discovers that the catalytic process of the A-Co-NG toward UA starts from the oxidation of Co species to form a Co³⁺-OH-UA*, followed by the generation of Co³⁺-OH + ^*UA_H, eventually leading to N-H bond dissociation for the formation of oxidized UA molecule and reduction of oxidized Co³⁺ to Co²⁺ for the regenerated A-Co-NG. This work provides a promising material to realize UA detection with wide detection range and low detection limit to meet the practical diagnosis requirements, and the proposed sensing mechanism sheds light on fundamental insights for guiding exploration of other biosensing processes.

Diagnostic methods and potential portable biosensors for coronavirus disease 2019

Timely detection and diagnosis are urgently needed to guide epidemiological measures, infection control, antiviral treatment, and vaccine research. In this review, biomarkers/indicators for diagnosis of coronavirus disease 2019 (COVID-19) or detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the environment are summarized and discussed. It is concluded that the detection methods targeting antibodies are not suitable for screening of early and asymptomatic cases since most patients had an antibody response at about 10 days after onset of symptoms. However, antibody detection methods can be combined with quantitative real-time reverse transcriptase-polymerase chain reaction (RT-qPCR) to significantly improve the sensitivity and specificity of diagnosis, and boost vaccine research. Fast, sensitive and accurate detection methods targeting antigens need to be developed urgently. Various specimens for diagnosis or detection are compared and analyzed. Among them, deep throat saliva and induced sputum are desired for RT-qPCR test or other early detection technologies. Chest computerized tomography (CT) scan, RT-qPCR, lateral flow immunochromatographic strip (LFICS) for diagnosis of COVID-19 are summarized and compared. Specially, potential electrochemical (EC) biosensor, surface enhanced Raman scattering (SERS)-based biosensor, field-effect transistor (FET)-based biosensor, surface plasmon resonance (SPR)-based biosensor and artificial intelligence (AI) assisted diagnosis of COVID-19 are emphasized. Finally, some commercialized portable detection device, current challenges and future directions are discussed.

Label-free immunodetection of α-synuclein by using a microfluidics coplanar electrolyte-gated organic field-effect transistor

The aggregation of α-synuclein is a critical event in the pathogenesis of neurological diseases, such as Parkinson or Alzheimer. Here, we present a label-free sensor based on an Electrolyte-Gated Organic Field-Effect Transistor (EGOFET) integrated with microfluidics that allows for the detection of amounts of α-synuclein in the range from 0.25 pM to 25 nM. The lower limit of detection (LOD) measures the potential of our integrated device as a tool for prognostics and diagnostics. In our device, the gate electrode is the effective sensing element as it is functionalised with anti-(α-synuclein) antibodies using a dual strategy: i) an amino-terminated self-assembled monolayer activated by glutaraldehyde, and ii) the His-tagged recombinant protein G. In both approaches, comparable sensitivity values were achieved, featuring very low LOD values at the sub-pM level. The microfluidics engineering is central to achieve a controlled functionalisation of the gate electrode and avoid contamination or physisorption on the organic semiconductor. The demonstrated sensing architecture, being a disposable stand-alone chip, can be operated as a point-of-care test, but also it might represent a promising label-free tool to explore in-vitro protein aggregation that takes place during the progression of neurodegenerative illnesses.

Evaluation of electrochemical quartz crystal microbalance based sensor modified by uric acid-imprinted polypyrrole

Uric acid-imprinted polypyrrole-based (MIP_(UA)-Ppy) electrochemical quartz crystal microbalance sensor (EQCM) was developed. Experiments and theoretical calculations were focused on molecular interactions between uric acid molecule and: i) polypyrrole imprinted by uric acid (MIP_(UA)-Ppy) ii) polypyrrole film without any molecular imprints (NIP-Ppy). Resonant frequency differences during electrochemical deposition of MIP_(UA)-Ppy and NIP-Ppy films were observed and were attributed to the phenomenon of molecule capture within formed Ppy matrix. EQCM-resonators modified by MIP-Ppy showed the following advantages: selectivity, qualitative response, cost-effectiveness, and simple procedure. The selectivity of MIP_(UA)-Ppy was tested by the replacement of uric acid in the PBS solution with several different concentrations of caffeine and glucose. Langmuir isotherm based molecular adsorption model was applied to evaluate the interaction of MIP_(UA)-Ppy with uric acid. From experimental results calculated the standard Gibbs free energy of association (ΔG_a) of uric acid with MIP_(UA)-Ppy is -16.4 ± 2.05 kJ/mol and with NIP-Ppy is -13.3 ± 8.56 kJ/mol ΔG values illustrate that the formation of uric acid complex with MIP_(UA)-Ppy is thermodynamically more favourable than that for complexation with NIP-Ppy.

Nanomaterial-based immunosensors for ultrasensitive detection of pesticides/herbicides: Current status and perspectives

The increasing level of pesticides and herbicides in food and water sources is a growing threat to human health and the environment. The development of portable, sensitive, specific, simple, and cost-effective sensors is hence in high demand to avoid exposure or consumption of these chemicals through efficient monitoring of their levels in food as well as water samples. The use of nanomaterials (NMs) for the construction of an immunosensing system was demonstrated to be an efficient and effective option to realize selective sensing against pesticides/herbicides. The potential of such applications has hence been demonstrated for a variety of NMs including graphene, carbon nanotubes (CNTs), metal nanoparticles, and nano-polymers either in pristine or composite forms based on diverse sensing principles (e.g., electrochemical, optical, and quartz crystal microbalance (QCM)). This article evaluates the development, applicability, and performances of NM-based immunosensors for the measurement of pesticides and herbicides in water, food, and soil samples. The performance of all the surveyed sensors has been evaluated on the basis of key parameters, e.g., detection limit (DL), sensing range, and response time.

White blood cell counting at point-of-care testing: A review

White blood cells, which are also called leukocytes, are found in the immune system that are involved in protecting the body against infections and foreign invaders. Conventional methods of leukocyte analysis provide valuable and accurate information to medical specialists. Analyzing and diagnosing of a disease requires a combination of multiple biomarkers, in some cases, however, such as personal health care, this will occupy some medical resources and causes unnecessary consumption. Traditional method (such as flow cytometer) for WBC counting is time and labor consuming. Compared to gold standard (flow-based fraction/micropore filtration) or improved filtration methods for WBC counting, this is still a lengthy and time consuming process and can lead to membrane fouling due to the rapid accumulation of biological materials. Therefore, the analysis of WBC counts requires more compact and efficient equipment. The microfluidic technologies, powered by different field (force, thermal, acoustic, optical, magnetic) and other methods for leukocyte counting and analysis, are much cost-efficient and can be used in in-home or in resource-limited areas to achieve Point-of-Care (POC). In this review, we highlight the mainstream devices that have been commercialized and extensively employed for patients for WBC counting, Next, we present some recent development with regards to leucocyte counting (mainly microfluidic technologies) and comment on their relative merits. We aim to focus and discuss the possibility of achieving POC and help researchers to tackle individual challenges accordingly. Finally, we offer some technologies in addition to previous detection devices, such as image recognition technology and cloud computing, which we believe have great potential to further promote real-time detection and improve medical diagnosis.

Accuracy improvement of electrochemical whole blood ketone sensor based on HCT compensation algorithm

In this manuscript, we demonstrated an electrochemical test strip with HCT (hematocrit) compensation algorithm to improve the accuracy of blood ketone sensor. In the conventional electrochemical sensor, the electrochemical current was directly resolved into the concentration value of the determinant without HCT compensation. For lower or higher HCT blood sample, the measured result was inaccurate. In the proposed design, the blood impedance can be measured to estimate the HCT, which was utilized to compensate the electrochemical current to resolve the more accurate concentration of determinant. The practical blood sample tests demonstrated the proposed design can provide more believable and reliable measured result in clinical point-of-care setting.

A Europium-based MOF Fluorescent Probe for Efficiently Detecting Malachite Green and Uric Acid

Lanthanide (such as Tb and Eu) metal-organic frameworks (MOFs) have been widely used in fluorescent probes because of their multiple coordination modes and brilliant fluorescence characteristic. Many lanthanide MOFs were applied in detecting metal ions, inorganic anions, and small molecules. However, it's rarely reported that Ln-MOF was devoted to detecting malachite green (MG) and uric acid (UA). We prepared a europium-based metal-organic framework (Eu-TDA) (TDA = 2,5-thiophenedicarboxylic acid group). Luminescence studies demonstrated that Eu-TDA can rapidly detect MG and UA with excellent selectivity and sensitivity, where individual quenching efficiency K_sv (MG: 5.8 × 10⁵ M^-1; UA: 4.15 × 10⁴ M^-1) and detection limit (MG: 0.0221 μM; UA: 0.689 μM) were regarded as the excellent MOF sensors for detecting MG and UA. The quenching of Eu-TDA's fluorescence emission by MG and UA was likely due to the spectral overlap, energy transfer, and competition. Among 11 metal cations and 14 anions, Eu-TDA can quickly and effectively recognize MG and UA with highly selective and sensitive properties. Our method possesses potential application in detecting UA in human blood and MG in the fishpond.

The Role and Challenges of Body Channel Communication in Wearable Flexible Electronics

Flexible electronics are compatible with film substrates that are soft and stretchable, resulting in conformal integration with human body. Integrated with various sensors and communication ICs, wearable flexible electronics are able to effectively track human vital signs without affecting the body activities. Such a wearable flexible system contains a sensor, a front-end amplifier (FEA), an analog-to-digital converter (ADC), a micro-controller unit (MCU), a radio, a power management unit (PMU), where the radio is the design bottleneck due to its high power consumption. Different from conventional wireless communications, body channel communication (BCC) uses the human body surface as the signal transmission medium resulting in less signal loss and low power consumption. However, there are some design challenges in BCC, including body channel model, backward loss, variable contact impedance, stringent spectral mask, crystalless design, body antenna effect, etc. In this paper, we conduct a survey on BCC transceiver, and analyze its potential role and challenges in wearable flexible electronics.

A smartphone-based biomedical sensory system

Disease diagnostics, food safety monitoring and environmental quality monitoring are the key means to safeguard human health. However, conventional detection devices for health care are costly, bulky and complex, restricting their applications in resource-limited areas of the world. With the rapid development of biosensors and the popularization of smartphones, smartphone-based sensing systems have emerged as novel detection devices that combine the sensitivity of biosensors and diverse functions of smartphones to provide a rapid, low-cost and convenient detection method. In these systems, a smartphone is used as a microscope to observe and count cells, as a camera to record fluorescence images, as an analytical platform to analyze experimental data, and as an effective tool to connect detection devices and online doctors. These systems are widely used for cell analysis, biochemical analysis, immunoassays, and molecular diagnosis, which are applied in the fields of disease diagnostics, food safety monitoring and environmental quality monitoring. Therefore, we discuss four types of smartphone-based sensing systems in this review paper, specifically in terms of the structure, performance and efficiency of these systems. Finally, we give some suggestions for improvement and future prospective trends.