A Capacitive Sweat Rate Sensor for Continuous and Real-Time Monitoring of Sweat Loss

High-Performance Supercapacitive Pressure Sensors via Height-Grading Micro-Domes of Ionic Conductive Elastomer

Soft capacitive sensors present numerous appealing characteristics, including simple structure, low power consumption, and fast response. However, they often suffer from low sensitivity and a limited linear sensing range. Herein, a concept is presented to enhance the sensitivity and linearity of supercapacitive pressure sensors by functionally grading the heights of macrodomes constructed from a highly elastic and ionic conductive elastomer made of poly(vinyl alcohol) and phosphoric acid (PVA/H3PO4). The resultant supercapacitive sensors exhibit a high sensitivity (423.42 kPa-1), wide linear sensing range (0-400 kPa), ultralow limit of detection (0.48 Pa), and high durability (stable signal outputs up to 5000 cycles of loading/unloading). Additionally, the sensors can maintain consistent sensing performance within a temperature range of 25-40 °C. The potential of the sensor in health monitoring is demonstrated through ultrahigh-resolution weight measurement, pulse detection, and respiration monitoring.

Flexible epidermal wearable sensor for Athlete's sweat biomarkers monitoring

Wearable sweat sensors hold great promise for the monitoring of athletic sweat biomarkers that are reflective of physical status and the inimitable feature of wearable sensors to conduct dynamic sweat analysis in situ. However, the preparative methods of wearable patches for monitoring athlete's biomarkers are often complicated. Here, we demonstrate the first example of "sports lab-on-skin" as a fully integrated epidermal sweat sensor through simple laser engraving and laser cutting methods, which enables on-body and wirelessly measuring sweat Na+, sweat K+, sweat lactate, and initial sweat rate for physical status assessment. We test the performance of the "sports lab-on-skin" in both physically trained and un-trained groups under the same exercise intensity. We also validate the influence of different scenarios (water intake, breakfast, and exercise intensity) on dehydration time, sweat K+ level, sweat lactate level, and initial sweat rate.

Quantitative analysis of sweat evaporation loss in epidermal microfluidic patches

Sweat analysis is identified as a promising biochemical technique for the non-invasive assessment of human health status. Epidermal microfluidic patches are the predominant sweat sampling and sensing devices. However, the sweat stored inside the patches may suffer from evaporation loss of moisture, which can increase the concentration of biomarkers and cause the biochemical analysis results of sweat to deviate from the actual results. This study focuses on quantitatively analysing the sweat evaporation loss within epidermal microfluidic patches. Analytical models based on the dissolution diffusion mechanism and corresponding partial differential equations for the diffusion process were initially developed. The analytical solution of the equation was derived using the method of separation of variables, and the steady-state concentration distribution of water in the materials of microfluidic patches was calculated when considering the application of epidermal microfluidics. Evaporation losses of sweat through different paths were quantitatively calculated and analysed, including permeation through covers, diffusion along microchannels, and absorption by sidewalls. Then, experiments on the evaporation loss of sweat within microfluidic patches were conducted to validate the theoretical calculations and analytical results. At last, the design of the anti-evaporation structure for microfluidic patches was discussed. This study can provide theoretical and experimental references for the design of water-retention structures in epidermal microfluidic patches, which significantly enhances the overall reliability of sweat biochemical analysis results.

Microfluidic Sensing Textile for Continuous Monitoring of Sweat Glucose at Rest

Wearable sweat sensors have received considerable attention due to their great potential for noninvasive continuous monitoring of an individual's health status applications. However, the low secretion rate and fast evaporation of sweat pose challenges in collecting sweat from sedentary individuals for noninvasive analysis of body physiology. Here, we demonstrate wearable textiles for continuous monitoring of sweat at rest using the combination of a heating element and a microfluidic channel to increase localized skin sweat secretion rates and combat sweat evaporation, enabling accurate and stable monitoring of trace amounts of sweat. The Janus sensing yarns with a glucose sensing sensitivity of 36.57 mA cm-2 mM-1 are embroidered into the superhydrophobic heated textile to collect sweat directionally, resulting in improved sweat collection efficiency of up to 96 and 75% retention. The device also maintains a highly durable sensing performance, even in dynamic deformation, recycling, and washing. The microfluidic sensing textile can be further designed into a wireless sensing system that enables sedentary-compatible sweat analysis for the continuous, real-time monitoring of body glucose levels at rest.

Harvesting and manipulating sweat and interstitial fluid in microfluidic devices

Microfluidic devices began to be used to facilitate sweat and interstitial fluid (ISF) sensing in the mid-2010s. Since then, numerous prototypes involving microfluidics have been developed in different form factors for sensing biomarkers found in these fluids under in vitro, ex vivo, and in vivo (on-body) settings. These devices transport and manipulate biofluids using microfluidic channels composed of silicone, polymer, paper, or fiber. Fluid flow transport and sample management can be achieved by controlling the flow rate, surface morphology of the channel, and rate of fluid evaporation. Although many devices have been developed for estimating sweat rate, electrolyte, and metabolite levels, only a handful have been able to proceed beyond laboratory testing and reach the stage of clinical trials and commercialization. To further this technology, this review reports on the utilization of microfluidics towards sweat and ISF management and transport. The review is distinguished from other recent reviews by focusing on microfluidic principles of sweat and ISF generation, transport, extraction, and management. Challenges and prospects are highlighted, with a discussion on how to transition such prototypes towards personalized healthcare monitoring systems.

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

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

Soft Epidermal Paperfluidics for Sweat Analysis by Ratiometric Raman Spectroscopy

The expanding interest in digital biomarker analysis focused on non-invasive human bodily fluids, such as sweat, highlights the pressing need for easily manufactured and highly efficient soft lab-on-skin solutions. Here, we report, for the first time, the integration of microfluidic paper-based devices (μPAD) and non-enhanced Raman-scattering-enabled optical biochemical sensing (Raman biosensing). Their integration merges the enormous benefits of μPAD, with high potential for commercialization and use in resource-limited settings, with biorecognition-element-free (but highly selective) optical Raman biosensing. The introduced thin (0.36 mm), ultra-lightweight (0.19 g), and compact footprint (3 cm2) opto-paperfluidic sweat patch is flexible, stretchable, and conforms, irritation-free, to hairless or minimally haired body regions to enable swift sweat collection. As a great advantage, this new bio-chemical sensory system excels through its absence of onboard biorecognition elements (bioreceptor-free) and omission of plasmonic nanomaterials. The proposed easy fabrication process is adaptable to mass production by following a fully sustainable and cost-effective process utilizing only basic tools by avoiding typically employed printing or laser patterning. Furthermore, efficient collection and transportation of precise sweat volumes, driven exclusively by the wicking properties of porous materials, shows high efficiency in liquid transportation and reduces biosensing latency by a factor of 5 compared to state-of-the-art epidermal microfluidics. The proposed unit enables electronic chip-free and imaging-less visual sweat loss quantification as well as optical biochemical analysis when coupled with Raman spectroscopy. We investigated the multimodal quantification of sweat urea and lactate levels ex vivo (with syntactic sweat including +30 sweat analytes on porcine skin) and achieved a linear dynamic range from 0 to 100 mmol/L during fully dynamic continuous flow characterization.

Novel Sweat-Based Wearable Device for Advanced Monitoring of Athletic Physiological Biometrics

Blood testing has traditionally been the gold standard for the physiological analysis and monitoring of professional athletes. In recent years, blood testing has moved out of the laboratory thanks to portable handheld devices, such as lactate meters. However, despite its usefulness and widespread use, blood testing has several drawbacks and limitations, such as the need for the athlete to stop exercising for blood extraction and the inability to have data continuously collected. In this scenario, sweat has become an alternative to blood testing because of its rich content of electrolytes and metabolites, as well as small quantities of sugars, proteins, and ions. Nevertheless, there are few devices capable of analyzing this biofluid and providing useful information to users. In this paper, an electronic system designed for the autonomous analysis of sweat electrolytes and metabolites along with heart rate dynamics is presented. This system is part of a novel wearable device tailored for athletes that offers to the user a real-time assessment of their physiological status and performance.

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Recent advances in skin-interfaced wearable sweat sensors enable the noninvasive, real-time monitoring of biochemical signals associated with health and wellness. These wearable platforms leverage microfluidic channels, biochemical sensors, and flexible electronics to enable the continuous analysis of sweat-based biomarkers such as electrolytes, metabolites, and hormones. As this field continues to mature, the potential of low-cost, continuous personalized health monitoring enabled by such wearable sensors holds significant promise for addressing some of the formidable obstacles to delivering comprehensive medical care in under-resourced settings. This Perspective highlights the transformative potential of wearable sweat sensing for providing equitable access to cutting-edge healthcare diagnostics, especially in remote or geographically isolated areas. It examines the current understanding of sweat composition as well as recent innovations in microfluidic device architectures and sensing strategies by showcasing emerging applications and opportunities for innovation. It concludes with a discussion on expanding the utility of wearable sweat sensors for clinically relevant health applications and opportunities for enabling equitable access to innovation to address existing health disparities.

Wearable Ion Sensors for the Detection of Sweat Ions Fabricated by Heat-Transfer Printing

Wearable ion sensors for the real-time monitoring of sweat biomarkers have recently attracted increasing research attention. Here, we fabricated a novel chloride ion sensor for real-time sweat monitoring. The printed sensor was heat-transferred onto nonwoven cloth, allowing for easy attachment to various types of clothing, including simple garments. Additionally, the cloth prevents contact between the skin and the sensor and acts as a flow path. The change in the electromotive force of the chloride ion sensor was -59.5 mTV/log CCl-. In addition, the sensor showed a good linear relationship with the concentration range of chloride ions in human sweat. Moreover, the sensor displayed a Nernst response, confirming no changes in the film composition due to heat transfer. Finally, the fabricated ion sensors were applied to the skin of a human volunteer subjected to an exercise test. In addition, a wireless transmitter was combined with the sensor to wirelessly monitor ions in sweat. The sensors showed significant responses to both sweat perspiration and exercise intensity. Thus, our research demonstrates the potential of using wearable ion sensors for the real-time monitoring of sweat biomarkers, which could significantly impact the development of personalized healthcare.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Flexible Sweat Sensors: From Films to Textiles

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

Paper-Based Sandwich-Structured Wearable Sensor with Sebum Filtering for Continuous Detection of Sweat pH

Wearable sweat sensors, a product of the development of flexible electronics and microfluidic technologies, can continuously and noninvasively monitor abundant biomarkers in human sweat; however, sweat interferences, such as sebum, can reduce sensor reliability and accuracy. Herein, for the first time, the influence of sebum on the potentiometric response of an all-solid-state pH sensor was studied, and the obtained experimental results show that sebum mixed in sweat can decrease the potential response of the sensor and the slope of its calibration curve. A paper-based sandwich-structured pH sensor that can filter the sebum mixed in sweat was proposed based on commonly used oil-control sheets. Moreover, the hydrophilic properties, microstructure, and microfluidic performance of the sensor were investigated. The detection performance of the paper-based sandwich-structured pH sensor was comprehensively evaluated in terms of calibration in the presence of sebum and potentiometric response upon the addition of sebum. Furthermore, the anti-interference ability of the sensor was evaluated using different analytes under various deformation conditions. On-body trials were conducted to verify the performance, and their results showed that the proposed sensor can filter over 90% of the sebum in sweat, significantly enhancing sensor reliability and accuracy. Additionally, microfluidic channels could be simply fabricated using a scissor and paper, obviating the need for complex micromachining processes, such as photolithography and laser engraving. Overall, this work illustrates the influence of sebum on the detection performance of traditional potentiometric wearable sensors and paves the way for their development for real-world applications.

Full-Cut Manufacture of Skin-Interfaced Microfluidic Patch with Copper Electrode for In Situ Admittance Sensing of Sweat Rate

Sweat-rate measurement has received more and more attention, especially for specific groups, such as athletes, soldiers and manual workers, due to their excessive sweat loss under prolonged intense heat stress, which increases the risk of dehydration and electrolyte imbalance. The highly effective manufacture of a sweat-sensing device is essential to its wide range of applications in perspiration-related physiological information detection. In this work, we propose a simple and cost-effective strategy for the manufacture of a microfluidic sweat-rate-sensing patch via laser cutting and transfer printing technology. A copper foil tape is used as the electrode for in situ admittance based sweat-rate-sensing. The detection circuits and measurement conditions are optimized to prevent the negative effect of an electrochemical reaction between a copper electrode and sweat for precise admittance measurement. In vitro and on-body experiments demonstrate that the copper electrode is applicable for admittance-based sweat sensing and is capable of achieving equivalent sensing accuracy as a gold electrode and that the proposed sensor structure can perform consecutive and accurate sweat-rate-sensing and facilitates a significant increase in manufacturing efficiency.

A Focused Review on the Flexible Wearable Sensors for Sports: From Kinematics to Physiologies

As an important branch of wearable electronics, highly flexible and wearable sensors are gaining huge attention due to their emerging applications. In recent years, the participation of wearable devices in sports has revolutionized the way to capture the kinematical and physiological status of athletes. This review focuses on the rapid development of flexible and wearable sensor technologies for sports. We identify and discuss the indicators that reveal the performance and physical condition of players. The kinematical indicators are mentioned according to the relevant body parts, and the physiological indicators are classified into vital signs and metabolisms. Additionally, the available wearable devices and their significant applications in monitoring these kinematical and physiological parameters are described with emphasis. The potential challenges and prospects for the future developments of wearable sensors in sports are discussed comprehensively. This review paper will assist both athletic individuals and researchers to have a comprehensive glimpse of the wearable techniques applied in different sports.

Development of a prototype toe sensor for detection of diabetic peripheral small fiber neuropathy

Diabetic peripheral neuropathy (DPN) affects a large proportion of people with diabetes, and early detection is essential to prevent further progression. Widespread clinical testing relies on simplicity and cost-effectiveness of examination. Early signs of DPN may be detected by assessing the sudomotor nerves, and sudomotor activity can be measured by bioimpedance. We present a prototype toe probe for DPN detection including sensors for measuring skin AC conductance, skin temperature and humidity. The prototype was tested on five participants with DPN and five healthy age-matched controls in a pilot study. Sudomotor sensor responses to a simple deep breathing test were very weak or absent in the DPN group, with all controls having larger responses than the DPN group. Evaporation was lower for the DPN group, and skin temperature was higher on average. For the same foot, the results for sudomotor responses were in agreement with sensory neurography amplitudes from the sural nerve whereas the monofilament test gave normal results for two of the DPN participants. If sufficient detection accuracy is confirmed in larger studies, the method may provide a simple and cost-effective tool to support clinical examination. Clinical Relevance- We present the early realization and testing of a simple device to support early detection of diabetic peripheral neuropathy.

Resettable Microfluidics for Broad-Range and Prolonged Sweat Rate Sensing

Wearable sweat sensors are emerging as promising platforms for personalized and real-time tracking of evolving health and fitness parameters. While most wearable sweat sensors focus on tracking biomarker concentration profiles, sweat secretion rate is a key metric with broad implications for assessing hydration, cardiac, and neural conditions. Here we present a wearable microfluidic sensor for continuous sweat rate measurement. A discrete impedimetric sensing scheme relying on interdigitated electrodes within a microfluidic sweat collector allows for precise and selective sweat rate measurement across a broad physiological range. Integration of a manually activated pressure pump to expel sweat from the device prevents sensor saturation and enables continuous sweat rate tracking over hours. By enabling broad range and prolonged sweat rate measurement, this platform tackles a key obstacle to realizing meaningful and actionable sweat sensing for applications in exercise physiology and medicine.

Dissolvable Polymer Valves for Sweat Chrono-Sampling in Wearable Paper-Based Analytical Devices

Paper sensors with colorimetric signal transduction mechanisms are promising for developing single-use wearable patches that only require a smartphone to quantify signals. However, measuring biomarker fluctuations with colorimetric wearable sensors requires implementing a chrono-sampling method for performing sequential measurements. In this article, we report on a chrono-sampling method that enables the fabrication of wearable devices made entirely of filter paper. It consists of using dried polymers as closed valves that deflect the flow of liquids to different transducers of a multisensor. As time passes by, the polymer dissolves and the valve opens. The sequential opening of the valves results in a succession of measurements that reveals fluctuations in the concentration of the target analyte. This concept was demonstrated with a paper multisensor capable of performing nine consecutive pH measurements. The device was also adapted for developing a urea biosensor that detects pH measurements generated by the hydrolysis of the analyte catalyzed by urease. The proposed analytical platform could monitor the pH of sweat with an accuracy and precision comparable to a laboratory-based method when worn during an exercise routine. The results shown here pave the way for developing colorimetric wearable biosensors that measure variations in the concentration of biomarkers such as glucose, lactate, creatinine, or uric acid over time.

Wearable Sweat Loss Measuring Devices: From the Role of Sweat Loss to Advanced Mechanisms and Designs

Wearable sweat sensors have received significant research interest and have become popular as sweat contains considerable health information about physiological and psychological states. However, measured biomarker concentrations vary with sweat rates, which has a significant effect on the accuracy and reliability of sweat biosensors. Wearable sweat loss measuring devices (SLMDs) have recently been proposed to overcome the limitations of biomarker tracking and reduce inter- and intraindividual variability. In addition, they offer substantial potential for monitoring human body homeostasis, because sweat loss plays an indispensable role in thermoregulation and skin hydration. Previous studies have not carried out a comprehensive and systematic review of the principles, importance, and development of wearable SLMDs. This paper reviews wearable SLMDs with a new health perspective from the role of sweat loss to advanced mechanisms and designs. Two types of sweat and their measurement significance for practical applications are highlighted. Then, a comprehensive review of advances in different wearable SLMDs based on hygrometers, absorbent materials, and microfluidics is presented by describing their respective device architectures, present situations, and future directions. Finally, concluding remarks on opportunities for future application fields and challenges for future sweat sensing are presented.

Biosymbiotic, personalized, and digitally manufactured wireless devices for indefinite collection of high-fidelity biosignals

Digital medicine, the ability to stream continuous information from the body to gain insight into health status, manage disease, and predict onset health problems, is only gradually developing. Key technological hurdles that slow the proliferation of this approach are means by which clinical grade biosignals are continuously obtained without frequent user interaction. To overcome these hurdles, solutions in power supply and interface strategies that maintain high-fidelity readouts chronically are critical. This work introduces a previously unexplored class of devices that overcomes the limitations using digital manufacturing to tailor geometry, mechanics, electromagnetics, electronics, and fluidics to create unique personalized devices optimized to the wearer. These elastomeric, three-dimensional printed, and laser-structured constructs, called biosymbiotic devices, enable adhesive-free interfaces and the inclusion of high-performance, far-field energy harvesting to facilitate continuous wireless and battery-free operation of multimodal and multidevice, high-fidelity biosensing in an at-home setting without user interaction.

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.