Flexible nanoporous tunable electrical double layer biosensors for sweat diagnostics

Selective detection of salivary cortisol using screen-printed electrode coated with molecularly imprinted polymer

A novel electrochemical sensor was developed for the detection of salivary cortisol levels. The sensor employs a combination of a molecularly imprinted polymer (MIP) and gold nanoparticles (AuNPs) that are electrodeposited onto a screen-printed electrode (SPE). The study utilised density functional theory and molecular docking techniques to determine the geometry of molecular orbitals, electrostatic potential energies, and binding energy of cortisol and the polymers. The thin film of cortisol-imprinted polymer on the SPE was created by electro-polymerizing pyrrole and thiophene-3-carboxylic acid on the electrode surface along with cortisol as the template molecule. The MIP film was characterised using scanning electron microscopy (SEM), Fourier-transform infrared spectroscopy (FTIR), and electrochemical techniques. The sensor exhibited a linear response in the concentration range of 0.05 nmol L-1 to 2.5 μmol L-1, with a limit of detection of 0.01 nmol L-1, as determined by differential pulse voltammetry. This method offers a simple yet efficient and sensitive approach to detecting cortisol levels in human saliva samples.

Rapid Near-Patient Impedimetric Sensing Platform for Prostate Cancer Diagnosis

With the global escalation of concerns surrounding prostate cancer (PCa) diagnosis, reliance on the serologic prostate-specific antigen (PSA) test remains the primary approach. However, the imperative for early PCa diagnosis necessitates more effective, accurate, and rapid diagnostic point-of-care (POC) devices to enhance the result reliability and minimize disease-related complications. Among POC approaches, electrochemical biosensors, known for their amenability and miniaturization capabilities, have emerged as promising candidates. In this study, we developed an impedimetric sensing platform to detect urinary zinc (UZn) in both artificial and clinical urine samples. Our approach lies in integrating label-free impedimetric sensing and the introduction of porosity through surface modification techniques. Leveraging a cellulose acetate/reduced graphene oxide composite, our sensor's recognition layer is engineered to exhibit enhanced porosity, critical for improving the sensitivity, capture, and interaction with UZn. The sensitivity is further amplified by incorporating zincon as an external dopant, establishing highly effective recognition sites. Our sensor demonstrates a limit of detection of 7.33 ng/mL in the 0.1-1000 ng/mL dynamic range, which aligns with the reference benchmark samples from clinical biochemistry. Our sensor results are comparable with the results of inductively coupled plasma mass spectrometry (ICP-MS) where a notable correlation of 0.991 is achieved. To validate our sensor in a real-life scenario, tests were performed on human urine samples from patients being investigated for prostate cancer. Testing clinical urine samples using our sensing platform and ICP-MS produced highly comparable results. A linear correlation with R2 = 0.964 with no significant difference between two groups (p-value = 0.936) was found, thus confirming the reliability of our sensing platform.

Continuous Monitoring of CRP, IL-6, and Calprotectin in Inflammatory Bowel Disease Using a Perspiration-Based Wearable Device

BACKGROUND

Wearable sensor devices represent a noninvasive technology to continuously track biomarkers linked to inflammatory bowel disease (IBD). We assessed the inflammatory markers associated with IBD in human perspiration.

METHODS

Participants with IBD were monitored for 40 to 130 minutes with a proprietary wearable sensor device used to measure C-reactive protein, interleukin-6, and calprotectin. Sensor response using electrochemical impedance spectroscopy and serum samples were measured on the same day. The Mann-Whitney test was used to analyze the relationship between active and remission IBD in serum and perspiration, classified according to endoscopic reports and serum biomarker levels. Asynchronously collected fecal calprotectin from a subset of the population was similarly analyzed.

RESULTS

A total of 33 subjects were enrolled. Expression of calprotectin was significantly elevated in the active cohort compared with the remission cohort in perspiration (P < .05; median = 906.69 ng/mL; active 95% confidence interval [CI], 466.0-1833 ng/mL; remission 95% CI, 328.4-950.8 ng/mL), serum (median = 1860.82 ng/mL; active 95% CI, 1705-2985 ng/mL; remission 95% CI, 870.2-1786 ng/mL), and stool (P < .05; median = 126.74 µg/g; active 95% CI, 77.08-347.1 µg/g; remission 95% CI, 5.038-190.4 µg/g). Expression of CRP in perspiration and serum was comparable between the active and remission cohorts (perspiration: P > .05; median = 970.83 pg/mL; active 95% CI, 908.7-992 pg/mL; remission 95% CI, 903.3-991.9 pg/mL; serum: median = 2.34 µg/mL; active 95% CI, 1.267-4.492 µg/mL; remission 95% CI, 1.648-4.287 µg/mL). Expression of interleukin-6 in perspiration was nonsignificant in the active cohort compared with the remission cohort and was significantly elevated in serum (perspiration: P < .05; median = 2.13 pg/mL; active 95% CI, 2.124-2.44 pg/mL; remission 95% CI, 1.661-2.451 pg/mL; serum: median = 1.15 pg/mL; active 95% CI, 1.549-3.964 pg/mL; remission 95% CI, 0.4301-1.257 pg/mL). Analysis of the linear relationship between perspiration and serum calprotectin (R2 = 0.7195), C-reactive protein (R2 = 0.615), and interleukin-6 (R2 = 0.5411) demonstrated a strong to moderate relationship across mediums.

CONCLUSIONS

We demonstrate the clinical utility of perspiration as a noninvasive medium for continuous measurement of inflammatory markers in IBD and find that the measures correlate with serum and stool markers across a range of disease activity.

Longitudinal assessment of sweat-based TNF-alpha in inflammatory bowel disease using a wearable device

Wearable devices can non-invasively monitor patients with chronic diseases. Sweat is an easily accessible biofluid for continuous sampling of analytes, including inflammatory markers and cytokines. We evaluated a sweat sensing wearable device in subjects with and without inflammatory bowel disease (IBD), a chronic inflammatory condition of the gastrointestinal tract. Participants with an IBD related hospital admission and a C-reactive protein level above 5 mg/L wore a sweat sensing wearable device for up to 5 days. Tumor necrosis factor-alpha (TNF-α) levels were continually assessed in the sweat via the sensor, and daily in the blood. A second cohort of healthy subjects without chronic diseases wore the device for up to 48 h. Twenty-eight subjects were enrolled. In the 16 subjects with IBD, a moderate linear relationship between serum and sweat TNF-α levels was observed (R2 = 0.72). Subjects with IBD were found to have a mean sweat TNF-α level of 2.11 pg/mL, compared to a mean value of 0.19 pg/mL in 12 healthy controls (p < 0.0001). Sweat TNF-α measurements differentiated subjects with active IBD from healthy subjects with an AUC of 0.962 (95% CI 0.894-1.000). A sweat sensing wearable device can longitudinally measure key sweat-based markers of IBD. TNF-α levels in the sweat of subjects with IBD correlate with serum values, suggesting feasibility in non-invasive disease monitoring.

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.

Field effect transistor based wearable biosensors for healthcare monitoring

The rapid advancement of wearable biosensors has revolutionized healthcare monitoring by screening in a non-invasive and continuous manner. Among various sensing techniques, field-effect transistor (FET)-based wearable biosensors attract increasing attention due to their advantages such as label-free detection, fast response, easy operation, and capability of integration. This review explores the innovative developments and applications of FET-based wearable biosensors for healthcare monitoring. Beginning with an introduction to the significance of wearable biosensors, the paper gives an overview of structural and operational principles of FETs, providing insights into their diverse classifications. Next, the paper discusses the fabrication methods, semiconductor surface modification techniques and gate surface functionalization strategies. This background lays the foundation for exploring specific FET-based biosensor designs, including enzyme, antibody and nanobody, aptamer, as well as ion-sensitive membrane sensors. Subsequently, the paper investigates the incorporation of FET-based biosensors in monitoring biomarkers present in physiological fluids such as sweat, tears, saliva, and skin interstitial fluid (ISF). Finally, we address challenges, technical issues, and opportunities related to FET-based biosensor applications. This comprehensive review underscores the transformative potential of FET-based wearable biosensors in healthcare monitoring. By offering a multidimensional perspective on device design, fabrication, functionalization and applications, this paper aims to serve as a valuable resource for researchers in the field of biosensing technology and personalized healthcare.

Electrochemical sensors for cortisol detection: Principles, designs, fabrication, and characterisation

Psychological stress is a major factor contributing to health discrepancies among individuals. Sustained exposure to stress triggers signalling pathways in the brain, which leading to the release of stress hormones in the body. Cortisol, a steroid hormone, is a significant biomarker for stress management due to its responsibility in the body's reply to stress. The release of cortisol in bloodstream prepares the body for a "fight or flight" response by increasing heart rate, blood pressure, metabolism, and suppressing the immune system. Detecting cortisol in biological samples is crucial for understanding its role in stress and personalized healthcare. Traditional techniques for cortisol detection have limitations, prompting researchers to explore alternative strategies. Electrochemical sensing has emerged as a reliable method for point-of-care (POC) cortisol detection. This review focuses on the progress made in electrochemical sensors for cortisol detection, covering their design, principle, and electroanalytical methodologies. The analytical performance of these sensors is also analysed and summarized. Despite significant advancements, the development of electrochemical cortisol sensors faces challenges such as biofouling, sample preparation, sensitivity, flexibility, stability, and recognition layer performance. Therefore, the need to develop more sensitive electrodes and materials is emphasized. Finally, we discussed the potential strategies for electrode design and provides examples of sensing approaches. Moreover, the encounters of translating research into real world applications are addressed.

Electric Double Layer Based Epidermal Electronics for Healthcare and Human-Machine Interface

Epidermal electronics, an emerging interdisciplinary field, is advancing the development of flexible devices that can seamlessly integrate with the skin. These devices, especially Electric Double Layer (EDL)-based sensors, overcome the limitations of conventional electronic devices, offering high sensitivity, rapid response, and excellent stability. Especially, Electric Double Layer (EDL)-based epidermal sensors show great potential in the application of wearable electronics to detect biological signals due to their high sensitivity, fast response, and excellent stability. The advantages can be attributed to the biocompatibility of the materials, the flexibility of the devices, and the large capacitance due to the EDL effect. Furthermore, we discuss the potential of EDL epidermal electronics as wearable sensors for health monitoring and wound healing. These devices can analyze various biofluids, offering real-time feedback on parameters like pH, temperature, glucose, lactate, and oxygen levels, which aids in accurate diagnosis and effective treatment. Beyond healthcare, we explore the role of EDL epidermal electronics in human-machine interaction, particularly their application in prosthetics and pressure-sensing robots. By mimicking the flexibility and sensitivity of human skin, these devices enhance the functionality and user experience of these systems. This review summarizes the latest advancements in EDL-based epidermal electronic devices, offering a perspective for future research in this rapidly evolving field.

MicroSweat: A Wearable Microfluidic Patch for Noninvasive and Reliable Sweat Collection Enables Human Stress Monitoring

Stress affects cognition, behavior, and physiology, leading to lasting physical and mental illness. The ability to detect and measure stress, however, is poor. Increased circulating cortisol during stress is mirrored by cortisol release from sweat glands, providing an opportunity to use it as an external biomarker for monitoring internal emotional state. Despite the attempts at using wearable sensors for monitoring sweat cortisol, there is a lack of reliable wearable sweat collection devices that preserve the concentration and integrity of sweat biomolecules corresponding to stress levels. Here, a flexible, self-powered, evaporation-free, bubble-free, surfactant-free, and scalable capillary microfluidic device, MicroSweat, is fabricated to reliably collect human sweat from different body locations. Cortisol levels are detected corresponding to severe stress ranging from 25 to 125 ng mL^-1 averaged across multiple body regions and 100-1000 ng mL^-1 from the axilla. A positive nonlinear correlation exists between cortisol concentration and stress levels quantified using the perceived stress scale (PSS). Moreover, owing to the sweat variation in response to environmental effects and physiological differences, the longitudinal and personalized profile of sweat cortisol is acquired, for the first time, for various body locations. The obtained sweat cortisol data is crucial for analyzing human stress in personalized and clinical healthcare sectors.

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.

Cortisol Immunosensors: A Literature Review

Cortisol is a steroid hormone that is involved in a broad range of physiological processes in human/animal organisms. Cortisol levels in biological samples are a valuable biomarker, e.g., of stress and stress-related diseases; thus, cortisol determination in biological fluids, such as serum, saliva and urine, is of great clinical value. Although cortisol analysis can be performed with chromatography-based analytical techniques, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS), conventional immunoassays (radioimmunoassays (RIAs), enzyme-linked immunosorbent assays (ELISAs), etc.) are considered the "gold standard" analytical methodology for cortisol, due to their high sensitivity along with a series of practical advantages, such as low-cost instrumentation, an assay protocol that is fast and easy to perform, and high sample throughput. Especially in recent decades, research efforts have focused on the replacement of conventional immunoassays by cortisol immunosensors, which may offer further improvements in the field, such as real-time analysis at the point of care (e.g., continuous cortisol monitoring in sweat through wearable electrochemical sensors). In this review, most of the reported cortisol immunosensors, mainly electrochemical and also optical ones, are presented, focusing on their immunosensing/detection principles. Future prospects are also briefly discussed.

Wearable chemical sensors based on 2D materials for healthcare applications

Chemical sensors worn on the body could make possible the continuous, noninvasive, and accurate monitoring of vital human signals, which is necessary for remote health monitoring and telemedicine. Attractive for creating high-performance, wearable chemical sensors are atomically thin materials with intriguing physical features, abundant chemistry, and high surface-to-volume ratios. These advantages allow for appropriate material-analyte interactions, resulting in a high level of sensitivity even at trace analyte concentrations. Previous review articles covered the material and device elements of 2D material-based wearable devices extensively. In contrast, little research has addressed the existing state, future outlook, and promise of 2D materials for wearable chemical sensors. We provide an overview of recent advances in 2D-material-based wearable chemical sensors to overcome this deficiency. The structure design, manufacturing techniques, and mechanisms of 2D material-based wearable chemical sensors will be evaluated, as well as their applicability in human health monitoring. Importantly, we present a thorough review of the current state of the art and the technological gaps that would enable the future design and nanomanufacturing of 2D materials and wearable chemical sensors. Finally, we explore the challenges and opportunities associated with designing and implementing 2D wearable chemical sensors.

Advances in wearable electrochemical antibody-based sensors for cortisol sensing

Cortisol is a crucial hormone involving many physiological processes. Hence, cortisol detection is essential. This review highlights the key progress made on wearable electrochemical sensors using antibodies. It covers the design, principle, and electroanalytical methodology for detecting cortisol noninvasively. This article also analyzes and collects the analytical performances of electrochemical cortisol sensors. The development of these sensors continues to face challenges such as biofouling, sample management, sensitivity, flexibility, stability, and recognition layer performance. It is also necessary to develop a sensitive electrode and material. This article also presents potential strategies for designing antibody electrodes and provides examples of sensing systems. Additionally, it discusses the challenges in translating research into practical applications.

A Proof-of-Concept Electrochemical Skin Sensor for Simultaneous Measurement of Glial Fibrillary Acidic Protein (GFAP) and Interleukin-6 (IL-6) for Management of Traumatic Brain Injuries

This work demonstrates the use of a noninvasive, sweat-based dual biomarker electrochemical sensor for continuous, prognostic monitoring of a Traumatic Brain Injury (TBI) with the aim of enhancing patient outcomes and reducing the time to treatment after injury. A multiplexed SWEATSENSER was used for noninvasive continuous monitoring of glial fibrillary acidic protein (GFAP) and Interleukin-6 (IL-6) in a human sweat analog and in human sweat. Electrochemical impedance spectroscopy (EIS) and chronoamperometry (CA) were used to measure the sensor response. The assay chemistry was characterized using Fourier Transform Infrared Spectroscopy (FTIR). The SWEATSENSER was able to detect GFAP and IL-6 in sweat over a dynamic range of 3 log orders for GFAP and 2 log orders for IL-6. The limit of detection (LOD) for GFAP detection in the sweat analog was estimated to be 14 pg/mL using EIS and the LOD for IL-6 was estimated to be 10 pg/mL using EIS. An interference study was performed where the specific signal was significantly higher than the non-specific signal. Finally, the SWEATSENSER was able to distinguish between GFAP and IL-6 in simulated conditions of a TBI in human sweat. This work demonstrates the first proof-of-feasibility of a multiplexed TBI marker combined with cytokine and inflammatory marker detection in passively expressed sweat in a wearable form-factor that can be utilized toward better management of TBIs. This is the first step toward demonstrating a noninvasive enabling technology that can enable baseline tracking of an inflammatory response.

Molecularly Imprinted Polymer-Based Sensor for Electrochemical Detection of Cortisol

As a steroid hormone, cortisol has a close relationship with the stress response, and therefore, can be used as a biomarker for early detection of stress. An electrochemical immunosensor is one of the most widely used methods to detect cortisol, with antibodies as its bioreceptor. Apart from conventional laboratory-based methods, the trend for cortisol detection has seemed to be exploiting antibodies and aptamers. Both can provide satisfactory performance with high selectivity and sensitivity, but they still face issues with their short shelf life. Molecularly imprinted polymers (MIPs) have been widely used to detect macro- and micro-molecules by forming artificial antibodies as bioreceptors. MIPs are an alternative to natural antibodies, which despite demonstrating high selectivity and a low degree of cross-reactivity, often also show a high sensitivity to the environment, leading to their denaturation. MIPs can be prepared with convenient and relatively affordable fabrication processes. They also have high durability in ambient conditions, a long shelf life, and the ability to detect cortisol molecules at a concentration as low as 2 ag/mL. By collecting data from the past five years, this review summarizes the antibody and aptamer-based amperometric sensors as well as the latest developments exploiting MIPs rather than antibodies. Lastly, factors that can improve MIPs performance and are expected to be developed in the future are also explained.

Antibody-Coated Wearable Organic Electrochemical Transistors for Cortisol Detection in Human Sweat

The dysregulation of the hormone cortisol is related to several pathological states, and its monitoring could help prevent severe stress, fatigue, and mental diseases. While wearable antibody-based biosensors could allow real-time and simple monitoring of antigens, an accurate and low-cost antibody-based cortisol detection through electrochemical methods is considerably challenging due to its low concentration and the high ionic strength of real biofluids. Here, a label-free and fast sensor for cortisol detection is proposed based on antibody-coated organic electrochemical transistors. The developed devices show unprecedented high sensitivities of 50 μA/dec for cortisol sensing in high-ionic-strength solutions with effective cortisol detection demonstrated with real human sweat. The sensing mechanism is analyzed through impedance spectroscopy and confirmed with electrical models. Compared to existing methods requiring bulky and expensive laboratory equipment, these wearable devices enable point-of-care cortisol detection in 5 min with direct sweat collection for personalized well-being monitoring.

Selective Amplification of Plasmonic Sensor Signal for Cortisol Detection Using Gold Nanoparticles

Herein, gold nanoparticles (AuNP)-modified cortisol-imprinted (AuNP-MIP) plasmonic sensor was developed for signal amplification and real-time cortisol determination in both aqueous and complex solutions. Firstly, the sensor surfaces were modified with 3-(trimethoxylyl)propyl methacrylate and then pre-complex was prepared using the functional monomer N-methacryloyl-L-histidine methyl ester. The monomer solution was made ready for polymerization by adding 2-hydroxyethyl methacrylate to ethylene glycol dimethacrylate. In order to confirm the signal enhancing effect of AuNP, only cortisol-imprinted (MIP) plasmonic sensor was prepared without AuNP. To determine the selectivity efficiency of the imprinting process, the non-imprinted (AuNP-NIP) plasmonic sensor was also prepared without cortisol. The characterization studies of the sensors were performed with atomic force microscopy and contact angle measurements. The kinetic analysis of the AuNP-MIP plasmonic sensor exhibited a high correlation coefficient (R² = 0.97) for a wide range (0.01–100 ppb) with a low detection limit (0.0087 ppb) for cortisol detection. Moreover, the high imprinting efficiency (k′ = 9.67) of the AuNP-MIP plasmonic sensor was determined by comparison with the AuNP-NIP plasmonic sensor. All kinetic results were validated and confirmed by HPLC.

Breath Analysis for the In Vivo Detection of Diabetic Ketoacidosis

Human breath analysis of volatile organic compounds has gained significant attention recently because of its rapid and noninvasive potential to detect various metabolic diseases. The detection of ketones in the breath and blood is key to diagnosing and managing diabetic ketoacidosis (DKA) in patients with type 1 diabetes. It may also be of increasing importance to detect euglycemic ketoacidosis in patients with type 1 or type 2 diabetes or heart failure, treated with sodium-glucose transporter-2 inhibitors (SGLT2-i). The present research evaluates the efficiency of colorimetry for detecting acetone and ethanol in exhaled human breath with the response time, pH effect, temperature effect, concentration effect, and selectivity of dyes. Using the proposed multidye system, we obtained a detection limit of 0.0217 ppm for acetone and 0.029 ppm for ethanol in the detection range of 0.05-50 ppm. A smartphone-assisted unit consisting of a portable colorimetric device was used to detect relative red/green/blue values within 60 s of the interface for practical and real-time application. The developed method could be used for rapid, low-cost detection of ketones in patients with type 1 diabetes and DKA and patients with type 1 or type 2 diabetes or heart failure treated with SGLT2-I and euglycemic ketoacidosis.

Targeted On-Demand Screening of Pesticide Panel in Soil Runoff

Using pesticides is a common agricultural and horticultural practice to serve as a control against weeds, fungi, and insects in plant systems. The application of these chemical agents is usually by spraying them on the crop or plant. However, this methodology is not highly directional, and so only a fraction of the pesticide actually adsorbs onto the plant, and the rest seeps through into the soil base contaminating its composition and eventually leaching into groundwater sources. Electrochemical sensors which are more practical for in situ analysis used for pesticide detection in soil runoff systems are still in dearth, while the ones published in the literature are attributed with complex sensor modification/functionalization and preprocessing of samples. Hence, in this work, we present a highly intuitive electroanalytical sensor approach toward rapid (10 min), on-demand screening of commonly used pesticides-glyphosate and atrazine-in soil runoff. The proposed sensor functions based on the affinity biosensing mechanism driven via thiol cross-linker and antibody receptors that holistically behaves as a recognition immunoassay stack that is specific and sensitive to track test pesticide analytes. Then, this developed sensor is integrated further to create a pesticide-sensing ecosystem using a front-end field-deployable smart device. The method put forward in this work is compared and validated against a standard laboratory potentiostat instrument to determine efficacy, feasibility, and robustness for a point-of-use (PoU) setting yielding LoD levels of 0.001 ng/ml for atrazine and 1 ng/ml for glyphosate. Also, the ML model integration resulted in an accurate prediction rate of ≈80% in real soil samples. Therefore, a universal pesticide screening analytical device is designed, fabricated, and tested for pesticide assessment in real soil runoff samples.

Hand-Held Raman Spectrometer-Based Dual Detection of Creatinine and Cortisol in Human Sweat Using Silver Nanoflakes

The conventional tissue biopsy method yields isolated snapshots of a narrow region. Therefore, it cannot facilitate comprehensive disease characterization and monitoring. Recently, the detection of tumor-derived components in body fluids─a practice known as liquid biopsy─has attracted increased attention from the biochemical research and clinical application viewpoints. In this vein, surface-enhanced Raman scattering (SERS) has been identified as one of the most powerful liquid-biopsy analysis techniques, owing to its high sensitivity and specificity. Moreover, it affords high-capacity spectral multiplexing for simultaneous target detection and a unique ability to obtain intrinsic biomolecule-fingerprint spectra. This paper presents the fabrication of silver nanosnowflakes (SNSFs) using the polyol method and their subsequent dropping onto a hydrophobic filter paper. The SERS substrate, which comprises the SNSFs and hydrophobic filter paper, facilitates the simultaneous detection of creatinine and cortisol in human sweat using a hand-held Raman spectrometer. The proposed SERS system affords Raman spectrometry to be performed on small sample volumes (2 μL) to identify the normal and at-risk creatinine and cortisol groups.

Tracking metabolic responses based on macronutrient consumption: A comprehensive study to continuously monitor and quantify dual markers (cortisol and glucose) in human sweat using WATCH sensor

Wearable Awareness Through Continuous Hidrosis (WATCH) sensor is a sweat based monitoring platform that tracks cortisol and glucose for the purpose of understanding metabolic responses related to macronutrient consumption. In this research article, we have demonstrated the ability of tracking these two biomarkers in passive human sweat over a workday period (8 h) for 10 human subjects in conjunction with their macronutrient consumption. The validation of the WATCH sensor performance was carried out via standard reference methods such as Luminex and ELISA This is a first demonstration of a passive sweat sensing technology that can detect interrelated dual metabolites, cortisol, and glucose, on a single sensing platform. The significance of detecting the two biomarkers simultaneously is that capturing the body's metabolic and endocrinal responses to dietary triggers can lead to improved lifestyle management. For sweat cortisol, we achieved a detection limit of 1 ng/ml (range ∼1-12.5 ng/ml) with Pearson's "r" of 0.897 in reference studies and 0.868 in WATCH studies. Similarly, for sweat glucose, we achieved a detection limit of 1 mg/dl (range ∼ 1-11 mg/dl) with Pearson's "r" of 0.968 in reference studies and 0.947 in WATCH studies, respectively. The statistical robustness of the WATCH sensor was established through the Bland-Altman analysis, whereby the sweat cortisol and sweat glucose levels are comparable to the standard reference method. The probability distribution (t-test), power analysis (power 0.82-0.87), α = 0.05. Mean absolute relative difference (MARD) outcome of ˷5.10-5.15% further confirmed the statistical robustness of the sweat sensing WATCH device output.

Wearable Biosensors for Non-Invasive Sweat Diagnostics

Recent advances in microfluidics, microelectronics, and electrochemical sensing methods have steered the way for the development of novel and potential wearable biosensors for healthcare monitoring. Wearable bioelectronics has received tremendous attention worldwide due to its great a potential for predictive medical modeling and allowing for personalized point-of-care-testing (POCT). They possess many appealing characteristics, for example, lightweight, flexibility, good stretchability, conformability, and low cost. These characteristics make wearable bioelectronics a promising platform for personalized devices. In this paper, we review recent progress in flexible and wearable sensors for non-invasive biomonitoring using sweat as the bio-fluid. Real-time and molecular-level monitoring of personal health states can be achieved with sweat-based or perspiration-based wearable biosensors. The suitability of sweat and its potential in healthcare monitoring, sweat extraction, and the challenges encountered in sweat-based analysis are summarized. The paper also discusses challenges that still hinder the full-fledged development of sweat-based wearables and presents the areas of future research.

Single-step label-free nanowell immunoassay accurately quantifies serum stress hormones within minutes

A non-faradaic label-free cortisol sensing platform is presented using a nanowell array design, in which the two probe electrodes are integrated within the nanowell structure. Rapid and low volume (≤5 μl) sensing was realized through functionalizing nanoscale volume wells with antibodies and monitoring the real-time binding events. A 28-well plate biochip was built on a glass substrate by sequential deposition, patterning, and etching steps to create a stack nanowell array sensor with an electrode gap of 40 nm. Sensor response for cortisol concentrations between 1 and 15 μg/dl in buffer solution was recorded, and a limit of detection of 0.5 μg/dl was achieved. Last, 65 human serum samples were collected to compare the response from human serum samples with results from the standard enzyme-linked immunosorbent assay (ELISA). These results confirm that nanowell array sensors could be a promising platform for point-of-care testing, where real-time, laboratory-quality diagnostic results are essential.

Autonomous, Real-Time Monitoring Electrochemical Aptasensor for Circadian Tracking of Cortisol Hormone in Sub-microliter Volumes of Passively Eluted Human Sweat

The proposed work involves the development of an autonomous, label-free electrochemical sensor for real-time monitoring of cortisol levels expressed naturally in sub-microliter sweat volumes, for prolonged sensing periods of ∼8 h. Highly specific single-stranded DNA (ssDNA) aptamer is used for affinity capture of cortisol hormone eluted in sweat dynamically. The cortisol present in sweat binds to the aptamer capture probe that changes conformation and modulates electrochemical properties at the electrode-buffer interface, which was studied using dynamic light scattering studies for the entire physiological sweat pH. Attenuated total reflectance-Fourier transform infrared spectroscopy and UV-vis spectroscopy were used to optimize the binding chemistry of the elements of the sensor stack. Nonfaradaic electrochemical impedance spectroscopy was used to calibrate the sensor for a dynamic range of 1-256 ng/mL. An R² of 0.97 with an output signal range of 20-50% was obtained. Dynamic cortisol level variation tracking was studied using continuous dosing experiments to calibrate the sensor for temporal variation. The sensor did not show significant susceptibility to noise due to cross-reactive interferents and nonspecific buffer constituents. The performance of the developed aptasensor was compared with the previously established cortisol immunosensor in terms of surface charge behavior and nonfaradaic biosensing. The aptamer sensor shows a higher signal-to-noise ratio, better resolution, and has a larger output range for the same input range as the cortisol immunosensor. The feasibility of deploying the developed aptasensing scheme as continuous lifestyle and performance monitors was validated through human subject studies.

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.

A Sweat-based Wearable Enabling Technology for Real-time Monitoring of IL-1β and CRP as Potential Markers for Inflammatory Bowel Disease

BACKGROUND

More than 1.2 million people in the United States are affected by inflammatory bowel disease (IBD). Inflammatory bowel disease has a natural course characterized by alternating periods of remission and relapse. Currently, disease flares are unpredictable as they occur in a random way. Further, current testing methods and practices lack the ability for real-time tracking of flares. There exists no technology that can be utilized for continuous monitoring of biomarkers, as most of these rely on samples such as blood, feces, and testing methods by which continuous monitoring is not feasible. Cytokines play a key role in IBD; the development, recurrence, and exacerbation of the inflammatory process are orchestrated by their levels in time and space. Cytokines are also present in sweat. We hypothesize that demonstrating real-time continuous monitoring of interleukin-1β (IL-1β) and C-reactive protein (CRP) may help create an enabling technology to track inflammation in IBD patients and identify flare-ups and assess efficacy of therapy.

METHODS

A multiplexed SWEATSENSER was used for noninvasive continuous monitoring of interleukin-1β and C-reactive protein in human eccrine sweat. Impedance spectroscopy was used to measure the sensor response. Sweat was collected using an FDA-approved PharmChek patch from 26 healthy human subjects to determine the levels of the 2 study inflammatory markers. Correlation analysis was performed for preclinical validation of the SWEATSENSER with ELISA as the reference method. On-body continuous monitoring measurements were performed on 20 human subjects using EnLiSense's SWEATSENSER wearable device for real-time monitoring studies.

RESULTS

The sensor device can detect interleukin-1β and C-reactive protein in sweat over a dynamic range of 3 log orders. Pearson correlation of r = 0.99 and r = 0.95 was achieved for IL-1β and CRP, respectively, for the SWEATSENSER with ELISA. Bland-Altman results further confirmed a good agreement (mean bias of -0.25 and -3.9 pg/mL for IL-1β and CRP, respectively) of the device with the reference method, demonstrating applicability of the device for real-time monitoring. Continuous on-body measurements were performed in 20 healthy human subjects for the detection of IL-1β to establish the preclinical utility of the sensor device. The continuous on-body measurements in healthy cohort reported a mean IL-1β concentration of ~28 pg/mL. Stable measurements for over continuous 30 hours was reported by the device.

CONCLUSION

This work demonstrates the first proof-of-feasibility of multiplexed cytokine and inflammatory marker detection in passively expressed eccrine sweat in a wearable form-factor that can be utilized toward better management of inflammatory bowel disease. This is a first step toward demonstrating a noninvasive enabling technology that can enable baseline tracking of an inflammatory response. Furthermore, this is the first study to report and quantify the presence of CRP in human eccrine sweat.

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.

Flexible Electrochemical Bioelectronics: The Rise of In Situ Bioanalysis

The amalgamation of flexible electronics in biological systems has shaped the way health and medicine are administered. The growing field of flexible electrochemical bioelectronics enables the in situ quantification of a variety of chemical constituents present in the human body and holds great promise for personalized health monitoring owing to its unique advantages such as inherent wearability, high sensitivity, high selectivity, and low cost. It represents a promising alternative to probe biomarkers in the human body in a simpler method compared to conventional instrumental analytical techniques. Various bioanalytical technologies are employed in flexible electrochemical bioelectronics, including ion-selective potentiometry, enzymatic amperometry, potential sweep voltammetry, field-effect transistors, affinity-based biosensing, as well as biofuel cells. Recent key innovations in flexible electrochemical bioelectronics from electrochemical sensing modalities, materials, systems, fabrication, to applications are summarized and highlighted. The challenges and opportunities in this field moving forward toward future preventive and personalized medicine devices are also discussed.

Salivary Cortisol Determination on Smartphone-Based Differential Pulse Voltammetry System

Cortisol is commonly used as a significant biomarker of psychological or physical stress. With the accelerated pace of life, non-invasive cortisol detection at the point of care (POC) is in high demand for personal health monitoring. In this paper, an ultrasensitive immunosensor using gold nanoparticles/molybdenum disulfide/gold nanoparticles (AuNPs/MoS2/AuNPs) as transducer was explored for non-invasive salivary cortisol monitoring at POC with the miniaturized differential pulse voltammetry (DPV) system based on a smartphone. Covalent binding of cortisol antibody (CORT-Ab) onto the AuNPs/MoS2/AuNPs transducer was achieved through the self-assembled monolayer of specially designed polyethylene glycol (PEG, SH-PEG-COOH). Non-specific binding was avoided by passivating the surface with ethanolamine. The miniaturized portable DPV system was utilized for human salivary cortisol detection. A series current response of different cortisol concentrations decreased and exhibited a linear range of 0.5-200 nM, the detection limit of 0.11 nM, and high sensitivity of 30 μA M-1 with a regression coefficient of 0.9947. Cortisol was also distinguished successfully from the other substances in saliva. The recovery ratio of spiked human salivary cortisol and the variation of salivary cortisol level during one day indicated the practicability of the immunosensor based on the portable system. The results demonstrated the excellent performance of the smartphone-based immunosensor system and its great potential application for non-invasive human salivary cortisol detection at POC.

Flex-GO (Flexible graphene oxide) sensor for electrochemical monitoring lactate in low-volume passive perspired human sweat

In this work, a low volume, sweat lactate sensor functioning on passively expressed eccrine sweat was designed, fabricated and tested in human sweat and its performance was benchmarked against a standard reference; Lactate Plus meter. This novel sensor comprises of graphene oxide (GO) nanosheets integrated into a nanoporous flexible electrode system for low-volume (1-5 μL) ultrasensitive impedance based detection of lactate using non-faradaic electron-ionic charge transfer. Lactate oxidase (LOD) enzyme was immobilized on the surface of GO nanosheets towards developing an affinity biosensor specific to the physiological relevant range (4-80 mM) of lactate in perspired human sweat. Sensing was achieved by measuring impedance changes specific to lactate binding along the GO nanosheet interface using electrochemical impedance spectroscopy. The sensor demonstrated a dynamic range from 1 to 100 mM spiked in synthetic and human sweat with a limit of detection of 1 mM. A specificity study conducted using cortisol expressed in sweat revealed a negative response to the lactate oxidase. Continuous lactate sensing studies were performed during which the sensor was responsive to concentrations of lactate up to 138.6 mM. Correlation of the sensor response with actual lactate concentration (1.3-113.4 mM) was found to be 0.955.

Development of a flexible, sweat-based neuropeptide Y detection platform

Neuropeptide Y (NPY) biomarker levels have a close association with the diagnosis of Major Depression Disorder (MDD) and anxiety disorders. Quantifying NPY in correlation to self-reported symptoms will be an important measure to ensure a relatively uniform diagnosis and help with disease prognosis of these disorders. The work presented is a novel, passive eccrine sweat based, electrochemical detection platform for quantification of NPY biomarker levels. The paper offers a comparison between non-porous and porous sensor platforms using various electrochemical detection techniques. This work uses a novel strategy towards designing an optimal nanobioelectronic interface to measure NPY. The portability aspect of this detection platform is discussed by the demonstration a novel, portable EmStat Pico based electronic platform. The detection limit of the sensor is 10 pg mL⁻¹ and its range is 20–500 pg mL⁻¹. The NPY detection platform is envisioned to be a wearable point-of need monitoring system for management of chronic anxiety disorders and MDD.

Novel wearable NPY biomarker tracking system, envisioned to be a chronic anxiety and MDD management platform via self-monitoring.

AWARE: A Wearable Awareness with Real-time Exposure, for monitoring alcohol consumption impact through ethyl glucuronide detection

Here we demonstrate for the first time a dynamic monitoring of the ethanol metabolite ethyl glucuronide (EtG) for a more robust evaluation of alcohol consumption, compared to conventional methods. A wearable biosensor device capable of reporting EtG levels in sweat continuously via low power impedance spectroscopy is reported. The custom hardware was compared against a conventional benchtop potentiostat, and demonstrated comparable results in the application of EtG detection in low volume sweat. The device successfully differentiated three distinct EtG concentrations correlating to simulated drinking scenarios estimated to be 1, 2, and 3 standard U.S. drinks consumed over a duration of 60 min, with p < 0.0001. This device has the potential to enable moderate drinkers to engage in guided decision-making, based on objective data, to address the needs of alcohol-sensitive populations. The device also will serve as a tool for researchers to better understand and characterize the relationship between sweat EtG and consumed alcohol.

Mechanical properties of honeycomb nanoporous silicon: a high strength and ductile structure

There are remarkable studies geared towards developing mechanical analysis of nanoporous structures, while the size effect has been a major concern so far to improve strength or deformability. In this study, molecular dynamics simulations are utilized to study the pore shape effect on the mechanical behaviour of nanoporous silicon with circular, elliptical, square and hexagonal pore shapes. The influence of pore configuration on load transfer capabilities is studied for nanoporous silicon. A distinguished set of mechanical properties is observed on silicon with a hexagonal pore shape-resembling a honeycomb structure-with a high tensile strength and toughness. The study exhibits an improvement in the ductility through unique stress transformation in the hexagonal pore shape. In addition to the relative density, the potential to control the mechanical properties is demonstrated through the hexagon angle. Finally, a scaling law is developed for the mechanical behaviour of honeycomb nanoporous silicon. In addition to their outstanding mechanical properties, the work provides further insight into the capability of nanoporous structures in sensing applications due to their high surface-to-volume ratios.

Electronic Skin: Recent Progress and Future Prospects for Skin-Attachable Devices for Health Monitoring, Robotics, and Prosthetics

Recent progress in electronic skin or e-skin research is broadly reviewed, focusing on technologies needed in three main applications: skin-attachable electronics, robotics, and prosthetics. First, since e-skin will be exposed to prolonged stresses of various kinds and needs to be conformally adhered to irregularly shaped surfaces, materials with intrinsic stretchability and self-healing properties are of great importance. Second, tactile sensing capability such as the detection of pressure, strain, slip, force vector, and temperature are important for health monitoring in skin attachable devices, and to enable object manipulation and detection of surrounding environment for robotics and prosthetics. For skin attachable devices, chemical and electrophysiological sensing and wireless signal communication are of high significance to fully gauge the state of health of users and to ensure user comfort. For robotics and prosthetics, large-area integration on 3D surfaces in a facile and scalable manner is critical. Furthermore, new signal processing strategies using neuromorphic devices are needed to efficiently process tactile information in a parallel and low power manner. For prosthetics, neural interfacing electrodes are of high importance. These topics are discussed, focusing on progress, current challenges, and future prospects.

Revealing the formation dynamics of the electric double layer by means of in-situ Rutherford backscattering spectrometry

We report on a new versatile experimental setup for in situ Rutherford backscattering spectrometry at solid-liquid interfaces which enables investigations of electric double layers directly and in a quantitative manner. A liquid cell with a three-electrode arrangement is mounted in front of the beam line, and a thin Si₃N₄ window (thickness down to 150 nm) separates the vacuum of the detector chamber from the electrolyte in the cell. By minimizing the contribution of the window to the measurement, a large variety of elements at the solid-liquid interface with sensitivities far below one monolayer can be monitored. The attachment of Ba onto the Si₃N₄ surface as a function of contact time and pH value of the electrolyte solution was chosen as an example system. From our measurement, we can not only follow the evolution of the double layer but also derive limits for the point of zero charge for the Si₃N₄ surface. Our findings of 5.7≤pH_PZC≤6.2 are in good agreement with values found in the literature obtained by other techniques. Despite focusing on a specific system in this work, the presented setup allows for a large variety of in situ investigations at solid-liquid interfaces such as, but not limited to, tracing electrochemical reactions and monitoring segregation, adsorption, and dissolution and corrosion processes.

A wearable microfluidic device for rapid detection of HIV-1 DNA using recombinase polymerase amplification

Although isothermal nucleic acid amplification is advantageous in pathogen detection in resource-limited settings, an electricity-dependent heating module is often required. Here, we developed a wearable microfluidic device combined with recombinase polymerase amplification (RPA) for simple and rapid amplification of HIV-1 DNA using human body heat. The human body temperature at the human wrist varied from 33 to 34 °C in the ambient environment, which is sufficient to perform RPA reactions. With the aid of a cellphone-based fluorescence detection system, this device detected HIV-1 DNA quantitatively ranging from 10² to 10⁵ copies/mL with a log linearity of 0.98 in 24 min. These results demonstrate that this wearable point-of-care (POC) nucleic acid testing method is advantageous over traditional PCR and other isothermal nucleic acid amplification methods in terms of time, portability and independence on electricity. This wearable microfluidic device in conjunction with a cellphone-based fluorescence detection system can be potentially used for the detection of HIV-1 and adapted for POC detection of a broad range of infectious pathogens in resource-limited settings.

Detection of unamplified target genes via CRISPR-Cas9 immobilized on a graphene field-effect transistor

Most methods for the detection of nucleic acids require many reagents and expensive and bulky instrumentation. Here, we report the development and testing of a graphene-based field-effect transistor that uses clustered regularly interspaced short palindromic repeats (CRISPR) technology to enable the digital detection of a target sequence within intact genomic material. Termed CRISPR-Chip, the biosensor uses the gene-targeting capacity of catalytically deactivated CRISPR-associated protein 9 (Cas9) complexed with a specific single-guide RNA and immobilized on the transistor to yield a label-free nucleic-acid-testing device whose output signal can be measured with a simple handheld reader. We used CRISPR-Chip to analyse DNA samples collected from HEK293T cell lines expressing blue fluorescent protein, and clinical samples of DNA with two distinct mutations at exons commonly deleted in individuals with Duchenne muscular dystrophy. In the presence of genomic DNA containing the target gene, CRISPR-Chip generates, within 15 min, with a sensitivity of 1.7 fM and without the need for amplification, a significant enhancement in output signal relative to samples lacking the target sequence. CRISPR-Chip expands the applications of CRISPR-Cas9 technology to the on-chip electrical detection of nucleic acids.

Electrochemical-digital immunosensor with enhanced sensitivity for detecting human salivary glucocorticoid hormone

In this work, an ultra-sensitive electrochemical-digital sensor chip is devised for potential use as a digital stress analyzer for point-of-care testing (POCT) and preventive on-site recording of the hormone 'cortisol', a glucocorticoid class of steroid hormone present in the human saliva. The sensor was interfaced and re-configured with a high precision impedance converter system (AD5933) and used for electrochemical impedance spectroscopy (EIS) to evaluate the cortisol levels in seven saliva samples. To obtain enhanced biological (cortisol) recognition and achieve a lower limit of detection 0.87 ± 0.12 pg mL-1 (2.4 ± 0.38 pmol mL-1) with a wide range from 1 pg mL-1 to 10 ng mL-1 (2.75 pmol mL-1 to 27.58 pmol mL-1; R2 = 0.9831), bovine serum albumin (1% BSA) was utilized as an effective sensitivity enhancer in addition to optimizing the other two parameters: (i) anti-cortisol antibody (anti-CAb) covalently attached to micro-Au electrodes and (ii) saliva sample incubation time on the sensor chip. The results obtained in this work were corroborated with the gold standard ELISA test with an accuracy of 96.3% and other previously reported biosensors. We envisage that the conceivable standpoint of this study can be a practice towards new development in cortisol biosensing, which will be pertinent to POCT targeted for in vitro psychobiological study on patient cortisol in saliva, and finally an implantable sensor chip in the future.