A wearable biochemical sensor for monitoring alcohol consumption lifestyle through Ethyl glucuronide (EtG) detection in human sweat

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.

The Evolving Role of Proteins in Wearable Sweat Biosensors

Sweat is an increasingly popular biological medium for fitness monitoring and clinical diagnostics. It contains an abundance of biological information and is available continuously and noninvasively. Sweat-sensing devices often employ proteins in various capacities to create skin-friendly matrices that accurately extract valuable and time-sensitive information from sweat. Proteins were first used in sensors as biorecognition elements in the form of enzymes and antibodies, which are now being tuned to operate at ranges relevant for sweat. In addition, a range of structural proteins, sometimes assembled in conjunction with polymers, can provide flexible and compatible matrices for skin sensors. Other proteins also naturally possess a range of functionalities─as adhesives, charge conductors, fluorescence emitters, and power generators─that can make them useful components in wearable devices. Here, we examine the four main components of wearable sweat sensors─the biorecognition element, the transducer, the scaffold, and the adhesive─and the roles that proteins have played so far, or promise to play in the future, in each component. On a case-by-case basis, we analyze the performance characteristics of existing protein-based devices, their applicable ranges of detection, their transduction mechanism and their mechanical properties. Thereby, we review and compare proteins that can readily be used in sweat sensors and others that will require further efforts to overcome design, stability or scalability challenges. Incorporating proteins in one or multiple components of sweat sensors could lead to the development and deployment of tunable, greener, and safer biosourced devices.

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.

The Impact of Acetic Acid on Measuring Ethanol Concentrations in Water and Human Serum Using Short-Wave Infrared Spectroscopy

Ethanol intoxication, although an elemental part of life in many places around the world, still presents several issues associated with excessive consumption. These issues range from drunk driving, violence, and antisocial behavior to self-harm, all exerting an increased cost on the society. Monitoring of intoxication levels can help to limit the impact of these issues by preventing the use of automobiles or heavy machinery and personal monitoring. Previous works on noninvasive measurement of ethanol tissue concentration for estimation of blood alcohol concentration (BAC) performed worst during the first hour of intoxication. Gas chromatography research of intoxication shows that levels of acetic acid rise together at a similar rate as those of ethanol after initial imbibement. In this research, short-wave infrared (SWIR) spectroscopy was utilized with the aim of establishing the interaction between ethanol and acetic acid in water and serum mixtures. The most consistent and clear correlation between ethanol and acetic acid was recorded at 2262 and 2302 nm wavelengths. Partial least-squares (PLS) analysis indicates that the most effective region for consideration in measurement of ethanol is the therapeutic window four (IV) due to high variance in vibration of carbon bonds. The behavior of spectra at different concentration ranges was examined and described in detail in relation to the consequence of alcohol measurement. The investigation concluded that ethanol shows distinctive regions of absorbance at wavelengths of 2262 and 2302 nm, with variations arising from increasing concentrations of acetic acid, whilst also showing that therapeutic window four is amongst the most influential regions of the spectrum for SWIR.

Graphene and Its Derivatives: Synthesis and Application in the Electrochemical Detection of Analytes in Sweat

Wearable sensors and invasive devices have been studied extensively in recent years as the demand for real-time human healthcare applications and seamless human-machine interaction has risen exponentially. An explosion in sensor research throughout the globe has been ignited by the unique features such as thermal, electrical, and mechanical properties of graphene. This includes wearable sensors and implants, which can detect a wide range of data, including body temperature, pulse oxygenation, blood pressure, glucose, and the other analytes present in sweat. Graphene-based sensors for real-time human health monitoring are also being developed. This review is a comprehensive discussion about the properties of graphene, routes to its synthesis, derivatives of graphene, etc. Moreover, the basic features of a biosensor along with the chemistry of sweat are also discussed in detail. The review mainly focusses on the graphene and its derivative-based wearable sensors for the detection of analytes in sweat. Graphene-based sensors for health monitoring will be examined and explained in this study as an overview of the most current innovations in sensor designs, sensing processes, technological advancements, sensor system components, and potential hurdles. The future holds great opportunities for the development of efficient and advanced graphene-based sensors for the detection of analytes in sweat.

Review of Ethanol Intoxication Sensing Technologies and Techniques

The field of alcohol intoxication sensing is over 100 years old, spanning the fields of medicine, chemistry, and computer science, aiming to produce the most effective and accurate methods of quantifying intoxication levels. This review presents the development and the current state of alcohol intoxication quantifying devices and techniques, separated into six major categories: estimates, breath alcohol devices, bodily fluid testing, transdermal sensors, mathematical algorithms, and optical techniques. Each of these categories was researched by analyzing their respective performances and drawbacks. We found that the major developments in monitoring ethanol intoxication levels aim at noninvasive transdermal/optical methods for personal monitoring. Many of the "categories" of ethanol intoxication systems overlap with each other with to a varying extent, hence the division of categories is based only on the principal operation of the techniques described in this review. In summary, the gold-standard method for measuring blood ethanol levels is through gas chromatography. Early estimation methods based on mathematical equations are largely popular in forensic fields. Breath alcohol devices are the most common type of alcohol sensors on the market and are generally implemented in law enforcement. Transdermal sensors vary largely in their sensing methodologies, but they mostly follow the principle of electrical sensing or enzymatic reaction rate. Optical devices and methodologies perform well, with some cases outperforming breath alcohol devices in terms of the precision of measurement. Other estimation algorithms consider multimodal approaches and should not be considered alcohol sensing devices, but rather as prospective measurement of the intoxication influence. This review found 38 unique technologies and techniques for measuring alcohol intoxication, which is testament to the acute interest in the innovation of noninvasive technologies for assessing intoxication.

A Review on Flexible Electrochemical Biosensors to Monitor Alcohol in Sweat

The continued focus on improving the quality of human life has encouraged the development of increasingly efficient, durable, and cost-effective products in healthcare. Over the last decade, there has been substantial development in the field of technical and interactive textiles that combine expertise in electronics, biology, chemistry, and physics. Most recently, the creation of textile biosensors capable of quantifying biometric data in biological fluids is being studied, to detect a specific disease or the physical condition of an individual. The ultimate goal is to provide access to medical diagnosis anytime and anywhere. Presently, alcohol is considered the most commonly used addictive substance worldwide, being one of the main causes of death in road accidents. Thus, it is important to think of solutions capable of minimizing this public health problem. Alcohol biosensors constitute an excellent tool to aid at improving road safety. Hence, this review explores concepts about alcohol biomarkers, the composition of human sweat and the correlation between alcohol and blood. Different components and requirements of a biosensor are reviewed, along with the electrochemical techniques to evaluate its performance, in addition to construction techniques of textile-based biosensors. Special attention is given to the determination of biomarkers that must be low cost and fast, so the use of biomimetic materials to recognize and detect the target analyte is turning into an attractive option to improve electrochemical behavior.

A Low-Power CMOS Bandgap Voltage Reference for Supply Voltages Down to 0.5 V

A voltage reference is strictly required for sensor interfaces that need to perform nonratiometric data acquisition. In this work, a voltage reference capable of working with supply voltages down to 0.5 V is presented. The voltage reference was based on a classic CMOS bandgap core, properly modified to be compatible with low-threshold or zero-threshold MOSFETs. The advantages of the proposed circuit are illustrated with theoretical analysis and supported by numerical simulations. The core was combined with a recently proposed switched capacitor, inverter-like integrator implementing offset cancellation and low-frequency noise reduction techniques. Experimental results performed on a prototype designed and fabricated using a commercial 0.18 μm CMOS process are presented. The prototype produces a reference voltage of 220 mV with a temperature sensitivity of 45 ppm/°C across a 10–50 °C temperature range. The proposed voltage reference can be used to source currents up to 100 μA with a quiescent current consumption of only 630 nA.

Luminescent wearable biosensors based on gold nanocluster networks for "turn-on" detection of Uric acid, glucose and alcohol in sweat

From the difficulty of awareness of abnormal concentrations of biochemical indexes in people's daily life come wearable sensing technologies. Recently, luminescent wearable biosensors are emerging with simple fabrication, easy use, cost-effectivity and reliability. But several challenges should be taken up, such as availability of varied analytes, high sensitivity, stability of enzymes, photostability, low signal noises and recyclability of sensors. Here, the Luminescent Wearable Sweat Tape (LWST) biosensor is developed via embedding multi-component nanoprobes onto microwell-patterned paper substrates of hollowed-out double-side tapes. The nanoprobes consist of responsive luminophores, enzyme-loaded gold nanocluster (AuNCs) nano-networks, which are wrapped by the switch, MnO₂ nanosheets. The responsive luminophores are constructed by 3 substitutable components: enzymes (uricase, GOx and alcohol dehydrogenase) for molecular target recognition, glutathione-protected AuNCs (yellow, red and green) for luminescent signal output and polycations PAH for integration. MnO₂ NSs as the switch can quench the emission of the AuNCs but degraded by the reductive product of incorporated enzymes. Thus, targeting analysts (uric acid, glucose and alcohol) can be dose-dependently detected through "turn-on" luminescence approach. After incorporating the nanoprobes into hollow-out tapes, the formed LWST biosensors can detect uric acid, glucose and alcohol in sweat with the help of a smartphone. Subsequently, we primarily apply them into human daily life scenario, sampling from dine parties, and the positive relationships of analyte intakes and the increase of analytes in sweat are significant with individual difference.

Doubly Photopolymerized Holographic Sensors

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

Point-of-Care Drug of Abuse Testing in the Opioid Epidemic

CONTEXT.—

The United States is experiencing an opioid overdose epidemic. Point-of-care (POC) drug of abuse testing is a useful tool to combat the intensified opioid epidemic.

OBJECTIVES.—

To review commercially available POC drug of abuse testing involving opioids, to review opportunities and challenges for POC opioid testing and emerging testing methods in research literature, and finally to summarize unmet clinical needs and future development prospects.

DATA SOURCES.—

The Google search engine was used to access information for commercial opioid POC devices and the Google Scholar search engine was used to access research literature published from 2000 to 2019 for opioid POC tests.

CONCLUSIONS.—

The opioid epidemic provides unprecedented opportunities for POC drug testing, with significant clinical needs. Compared with gold standard tests, limitations for commercially available opioid POC testing include lower analytical sensitivity, lower specificity, and cross-reactivity. In response to unmet clinical needs, novel methods have emerged in research literature, such as microfluidics and miniature mass spectrometry. Future prospects include the development of quantitative POC devices and smarter and real-time drug testing.

Digital Phenotyping to Enhance Substance Use Treatment During the COVID-19 Pandemic

Due to the COVID-19 pandemic, many clinical addiction treatment programs have been required to transition to telephonic or virtual visits. Novel solutions are needed to enhance substance use treatment during a time when many patients are disconnected from clinical care and social support. Digital phenotyping, which leverages the unique functionality of smartphone sensors (GPS, social behavior, and typing patterns), can buttress clinical treatment in a remote, scalable fashion. Specifically, digital phenotyping has the potential to improve relapse prediction and intervention, relapse detection, and overdose intervention. Digital phenotyping may enhance relapse prediction through coupling machine learning algorithms with the enormous amount of collected behavioral data. Activity-based analysis in real time can potentially be used to prevent relapse by warning substance users when they approach locational triggers such as bars or liquor stores. Wearable devices detect when a person has relapsed to substances through measuring physiological changes such as electrodermal activity and locomotion. Despite the initial promise of this approach, privacy, security, and barriers to access are important issues to address.

Wearable Electrochemical Sensors for the Monitoring and Screening of Drugs

Wearable electrochemical sensors capable of noninvasive monitoring of chemical markers represent a rapidly emerging digital-health technology. Recent advances toward wearable continuous glucose monitoring (CGM) systems have ignited tremendous interest in expanding such sensor technology to other important fields. This article reviews for the first time wearable electrochemical sensors for monitoring therapeutic drugs and drugs of abuse. This rapidly emerging class of drug-sensing wearable devices addresses the growing demand for personalized medicine, toward improved therapeutic outcomes while minimizing the side effects of drugs and the related medical expenses. Continuous, noninvasive monitoring of therapeutic drugs within bodily fluids empowers clinicians and patients to correlate the pharmacokinetic properties with optimal outcomes by realizing patient-specific dose regulation and tracking dynamic changes in pharmacokinetics behavior while assuring the medication adherence of patients. Furthermore, wearable electrochemical drug monitoring devices can also serve as powerful screening tools in the hands of law enforcement agents to combat drug trafficking and support on-site forensic investigations. The review covers various wearable form factors developed for noninvasive monitoring of therapeutic drugs in different body fluids and toward on-site screening of drugs of abuse. The future prospects of such wearable drug monitoring devices are presented with the ultimate goals of introducing accurate real-time drug monitoring protocols and autonomous closed-loop platforms toward precise dose regulation and optimal therapeutic outcomes. Finally, current unmet challenges and existing gaps are discussed for motivating future technological innovations regarding personalized therapy. The current pace of developments and the tremendous market opportunities for such wearable drug monitoring platforms are expected to drive intense future research and commercialization efforts.

Carbon Dots for Forensic Applications: A Critical Review

Owing to their superior fluorescence performance, inexpensive synthesis and nontoxic nature, carbon dots (C-dots) are systematically explored in a variety of applications; in this review, we outline and critically discuss recent trends with respect to their potential exploitation in criminal investigation, forensic toxicology and anti-counterfeit interventions. Capitalising on their colour-tuneable behaviour (in the sense that they adopt different colours with respect to the incident radiation), C-dot-based compositions are ideal for the visual enhancement of latent fingerprints, affording improved contrast against multicoloured and patterned backgrounds. As highly sensitive and highly selective optical nanoprobes, C-dots show excellent analytical performance in detecting biological compounds, drugs, explosives, heavy metals and poisonous reactants. In addition, benefiting from their versatile structural and chemical composition, C-dots can be incorporated into ink and polymeric formulations capable of functioning as a new generation of cost-effective barcodes and security nanotags for object authentication and anti-counterfeit applications. Translating these encouraging research outcomes into real-life innovations with significant social and economic impact requires an open, multidisciplinary approach and a close synergy between materials scientists, biologists, forensic investigators and digital engineers.

Elevating Chemistry Research with a Modern Electronics Toolkit

With the rapid development of high technology, chemical science is not as it used to be a century ago. Many chemists acquire and utilize skills that are well beyond the traditional definition of chemistry. The digital age has transformed chemistry laboratories. One aspect of this transformation is the progressing implementation of electronics and computer science in chemistry research. In the past decade, numerous chemistry-oriented studies have benefited from the implementation of electronic modules, including microcontroller boards (MCBs), single-board computers (SBCs), professional grade control and data acquisition systems, as well as field-programmable gate arrays (FPGAs). In particular, MCBs and SBCs provide good value for money. The application areas for electronic modules in chemistry research include construction of simple detection systems based on spectrophotometry and spectrofluorometry principles, customizing laboratory devices for automation of common laboratory practices, control of reaction systems (batch- and flow-based), extraction systems, chromatographic and electrophoretic systems, microfluidic systems (classical and nonclassical), custom-built polymerase chain reaction devices, gas-phase analyte detection systems, chemical robots and drones, construction of FPGA-based imaging systems, and the Internet-of-Chemical-Things. The technology is easy to handle, and many chemists have managed to train themselves in its implementation. The only major obstacle in its implementation is probably one's imagination.

Epidermal Enzymatic Biosensors for Sweat Vitamin C: Toward Personalized Nutrition

Recent advances in wearable sensor technologies offer new opportunities for improving dietary adherence. However, despite their tremendous promise, the potential of wearable chemical sensors for guiding personalized nutrition solutions has not been reported. Herein, we present an epidermal biosensor aimed at following the dynamics of sweat vitamin C after the intake of vitamin C pills and fruit juices. Such skin-worn noninvasive electrochemical detection of sweat vitamin C has been realized by immobilizing the enzyme ascorbate oxidase (AAOx) on flexible printable tattoo electrodes and monitoring changes in the vitamin C level through changes in the reduction current of the oxygen cosubstrate. The flexible vitamin C tattoo patch was fabricated on a polyurethane substrate and combined with a localized iontophoretic sweat stimulation system along with amperometric cathodic detection of the oxygen depletion during the enzymatic reaction. The enzyme biosensor offers a highly selective response compared to the common direct (nonenzymatic) voltammetric measurements, with no effect on electroactive interfering species such as uric acid or acetaminophen. Temporal vitamin C profiles in sweat are demonstrated using different subjects taking varying amounts of commercial vitamin C pills or vitamin C-rich beverages. The dynamic rise and fall of such vitamin C sweat levels is thus demonstrated with no interference from other sweat constituents. Differences in such dynamics among the individual subjects indicate the potential of the epidermal biosensor for personalized nutrition solutions. The flexible tattoo patch displayed mechanical resiliency to multiple stretching and bending deformations. In addition, the AAOx biosensor is shown to be useful as a disposable strip for the rapid in vitro detection of vitamin C in untreated raw saliva and tears following pill or juice intake. These results demonstrate the potential of wearable chemical sensors for noninvasive nutrition status assessments and tracking of nutrient uptake toward detecting and correcting nutritional deficiencies, assessing adherence to vitamin intake, and supporting dietary behavior change.

Sensitivity and specificity of a commercial urinary ethyl glucuronide (ETG) test in heavy drinkers

Introduction

To advance the use of alcohol metabolites as biomarkers in the context of alcohol research, the present study tested the sensitivity and specificity of a commercially available urinary ethyl glucuronide (uEtG) test (DrugConfirm Advanced 80hr EtG) in a clinical research context.

Methods

A community sample of heavy drinkers (N = 68) completed the 30-day Timeline Follow-Back (TLFB) interview and provided a urine sample for uEtG analysis. Analyses of sensitivity and specificity of the uEtG assay were conducted using the following outcomes: (a) past day drinking, (b) past day binge drinking (defined as ≥4 drinks for women and ≥5 drinks for men), (c) past 3-day drinking, and (d) past 3-day binge drinking.

Results

The majority of participants reported past-3-day drinking (80.9%) and a sizeable minority reported past day drinking (33.8%). While uEtG-based detection of past day drinking and binge drinking was acceptable (sensitivity = 73.91%, and 83.33%; specificity = 80.00% and 66.13%, respectively), detection of any drinking and binge drinking in the past 3 days was poor (sensitivity and specificity of 43.64% and 84.62%, and 39.39% and 62.86%, respectively).

Conclusions

This study contributes to the mixed findings on the validity of EtG tests, which suggest that commercial uEtG tests with conservative detection thresholds are not a reliable alcohol biomarker without corroborating self-report data. Lower detection thresholds are recommended when using uEtG as an alcohol biomarker. Efforts to reach acceptable levels of sensitivity and specificity with commercial assays hold potential to advance the measurement of alcohol intake, overcoming the pitfalls of self-report data.

Point-of-care assay for drunken driving with Pd@Pt core-shell nanoparticles-decorated ploy(vinyl alcohol) aerogel assisted by portable pressure meter

Alcohol abuse causes health problems and security accidents. A reliable and sensitive detection system for alcohol has been an instinctive demand in law enforcement and forensic. More efforts are demanded in developing new sensing strategy preferably with portable and non-invasive traits for the pushforward of point-of-care (POC) device popularization.

Methods: We developed a POC diagnosis system for alcohol assay with the aid of alcohol oxidase (AOX) pre-joining in the system as well as Pd@Pt core-shell nanoparticles (abbreviated to Pd@Pt) that were decorated on ploy(vinyl alcohol) aerogel with amphiphilicity. Biological samples like saliva and whole blood can be absorbed by the aerogel in a quick process, in which the analyte would go through a transformation from alcohol, H₂O₂, to a final production of O₂, causing an analyte dose-dependent signal change in the commercial portable pressure meter. The cascade reactions are readily catalyzed by AOX and Pd@Pt, of which the latter one possesses excellent peroxidase-like activity.

Results: Our design has smartness embodied in the aerogel circumvents the interference from methanol which is more ready to be catalyzed by AOX. Under the optimal conditions, the limit of detection for alcohol was 0.50 mM in saliva, and is able to distinguish the driving under the influence (DUI) (1.74 mM in saliva) and driving while impaired (DWI) (6.95 mM in saliva) in the national standard of China.

Conclusion: Our proof-of-concept study provides the possibility for the establishment of POC device for alcohol and other target detection, not only owing to the sensing qualification but also thanks to the architecture of such sensor that has great flexibility by replacing the AOX with glucose oxidase (GOX), thenceforth realizing the accurate detection of glucose in 0.5% whole blood sample. With the advantages of easy accessibility and anti-interference ability, our sensor exhibits great potential for quantitative diagnostics in biological system.

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.

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

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

Positive findings of ethyl glucuronide in hair of young children from families with addiction background

AIMS

Small children are expected to be abstinent from alcohol, and children's hair is frequently used as the blank matrix for calibration of the alcohol consumption marker ethyl glucuronide (EtG). The basal EtG concentrations of total abstainers were described to be 0.3-2.1 pg/mg (Pirro et al. 2013). It is examined whether this assumption is valid for children from families with addiction background.

METHODS

In a social support system for families with drug and/or alcohol addicted parents, 161 hair samples from 126 children (age 1-14 years, hair segment 0-3 cm) were analyzed for EtG by a validated LC-MS/MS method (LOD 0.56 pg/mg, LLOQ 2.3 pg/mg). For comparison, ethyl palmitate (EtPa) was measured and hair samples from parents were included. EtG ≥ 3 pg/mg was considered as an alarming result for children.

RESULTS AND DISCUSSION

EtG concentrations between 3.0 and 42.6 pg/mg (mean 9.55 pg/mg, median 6.40 pg/mg) were measured for 25 samples (15.5%, age 22 × 1-5 years, 3 × 9-11 years). Elevated EtPa (0.15-0.46 ng/mg) was found in 6 samples and cocaethylene (0.02-0.07 ng/mg) was detected in 5 samples with high cocaine findings. Hair results of one or both parents indicated drug abuse in 12 from 14 cases (85.7%) if both parents were tested.

CONCLUSION

Although accidental or voluntary intake of alcoholic beverages cannot be excluded, the external contamination of children's hair by EtG-containing wine and sweat or urine of the alcohol abusing parents is assumed to be the most probable explanation for the positive EtG results in hair of 1-5-year-old children.

State of the Art in Alcohol Sensing with 2D Materials

Since the discovery of graphene, the star among new materials, there has been a surge of attention focused on the monatomic and monomolecular sheets which can be obtained by exfoliation of layered compounds. Such materials are known as two-dimensional (2D) materials and offer enormous versatility and potential. The ultimate single atom, or molecule, thickness of the 2D materials sheets provides the highest surface to weight ratio of all the nanomaterials, which opens the door to the design of more sensitive and reliable chemical sensors. The variety of properties and the possibility of tuning the chemical and surface properties of the 2D materials increase their potential as selective sensors, targeting chemical species that were previously difficult to detect. The planar structure and the mechanical flexibility of the sheets allow new sensor designs and put 2D materials at the forefront of all the candidates for wearable applications. When developing sensors for alcohol, the response time is an essential factor for many industrial and forensic applications, particularly when it comes to hand-held devices. Here, we review recent developments in the applications of 2D materials in sensing alcohols along with a study on parameters that affect the sensing capabilities. The review also discusses the strategies used to develop the sensor along with their mechanisms of sensing and provides a critique of the current limitations of 2D materials-based alcohol sensors and an outlook for the future research required to overcome the challenges.

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.

Hollow Prussian Blue nanocubes as peroxidase mimetic and enzyme carriers for colorimetric determination of ethanol

The peroxidase-like activity of hollow Prussian Blue nanocubes (hPBNCs) is used, in combination with the enzyme alcohol oxidase (AOx), in a colorimetric ethanol assay. Different from other nanozymes, the large cavity structure of the hPBNCs provides a larger surface and more binding sites for AOx to be bound on their surface or in the pores. This extremely enhances the sensitivity of the assay system. In the presence of ethanol, AOx is capable of catalyzing the oxidation of alcohols to aldehydes, accompanied by the generation of hydrogen peroxide (H₂O₂). The hPBNCs act as peroxidase mimics and then can catalyze the oxidation of 3,3'5,5'-tetramethylbenzidine (TMB) by H₂O₂, resulting in a color change of the solution from colorless to blue with a strong absorption at 652 nm. The lower detection limit for ethanol is 1.41 μg∙mL^-1. Due to the high catalytic activity of hPBNCs in weakly acidic and neutral solutions, the system was successfully applied to the determination of ethanol in mice blood. This is critically important for studying the alcohol consumption and monitoring the ethanol toxicokinetics. Graphical abstract Schematic representation of hollow Prussian Blue nanocubes (hPBNCs) used as both a peroxidase mimetic and as a carrier for alcohol oxidase. Utilizing hPBNCs along with the ethanol conversion enzyme, a sensitive colorimetric assay for ethanol was developed and applied to blood samples with satisfactory results.

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.

What Electrochemical Biosensors Can Do for Forensic Science? Unique Features and Applications

This article critically discusses the latest advances in the use of voltammetric, amperometric, potentiometric, and impedimetric biosensors for forensic analysis. Highlighted examples that show the advantages of these tools to develop methods capable of detecting very small concentrations of analytes and provide selective determinations through analytical responses, without significant interferences from other components of the samples, are presented and discussed, thus stressing the great versatility and utility of electrochemical biosensors in this growing research field. To illustrate this, the determination of substances with forensic relevance by using electrochemical biosensors reported in the last five years (2015–2019) are reviewed. The different configurations of enzyme or affinity biosensors used to solve analytical problems related to forensic practice, with special attention to applications in complex samples, are considered. Main prospects, challenges to focus, such as the fabrication of devices for rapid analysis of target analytes directly on-site at the crime scene, or their widespread use and successful applications to complex samples of interest in forensic analysis, and future efforts, are also briefly discussed.

A Fully Integrated and Self-Powered Smartwatch for Continuous Sweat Glucose Monitoring

Wearable devices for health monitoring and fitness management have foreseen a rapidly expanding market, especially those for noninvasive and continuous measurements with real-time display that provide practical convenience and eliminated safety/infection risks. Herein, a self-powered and fully integrated smartwatch that consists of flexible photovoltaic cells and rechargeable batteries in the forms of a "watch strap", electrochemical glucose sensors, customized circuits, and display units integrated into a "dial" platform is successfully fabricated for real-time and continuous monitoring of sweat glucose levels. The functionality of the smartwatch, including sweat glucose sensing, signal processing, and display, can be supported with the harvested/converted solar energy without external charging devices. The Zn-MnO₂ batteries serve as intermediate energy storage units and the utilization of aqueous electrolytes eliminated safety concerns for batteries, which is critical for wearable devices. Such a wearable system in a smartwatch fashion realizes integration of energy modules with self-powered capability, electrochemical sensors for noninvasive glucose monitoring, and in situ and real-time signal processing/display in a single platform for the first time. The as-fabricated fully integrated and self-powered smartwatch also provides a promising protocol for statistical study and clinical investigation to reveal correlations between sweat compositions and human body dynamics.

Disposable Sensors in Diagnostics, Food, and Environmental Monitoring

Disposable sensors are low-cost and easy-to-use sensing devices intended for short-term or rapid single-point measurements. The growing demand for fast, accessible, and reliable information in a vastly connected world makes disposable sensors increasingly important. The areas of application for such devices are numerous, ranging from pharmaceutical, agricultural, environmental, forensic, and food sciences to wearables and clinical diagnostics, especially in resource-limited settings. The capabilities of disposable sensors can extend beyond measuring traditional physical quantities (for example, temperature or pressure); they can provide critical chemical and biological information (chemo- and biosensors) that can be digitized and made available to users and centralized/decentralized facilities for data storage, remotely. These features could pave the way for new classes of low-cost systems for health, food, and environmental monitoring that can democratize sensing across the globe. Here, a brief insight into the materials and basics of sensors (methods of transduction, molecular recognition, and amplification) is provided followed by a comprehensive and critical overview of the disposable sensors currently used for medical diagnostics, food, and environmental analysis. Finally, views on how the field of disposable sensing devices will continue its evolution are discussed, including the future trends, challenges, and opportunities.

Real-time optical fiber sensors based on light diffusing microlens arrays

The applications of optical fibers are impeded in implantable medical diagnostics due to incompatibility with biological tissues, and immune reaction in vivo. The utilization of biocompatible materials to construct a photonic sensing platform can reduce the immune response in in vivo medical diagnostics. Here, we developed real-time optical fiber sensors to determine the volumetric modulation of stimuli-responsive polymers. Asymmetric microlens structures were replicated on stimuli-sensitive hydrogels as stand-alone sensors and were chemically attached to the tips of silica and biocompatible optical fibers. Quantitative measurements were carried out using a smartphone to demonstrate the ease, simplicity, and practicality of the readout methodology. To demonstrate the utility in real-time sensing, the fiber probe was investigated in various concentrations of ethanol, propan-2-ol, and dimethyl sulfoxide. Also, the fiber probe showed a rapid response to pH in the acidic region with a sensitivity of 40 nW pH-1. To develop biocompatible probes for physiological applications, a microlens array-imprinted polymer was attached to the tip of a hydrogel optical fiber. The optical fiber probe in the refection configuration showed a sensitivity of 7 nW pH-1. The developed hydrogel fiber probes may have application in point-of-care diagnostics, continuous biomarker monitoring, and critical care sensing devices.

Wearable and flexible electronics for continuous molecular monitoring

Wearable biosensors have received tremendous attention over the past decade owing to their great potential in predictive analytics and treatment toward personalized medicine. Flexible electronics could serve as an ideal platform for personalized wearable devices because of their unique properties such as light weight, low cost, high flexibility and great conformability. Unlike most reported flexible sensors that mainly track physical activities and vital signs, the new generation of wearable and flexible chemical sensors enables real-time, continuous and fast detection of accessible biomarkers from the human body, and allows for the collection of large-scale information about the individual's dynamic health status at the molecular level. In this article, we review and highlight recent advances in wearable and flexible sensors toward continuous and non-invasive molecular analysis in sweat, tears, saliva, interstitial fluid, blood, wound exudate as well as exhaled breath. The flexible platforms, sensing mechanisms, and device and system configurations employed for continuous monitoring are summarized. We also discuss the key challenges and opportunities of the wearable and flexible chemical sensors that lie ahead.

Recent Developments in Printing Flexible and Wearable Sensing Electronics for Healthcare Applications

Wearable biosensors attract significant interest for their capabilities in real-time monitoring of wearers' health status, as well as the surrounding environment. Sensor patches are embedded onto the human epidermis accompanied by data readout and signal conditioning circuits with wireless communication modules for transmitting data to the computing devices. Wearable sensors designed for recognition of various biomarkers in human epidermis fluids, such as glucose, lactate, pH, cholesterol, etc., as well as physiological indicators, i.e., pulse rate, temperature, breath rate, respiration, alcohol, activity monitoring, etc., have potential applications both in medical diagnostics and fitness monitoring. The rapid developments in solution-based nanomaterials offered a promising perspective to the field of wearable sensors by enabling their cost-efficient manufacturing through printing on a wide range of flexible polymeric substrates. This review highlights the latest key developments made in the field of wearable sensors involving advanced nanomaterials, manufacturing processes, substrates, sensor type, sensing mechanism, and readout circuits, and ends with challenges in the future scope of the field. Sensors are categorized as biological and fluidic, mounted directly on the human body, or physiological, integrated onto wearable substrates/gadgets separately for monitoring of human-body-related analytes, as well as external stimuli. Special focus is given to printable materials and sensors, which are key enablers for wearable electronics.

Rapid electrochemical device for single-drop point-of-use screening of parathyroid hormone

Aim: Novel electrochemical point-of-use biosensing device for rapid assessment of parathyroid hormone (PTH) levels has been developed. Materials & methods: The analytical nanobiosensor was designed by integrating unique high density semiconducting nanostructured arrays on a flexible sensing surface. Surface modification technique was tailored for enhancing the interaction of nanostructure–biological interface to capture the target PTH level. Results & conclusion: We demonstrate a rapid nanobiosensor to detect PTH in human serum, plasma and whole blood with a limit of detection of 1 pg/ml and a clinically relevant dynamic range from 1 to 1000 pg/ml. This is the first demonstration of detecting PTH as a point-of-use device devoid of sample pretreatment suitable in a surgical setting with high specificity to PTH.

CMOS Interfaces for Internet-of-Wearables Electrochemical Sensors: Trends and Challenges

Smart wearables, among immediate future IoT devices, are creating a huge and fast growing market that will encompass all of the next decade by merging the user with the Cloud in a easy and natural way. Biological fluids, such as sweat, tears, saliva and urine offer the possibility to access molecular-level dynamics of the body in a non-invasive way and in real time, disclosing a wide range of applications: from sports tracking to military enhancement, from healthcare to safety at work, from body hacking to augmented social interactions. The term Internet of Wearables (IoW) is coined here to describe IoT devices composed by flexible smart transducers conformed around the human body and able to communicate wirelessly. In addition the biochemical transducer, an IoW-ready sensor must include a paired electronic interface, which should implement specific stimulation/acquisition cycles while being extremely compact and drain power in the microwatts range. Development of an effective readout interface is a key element for the success of an IoW device and application. This review focuses on the latest efforts in the field of Complementary Metal–Oxide–Semiconductor (CMOS) interfaces for electrochemical sensors, and analyses them under the light of the challenges of the IoW: cost, portability, integrability and connectivity.

Electrically-Transduced Chemical Sensors Based on Two-Dimensional Nanomaterials

Electrically-transduced sensors, with their simplicity and compatibility with standard electronic technologies, produce signals that can be efficiently acquired, processed, stored, and analyzed. Two dimensional (2D) nanomaterials, including graphene, phosphorene (BP), transition metal dichalcogenides (TMDCs), and others, have proven to be attractive for the fabrication of high-performance electrically-transduced chemical sensors due to their remarkable electronic and physical properties originating from their 2D structure. This review highlights the advances in electrically-transduced chemical sensing that rely on 2D materials. The structural components of such sensors are described, and the underlying operating principles for different types of architectures are discussed. The structural features, electronic properties, and surface chemistry of 2D nanostructures that dictate their sensing performance are reviewed. Key advances in the application of 2D materials, from both a historical and analytical perspective, are summarized for four different groups of analytes: gases, volatile compounds, ions, and biomolecules. The sensing performance is discussed in the context of the molecular design, structure-property relationships, and device fabrication technology. The outlook of challenges and opportunities for 2D nanomaterials for the future development of electrically-transduced sensors is also presented.

How data science can advance mental health research

Accessibility of powerful computers and availability of so-called big data from a variety of sources means that data science approaches are becoming pervasive. However, their application in mental health research is often considered to be at an earlier stage than in other areas despite the complexity of mental health and illness making such a sophisticated approach particularly suitable. In this Perspective, we discuss current and potential applications of data science in mental health research using the UK Clinical Research Collaboration classification: underpinning research; aetiology; detection and diagnosis; treatment development; treatment evaluation; disease management; and health services research. We demonstrate that data science is already being widely applied in mental health research, but there is much more to be done now and in the future. The possibilities for data science in mental health research are substantial.

Sub-picomolar label-free detection of thrombin using electrochemical impedance spectroscopy of aptamer-functionalized MoS2

An ultrasensitive aptasensor for the label free non-faradaic detection of thrombin has been demonstrated on molybdenum disulphide (MoS₂) nanosheets. These nanosheets were physiochemically immobilized onto a silicon micro-electrode platform. Thrombin detection was achieved through the charge modulation of the electrical double layer due to the specific and dose dependent binding of thrombin to the surface of thiol terminated ssDNA aptamer functionalized MoS₂ nanosheets. Electrical double layer charge modulation associated with thrombin binding was characterized using electrochemical impedance spectroscopy. Dynamic light scattering was also used to confirm the dose dependent behavior. ATR-FTIR spectroscopy and XPS analysis were independently used to validate the functionalization of the ssDNA aptamer onto MoS₂ nanosheets. ssDNA aptamer functionalized molybdenum disulfide (MoS₂) for selective and specific capture of thrombin was demonstrated both in phosphate buffered saline (PBS) and human serum. The optimized immunoassay enabled the detection of thrombin ranging from 267 fM to 267 pM in phosphate buffer. The limit of detection of 53 pM and the linear dynamic range of detection of thrombin ranged from 53 to 854 pM in human serum. The rapid response time for the electrochemical impedance spectroscopy signal makes it an attractive option for the real-time detection of thrombin based point-of-care diagnostic devices.

Highly sensitive and specific noninvasive in-vivo alcohol detection using wavelength-modulated differential photothermal radiometry

This paper reports the application of wavelength modulated differential photothermal radiometry (WM-DPTR) to blood alcohol (ethanol) concentration (BAC) measurements in the mid-infrared range to prevent impaired driving. In-vivo alcohol consumption measurements performed in the BAC range of interest (0-80 mg/dl) with an optimal wavelength pair demonstrated the alcohol detection capability of WM-DPTR with high resolution (~5 mg/dl) and a low detection limit (~10 mg/dl). Oral glucose tolerance tests using both glucose and alcohol sensitive wavelength pairs in the normal-to-hyperglycemia range (~80-320 mg/dl) proved the blood glucose screening ability and ethanol detection specificity of WM-DPTR. The immunity of WM-DPTR to temperature and glucose variation makes the differential signals alcohol sensitive and specific, yielding precise and accurate noninvasive alcohol measurements in the interstitial fluid.

Current, future and potential use of mobile and wearable technologies and social media data in the ABCD study to increase understanding of contributors to child health

Mobile and wearable technologies and novel methods of data collection are innovating health-related research. These technologies and methods allow for multi-system level capture of data across environmental, physiological, behavioral, and psychological domains. In the Adolescent Brain Cognitive Development (ABCD) Study, there is great potential for harnessing the acceptability, accessibility, and functionality of mobile and social technologies for in-vivo data capture to precisely measure factors, and interactions between factors, that contribute to childhood and adolescent neurodevelopment and psychosocial and health outcomes. Here we discuss advances in mobile and wearable technologies and methods of analysis of geospatial, ecologic, social network and behavioral data. Incorporating these technologies into the ABCD study will allow for interdisciplinary research on the effects of place, social interactions, environment, and substance use on health and developmental outcomes in children and adolescents.