Smartphone based health accessory for colorimetric detection of biomarkers in sweat and saliva

Smartphone-based detection and discrimination of amine vapors by a single dye-adsorbed material

Smartphone-assisted analysis has become widely utilized for detecting various species in recent years. In such studies, multiple dyes should be employed to ensure selectivity and analyte discrimination. In our research, we have demonstrated the capability of a specially synthesized dye to selectively detect and discriminate liquid amine vapors. The developed material employs meso-toluene-α,β,α',β'-tetrabromoBODIPY immobilized on a thin-layer chromatography plate, exhibiting structure-specific color changes in response to amine vapors. The hue values of these colors, observed under both ambient and UV light, enable discrimination even among closely related amine structures. A mobile application has also been developed for the rapid interpretation of test results.

Domain-Agnostic Representation of Side-Channels

Side channels are unintended pathways within target systems that leak internal target information. Side-channel sensing (SCS) is the process of exploiting side channels to extract embedded target information. SCS is well established within the cybersecurity (CYB) domain, and has recently been proposed for medical diagnostics and monitoring (MDM). Remaining unrecognised is its applicability to human-computer interaction (HCI), among other domains (Misc). This article analyses literature demonstrating SCS examples across the MDM, HCI, Misc, and CYB domains. Despite their diversity, established fields of advanced sensing and signal processing underlie each example, enabling the unification of these currently otherwise isolated domains. Identified themes are collating under a proposed domain-agnostic SCS framework. This SCS framework enables a formalised and systematic approach to studying, detecting, and exploiting of side channels both within and between domains. Opportunities exist for modelling SCS as data structures, allowing for computation irrespective of domain. Future methodologies can take such data structures to enable cross- and intra-domain transferability of extraction techniques, perform side-channel leakage detection, and discover new side channels within target systems.

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

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

Sample preparation and detection methods in point-of-care devices towards future at-home testing

Timely and accurate diagnosis is critical for effective healthcare, yet nearly half the global population lacks access to basic diagnostics. Point-of-care (POC) testing offers partial solutions by enabling low-cost, rapid diagnosis at the patient's location. At-home POC devices have the potential to advance preventive care and early disease detection. Nevertheless, effective sample preparation and detection methods are essential for accurate results. This review surveys recent advances in sample preparation and detection methods at POC. The goal is to provide an in-depth understanding of how these technologies can enhance at-home POC devices. Lateral flow assays, nucleic acid tests, and virus detection methods are at the forefront of POC diagnostic technology, offering rapid and sensitive tools for identifying and measuring pathogens, biomarkers, and viral infections. By illuminating cutting-edge research on assay development for POC diagnostics, this review aims to accelerate progress towards widely available, user-friendly, at-home health monitoring tools that empower individuals in personalized healthcare in the future.

Sweat as a source of non-invasive biomarkers for clinical diagnosis: An overview

Sweat has excellent potential as one of the sources of non-invasive biomarkers for clinical diagnosis. It is relatively easy to collect and process and may contain different disease-specific markers and drug metabolites, making it ideal for various clinical applications. This article discusses the anatomy of sweat glands and their role in sweat production, as well as the history and development of multiple sweat sample collection and analysis techniques. Another primary focus of this article is the application of sweat detection in clinical disease diagnosis and other life scenarios. Finally, the limitations and prospects of sweat analysis are discussed.

Discoloration of stretched colored elastomeric modules : An in vivo study

BACKGROUND

As the demands on esthetic orthodontic devices continue to increase, discoloration of colored elastomeric modules is still a concern for patients and orthodontics. Thus, we performed an in vivo study evaluating discoloration of stretched colored elastomeric modules (i.e., white, gray, and pink).

MATERIALS AND METHODS

In all, 90 elastomeric modules of three different colors (white, gray and pink; 30 elastics from each color) were placed around brackets. The elastomeric modules were distributed and arranged randomly in the patients' four dental quadrants, and were removed after 1, 2, and 4 weeks. Color measurements were made before and after insertion into each patient's mouth. Digital images were taken with the camera of a mobile phone (iPhone X, Cupertino, CA, USA), and the variations in color were characterized using the Commission Internationale de l'Eclairage (CIE) color space system (L*a*b*) offered by Photoshop (Adobe, San Jose, CA, USA). Analysis of variance (ANOVA) and least significant difference (LSD) tests were used for statistical analyses.

RESULTS

The white elastomeric modules were most prone to discoloration, followed by the pink and then finally by the gray colored modules. The amount of discoloration resulting from a random diet practiced by the patients increased gradually (but was not significant) for all elastomeric modules studied and reach a peak after 2 weeks for the white and gray elastomeric modules, while discoloration of the pink elastomeric modules plateaued after 1 week.

CONCLUSION

Colored elastomeric modules (e.g., white, gray, and pink) discolor to variable degrees over time. Thus, patients should be advised that the consumption of food and drinks may result in discoloration of the elastomeric modules.

Liquid Metal-Polymer Conductor-Based Conformal Cyborg Devices

Gallium-based liquid metal (LM) exhibits exceptional properties such as high conductivity and biocompatibility, rendering it highly valuable for the development of conformal bioelectronics. When combined with polymers, liquid metal-polymer conductors (MPC) offer a versatile platform for fabricating conformal cyborg devices, enabling functions such as sensing, restoration, and augmentation within the human body. This review focuses on the synthesis, fabrication, and application of MPC-based cyborg devices. The synthesis of functional materials based on LM and the fabrication techniques for MPC-based devices are elucidated. The review provides a comprehensive overview of MPC-based cyborg devices, encompassing their applications in sensing diverse signals, therapeutic interventions, and augmentation. The objective of this review is to serve as a valuable resource that bridges the gap between the fabrication of MPC-based conformal devices and their potential biomedical applications.

A digital image colorimetry system based on smart devices for immediate and simultaneous determination of enzyme-linked immunosorbent assays

Standard enzyme-linked immunosorbent assays based on microplates are frequently utilized for various molecular sensing, disease screening, and nanomedicine applications. Comparing this multi-well plate batched analysis to non-batched or non-standard testing, the diagnosis expenses per patient are drastically reduced. However, the requirement for rather big and pricey readout instruments prevents their application in environments with limited resources, especially in the field. In this work, a handheld cellphone-based colorimetric microplate reader for quick, credible, and novel analysis of digital images of human cancer cell lines at a reasonable price was developed. Using our in-house-developed app, images of the plates are captured and sent to our servers, where they are processed using a machine learning algorithm to produce diagnostic results. Using FDA-approved human epididymis protein of ovary IgG (HE4), prostate cancer cell line (PC3), and bladder cancer cell line (5637) ELISA tests, we successfully examined this mobile platform. The accuracies for the HE4, PC3, and 5637 tests were 93%, 97.5%, and 97.2%, respectively. By contrasting the findings with the measurements made using optical absorption EPOCH microplate readers and optical absorption Tecan microplate readers, this approach was found to be accurate and effective. As a result, digital image colorimetry on smart devices offered a practical, user-friendly, affordable, precise, and effective method for quickly identifying human cancer cell lines. Thus, healthcare providers might use this portable device to carry out high-throughput illness screening, epidemiological investigations or monitor vaccination campaigns.

Progress in the design of portable colorimetric chemical sensing devices

The need for precise determination of heavy metals, anions, biomolecules, pesticides, drugs, and other substances is vital across clinical, environmental, and food safety domains. Recent years have seen significant progress in portable colorimetric chemical sensing devices, revolutionizing on-the-spot analysis. This review offers a comprehensive overview of these advancements, covering handheld colorimetry, RGB-based colorimetry, paper-based colorimetry, and wearable colorimetry devices. It explores the underlying principles, functional materials (chromophoric reagents/dyes and nanoparticles), detection mechanisms, and their applications in environmental monitoring, clinical care, and food safety. Noble metal nanoparticles (NPs) have arisen as promising substitutes in the realm of sensing materials. They display notable advantages, including heightened sensitivity, the ability to fine-tune their plasmonic characteristics for improved selectivity, and the capacity to induce visible color changes, and simplifying detection. Integration of NPs fabricated paper device with smartphones and wearables facilitates reagent-free, cost-effective, and portable colorimetric sensing, enabling real-time analysis and remote monitoring.

Quantitative and Multiplexed Chopper-Based Time-Gated Imaging for Bioanalysis on a Smartphone

Smartphones are emerging platforms for point-of-care diagnostics (POCDs), where the on-board camera is, for example, used to image fluorescence. Many laboratory instruments are capable of time-gated (TG) photoluminescence (PL) measurements─an analytical method leveraged by multiple commercial assay kits. When paired with long-lived PL emitters such as luminescent lanthanide complexes (LLCs), time-gating eliminates background from sample autofluorescence and many other sources. This capability is amenable to minimally processed samples and would thus be useful for POCDs on a smartphone-based platform. Here, we report a double-chopper design for TG PL imaging using a portable, 3D-printed, smartphone-based device. The rotation speed, dimensions, and overlap of the chopper blades and gaps set the timing parameters, with delay times on the order of hundreds of microseconds to milliseconds. The device was capable of quantitative TG imaging of PL from terbium(III) and europium(III) LLCs, including rejection of short-lived PL background from serum and tissue phantoms, spectral and temporal multiplexing, a model time-gated Förster resonance energy transfer (TG-FRET) assay, and imaging of cells. As the first smartphone-based demonstrations of these important analytical capabilities, this work is an important foundation for developing POCD methods based on TG PL imaging.

Recent Advances in Batteryless NFC Sensors for Chemical Sensing and Biosensing

This article reviews the recent advances in the field of batteryless near-field communication (NFC) sensors for chemical sensing and biosensing. The commercial availability of low-cost commercial NFC integrated circuits (ICs) and their massive integration in smartphones, used as readers and cloud interfaces, have aroused great interest in new batteryless NFC sensors. The fact that coil antennas are not importantly affected by the body compared with other wireless sensors based on far-field communications makes this technology suitable for future wearable point-of-care testing (PoCT) devices. This review first compares energy harvesting based on NFC to other energy-harvesting technologies. Next, some practical recommendations for designing and tuning NFC-based tags are described. Power transfer is key because in most cases, the energy harvested has to be stable for several seconds and not contaminated by undesired signals. For this reason, the effect of the dimensions of the coils and the conductivity on the wireless power transfer is thoroughly discussed. In the last part of the review, the state of the art in NFC-based chemical and biosensors is presented. NFC-based tags (or sensor tags) are mainly based on commercial or custom NFC ICs, which are used to harvest the energy from the RF field generated by the smartphone to power the electronics. Low-consumption colorimeters and potentiostats can be integrated into these NFC tags, opening the door to the integration of chemical sensors and biosensors, which can be harvested and read from a smartphone. The smartphone is also used to upload the acquired information to the cloud to facilitate the internet of medical things (IoMT) paradigm. Finally, several chipless sensors recently proposed in the literature as a low-cost alternative for chemical applications are discussed.

Graphene-interfaced flexible and stretchable micro-nano electrodes: from fabrication to sweat glucose detection

Flexible and stretchable wearable electronic devices have received tremendous attention for their non-invasive and personal health monitoring applications. These devices have been fabricated by integrating flexible substrates and graphene nanostructures for non-invasive detection of physiological risk biomarkers from human bodily fluids, such as sweat, and monitoring of human physical motion tracking parameters. The extraordinary properties of graphene nanostructures in fully integrated wearable devices have enabled improved sensitivity, electronic readouts, signal conditioning and communication, energy harvesting from power sources through electrode design and patterning, and graphene surface modification or treatment. This review explores advances made toward the fabrication of graphene-interfaced wearable sensors, flexible and stretchable conductive graphene electrodes, as well as their potential applications in electrochemical sensors and field-effect-transistors (FETs) with special emphasis on monitoring sweat biomarkers, mainly in glucose-sensing applications. The review emphasizes flexible wearable sweat sensors and provides various approaches thus far employed for the fabrication of graphene-enabled conductive and stretchable micro-nano electrodes, such as photolithography, electron-beam evaporation, laser-induced graphene designing, ink printing, chemical-synthesis and graphene surface modification. It further explores existing graphene-interfaced flexible wearable electronic devices utilized for sweat glucose sensing, and their technological potential for non-invasive health monitoring applications.

A non-invasive wearable stress patch for real-time cortisol monitoring using a pseudoknot-assisted aptamer

Stress is part of everyone's life and is exacerbated by traumatic events such as pandemics, disasters, violence, lifestyle changes, and health disorders. Chronic stress has many detrimental health effects and can even be life-threatening. Long-term stress monitoring outside of a hospital is often accomplished by measuring heart rate variability. While easy to measure, this digital biomarker has low specificity, greatly limiting its utility. To address this shortcoming, we report a non-invasive, wearable biomolecular sensor to monitor cortisol levels in sweat. Cortisol is a neuroendocrine hormone that regulates homeostasis as part of the stress pathway. Cortisol is detected using an electrochemical sensor functionalized with a pseudoknot-assisted aptamer and a flexible microfluidic sweat sampling system. The skin-worn microfluidic sampler provides rapid sweat collection while separating old and new sweat. The conformation-switching aptamer provides high specificity towards cortisol while being regenerable, allowing it to monitor temporal changes continuously. The aptamer was engineered to add a pseudoknot, restricting it to only two states, thus minimizing the background signal and enabling high sensitivity. An electrochemical pH sensor allows pH-corrected amperometric measurements. Device operation was demonstrated invitro with a broad linear dynamic range (1 pM - 1 μM) covering the physiological range and a sub-picomolar (0.2 pM) limit of detection in sweat. Real-time, on-body measurements were collected from human subjects using an induced stress protocol, demonstrating in-situ signal regeneration and the ability to detect dynamic cortisol fluctuations continuously for up to 90 min. The reported device has the potential to improve prognosis and enable personalized treatments.

Cloth-based microfluidic devices integrated onto the patch as wearable colorimetric sensors for simultaneous sweat analysis

Introduction

In this work, a flexible, and wearable point-of-care (POC) device integrated on a pain relief patch as wearable colorimetric sensors have been developed for sweat analysis, such as lactic acid, sodium ions, and pH simultaneously. Herein, the patch has still functioned as pain relief, while it allows for sweat monitoring during exercise, and in daily activities.

Methods

It was constructed on cotton cloth using wax printing technology (batik stamp) as cloth-based microfluidic devices (CMDs). Here, it uses micro volumes of samples to perform the reaction in the sensing zones, where the sensitive reagents are immobilized so that it can collect and analyze the sweat (lactic acid, sodium ions, and pH) as the model for sweat analytes. The colorimetric analysis was conducted via a smartphone camera by using a free app (Color Grab) for a color image analysis that uses for quantitative analysis or naked eye for semi-qualitative analysis.

Results

The ∆RGB value of the CMDS shows the excellent linear correlation vs analytes concentration, where the coefficient of correlations was found for lactic acid (R2 = 0.994), sodium ion (R2 = 0.998), and pH (R2 = 0.994). The ∆RGB value shows the appropriate color value for the linear correlation of the analyte target concentrations in the sweat samples. Here, the limit of detection (LOD) was found at 45.73 µg/mL for lactic acid and 56.46 µg/mL for sodium ions. The reproducibility was found at 0.79% and 0.89%, for lactic acid and sodium ions respectively.

Conclusion

It was applied for sweat analysis during exercise, and the results show in agreement with the standard methods used in a clinical laboratory.

Smartphone-based platforms implementing microfluidic detection with image-based artificial intelligence

The frequent outbreak of global infectious diseases has prompted the development of rapid and effective diagnostic tools for the early screening of potential patients in point-of-care testing scenarios. With advances in mobile computing power and microfluidic technology, the smartphone-based mobile health platform has drawn significant attention from researchers developing point-of-care testing devices that integrate microfluidic optical detection with artificial intelligence analysis. In this article, we summarize recent progress in these mobile health platforms, including the aspects of microfluidic chips, imaging modalities, supporting components, and the development of software algorithms. We document the application of mobile health platforms in terms of the detection objects, including molecules, viruses, cells, and parasites. Finally, we discuss the prospects for future development of mobile health platforms.

Moving toward smart biomedical sensing

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

A self-powered sound-driven humidity sensor for wearable intelligent dehydration monitoring system

Self-powered wearable sensing systems have attracted great attention for their application in continuous health monitoring, which can reveal real-time physiological information on the body. Here, an innovative self-powered sound-driven humidity sensor for wearable intelligent dehydration monitoring system has been proposed. The sensor is primarily comprised of PTFE membrane, ZnO nanoarrays and Ti thin film. The piezoelectric/triboelectric effect of ZnO nanoarrays/PTFE membrane is coupled with the humidity sensing process. Sound wave can drive PTFE membrane to vibrate, and the contact and separation between PTFE and ZnO can generate electrical signals through piezoelectric/triboelectric effect. At the same time, the surface of the nanostructures can absorb the water molecules, which will influence the electrical output of the device. The device can convert sound energy into electrical output without any external electricity power supply, and the outputting voltage decreases with increasing relative humidity, acting as the sensing signal. The sensor has been integrated with data processing unit and wireless transmission module to form a self-powered wearable intelligent dehydration monitoring system, which can actively monitor the humidity of exhaled breath and transmit the information to the mobile phone. The results can open a possible new direction for the development of sound-driven gas sensors and will further expand the scope for self-powered nanosystems.

"Do it yourself" protocol to fabricate dual-detection paper-based analytical device for salivary biomarker analysis

This paper describes the design and construction of dual microfluidic paper-based analytical devices (dual-μPADs) as a lab-on-paper platform involving a "do-it-yourself" fabrication protocol. The device comprises a colorimetric and electrochemical module to obtain a dual-mode signal readout sensing strategy. A 3D pen polymeric resin was used to prepare graphite carbon-based electrodes and hydrophobic barriers on paper substrates. The proposed carbon-based ink was employed to manufacture electrodes on paper based on a stencil-printing approach, which were further characterized by electrochemical and morphological analyses. The analytical performance of the dual-μPADs was simultaneously evaluated for lactate, pH, nitrite, and salivary amylase (sAA) analysis. To demonstrate the proof-of-concept, saliva samples collected from both healthy individuals and those with periodontitis were successfully tested to demonstrate the feasibility of the proposed devices. Samples collected from individuals previously diagnosed with periodontitis showed high levels of nitrite and sAA (> 94 μmol L^-1 and > 610 U mL^-1) in comparison with healthy individuals (≤ 16 μmol L^-1 and 545 U mL^-1). Moreover, periodontitis saliva resulted in acid solution and almost null lactate levels. Notably, this protocol supplies a simple way to manufacture dual-μPADs, a versatile platform for sensitive detecting of biomarkers in saliva playing a crucial role towards the point-of-care diagnosis of periodontal disease.

Development of an automated colorimeter controlled by Raspberry Pi4

A low-cost new instrument to carry out automated colorimetric analysis has been developed. The device consists of a carousel sampler, built by a 3D-printer, and a Raspberry Pi4-controlled signal measurement module based on the RGBC (red, green, blue and clear) responses of a TCS34725 color light-to-digital converter with IR filter. The device has been tested with calibration standards of different food dyes (Tartrazine, Red Allure AC and Brilliant Blue FCF) and three food samples containing one of each food dye. The new device provides R² > 0.995 and a LOD of 1.1, 1.4 and 0.1 μmol L^-1 for each food dye, respectively. The results are statistically comparable to those obtained with a conventional benchtop spectrophotometer. The proposed device achieves a reduction in sample and waste volume and in analysis time, minimizes the use of energy, and allows in situ measurements, being an automated method it is safer for operators in comparison to the reference method, yielding similar analytical results and following the principles of green analytical chemistry.

Development of an insilico model of eccrine sweat using molecular modelling techniques

Eccrine sweat is an ideal surrogate diagnostic biofluid for physiological and metabolic biomarkers for wearable biosensor design. Its periodic and non-invasive availability for candidate analytes such as glucose and cortisol along with limited correlation with blood plasma is of significant research interest. An insilico model of eccrine sweat can assist in the development of such wearable biosensors. In this regard, molecular modelling can be employed to observe the most fundamental interactions. Here, we determine a suitable molecular model for building eccrine sweat. The basic components of sweat are water and sodium chloride, in which glucose and other analytes are present in trace quantities. Given the wide range of water models available in the molecular dynamics space, in this study, we first validate the water models. We use three compounds to represent the base to build bulk sweat fluid and validate the force fields. We compare the self-diffusivity of water, glucose, sodium, and chloride ions as well as bulk viscosity values and present the results which are > 90% accurate as compared with the available literature. This validated insilico eccrine sweat model can serve as an aid to expedite the development de novo biosensors by addition of other analytes of interest e.g. cortisol, uric acid etc., simulate various temperatures and salt concentrations, expand search space for screening candidate target receptors by their binding affinity and assess the interference between competing species via simulations.

Rapid and inexpensive process to fabricate paper based microfluidic devices using a cut and heat plastic lamination process

Microfluidic paper-based analytical devices (microPADs) are emerging as simple-to-use, low-cost point-of-care testing platforms. Such devices are mostly fabricated at present by creating hydrophobic barriers using wax or photoresist patterning on porous paper sheets. Even though devices fabricated using these methods are used and tested with a wide variety of analytes, still they pose many serious practical limitations for low-cost automated mass fabrication for their widespread applicability. We present an affordable and simple two-step process - cut and heat (CH-microPADs) - for the selective fabrication of hydrophilic channels and reservoirs on a wide variety of porous media such as tissue/printing/filter paper and cloth types, such as cotton and polyester, by a lamination process. The technique presents many advantages as compared to existing commonly used methods. The devices possess excellent mechanical strength against bending, folding and twisting, making them virtually unbreakable. They are structurally flexible and show good chemical resistance to various solvents, acids and bases, presenting widespread applicability in areas such as clinical diagnostics, biological sensing applications, food processing, and the chemical industry. Fabricated paper media 96 well-plate CH-microPAD configurations were tested for cell culture applications using mice embryonic fibroblasts and detection of proteins and enzymes using ELISA. With a simple two-step process and minimal human intervention, the technique presents a promising step towards mass fabrication of inexpensive disposable diagnostic devices for both resource-limited and developed regions.

Microfluidic wearable electrochemical sweat sensors for health monitoring

Research on remote health monitoring through wearable sensors has attained popularity in recent decades mainly due to aging population and expensive health care services. Microfluidic wearable sweat sensors provide economical, non-invasive mode of sample collection, important physiological information, and continuous tracking of human health. Recent advances in wearable sensors focus on electrochemical monitoring of biomarkers in sweat and can be applicable in various fields like fitness monitoring, nutrition, and medical diagnosis. This review focuses on the evolution of wearable devices from benchtop electrochemical systems to microfluidic-based wearable sensors. Major classification of wearable sensors like skin contact-based and biofluidic-based sensors are discussed. Furthermore, sweat chemistry and related biomarkers are explained in addition to integration of microfluidic systems in wearable sweat sensors. At last, recent advances in wearable electrochemical sweat sensors are discussed, which includes tattoo-based, paper microfluidics, patches, wrist band, and belt-based wearable sensors.

Miniaturized Method for Chemical Oxygen Demand Determination Using the PhotoMetrix PRO Application

The analysis of chemical oxygen demand (COD) plays an important role in measuring water pollution, but it normally has a high ecological price. Advances in image acquisition and processing techniques enable the use of mobile devices for analytical purposes. Here, the PhotoMetrix PRO application was used for image acquisition and multivariate analysis. Statistical analysis showed no significant difference in the results compared to the standard method, with no adverse effect of the volume reduction. The cost of analysis and waste generation were reduced by one third, while the analysis time was reduced by one fifth. The miniaturized method was successfully employed in the analysis of several matrices and for the evaluation of advanced oxidation processes. The AGREE score was improved by 25% due to miniaturization. For these reasons, the miniaturized PhotoMetrix PRO method is a suitable option for COD analysis, being less hazardous to the environment due to reductions in the chemicals used and in waste generation.

CandyCodes: simple universally unique edible identifiers for confirming the authenticity of pharmaceuticals

Counterfeit or substandard medicines adversely affect the health of millions of people and cost an estimated $200 billion USD annually. Their burden is greatest in developing countries, where the World Health Organization estimates that one in ten medical products are fake. In this work, I describe a simple addition to the existing drug manufacturing process that imparts an edible universally unique physical identifier to each pill, tablet, capsule, caplet, etc. This technique uses nonpareils (also called sprinkles and "hundreds and thousands"), tiny inexpensive multicolor candy spheres that are normally added to other candies or desserts as decorations. If nonpareils are applied at random to a pill immediately after manufacture, the specific pattern they form is unlikely to ever be repeated by random chance; this means that the pattern (or "CandyCode") can be used to uniquely identify the pill and distinguish it from all other pills. By taking a photograph of each CandyCoded pill after manufacture and recording the location and color of each nonpareil, a manufacturer can construct a database containing the CandyCodes of all known-authentic pills they produce. A consumer can then simply use a cellphone to photograph a pill and transfer its image to the manufacturer's server, which determines whether the pill's CandyCode matches a known-good CandyCode in their database (meaning that the pill is authentic) or does not have a match in the database (in which case the consumer is warned that the pill may be counterfeit and should not be consumed). To demonstrate the feasibility of using random particles as universal identifiers, I performed a series of experiments using both real CandyCodes (on commercially produced chocolate candies) and simulated CandyCodes (generated by software). I also developed a simple method for converting a CandyCode photo to a set of strings for convenient storage and retrieval in a database. Even after subjecting CandyCodes to rough handling to simulate shipping conditions, the CandyCodes were still easily verifiable using a cellphone camera. A manufacturer could produce at least [Formula: see text] CandyCoded pills-41 million for each person on Earth-and still be able to uniquely identify each CandyCode. By providing universally-unique IDs that are easy to manufacture but hard to counterfeit, require no alteration of the existing drug formulation and minimal alteration of the manufacturing process, and need only a cameraphone for verification, CandyCodes could play an important role in the fight against fraud in pharmaceuticals and many other products.

Evaluation of Sweat-Sampling Procedures for Human Stress-Biomarker Detection

Sweat is a potential biological fluid for the non-invasive analytical assessment of diverse molecules, including biomarkers. Notwithstanding, the sampling methodology is critical, and it must be assessed prior to using sweat for clinical diagnosis. In the current work, the analytical methodology was further developed taking into account the sampling step, in view of the identification and level variations of sweat components that have potential to be stress biomarkers using separation by liquid chromatography and detection by tandem mass spectrometry, in order to attain a screening profile of 26 molecules in just one stage. As such, the molecule identification was used as a test for the evaluation of the sampling procedures, including the location on the body, using patches for long-term sampling and vials for direct sampling, through a qualitative approach. From this evaluation it was possible to conclude that the sampling may be performed on the chest or back skin. Additionally, possible interference was evaluated. The long-term sampling with patches can be used under both rest and exercise conditions with variation of the detected molecule’s levels. The direct sampling, using vials, has the advantage of not having interferences but the disadvantage of only being effective after exercise in order to have enough sample for sweat analysis.

Smartphone-based mobile biosensors for the point-of-care testing of human metabolites

Rapid, accurate, portable and quantitative profiling of metabolic biomarkers is of great importance for disease diagnosis and prognosis. The recent development in the optical and electric biosensors based on the smartphone is promising for profiling of metabolites with advantages of rapid, reliability, accuracy, low-cost and multi-analytes analysis capability. In this review, we introduced the optical biosensing platforms including colorimetric, fluorescent and chemiluminescent sensing, and electrochemical biosensing platforms including wired and wireless communication. Challenges and future perspectives desired for reliable, accurate, cost-effective, and multi-functions smartphone-based biosensing systems were also discussed. We envision that such smartphone-based biosensing platforms will allow daily and comprehensive metabolites monitoring in the future, thus unlocking the potential to transform clinical diagnostics into non-clinical self-testing. We also believed that this progress report will encourage future research to develop advanced, integrated and multi-functional smartphone-based Point-of-Care testing (POCT) biosensors for the monitoring and diagnosis as well as personalized treatments of a spectrum of metabolic-disorder related diseases.

Smartphone-Based Device for Colorimetric Detection of MicroRNA Biomarkers Using Nanoparticle-Based Assay

The detection of microRNAs (miRNAs) is emerging as a clinically important tool for the non-invasive detection of a wide variety of diseases ranging from cancers and cardiovascular illnesses to infectious diseases. Over the years, miRNA detection schemes have become accessible to clinicians, but they still require sophisticated and bulky laboratory equipment and trained personnel to operate. The exceptional computing ability and ease of use of modern smartphones coupled with fieldable optical detection technologies can provide a useful and portable alternative to these laboratory systems. Herein, we present the development of a smartphone-based device called Krometriks, which is capable of simple and rapid colorimetric detection of microRNA (miRNAs) using a nanoparticle-based assay. The device consists of a smartphone, a 3D printed accessory, and a custom-built dedicated mobile app. We illustrate the utility of Krometriks for the detection of an important miRNA disease biomarker, miR-21, using a nanoplasmonics-based assay developed by our group. We show that Krometriks can detect miRNA down to nanomolar concentrations with detection results comparable to a laboratory-based benchtop spectrophotometer. With slight changes to the accessory design, Krometriks can be made compatible with different types of smartphone models and specifications. Thus, the Krometriks device offers a practical colorimetric platform that has the potential to provide accessible and affordable miRNA diagnostics for point-of-care and field applications in low-resource settings.

Quantitative pH Determination Based on the Dominant Wavelength Analysis of Commercial Test Strips

The determination of pH values is essential in many chemical, medical, and environmental monitoring processes, which has been relying on conventional pH meters (glass electrodes) for quantitation and pH test strips for qualitative (or semi-quantitative) assessment. In this work, we demonstrate a smartphone-based pH determination technique, which performs digital image analysis of commercial test strips, particularly the determination of either the dominant wavelength (λ_d) or complementary wavelength (λ_c) of the color image. In conjunction with a 3D-printed optical accessory (with a surface light source and a macro lens), the quality of captured images have been warranted, and the quantitation accuracy of 0.05 pH units has been achieved. More importantly, the performance of this smartphone-based pH reading system (namely "Smart-pH-Reader") was validated using multiple real-world samples, as the results are consistent with those determined with a standard pH meter. The Smart-pH-Reader is envisioned to be a simple, portable, and accurate tool for pH determination in the fields of environmental monitoring, medical diagnosis, and beyond.

Optical-Based Biosensors and Their Portable Healthcare Devices for Detecting and Monitoring Biomarkers in Body Fluids

The detection and monitoring of biomarkers in body fluids has been used to improve human healthcare activities for decades. In recent years, researchers have focused their attention on applying the point-of-care (POC) strategies into biomarker detection. The evolution of mobile technologies has allowed researchers to develop numerous portable medical devices that aim to deliver comparable results to clinical measurements. Among these, optical-based detection methods have been considered as one of the common and efficient ways to detect and monitor the presence of biomarkers in bodily fluids, and emerging aggregation-induced emission luminogens (AIEgens) with their distinct features are merging with portable medical devices. In this review, the detection methodologies that use optical measurements in the POC systems for the detection and monitoring of biomarkers in bodily fluids are compared, including colorimetry, fluorescence and chemiluminescence measurements. The current portable technologies, with or without the use of smartphones in device development, that are combined with optical biosensors for the detection and monitoring of biomarkers in body fluids, are also investigated. The review also discusses novel AIEgens used in the portable systems for the detection and monitoring of biomarkers in body fluid. Finally, the potential of future developments and the use of optical detection-based portable devices in healthcare activities are explored.

Stretchable and Superwettable Colorimetric Sensing Patch for Epidermal Collection and Analysis of Sweat

Stretchable and wearable sensors allow intimate integration with the human body for health and fitness monitoring. In addition to the acquisition of various physical parameters, quantitative analysis of chemical biomarkers present in sweat may provide vital insights into the physiological state of an individual. A widely investigated system utilizes electrochemical techniques for continuous monitoring of these biomarkers. The required supporting electronics and batteries are often challenging to form a deformable system. In this study, an intrinsically stretchable sensing patch is developed with compliant mechanical properties for conformal attachment to the skin and reliable collection of sweat. In these patches, superhydrophilic colorimetric assays consisting of thermoplastic polyurethane nanofiber textiles decorated with silica nanoparticles are assembled over a styrene-ethylene-butylene-styrene-based superhydrophobic substrate, thereby generating a large wettability contrast to efficiently concentrate the sweat. The system supports multiplexed colorimetric analysis of sweat to quantify pH and ion concentrations with images acquired using smartphones, in which the influence of ambient lighting conditions is largely compensated with a set of reference color markers. Successful demonstrations of in situ analysis of sweat after physical exercises effectively illustrate the practical suitability of the sensing patch, which is attractive for advanced health monitoring, clinical diagnostics, and competitive sports.

Molecular and physical technologies for monitoring fluid and electrolyte imbalance: A focus on cancer population

Several clinical examinations have shown the essential impact of monitoring (de)hydration (fluid and electrolyte imbalance) in cancer patients. There are multiple risk factors associated with (de)hydration, including aging, excessive or lack of fluid consumption in sports, alcohol consumption, hot weather, diabetes insipidus, vomiting, diarrhea, cancer, radiation, chemotherapy, and use of diuretics. Fluid and electrolyte imbalance mainly involves alterations in the levels of sodium, potassium, calcium, and magnesium in extracellular fluids. Hyponatremia is a common condition among individuals with cancer (62% of cases), along with hypokalemia (40%), hypophosphatemia (32%), hypomagnesemia (17%), hypocalcemia (12%), and hypernatremia (1-5%). Lack of hydration and monitoring of hydration status can lead to severe complications, such as nausea/vomiting, diarrhea, fatigue, seizures, cell swelling or shrinking, kidney failure, shock, coma, and even death. This article aims to review the current (de)hydration (fluid and electrolyte imbalance) monitoring technologies focusing on cancer. First, we discuss the physiological and pathophysiological implications of fluid and electrolyte imbalance in cancer patients. Second, we explore the different molecular and physical monitoring methods used to measure fluid and electrolyte imbalance and the measurement challenges in diverse populations. Hydration status is assessed in various indices; plasma, sweat, tear, saliva, urine, body mass, interstitial fluid, and skin-integration techniques have been extensively investigated. No unified (de)hydration (fluid and electrolyte imbalance) monitoring technology exists for different populations (including sports, elderly, children, and cancer). Establishing novel methods and technologies to facilitate and unify measurements of hydration status represents an excellent opportunity to develop impactful new approaches for patient care.

Functionalized Mouth-Conformable Interfaces for pH Evaluation of the Oral Cavity

Oral health monitoring is highly desired, especially for in home use, however, current methods are not sensitive enough and technically convoluted for this purpose. This paper presents incorporation of bioactive materials and colorimetric chemical sensors into routinely used oral appliances transforming them into bioresponsive, conformable interfaces. Specifically, endodontic paper points and dental floss can be functionalized to locally sense and monitor pH variations within the oral cavity via color changes. Moreover, edible colorimetric indicators are developed and used to make sensing, edible devices in the form factor of candies that can dynamically and visually respond to acidity changes in saliva. These interfaces would enable early detection of caries (e.g., using dental floss and paper points) providing low-cost point of care devices that respond in real-time by detecting pH variations in biological fluids thus bringing monitoring to home settings .

Effect of Serum on Electrochemical Detection of Bioassays Having Ag Nanoparticle Labels

The effect of serum on electrochemical detection of bioassays having silver nanoparticle (AgNP) detection labels was investigated. Both a model assay and an antigen-specific sandwich bioassay for the heart failure marker NT-proBNP were examined. In both cases, the AgNP labels were conjugated to a detection antibody. Electrochemical detection was carried out using a galvanic exchange/anodic stripping voltammetry method in which Au3+ exchanges with AgNP labels. The assays were carried out using a paper-based electrode platform. The bioassays were exposed to different serum conditions prior to and during detection. There are three important outcomes reported in this article. First, both the model- and antigen-specific assays could be formed in undiluted serum with no detectable interferences from the serum components. Second, to achieve the maximum possible electrochemical signal, the highest percentage of serum that can remain in an assay buffer during electrochemical detection is 0.25% when no washing is performed. The assay results are rendered inaccurate when 0.50% or more of serum is present. Third, the factors inhibiting galvanic exchange in serum probably relate to surface adsorption of biomolecules onto the AgNP labels, chelation of Au3+ by serum components, or both. The results reported here provide general guidance for using metal NP labels for electrochemical assays in biofluids.

Smartphone-based optical analysis systems

During the past few decades, there has been a growing trend towards the use of smartphone-based analysis systems. This is mainly due to its ubiquity, its increasing computing capacity, its relatively low cost and the ability to acquire and process data at the same time. Furthermore, there are many sensors integrated into a smartphone, for example a complementary metal-oxide semiconductor (CMOS) sensor. A CMOS sensor enables optical analysis for example by using it as a colorimeter, photometer or spectrometer. This review explores the current state-of-the-art smartphone-based optical analysis systems in various areas of application. It is organized into three sections, each of which investigates one class of smartphone-based devices: (i) smartphone-based colorimeters (ii) smartphone-based photo- and spectrometers and (iii) smartphone-based fluorimeters.

Development and virtual validation of a novel digital workflow to rehabilitate palatal defects by using smartphone-integrated stereophotogrammetry (SPINS)

Palatal defects are rehabilitated by fabricating maxillofacial prostheses called obturators. The treatment incorporates taking deviously unpredictable impressions to facsimile the palatal defects into plaster casts for obturator fabrication in the dental laboratory. The casts are then digitally stored using expensive hardware to prevent physical damage or data loss and, when required, future obturators are digitally designed, and 3D printed. Our objective was to construct and validate an economic in-house smartphone-integrated stereophotogrammetry (SPINS) 3D scanner and to evaluate its accuracy in designing prosthetics using open source/free (OS/F) digital pipeline. Palatal defect models were scanned using SPINS and its accuracy was compared against the standard laser scanner for virtual area and volumetric parameters. SPINS derived 3D models were then used to design obturators by using (OS/F) software. The resultant obturators were virtually compared against standard medical software designs. There were no significant differences in any of the virtual parameters when evaluating the accuracy of both SPINS, as well as OS/F derived obturators. However, limitations in the design process resulted in minimal dissimilarities. With further improvements, SPINS based prosthetic rehabilitation could create a viable, low cost method for rural and developing health services to embrace maxillofacial record keeping and digitised prosthetic rehabilitation.

A novel vertical flow assay for point of care measurement of iron from whole blood

Disorders in iron metabolism are endemic globally, affecting more than several hundred million individuals and often resulting in increased rates of mortality or general deterioration of quality of life. To both prevent and monitor treatment of iron related disorders, we present a point of care medical device which leverages a simple smartphone camera to measure total iron concentration from a finger-prick sample. The system consists of a smartphone and an in-house developed app, a 3D printed sensing chamber and a vertical flow membrane-based sensor strip designed to accommodate 50 μl of whole blood, filter out the cellular components and carry out a colorimetric chelation reaction producing a colour change which is detected by our smartphone device. The app's accuracy and precision were assessed via comparison of the mobile app's RGB output to a reference imaging software, ImageJ for the same colorimetric sensing strip. Correlation plots resulted in slopes of 0.99 and coefficient of determination (R² = 0.99). The device was determined to have a signal to noise ratio >40 and a mean bias of 2% which both indicate high analytical accuracy and precision (in terms of RGB measurement). The smartphone device's iron concentration readout was then studied using an extensively validated laboratory developed test (LDT) for iron detection, which is an optimized spectrophotometry-based technique (this is considered the gold standard for iron quantification among LDTs). In comparison of the smartphone-based technique with the gold standard LDT, a calibration slope of 0.0004 au μg^-1 dL^-1, a correlation plot with slope of 1.09 and coefficient of determination (R²) of 0.96 and a mean bias of 5.3%, our device can accurately measure iron levels in blood. With detection times of five minutes, fingerpick sample and sensor cost less than 10 cents, the device shows great promise in being developed as the first ever commercial device for iron quantification in blood.

Wearable Biosensors: An Alternative and Practical Approach in Healthcare and Disease Monitoring

With the increasing prevalence of growing population, aging and chronic diseases continuously rising healthcare costs, the healthcare system is undergoing a vital transformation from the traditional hospital-centered system to an individual-centered system. Since the 20th century, wearable sensors are becoming widespread in healthcare and biomedical monitoring systems, empowering continuous measurement of critical biomarkers for monitoring of the diseased condition and health, medical diagnostics and evaluation in biological fluids like saliva, blood, and sweat. Over the past few decades, the developments have been focused on electrochemical and optical biosensors, along with advances with the non-invasive monitoring of biomarkers, bacteria and hormones, etc. Wearable devices have evolved gradually with a mix of multiplexed biosensing, microfluidic sampling and transport systems integrated with flexible materials and body attachments for improved wearability and simplicity. These wearables hold promise and are capable of a higher understanding of the correlations between analyte concentrations within the blood or non-invasive biofluids and feedback to the patient, which is significantly important in timely diagnosis, treatment, and control of medical conditions. However, cohort validation studies and performance evaluation of wearable biosensors are needed to underpin their clinical acceptance. In the present review, we discuss the importance, features, types of wearables, challenges and applications of wearable devices for biological fluids for the prevention of diseased conditions and real-time monitoring of human health. Herein, we summarize the various wearable devices that are developed for healthcare monitoring and their future potential has been discussed in detail.

Wearable Analytical Platform with Enzyme-Modulated Dynamic Range for the Simultaneous Colorimetric Detection of Sweat Volume and Sweat Biomarkers

In this manuscript, we introduce a wearable analytical platform that simultaneously measures the concentration of sweat lactate and sample volume. It contains two sensors entirely made of filter paper that can be easily affixed on the skin with medical-grade tape. The lactate biosensor features a unique signal modulation mechanism that enables fine-tuning the dynamic range. It consists of adding a competitive enzyme inhibitor in different reservoirs. Thanks to this, it is possible to choose between a very low limit of detection (0.06 mM) and a linear response in the physiological concentration range (10-30 mM). The sweat volume sensor was obtained by adding a reservoir containing gold nanoparticles. As the wearer sweats, the nanoparticles are carried through a paper channel. This is used to gauge the volume of sample by measuring the distance traveled by the nanoprobes. Using fine-tuned lactate biosensors and combining them with the volume sensors allowed us to quantify variations in the levels of sweat lactate independently of the wearer's sweat rate during an exercise routine. The platform design can be customized to meet the end user's needs, which makes it ideal for developing a wide array of disposable wearable biosensors.

Paper-Based Semi-quantitative Antimicrobial Susceptibility Testing

Antimicrobial resistance is increasingly recognized as a major threat to global health. To combat this emerging threat, accessible antimicrobial susceptibility testing should be prioritized as a key component of stewardship efforts. In this work, we developed a user-friendly paper-based test that provides visual readout of bacterial antibiotic susceptibility in a semiquantitative format. We leveraged on-chip paper microfluidics to enable multiplexed testing of multiple antibiotic dilutions with a single sample addition step, replicating the functionality of traditional broth-dilution-based susceptibility testing in a simplified format. Our paper-based test offers several advantages including low sample volume requirement and lack of need for humidity control during incubation, an innovation that addresses a key limitation of conventional paper-microfluidic devices. Using several clinically relevant bacterial organisms and antimicrobial agents, we demonstrate that our colorimetric readout approach provides a strong predictor of susceptibility category.

User-friendly lab-on-paper optical sensor for the rapid detection of bacterial spoilage in packaged meat products

A lab-on-paper colorimetric sensor for detection and quantification of bacterial meat spoilage is reported.

Recent Progress in Wearable Biosensors: From Healthcare Monitoring to Sports Analytics

Recent advances in lab-on-a-chip technology establish solid foundations for wearable biosensors. These newly emerging wearable biosensors are capable of non-invasive, continuous monitoring by miniaturization of electronics and integration with microfluidics. The advent of flexible electronics, biochemical sensors, soft microfluidics, and pain-free microneedles have created new generations of wearable biosensors that explore brand-new avenues to interface with the human epidermis for monitoring physiological status. However, these devices are relatively underexplored for sports monitoring and analytics, which may be largely facilitated by the recent emergence of wearable biosensors characterized by real-time, non-invasive, and non-irritating sensing capacities. Here, we present a systematic review of wearable biosensing technologies with a focus on materials and fabrication strategies, sampling modalities, sensing modalities, as well as key analytes and wearable biosensing platforms for healthcare and sports monitoring with an emphasis on sweat and interstitial fluid biosensing. This review concludes with a summary of unresolved challenges and opportunities for future researchers interested in these technologies. With an in-depth understanding of the state-of-the-art wearable biosensing technologies, wearable biosensors for sports analytics would have a significant impact on the rapidly growing field-microfluidics for biosensing.

Application of smartphone-based spectroscopy to biosample analysis: A review

The emergence of the smartphones has brought extensive changes to our lifestyles, from communicating with one another, to shopping and enjoyment of entertainment, and from studying to functioning at the workplace (and in the field). At the same time, this portable device has also provided new possibilities in scientific research and applications. Based on the growing awareness of good health management, researchers have coupled health monitoring to smartphone sensing technologies. Along the way, there have been developed a variety of smartphone-based optical detection platforms for analyzing biological samples, including standalone smartphone units and integrated smartphone sensing systems. In this review, we outline the applications of smartphone-based optical sensors for biosamples. These applications focus mainly on three aspects: Microscopic imaging sensing, colorimetric sensing and luminescence sensing. We also discuss briefly some limitations of the current state of smartphone-based spectroscopy and present prospects of the future applicability of smartphone sensors.