A paper-based potentiometric cell for decentralized monitoring of Li levels in whole blood

Novel sample double dilution calibration method for determination of lithium in biological samples using automatic flow system with in-syringe reaction

A novel sample double dilution calibration method (SDDCM) and an automatic flow system with in-syringe reaction and spectrophotometric detection were developed for determining lithium in biological samples. The method is based on the reaction of lithium with Thorin in an alkaline medium and the signal was measured at 480 nm. The reaction was performed simultaneously for both standards and samples in three syringes of the automatic flow system. The method was validated and successfully applied to the determination of lithium in synthetic and pharmaceutical samples, with results consistent with the ICP OES method. The novel calibration method, developed for the determination of lithium in biological samples, uses a sample with two dilution degrees. Using the method, the concentration of the analyte is determined by relating the signal for a less diluted sample to the calibration plot for a more diluted sample and vice versa. The implementation of the calibration method was facilitated by preparing solutions directly in the flow system. The use of two sample dilutions makes it possible to determine the analyte in the sample without preliminary preparation. Moreover, obtaining two results based on signals for a sample diluted to different degrees allows them to be verified for accuracy. The proposed approach was successfully verified by the determination of lithium in certified reference materials of blood serum and urine. Using the developed method lithium was determined within the concentration range of 0.06-1.5 mg L-1, with precision (CV, %) less than 6.7, and accuracy (RE, %) better than 6.9. The detection limit was 0.03 mg L-1.

Sonochemical synthesis of graphene oxide-Ag2O nanozyme as an oxidize-like mimic for the highly sensitive detection of lithium in blood serum

Bipolar disorder is commonly treated with lithium carbonate. The concentration of lithium in the blood serum should be closely monitored in patients who require long-term lithium therapy. To date, no colorimetric method of detecting lithium ions has been reported using nanosensors. We have developed a novel chemosensor based on nanozyme (NZ) to address this clinical need. The GO-Ag2O NZs were synthesized by a sonochemical method and used as a colorimetric nanosensor to detect lithium ions in human blood serum (Li (I)). To characterize NZs, various techniques were employed, including XRD, FTIR, TEM, FESEM, EDX, Raman spectroscopy, BET, DLS, Zeta potential, and ICP-OES. According to TEM and FESEM images of GO-Ag2O, the nanoparticles (NPs) of Ag2O are uniformly distributed on the surface of 2D graphene oxide sheets. In addition, silver oxide nanoparticles exhibited a cubic morphology with an average size of 3.5 nm. We have examined the performance of the NZs in an aqueous medium and in human blood serum that contains Li (I). A colorimetric test revealed that NZs synthesized in the presence of ultrasound were more sensitive to Li (I). According to the linearity of the calibration curves' ranges, Li (I) has a limit of detection (LOD) of 0.01 µg/mL. Furthermore, it displayed a linear range between 0 and 12 µg/mL. GO-Ag2O NZs showed noticeable color changes from green to orange after exposure to Li (I). An incubation time of two minutes was found to be the most effective for sensing. This innovative approach provides a reliable method for monitoring lithium levels and ensuring patient safety during long-term lithium therapy for bipolar disorder.

LiFT (a Lithium Fiber-Based Test): An At-Home Companion Diagnostics for a Safer Lithium Therapy in Bipolar Disorder

This work presents LiFT (a lithium fiber-based test), a low-cost electrochemical sensor that can measure lithium in human saliva and urine with FDA-required accuracy. Lithium is used for the treatment of bipolar disorder, and has a narrow therapeutic window. Close monitoring of lithium concentration in biofluids and adjustment of drug dosage can minimize the devastating side effects. LiFT is an inexpensive, yet accurate and simple-to-operate lithium sensor for frequent at-home testing for early identification of lithium toxicity. The low cost and high accuracy of LiFT are enabled through an innovative design and the use of ubiquitous materials such as yarn and carbon black for fabrication. LiFT measures Li+ through potentiometric recognition using a lithium selective sensing membrane that is deposited on the ink-coated yarn. A detection limit of 0.97 µM is obtained with a sensitivity of 59.07±1.25 mV/decade for the Li+ sensor in deionized water. Moreover, the sodium correction extended LiFT's linear range in urine and saliva to 0.5 mM. The LiFT platform sends the test results to the patient's smartphone, which subsequently can be shared with the patient's healthcare provider to expedite diagnosis and prevention of acute lithium toxicity.

Ion-selective electrodes based on laser-induced graphene as an alternative method for nitrite monitoring

Nitrite is an important food additive for cured meats; however, high nitrite levels pose adverse health effects to humans. Hence, monitoring nitrite concentration is critical to comply with limits imposed by regulatory agencies. Laser-induced graphene (LIG) has proven to be a scalable manufacturing alternative to produce high-performance electrochemical transducers for sensors. Herein, we expand upon initial LIG studies by fabricating hydrophilic and hydrophobic LIG that are subsequently converted into ion-selective sensors to monitor nitrite in food samples with comparable performance to the standard photometric method (Griess method). The hydrophobic LIG resulted in an ion-selective electrode with improved potential stability due partly to a decrease in the water layer between the electrode and the nitrite poly(vinyl) chloride-based ion-selective membrane. These resultant nitrite ion-selective sensors displayed Nernstian response behavior with a sensitivity of 59.5 mV dec-1, a detection limit of 0.3 ± 0.1 mg L-1 (mean ± standard deviation), and a broad linear sensing range from 10-5 to 10-1 M, which was significantly larger than currently published nitrite methods. Nitrite levels were determined directly in food extract samples of sausage, ham, and bacon for 5 min. These sensor metrics are significant as regulatory agencies limit nitrite levels up to 200 mg L-1 in finished products to reduce the potential formation of nitrosamine (carcinogenic compound). These results demonstrate the versatility of LIG as a platform for ion-selective-LIG sensors and simple, efficient, and scalable electrochemical sensing in general while demonstrating a promising alternative to monitor nitrite levels in food products ensuring regulatory compliance.

Advances in Therapeutic Monitoring of Lithium in the Management of Bipolar Disorder

Since the mid-20th century, lithium continues to be prescribed as a first-line mood stabilizer for the management of bipolar disorder (BD). However, lithium has a very narrow therapeutic index, and it is crucial to carefully monitor lithium plasma levels as concentrations greater than 1.2 mmol/L are potentially toxic and can be fatal. The quantification of lithium in clinical laboratories is performed by atomic absorption spectrometry, flame emission photometry, or conventional ion-selective electrodes. All these techniques are cumbersome and require frequent blood tests with consequent discomfort which results in patients evading treatment. Furthermore, the current techniques for lithium monitoring require highly qualified personnel and expensive equipment; hence, it is crucial to develop low-cost and easy-to-use devices for decentralized monitoring of lithium. The current paper seeks to review the pertinent literature rigorously and critically with a focus on different lithium-monitoring techniques which could lead towards the development of automatic and point-of-care analytical devices for lithium determination.

Determination of blood lithium-ion concentration using digital microfluidic whole-blood separation and preloaded paper sensors

Existing microfluidic technologies for blood tests have several limitations, including difficulties in integrating the sample preparation steps, such as blood dilution, and precise metering of tiny samples (microliter) for accurate downstream analyses on a chip. Digital microfluidics (DMF) is a liquid manipulation technique that can provide precise volume control of micro or nano-liter liquid droplets. Without using sensitive but complex detection methods for tiny droplets involving fluorescence, luminescence, and electrochemistry, this article presents a DMF device with embedded paper-based sensors to detect blood lithium-ion (Li⁺) concentration by colorimetry. Dielectrophoresis on the DMF device between two parallel planar electrodes separates plasma droplets (from tens to hundreds of nanoliters in volume) from undiluted whole blood (a few microliters) within 4 min with an efficiency exceeding 90%. The embedded paper sensors contain a detection reagent to absorb the DMF-transported plasma droplets. These droplets change the color of the paper sensors in accordance with the Li⁺ concentration. Subsequently, colorimetry is used to reveal the Li⁺ concentration via image analysis. The proposed method meets the detection-sensitivity requirement for clinical diagnosis of bipolar disorder, making the DMF device a potential therapeutic tool for rapid whole-blood Li⁺ detection.

Optical Determination of Lithium Levels in Artificial Interstitial Fluid for Treatment Management of Bipolar Disorder

Bipolar Disorder (BD), characterized by mood fluctuating between episodes of mood elevation and depression, is a leading cause of disability worldwide. Lithium continues to be prescribed as a first-line mood stabilizer for the management of BD. However, lithium has a very narrow therapeutic index and it is crucial to carefully monitor lithium plasma levels as concentrations greater than 1.2 mmol/L are potentially toxic and can be fatal. The current techniques of lithium monitoring are cumbersome and require frequent blood tests with the consequent discomfort which results in patients evading treatment. Dermal interstitial fluid (ISF), an underutilized information-rich biofluid, can be a proxy for direct blood sampling and allow lithium drug monitoring as its lithium concentration is proportional to the concentrations in blood. Therefore, in this study we seek to investigate the measurement of lithium therapeutic concentrations in artificial ISF. Our study employs a colorimetric method, based on the reaction between chromogenic agent Quinizarin and Li⁺ ion which can be detected using optical spectroscopy in the visible region (400-800 nm), to determine lithium levels in artificial ISF. The resulting spectra of our experiments show spectral variations which are related to lithium concentrations in spiked samples of artificial ISF, with a correlation coefficient (R) of 0.9. Future work will focus on investigating the feasibility of utilizing ISF for real-time and minimally-invasive lithium drug monitoring.

Development of a Portable Method for Serum Lithium Measurement Based on Low-Cost Miniaturized Ultrasonic Nebulization Coupled with Atmospheric-Pressure Air-Sustained Discharge

An accurate, rapid but cheap, and portable method for monitoring of serum lithium (Li) is highly desirable for mental patients who take Li medicine for treatment. Conventional techniques are usually bulky, costly, and cannot provide on-site real-time measurements. Herein, a miniaturized, reliable, cost-effective, and portable optical emission method for rapid and sensitive determination of serum Li was developed based on a combination of miniaturized ultrasonic nebulization (MUN) and a low-power (≈22 W) atmospheric-pressure air-sustained discharge (APAD) excitation source. The proposed method eliminates the use of any compressed gas or pump and can achieve serum Li detection within 40 s with low sample consumption (less than 20 μL serum). Except for dilution with water, no extra treatment is needed for serum Li analysis by MUN-APAD-OES. In addition, it offers a significant advantage of good tolerance to the coexisting high concentration of Na, K, Ca, and Mg, which is in contrast with the obvious matrix effect encountered in conventional inductively coupled plasma optical emission spectrometry (ICP-OES). Different operating parameters affecting the performance of MUN-APAD-OES were evaluated. Under optimized conditions, the detection limit of Li (670.8 nm) was calculated to be 0.6 μg L^-1 (6 μg L^-1 in serum). Finally, the accuracy of the proposed method was validated by the analysis of two certified reference materials (Seronorm serum L-1 and L-2 RUO), six real human serum samples, and eight real animal serum samples. All of the results indicate that the low-cost and low-power MUN-APAD-OES provides a promising reliable method for on-site serum Li measurement and may also be extended to other elements.

Laser-induced graphene electrodes for electrochemical ion sensing, pesticide monitoring, and water splitting

Laser-induced graphene (LIG) has shown to be a scalable manufacturing route to create graphene electrodes that overcome the expense associated with conventional graphene electrode fabrication. Herein, we expand upon initial LIG reports by functionalizing the LIG with metallic nanoparticles for ion sensing, pesticide monitoring, and water splitting. The LIG electrodes were converted into ion-selective sensors by functionalization with poly(vinyl chloride)-based membranes containing K⁺ and H⁺ ionophores. These ion-selective sensors exhibited a rapid response time (10-15 s), near-Nernstian sensitivity (53.0 mV/dec for the K⁺ sensor and - 56.6 mV/pH for the pH sensor), and long storage stability for 40 days, and were capable of ion monitoring in artificial urine. The pesticide biosensors were created by functionalizing the LIG electrodes with the enzyme horseradish peroxidase and displayed a high sensitivity to atrazine (28.9 nA/μM) with negligible inference from other common herbicides (glyphosate, dicamba, and 2,4-dichlorophenoxyacetic acid). Finally, the LIG electrodes also exhibited a small overpotential for hydrogen evolution reaction and oxygen evolution reaction. The oxygen evolution reaction tests yielded overpotentials of 448 mV and 995 mV for 10 mA/cm² and 100 mA/cm², respectively. The hydrogen evolution reaction tests yielded 35 mV and 281 mV for the corresponding current densities. Such a versatile LIG platform paves the way for simple, efficient electrochemical sensing and energy harvesting applications.

Microfabricated potentiometric sensor for personalized methacholine challenge tests during the COVID-19 pandemic

The methacholine challenge test is considered to be the gold standard bronchoprovocation test used to diagnose asthma, and this test is always performed in pulmonary function labs or doctors' offices. Methacholine (MCH) acts by inducing airway tightening/bronchoconstriction, and more importantly, MCH is hydrolyzed by cholinesterase enzyme (ChE). Recently, the American Thoracic Society raised concerns about pulmonary function testing during the COVID-19 pandemic due to recently reported correlation between cholinesterase and COVID-19 pneumonia severity/mortality, and it was shown that cholinesterase levels are reduced in the acute phase of severe COVID-19 pneumonia. This work describes the microfabrication of potentiometric sensors using copper as the substrate and chemically polymerized graphene nanocomposites as the transducing layer for tracking the kinetics of MCH enzymatic degradation in real blood samples. The in-vitro estimation of the characteristic parameters of the MCH metabolism [Michaelis-Menten constant (K_m) and reaction velocity (V_max)] were found to be 241.041 μM and 56.8 μM/min, respectively. The proposed sensor is designed to be used as a companion diagnostic device that can (i) answer questions about patient eligibility to perform methacholine challenge tests, (ii) individualize/personalize medical dosing of methacholine, (iii) provide portable and inexpensive devices allowing automated readouts without the need for operator intervention (iv) recommend therapeutic interventions including intensive care during early stages and reflecting the disease state of COVID-19 pneumonia. We hope that this methacholine electrochemical sensor will help in assaying ChE activity in a "timely" manner and predict the severity and prognosis of COVID-19 to improve treatment outcomes and decrease mortality.

Solid-Contact Ion Sensing Without Using an Ion-Selective Membrane through Classic Li-Ion Battery Materials

The solid-contact ion-selective electrodes (SC-ISEs) are a type of potentiometric analytical device with features of rapid response, online analysis, and miniaturization. The state-of-the-art SC-ISEs are composed of a solid-contact (SC) layer and an ion-selective membrane (ISM) layer with respective functions of ion-to-electron transduction and ion recognition. Two challenges for the SC-ISEs are the water-layer formation at the SC/ISM phase boundary and the leaking of ISM components, which are both originated from the ISM. Herein, we report a type of SC-ISE based on classic Li-ion battery materials as the SC layer without using the ISM for potentiometric lithium-ion sensing. Both LiFePO₄- and LiMn₂O₄-based SC-ISEs display good Li⁺ sensing properties (sensitivity, selectivity, and stability). The proposed LiFePO₄ electrode exhibits comparable sensitivity and a linear range to conventional SC-ISEs with ISM. Owing to the nonexistence of ISM, the LiFePO₄ electrode displays high potential stability. Besides, the LiMn₂O₄ electrode shows a Nernstian response toward Li⁺ sensing in a human blood serum solution. This work emphasizes the concept of non-ISM-based SC-ISEs for potentiometric ion sensing.

A Paper-Based Potentiometric Platform for Determination of Water Hardness

A novel paper-based potentiometric platform for the simple and fast monitoring of water hardness is presented. First, potentiometric ion-selective electrodes for calcium and magnesium printed on a paper substrate were built and optimized. These sensors, which display near-Nernstian sensitivity, were used for the determination of the concentration of these cations and the calculation of the water hardness. Second, the incorporation of a solid-state reference electrode allowed building an integrated paper-based potentiometric cell for the determination of the hardness of artificial and real samples (mineral waters). The validation of the results shows good ability to predict hardness in the conventional scale. Truly decentralized measurements were demonstrated by integration of a miniaturized instrument and dedicated software in a portable device. The measurements were able to be performed in just under two minutes, including a two-point calibration. Since the method is simple to use and cost-effective, it can be implemented in domestic and industrial settings.

An All-in-One Solid State Thin-Layer Potentiometric Sensor and Biosensor Based on Three-Dimensional Origami Paper Microfluidics

An origami three-dimensional design of a paper-based potentiometric sensor is described. In its simplest form, this electrochemical paper-based analytical device (ePAD) is made from three small parts of the paper. Paper layers are folded on each other for the integration of a solid contact ion selective electrode (here a carbon-paste composite electrode) and a solid-state pseudo-reference electrode (here writing pencil 6B on the paper), which are in contact with a hydrophilic channel fabricated on the middle part (third part) of the paper. In this case, the pseudo-reference and working electrodes are connected to the two sides of the hydrophilic channel and hence the distance between them is as low as the width of paper. The unmodified carbon paste electrode (UCPE) and modification with the crown ether benzo15-crown-5 (B15C5) represented a very high sensitivity to Cu (II) and Cd2+ ions, respectively. The sensor responded to H2O2 using MnO2-doped carbon paste electrode (CPE). Furthermore, a biosensor was achieved by the addition of glucose oxidase to the MnO2-doped CPE and hence made it selective to glucose with ultra-sensitivity. In addition to very high sensitivity, our device benefits from consuming a very low volume of sample (10.0 µL) and automatic sampling without need for sampling devices.

Ion Transfer Voltammetry with an Electrochemical Pen

We present a new electrochemical system that combines paper-based sensing and ion-transfer voltammetry, bringing the latter a step closer toward point-of-care applications. Studies at the interface between two immiscible electrolyte solutions (ITIES) are often performed to detect redox-inactive species; unfortunately, due to the inherent instability of the interface, it is rather poorly explored outside specialized laboratories. Here, we address this limitation by combining a pen-like device containing the gelled organic phase with a paper-supported aqueous phase. This combination makes the system more user-friendly, potentially low-cost, and easy to assemble. We show the applicability of the new cell to analyze both simple and ionophore-facilitated transfer of ions and proteins, preconcentration of species, and analysis of mixtures through combination with paper chromatography. The native ion content of the paper also enabled measurements without added electrolytes. Those studies could broaden the scope for the application of the label-free electrochemical detection of nonredox-active species at points-of-need.

Whole virus detection using aptamers and paper-based sensor potentiometry

Paper-based sensors, microfluidic platforms, and electronics have attracted attention in the past couple of decades because they are flexible, can be recycled easily, environmentally friendly, and inexpensive. Here we report a paper-based potentiometric sensor to detect the whole Zika virus with a minimum sensitivity of 0.26 nV/Zika and a minimum detectable signal (MDS) of 2.4x10⁷ Zika. Our paper sensor works very similar to a P-N junction where a junction is formed between two different regions with different electrochemical potentials on the paper. These two regions with slightly different ionic contents, ionic species and concentrations, produce a potential difference given by the Nernst equation. Our paper sensor consists of 2-3 mm x 10 mm segments of paper with conducting silver paint contact patches on two ends. The paper is dipped in a buffer solution containing aptamers designed to bind to the capsid proteins on Zika. We then added the Zika (in its own buffer) to the region close to one of the silver-paint contacts. The Zika virus (40 nm diameter with 43 kDa or 7.1x10^-20 gm weight) became immobilized in the paper's pores and bonded with the resident aptamers creating a concentration gradient. Atomic force microscopy and Raman spectroscopy were carried out to verify that both the aptamer and Zika become immobilized in the paper. The potential measured between the two silver paint contacts reproducibly became more negative upon adding the Zika. We also showed that a Liquid Crystalline Display (LCD) powered by the sensor can be used to read the sensor output.

Paper-Based Device for the Facile Colorimetric Determination of Lithium Ions in Human Whole Blood

Lithium carbonate is an effective medicine for the treatment of the bipolar disorder, but the concentration of lithium in the patient's blood must be frequently monitored because of its toxicity. To date, no colorimetric methods of lithium ion detection in whole blood without pretreatment have been reported. Here, we report a colorimetric paper-based device that allows point-of-care testing in one step. This device is composed of two paper-based elements linked to each other: a blood cell separation unit and a colorimetric detection unit. After a portion of whole blood has been placed on the end of the separation unit, plasma in the sample is automatically transported to the detection unit, which displays a diagnostic color. The key feature of this device is its simple, user-friendly operation. The limit of detection is 0.054 mM and the coefficient of variance is below 6.1%, which are comparable to those of conventional instruments using the same colorimetric reaction. Furthermore, we achieved high recovery (>90%) and reproducibility (<9.8%) with spiked human blood samples. Thus, the presented device provides an alternative method for the regular monitoring of lithium concentrations in the treatment of bipolar disorder by augmenting the coefficient of variation (maximum value, 6.1%).

A novel trimodal system on a paper-based microfluidic device for on-site detection of the date rape drug "ketamine"

Paper-based microfluidic device was designed with wax-printing to combine potentiometric, fluorimetric and colorimetric detection zones. This newly developed trimodal paper chip has been used for on-site determination of ketamine hydrochloride (KET) as a date rape drug in beverages. The device employed polyaniline nano-dispersion as conducting polymer in ion sensing paper electrodes designed to fit USB plug connector. Carbon dots-gold nanoparticles and cobalt thiocyanate were used in fluorescence and color detection zones, respectively. Cellular phone's camera facilitated the on-site fluorimetric and color detection. The implemented trimodal detection system exhibited specificity for KET detection in the presence of several other beverage interferences i.e., biogenic amines. This innovative sensor brings together analytical figures of merit for effective KET detection in single aliquot of spiked beverages. The proposed paper-based chip also fulfils WHO criteria for point-of-care devices posing the proposed trimodal paper device as an active part for rapid, on-site drug diagnostics and to be applied further for other similar drugs.

Recent advances in solid-contact ion-selective electrodes: functional materials, transduction mechanisms, and development trends

This article presents a comprehensive overview of recent progress in the design and applications of solid-contact ion-selective electrodes (SC-ISEs).

Controlling the mixed potential of polyelectrolyte-coated platinum electrodes for the potentiometric detection of hydrogen peroxide

The use of a Pt electrode coated with a layer of Nafion has been described in previous works as an attractive way to perform the potentiometric detection of hydrogen peroxide. Despite of the attractive features of this approach, the nature of the non-Nernstian response of this system was not properly addressed. In this work, using a mixed potential model, the open circuit potential of the Pt electrode is shown to be under kinetic control of the oxygen reduction reaction (ORR). It is proposed that hydrogen peroxide acts as an oxygenated species that blocks free sites on the Pt surface, interfering with the ORR. Therefore, the effect of the polyelectrolyte coating can be understood in terms of the modulation of the factors that affects the kinetics of the ORR, such as an increase of the H⁺ concentration, minimization of the effect of the spectator species, etc. Because of the complexity and the lack of models that accurately describe systems with practical applications, this work is not intended to provide a mechanistic but rather a phenomenological view on problem. A general framework to understand the factors that affect the potentiometric response is provided. Experimental evidence showing that the use of polyelectrolyte coatings are a powerful way to control the mixed potential open new ways for the development of robust and simple potentiometric sensors.

Electrochemical Detection and Quantification of Lithium Ions in Authentic Human Saliva Using LiMn2O4-Modified Electrodes

We report an electrochemical sensor for the detection of lithium ions (Li⁺) in authentic human saliva at lithium manganese oxide (LiMn₂O₄)-modified glassy carbon electrodes (LMO-GCEs) and screen-printed electrodes (LMO-SPEs). The sensing strategy is based on an initial galvanostatic delithiation of LMO followed by linear stripping voltammetry (LSV) to detect the reinsertion of Li⁺ in the analyte. The process was investigated using powder X-ray diffraction and voltammetry. LSV measurements reveal a measurable lower limit of 50.0 μM in both LiClO₄ aqueous solutions and synthetic saliva samples, demonstrating the applicability of the proposed analytical method down to low Li⁺ concentrations. Four different samples of authentic human saliva were then analyzed with the established sensing strategy using LMO-SPEs, showing good linearity over a concentration range up to 5.0 mM Li⁺ with high reproducibility (RSD < 7%) and applicability for routine monitoring purposes. The total time needed to analyze a sample is less than 3 min.

Wearable All-Solid-State Potentiometric Microneedle Patch for Intradermal Potassium Detection

A new analytical all-solid-state platform for intradermal potentiometric detection of potassium in interstitial fluid is presented here. Solid microneedles are modified with different coatings and polymeric membranes to prepare both the potassium-selective electrode and reference electrode needed for the potentiometric readout. These microneedle-based electrodes are fixed in an epidermal patch suitable for insertion into the skin. The analytical performances observed for the potentiometric cell (Nernstian slope, limit of detection of 10^-4.9 potassium activity, linear range of 10^-4.2 to 10^-1.1, drift of 0.35 ± 0.28 mV h^-1), together with a fast response time, adequate selectivity, and excellent reproducibility and repeatability, are appropriate for potassium analysis in interstitial fluid within both clinical and harmful levels. The potentiometric response is maintained after several insertions into animal skin, confirming the resiliency of the microneedle-based sensor. Ex vivo tests based on the intradermal detection of potassium in chicken and porcine skin demonstrate that the microneedle patch is suitable for monitoring potassium changes inside the skin. In addition, the dimensions of the microneedles modified with the corresponding layers necessary to enhance robustness and provide sensing capabilities (1000 μm length, 45° tip angle, 15 μm thickness in the tip, and 435 μm in the base) agree with the required ranges for a painless insertion into the skin. In vitro cytotoxicity experiments showed that the patch can be used for at least 24 h without any side effect for the skin cells. Overall, the developed concept constitutes important progress in the intradermal analysis of ions related to an electrolyte imbalance in humans, which is relevant for the control of certain types of diseases.

A novel electrochemical sensor for non-invasive monitoring of lithium levels in mood disorders

Lithium is the main drug for the treatment of mood disorders. Due to its narrow therapeutic window, Therapeutic Drug Monitoring (TDM) is a norm during therapy in order to avoid adverse effects. Consequently, patients are obliged to frequent check-ups in hospitals to determine their serum concentration and optimize accordingly the drug dose. Wearable sensors have attracted a growing interest in the research community in recent years owing to their promising impact in personalized healthcare. In particular, sweat diagnosis has seen an enormous expansion and is currently entering the market thanks to the large availability and simple collection of this fluid. In this paper a novel approach for non-invasive decentralized monitoring of lithium drug concentration through sweat analysis is proposed for the first time. An all-solid-state Ion- Selective Electrode (ISE) with a nanostructured Solid-Contact (SC) is used to detect lithium ions in sweat. The sensor offers near-Nernstian behaviour (57:6±2:1 mV/decade) in the concentration range of interest. In addition, it shows fast response (15-30 s), good reversibility and small potential drift over time. A wide pH stability window (pH 4-12) is also proved.

Fabrication and Optimization of Fiber-Based Lithium Sensor: A Step toward Wearable Sensors for Lithium Drug Monitoring in Interstitial Fluid

A miniaturized, flexible fiber-based lithium sensor was fabricated from low-cost cotton using a simple, repeatable dip-coating technique. This lithium sensor is highly suited for ready-to-use wearable applications and can be used directly without the preconditioning steps normally required with traditional ion-selective electrodes. The sensor has a stable, rapid, and accurate response over a wide Li⁺ concentration range that spans over the clinically effective and the toxic concentration limits for lithium in human serum. The sensor is selective to Li⁺ in human plasma even in the presence of a high concentration of Na⁺ ions. This novel sensor concept represents a significant advance in wearable sensor technology which will target lithium drug monitoring from under the skin.

Ion sensing with thread-based potentiometric electrodes

Potentiometric sensing of ions with ion-selective electrodes (ISEs) is a powerful technique for selective and sensitive measurement of ions in complex matrices. The application of ISEs is generally limited to laboratory settings, because most commercially available ISEs and reference electrodes are large, delicate, and expensive, and are not suitable for point-of-use or point-of-care measurements. This work utilizes cotton thread as a substrate for fabrication of robust and miniaturized ISEs that are suitable for point-of-care or point-of-use applications. Thread-based ISEs selective for Cl-, K+, Na+, and Ca2+ were developed. The cation-selective ISEs were fabricated by coating the thread with a surfactant-free conductive ink (made of carbon black) and then coating the tip of the conductive thread with the ion-selective membrane. The Cl- ISE was fabricated by coating the thread with an Ag/AgCl ink. These sensors exhibited slopes (of electrical potential vs. log concentration of target ion), close to the theoretically-expected values, over four orders of magnitude in concentrations of ions. Because thread is mechanically strong, the thread-based electrodes can be used in multiple-use applications as well as single-use applications. Multiple thread-based sensors can be easily bundled together to fabricate a customized sensor for multiplexed ion-sensing. These electrodes require volumes of sample as low as 200 μL. The application of thread-based ISEs is demonstrated in the analysis of ions in soil, food, and dietary supplements (Cl- in soil/water slurry, K+ and Na+ in coconut water, and Ca2+ in a calcium supplement), and in detection of physiological electrolytes (K+ and Na+ in blood serum and urine, with sufficient accuracy for clinical diagnostics).

Distributed electrochemical sensors: recent advances and barriers to market adoption

Despite predictions of their widespread application in healthcare and environmental monitoring, electrochemical sensors are yet to be distributed at scale, instead remaining largely confined to R&D labs. This contrasts sharply with the situation for physical sensors, which are now ubiquitous and seamlessly embedded in the mature ecosystem provided by electronics and connectivity protocols. Although chemical sensors could be integrated into the same ecosystem, there are fundamental issues with these sensors in the three key areas of analytical performance, usability, and affordability. Nevertheless, advances are being made in each of these fields, leading to hope that the deployment of automated and user-friendly low-cost electrochemical sensors is on the horizon. Here, we present a brief survey of key challenges and advances in the development of distributed electrochemical sensors for liquid samples, geared towards applications in healthcare and wellbeing, environmental monitoring, and homeland security. As will be seen, in many cases the analytical performance of the sensor is acceptable; it is usability that is the major barrier to commercial viability at this moment. Were this to be overcome, the issue of affordability could be addressed. Graphical Abstract ᅟ.

Highly-stable Li+ ion-selective electrodes based on noble metal nanostructured layers as solid-contacts

Nowadays the development of stable and highly efficient Solid-Contact Ion-Selective Electrodes (SC-ISEs) attracts much attention in the research community because of the great expansion of portable analytical devices. In this work, we present highly stable Li⁺ all-solid-state ISEs exploiting noble metals nanostructures as ion-to-electron transducers. The detection of lithium is essential for therapeutic drug monitoring of bipolar patients. In addition, greater environmental exposure to this ion is occurring due to the large diffusion of lithium-ion batteries. However, only a limited number of SC Li⁺ ISEs already exists in literature based on Conductive Polymers (CPs) and carbon nanotubes. The use of noble metals for ion-to-electron transduction offers considerable advantages over CPs and carbon materials, including fast and conformal one-step deposition by electrochemical means, non-toxicity and high stability. We investigate for the first time the use of gold nanocorals obtained by means of a one-step electrodeposition process to improve sensor performance and we compare it to all-solid-state ISEs based on electrodeposited platinum nanoflowers. In addition, the effect of substrate electrode material, membrane thickness and conditioning concentration on the potentiometric response is carefully analysed. Scanning Electron Microscopy (SEM) and Current Reversal Chronopotentiometry (CRC) techniques are used to characterize the morphology and the electrochemical behaviour of the different ISEs. The use of nanostructured gold and platinum contacts allows the increase of the SC capacitance by one or two orders of magnitude, respectively, with respect to the flat metal, while the SC resistance is significantly reduced. We show that the microfabricated sensors offer Nernstian behaviour (58.7±0.8 mV/decade) in the activity range from 10^-5 to 0.1 M, with short response time (∼15 s) and small potential drift during CRC measurements (dEdt=3×10^-5±2×10^-5 V/s). The exceptional response stability is verified also when no potential is applied. The sensor shows high selectivity towards all clinically important ions, with values very similar to conventional ISEs. Furthermore, to our knowledge, the selectivity towards Ca⁺² is the best ever reported for SC-ISEs. In conclusion, the present study opens up new interesting perspectives towards the development of simple and reproducible fabrication protocols to obtain high-quality and high-stability all-solid-state ISEs.

Carbon nanotubes in microfluidic lab-on-a-chip technology: current trends and future perspectives

Advanced nanomaterials such as carbon nano-tubes (CNTs) display unprecedented properties such as strength, electrical conductance, thermal stability, and intriguing optical properties. These properties of CNT allow construction of small microfluidic devices leading to miniaturization of analyses previously conducted on a laboratory bench. With dimensions of only millimeters to a few square centimeters, these devices are called lab-on-a-chip (LOC). A LOC device requires a multidisciplinary contribution from different fields and offers automation, portability, and high-throughput screening along with a significant reduction in reagent consumption. Today, CNT can play a vital role in many parts of a LOC such as membrane channels, sensors and channel walls. This review paper provides an overview of recent trends in the use of CNT in LOC devices and covers challenges and recent advances in the field. CNTs are also reviewed in terms of synthesis, integration techniques, functionalization and superhydrophobicity. In addition, the toxicity of these nanomaterials is reviewed as a major challenge and recent approaches addressing this issue are discussed.

A novel wireless paper-based potentiometric platform for monitoring glucose in blood

A novel low-cost, compact and sensitive paper-based platform for the accurate monitoring of glucose in biological fluids is presented. Paper-based working and reference electrodes are combined to build a whole potentiometric cell, which also fits a sampling module for simple and fast determination of glucose in a single drop of blood. The working electrode is built using a platinized filter paper coated with a Nafion membrane that entraps the enzyme glucose oxidase; the reference electrode is made by casting a polyvinylbutyral-based membrane onto a conductive paper. The system works by detecting the hydrogen peroxide generated as a result of the enzymatic reaction. Selectivity is achieved due to the permselective behaviour of Nafion, while a significant enhancement of the sensitivity is reached by exploiting the Donnan-coupled formal potential. Under optimum conditions, a sensitivity of -95.9 ± 4.8 mV per decade in the 0.3-3 mM range is obtained. Validation of the measurements has been performed against standard methods in human serum and blood. Final integration with a wireless reader allows for truly in situ measurements with a less than 2 minute procedure including a two-point calibration, washing and measurement. This low-cost analytical device opens up new prospects for rapid diagnostic results in non-laboratory settings.

Using the Rubik's Cube to directly produce paper analytical devices for quantitative point-of-care aptamer-based assays

In this article, we describe a facile method named as Rubik's Cube stamping (RCS) for equipment-free fabrication of microfluidic paper-based analytical devices (μPADs). RCS is inspired by the worldwide ubiquitous RC toy and requires no specialized electric equipment other than a classical six-faced RC that is assembled with home-made small iron components. It can pattern various rosin microstructures in paper simply by either using different functional faces of the modified RC or applying its internal pivot mechanism to adjust the components' patterning forms on one functional face. Such a versatile stamping method is quite simple and inexpensive, and thus holds potential for producing rosin-patterned μPADs by untrained users in resource-limited environments such as small laboratories and private clinics, or even at home and in the field. Moreover, a set of one-channel devices are fabricated to design a point-of-care aptamer-based assay with near sample-in-answer-out capability that integrates enzymatic reactions for robust yet efficient signal amplification and a personal glucometer for portable, user-friendly, rapid and quantitative readout. Its utility is well demonstrated with the sensitive and specific detection of adenosine as a model target in buffer samples and undiluted human urine within several minutes. With the advantages of low cost, simplicity, portability, rapidity, and aptamer variety, this general point-of-care assay system reported here may find broad applications including home healthcare, field-based environmental monitoring or food analysis and emergency situations.