Recent progress, challenges, and prospects of fully integrated mobile and wearable point-of-care testing systems for self-testing

Evaluation of a miniature mass spectrometer based point-of-care-test method for direct analysis of amlodipine and benazepril in whole blood

A miniature mass spectrometer (mMS) based point-of-care testing (POCT) method was evaluated for on-site detecting the hypertension drugs, amlodipine and benazepril. The instrument parameters, including voltage, ISO1, ISO2, and CID, were optimized, under which the target compounds could be well detected in MS2. When these two drugs were injected simultaneously, the mutual ionization inhibition and mutual reduction between amlodipine and benazepril were evaluated. This phenomenon was severe on the precursor ions but had a small impact on the product ions, thus making this POCT method suitable for analysis using product ions. Finally, the method was validated and applied. The blood samples from patients were tested one hour after oral administration of the drugs (20 mg), and the benazepril was quantitatively analyzed using a standard curve, with detected concentrations ranging from 190.6 to 210 μg L-1 and a relative standard deviation (RSD) of 8.6 %. In summary, amlodipine has low sensitivity and can only be detected at higher concentrations, while benazepril has high sensitivity, good linearity, and even meets semi-quantitative requirements. The research results of this study are of great clinical significance for monitoring blood drug concentrations during hypertension medication, predicting drug efficacy, and customizing individualized medication plans.

Revolutionary Point-of-Care Wearable Diagnostics for Early Disease Detection and Biomarker Discovery through Intelligent Technologies

Early-stage disease detection, particularly in Point-Of-Care (POC) wearable formats, assumes pivotal role in advancing healthcare services and precision-medicine. Public benefits of early detection extend beyond cost-effectively promoting healthcare outcomes, to also include reducing the risk of comorbid diseases. Technological advancements enabling POC biomarker recognition empower discovery of new markers for various health conditions. Integration of POC wearables for biomarker detection with intelligent frameworks represents ground-breaking innovations enabling automation of operations, conducting advanced large-scale data analysis, generating predictive models, and facilitating remote and guided clinical decision-making. These advancements substantially alleviate socioeconomic burdens, creating a paradigm shift in diagnostics, and revolutionizing medical assessments and technology development. This review explores critical topics and recent progress in development of 1) POC systems and wearable solutions for early disease detection and physiological monitoring, as well as 2) discussing current trends in adoption of smart technologies within clinical settings and in developing biological assays, and ultimately 3) exploring utilities of POC systems and smart platforms for biomarker discovery. Additionally, the review explores technology translation from research labs to broader applications. It also addresses associated risks, biases, and challenges of widespread Artificial Intelligence (AI) integration in diagnostics systems, while systematically outlining potential prospects, current challenges, and opportunities.

Electrochemical Biosensor for Point-of-Care Testing of Low-Abundance Biomarkers of Neurological Diseases

The neurofilament protein light chain (NEFL) is a potential biomarker of neurodegenerative diseases, and interleukin-6 (IL-6) is also closely related to neuroinflammation. Especially, NEFL and IL-6 are the two most low-abundance known protein markers of neurological diseases, making their detection very important for the early diagnosis and prognosis prediction of such kinds of diseases. Nevertheless, quantitative detection of low concentrations of NEFL and IL-6 in serum remains quite difficult, especially in the point-of-care test (POCT). Herein, we developed a portable, sensitive electrochemical biosensor combined with smartphones that can be applied to multiple scenarios for the quantitative detection of NEFL and IL-6, meeting the need of the POCT. We used a double-antibody sandwich configuration combined with polyenzyme-catalyzed signal amplification to improve the sensitivity of the biosensor for the detection of NEFL and IL-6 in sera. We could detect NEFL as low as 5.22 pg/mL and IL-6 as low as 3.69 pg/mL of 6 μL of serum within 2 h, demonstrating that this electrochemical biosensor worked well with serum systems. Results also showed its superior detection capabilities over those of high-sensitivity ELISA for serum samples. Importantly, by detecting NEFL and IL-6 in sera, the biosensor showed its potential for the POCT model detection of all known biomarkers of neurological diseases, making it possible for the mass screening of patients with neurodegenerative diseases.

Synergizing Nanomaterials and Artificial Intelligence in Advanced Optical Biosensors for Precision Antimicrobial Resistance Diagnosis

Antimicrobial resistance (AMR) poses a critical global One Health concern, ensuing from unintentional and continuous exposure to antibiotics, as well as challenges in accurate contagion diagnostics. Addressing AMR requires a strategic approach that emphasizes early stage prevention through screening in clinical, environmental, farming, and livestock settings to identify nonvulnerable antimicrobial agents and the associated genes. Conventional AMR diagnostics, like antibiotic susceptibility testing, possess drawbacks, including high costs, time-consuming processes, and significant manpower requirements, underscoring the need for intelligent, prompt, and on-site diagnostic techniques. Nanoenabled artificial intelligence (AI)-supported smart optical biosensors present a potential solution by facilitating rapid point-of-care AMR detection with real-time, sensitive, and portable capabilities. This Review comprehensively explores various types of optical nanobiosensors, such as surface plasmon resonance sensors, whispering-gallery mode sensors, optical coherence tomography, interference reflection imaging sensors, surface-enhanced Raman spectroscopy, fluorescence spectroscopy, microring resonance sensors, and optical tweezer biosensors, for AMR diagnostics. By harnessing the unique advantages of these nanoenabled smart biosensors, a revolutionary paradigm shift in AMR diagnostics can be achieved, characterized by rapid results, high sensitivity, portability, and integration with Internet-of-Things (IoT) technologies. Moreover, nanoenabled optical biosensors enable personalized monitoring and on-site detection, significantly reducing turnaround time and eliminating the human resources needed for sample preservation and transportation. Their potential for holistic environmental surveillance further enhances monitoring capabilities in diverse settings, leading to improved modern-age healthcare practices and more effective management of antimicrobial treatments. Embracing these advanced diagnostic tools promises to bolster global healthcare capacity to combat AMR and safeguard One Health.

An integrated electronic tag-based vertical flow assay (e-VFA) with micro-sieve and AlGaN/GaN HEMT sensors for multi-target detection in actual saliva

Vertical flow assay (VFA) is an effective point-of-care (POC) diagnostic tool for widespread application. Nevertheless, the lack of multi-target detection and multi-signal readout capability still remains a challenge. Herein, a brand new VFA scheme for multi-target saliva detection based on electronic tags was proposed, where AlGaN/GaN HEMT sensors modified with different bio-receptors as electronic tags endowed the VFA with multi-target detection capability. In addition, the use of electronic tags instead of optical tags allowed the VFA to simultaneously carry out direct multi-target readouts, which ensure effective POC diagnostics for saliva analysis. Moreover, by integrating a hydrophilically optimized micro-sieve, impurities like sticky filaments, epidermal cells and other large-scale charged particles in saliva were effectively screened, which enabled the direct detection of saliva using AlGaN/GaN HEMT sensors. Glucose, urea, and cortisol were selected to verify the feasibility of the multi-target e-VFA scheme, and the results showed that the limit of detection (LOD) was as low as 100 aM. The linear response was demonstrated in the dynamic range of 100 aM to 100 μM, and the specificity, long-term stability and validity of the actual saliva test were also verified. These results demonstrated that the as-proposed e-VFA has potential for application in saliva detection for simultaneous multi-target detection, and it is expected to achieve the real-time detection of more biological targets in saliva.

Trimodal operation of a robust smart organic crystal

We describe a dynamic crystalline material that integrates mechanical, thermal, and light modes of operation, with unusual robustness and resilience and a variety of both slow and fast kinematic effects that occur on very different time scales. In the mechanical mode of operation, crystals of this material are amenable to elastic deformation, and they can be reversibly morphed and even closed into a loop, sustaining strains of up to about 2.6%. Upon release of the external force, the crystals resume their original shape without any sign of damage, demonstrating outstanding elasticity. Application of torque results in plastic twisting for several rotations without damage, and the twisted crystal can still be bent elastically. The thermal mode of operation relies on switching the lattice at least several dozen times. The migration of the phase boundaries depends on the crystal habit. It can be precisely controlled by temperature, and it is accompanied by both slow and fast motions, including shear deformation and leaping. Parallel boundaries result in a thermomechanical effect, while non-parallel boundaries result in a thermosalient effect. Finally, the photochemical mode of operation is driven by isomerization and can be thermally reverted. The structure of the crystal can also be switched photochemically, and the generation of a bilayer induces rapid bending upon exposure to ultraviolet light, an effect that further diversifies the mechanical response of the material. The small structural changes, low-energy and weak intramolecular hydrogen bonds, and shear deformation, which could dissipate part of the elastic energy, are considered to be the decisive factors for the conservation of the long-range order and the extraordinary diversity in the response of this, and potentially many other dynamic crystalline materials.

Nanoenzyme Hydrogel Film-Based Portable Point-of-Care Testing Platform for Double-Signal Visual Detection of PSA

The development of the Point-of-Care Testing (POCT) platform that combines convenience and cost-effectiveness is crucial for enabling the visual detection of disease biomarkers. In this work, a POCT platform for the sensitive in situ detection of prostate specific antigen (PSA) with dual-signal output was constructed by functionalizing the Eppendorf (EP) tube. This was achieved through the modification of aptamer hairpin probes (AHPs) on the lid of the EP tube and the assembly of a nanoenzyme hydrogel film on its inner wall. The target could trigger the release of Ag+ by AHP and subsequently activate Ag+-dependent DNAzyme (Ag-DNAzyme). This would initiate the cleavage of the DNA-Au/Pt NP hydrogel network, leading to the release of Au/Pt NPs. The released Au/Pt NPs exhibit both peroxidase (POD)-like and catalase (CAT)-like activity to produce a colorimetric response and induce liquid flow under pressure. Therefore, the target can be measured visually and quantitatively through colorimetric analysis and the measurement of total dissolved solids (TDS) using a pressure-triggered liquid flow device integrated into the platform. The designed platform is distinguished by its simplicity, specificity, cost-effectiveness, and remarkable sensitivity. It allows for the visual detection of PSA within concentration ranges of 0.5-100 ng/L (colorimetric) and 3-100 ng/L (TDS reading), boasting detection limits as low as 0.15 ng/L (colorimetric) and 0.57 ng/L (TDS reading). The strategy of target-triggered nanoenzyme release significantly enhances sensitivity and provides a guiding approach for visual biomarker detection.

Sensitive, Semiquantitative, and Portable Nucleic Acid Detection of Rabies Virus Using a Personal Glucose Meter

Rabies is a zoonotic infection with the potential to infect all mammals and poses a significant threat to mortality. Although enzyme-linked immunosorbent tests and real-time reverse transcription-quantitative polymerase chain reaction (RT-qPCR) have been established for rabies virus (RABV) detection, they require skilled staff. Here, we introduce a personal glucose meter (PGM)-based nucleic acid (NA-PGM) detection method to diagnose RABV. This method ensures sensitive and convenient RABV diagnosis through hybridization of reverse transcription-recombinase aided amplification (RT-RAA) amplicons with probes labeled with sucrose-converting enzymes, reaching a detection level as low as 6.3 copies/μL equivalent to 12.26 copies. NA-PGM allows for the differentiation of RABV from other closely related viruses. In addition, NA-PGM showed excellent performance on 65 clinical samples with a 100% accuracy rate compared with the widely adopted RT-qPCR method. Thus, our developed NA-PGM method stands out as sensitive, semiquantitative, and portable for RABV detection, showcasing promise as a versatile platform for a wide range of pathogens.

Clinical translation of nanomedicine with integrated digital medicine and machine learning interventions

Nanomaterials based therapeutics transform the ways of disease prevention, diagnosis and treatment with increasing sophistications in nanotechnology at a breakneck pace, but very few could reach to the clinic due to inconsistencies in preclinical studies followed by regulatory hinderances. To tackle this, integrating the nanomedicine discovery with digital medicine provide technologies as tools of specific biological activity measurement. Hence, overcome the redundancies in nanomedicine discovery by the on-site data acquisition and analytics through integrating intelligent sensors and artificial intelligence (AI) or machine learning (ML). Integrated AI/ML wearable sensors directly gather clinically relevant biochemical information from the subject's body and process data for physicians to make right clinical decision(s) in a time and cost-effective way. This review summarizes insights and recommend the infusion of actionable big data computation enabled sensors in burgeoning field of nanomedicine at academia, research institutes, and pharmaceutical industries, with a potential of clinical translation. Furthermore, many blind spots are present in modern clinically relevant computation, one of which could prevent ML-guided low-cost new nanomedicine development from being successfully translated into the clinic was also discussed.

An Updated Review on Functionalized Graphene as Sensitive Materials in Sensing of Pesticides

Numerous chemical pesticides were employed for a long time to manage pests, but their uncontrolled application harmed the health and the environment. Accurately quantifying pesticide residues is essential for risk evaluation and regulatory purposes. Numerous analytical methods have been developed and utilized to achieve sensitive and specific detection of pesticides in intricate sampl es like water, soil, food, and air. Electrochemical sensors based on amperometry, potentiometry, or impedance spectroscopy offer portable, rapid, and sensitive detection suitable for on-site analysis. This study examines the potential of electrochemical sensors for the accurate evaluation of various effects of pesticides. Emphasizing the use of Graphene (GR), Graphene Oxide (GO), Reduced Graphene Oxide (rGO), and Graphdiyne composites, the study highlights their enhanced performance in pesticide sensing by stating the account of many actual sensors that have been made for specific pesticides. Computational studies provide valuable insights into the adsorption kinetics, binding energies, and electronic properties of pesticide-graphene complexes, guiding the design and optimization of graphene-based sensors with improved performance. Furthermore, the discussion extends to the emerging field of biopesticides. While the GR/GO/rGO based sensors hold immense future prospects, and their existing limitations have also been discussed, which need to be solved with future research.

An intelligent wearable artificial pancreas patch based on a microtube glucose sensor and an ultrasonic insulin pump

In order to improve the living standards of diabetes patients and reduce the negative health effects of this disease, the medical community has been actively searching for more effective treatments. In recent years, an artificial pancreas has emerged as an important approach to managing diabetes. Despite these recent advances, meeting the requirements for miniaturized size, accurate sensing and large-volume pumping capability remains a great challenge. Here, we present a novel miniaturized artificial pancreas based on a long microtube sensor integrated with an ultrasonic pump. Our device meets the requirements of achieving both accurate sensing and high pumping capacity. The artificial pancreas is constructed based on a long microtube that is low cost, painless and simple to operate, where the exterior of the microtube is fabricated as a glucose sensor for detecting diabetes and the interior of the microtube is used as a channel for delivering insulin through an ultrasonic pump. This work successfully achieved closed-loop control of blood glucose and treatment of diabetes in rats. It is expected that this work can open up new methodologies for the development of microsystems, and advance the management approach for diabetes patients.

Enhanced Interstitial Fluid Extraction and Rapid Analysis via Vacuum Tube-Integrated Microneedle Array Device

Advancing the development of point-of-care testing (POCT) sensors that utilize interstitial fluid (ISF) presents considerable obstacles in terms of rapid sampling and analysis. Herein, an innovative strategy is introduced that involves the use of a 3D-printed, hollow microneedle array patch (MAP), in tandem with a vacuum tube (VT) connected through a hose, to improve ISF extraction efficiency and facilitate expedited analysis. The employment of negative pressure by the VT allows the MAP device to effectively gather ≈18 µL of ISF from the dermis of a live rabbit ear within a concise period of 5 min. This methodology enables the immediate and minimally invasive measurement of glucose levels within the body, employing personal healthcare meters for quantification. The fusion of the VT and MAP technologies provides for their effortless integration into a comprehensive and mobile system for ISF analysis, accomplished by preloading the hose with custom sensing papers designed to detect specific analytes. Moreover, the design and functionality of this integrated VT-MAP system are intuitively user-friendly, eliminating the requirement for specialized medical expertise. This feature enhances its potential to make a significant impact on the field of decentralized personal healthcare.

An electrochemically synthesized molecularly imprinted polymer for highly selective detection of breast cancer biomarker CA 15-3: a promising point-of-care biosensor

In this study, a molecularly imprinted polymer film (MIP) was prepared on the surface of a disposable carbon screen-printed electrode (C-SPE) using (3-acrylamidopropyl)trimethylammonium chloride (AMPTMA) as a functional monomer and the cancer biomarker carbohydrate antigen 15-3 (CA 15-3) as a template. The MIP was synthesized by in situ electropolymerization (ELP) of the AMPTMA monomer in the presence of the CA 15-3 protein on the C-SPE surface. The target was subsequently removed from the polymer matrix by the action of proteinase K, resulting in imprinted cavities with a high affinity for CA 15-3. Electrochemical techniques such as cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) were used to characterize the different phases of the sensor assembly. Chemical and morphological analysis was performed using RAMAN and scanning electron microscopy (SEM). CA 15-3 was successfully detected in a wide working range from 0.001 U mL-1 to 100 U mL-1 with a correlation coefficient (R2) of 0.994 in 20 min. The MIP sensor showed minimal interference with other cancer proteins (CEA and CA 125). Overall, the developed device provides a rapid, sensitive, and cost-effective response in the detection of CA 15-3. Importantly, this comprehensive approach appears suitable for point-of-care (PoC) use, particularly in a clinical context.

Programmable Gravity Self-Driven Microfluidic Chip for Point-of-Care Multiplied Immunoassays

Point-of-care testing (POCT) is experiencing a groundbreaking transformation with microfluidic chips, which offer precise fluid control and manipulation at the microscale. Nevertheless, chip design or operation for existing platforms is rather cumbersome, with some even heavily depending on external drivers or devices, impeding their broader utilization. This study develops a unique programmable gravity self-driven microfluidic chip (PGSMC) capable of simultaneous multi-reagent sequential release, multi-target analysis, and multi-chip operation. All necessary reagents are introduced in a single step, and the process is initiated simply by flipping the PGSMC vertically, eliminating the need for additional steps or devices. Additionally, it demonstrates successful immunoassays in less than 60 min for antinuclear antibodies testing, compared to more than 120 min by traditional methods. Assessment using 25 clinically diagnosed cases showcases remarkable sensitivity (96%), specificity (100%), and accuracy (99%). These outcomes underscored its potential as a promising platform for POCT with high accuracy, speed, and reliability, highlighting its capability for automated fluid control.

Quantitative Assessment of Fungal Biomarkers in Clinical Samples via an Interface-Modulated Optical Fiber Biosensor

Invasive fungal infections pose a significant public health threat. The lack of precise and timely diagnosis is a primary factor contributing to the significant increase in patient mortality rates. Here, an interface-modulated biosensor utilizing an optical fiber for quantitative analysis of fungal biomarkers at the early stage of point-of-care testing (POCT), is reported. By integrating surface refractive index (RI) modulation and plasmon enhancement, the sensor to achieve high sensitivity in a directional response to the target analytes, is successfully optimized. As a result, a compact fiber-optic sensor with rapid response time, cost-effectiveness, exceptional sensitivity, stability, and specificity, is developed. This sensor can successfully identify the biomarkers of specific pathogens from blood or other tissue specimens in animal models. It quantifies clinical blood samples with precision and effectively discriminates between negative and positive cases, thereby providing timely alerts to potential patients. It significantly reduces the detection time of fungal infection to only 30 min. Additionally, this approach exhibits remarkable stability and achieves a limit of detection (LOD) three orders of magnitude lower than existing methods. It overcomes the limitations of existing detection methods, including a high rate of misdiagnosis, prolonged detection time, elevated costs, and the requirement for stringent laboratory conditions.

5G NB-IoT System Integrated with High-Performance Fiber Sensor Inspired by Cirrus and Spider Structures

Real-time telemedicine detection can solve the problem of the shortage of public medical resources caused by the coming aging society. However, the development of such an integrated monitoring system is hampered by the need for high-performance sensors and the strict-requirement of long-distance signal transmission and reproduction. Here, a bionic crack-spring fiber sensor (CSFS) inspired by spider leg and cirrus whiskers for stretchable and weavable electronics is reported. Trans-scale conductive percolation networks of multilayer graphene around the surface of outer spring-like Polyethylene terephthalate (PET) fibers and printing Ag enable a high sensitivity of 28475.6 and broad sensing range over 250%. The electromechanical changes in different stretching stages are simulated by Comsol to explain the response mechanism. The CSFS is incorporated into the fabric and realized the human-machine interactions (HMIs) for robot control. Furthermore, the 5G Narrowband Internet of Things (NB-IoT) system is developed for human healthcare data collection, transmission, and reproduction together with the integration of the CSFS, illustrating the huge potential of the approach in human-machine communication interfaces and intelligent telemedicine rehabilitation and diagnosis monitoring.

Multicolor-Assay-on-a-Chip Processed by Robotic Operation (MACpro) with Improved Diagnostic Accuracy for Field-Deployable Detection

The ability to deploy decentralized laboratories with autonomous and reliable disease diagnosis holds the potential to deliver accessible healthcare services for public safety. While microfluidic technologies provide precise manipulation of small fluid volumes with improved assay performance, their limited automation and versatility confine them to laboratories. Herein, we report the utility of multicolor assay-on-a-chip processed by robotic operation (MACpro), to address this unmet need. The MACpro platform comprises a robot-microfluidic interface and an eye-in-hand module that provides flexible yet stable actions to execute tasks in a programmable manner, such as the precise manipulation of the microfluidic chip along with different paths. Notably, MACpro shows improved detection performance by integrating the microbead-based antibody immobilization with enhanced target recognition and multicolor sensing via Cu2+-catalyzed plasmonic etching of gold nanorods for rapid and sensitive analyte quantification. Using interferon-gamma as an example, we demonstrate that MACpro completes a sample-to-answer immunoassay within 30 min and achieves a 10-fold broader dynamic range and a 10-fold lower detection limit compared to standard enzyme-linked immunosorbent assays (0.66 vs 5.2 pg/mL). MACpro extends the applications beyond traditional laboratories and presents an automated solution to expand diagnostic capacity in diverse settings.

A Fully Integrated Handheld Electrochemical Sensing Platform for Point-of-Care Testing of Escherichia coli O157:H7

Fully integrated devices that enable full functioning execution without or with minimum external accessories or equipment are deemed to be one of the most desirable and ultimate objectives for modern device design and construction. Escherichia coli O157:H7 (E. coli O157:H7) is often linked to outbreaks caused by contaminated water and food. However, the sensors that are currently used for point-of-care E. coli O157:H7 (E. coli O157:H7) detection are often large and cumbersome. Herein, we demonstrate the first example of a handheld and pump-free fully integrated electrochemical sensing platform with the capability to point-of-care test E. coli O157:H7 in the actual samples of E. coli O157:H7-spiked tap water and E. coli O157:H7-spiked watermelon juice. This platform was made possible by overcoming major engineering challenges in the seamless integration of a microfluidic module for pump-free liquid sample collection and transportation, a sensing module for efficient E. coli O157:H7 testing, and an electronic module for automatically converting and wirelessly transmitting signals into a single and compact electrochemical sensing platform that retains its inimitable stand-alone, handheld, pump-free, and cost-effective feature. Although our primary emphasis in this study is on detecting E. coli O157:H7, this pump-free fully integrated handheld electrochemical sensing platform may also be used to monitor other pathogens in food and water by including specific antipathogen antibodies.

Advanced Terahertz Refractive Sensing And Fingerprint Recognition Through Metasurface-Excited Surface Waves

High-sensitive metasurface-based sensors are essential for effective substance detection and insightful bio-interaction studies, which compress light in subwavelength volumes to enhance light-matter interactions. However, current methods to improve sensing performance always focus on optimizing near-field response of individual meta-atom, and fingerprint recognition for bio-substances necessitates several pixelated metasurfaces to establish a quasi-continuous spectrum. Here, a novel sensing strategy is proposed to achieve Terahertz (THz) refractive sensing, and fingerprint recognition based on surface waves (SWs). Leveraging the long-range transmission, strong confinement, and interface sensitivity of SWs, a metasurface-supporting SWs excitation and propagation is experimentally verified to achieve sensing integrations. Through wide-band information collection of SWs, the proposed sensor not only facilitates refractive sensing up to 215.5°/RIU, but also enables the simultaneous resolution of multiple fingerprint information within a continuous spectrum. By covering 5 µm thickness of polyimide, quartz and silicon nitride layers, the maximum phase change of 91.1°, 101.8°, and 126.4° is experimentally obtained within THz band, respectively. Thus, this strategy broadens the research scope of metasurface-excited SWs and introduces a novel paradigm for ultrasensitive sensing functions.

Recent developments and future perspectives of microfluidics and smart technologies in wearable devices

Wearable devices are gaining popularity in the fields of health monitoring, diagnosis, and drug delivery. Recent advances in wearable technology have enabled real-time analysis of biofluids such as sweat, interstitial fluid, tears, saliva, wound fluid, and urine. The integration of microfluidics and emerging smart technologies, such as artificial intelligence (AI), machine learning (ML), and Internet of Things (IoT), into wearable devices offers great potential for accurate and non-invasive monitoring and diagnosis. This paper provides an overview of current trends and developments in microfluidics and smart technologies in wearable devices for analyzing body fluids. The paper discusses common microfluidic technologies in wearable devices and the challenges associated with analyzing each type of biofluid. The paper emphasizes the importance of combining smart technologies with microfluidics in wearable devices, and how they can aid diagnosis and therapy. Finally, the paper covers recent applications, trends, and future developments in the context of intelligent microfluidic wearable devices.

Afterglow Nanoprobe-Enabled Quantitative Lateral Flow Immunoassay by a Palm-Size Device for Household Healthcare

Lateral flow immunoassay (LFIA), a classical point-of-care testing (POCT) technique, plays an important role in disease screening and healthcare monitoring. However, traditional LFIA is either designed for qualitative analysis or requires expensive equipment for quantification, limiting its use in household diagnosis. In this study, we proposed a new generation of LFIA for household health monitoring by using ultralong organic phosphorescence (UOP) nanomaterials as afterglow nanoprobes with a self-developed palm-size sensing device. The UOP nanoprobes exhibit a phosphorescence signal with a second-level lifetime, which completely avoids the interference from excitation light and biological background fluorescence. Therefore, an ultraminiaturized and low-cost UOP nanosensor was successfully designed by eliminating the complex optical path and filtering systems. We chose an inflammatory factor, C-reactive protein (CRP), for household POCT validation. The whole analysis was completed within 9 min. A limit of detection (LOD) of 0.54 ng/mL of CRP antigen was achieved with high stability and good specificity, which is comparable to laboratory instruments and fully satisfying the clinical diagnosis requirement.

Paper-based uric acid assay in whole blood samples by Zn2+ protein precipitation and enzyme-free colorimetric detection

Uric acid (UA) is an important biomarker, as a high concentration in blood can lead to gout and further renal syndrome. Although several point-of-care testing (POCT) devices have been reported to detect UA, there are some limitations such as the requirement for uricase and the complicated pretreatment of serum/plasma samples, which restricts their use at home or in undeveloped areas. In this work, we developed an approach by applying Zn2+ to precipitate proteins and cells in whole blood to avoid interference with the chromogenic reaction. We used carboxymethylcellulose (CMC) to immobilize tetramethylbenzidine (TMB) on a nitrocellulose membrane for colorimetric detection. Using the oxidization properties of H2O2, which turns TMB into oxidized tetramethylbenzidine (TMBox) in the presence of catalyst gold nanoparticles (AuNPs), we successfully constructed an enzyme-free paper-based POCT device using the reduction reaction of UA and TMBox for simple, speedy, and cheap colorimetric detection of UA, achieving a detection time of 8 min, a linear range of 0-150 μg/mL, and an LOD of 25.79 μg/mL. The UA concentration in whole blood samples was further measured and correlated well with the clinical value (R2 = 0.8212). Thus, the proposed assay has the potential for POCT diagnosis, monitoring, and prognosis of diseases related to UA.

Solid-State Cholesteric Liquid Crystals as an Emerging Platform for the Development of Optical Photonic Sensors

Over the past decade, solid-state cholesteric liquid crystals (CLCsolid ) have emerged as a promising photonic material, heralding new opportunities for the advancement of optical photonic biosensors and actuators. The periodic helical structure of CLCsolid s gives rise to their distinctive capability of selectively reflecting incident radiation, rendering them highly promising contenders for a wide spectrum of photonic applications. Extensive research is conducted on utilizing CLCsolid 's optical characteristics to create optical sensors for bioassays, diagnostics, and environmental monitoring. This review provides an overview of emerging technologies in the field of interpenetrating polymeric network-CLCsolid (IPN) and CLCsolid -based optical sensors, including their structural designs, processing, essential materials, working principles, and fabrication methodologies. The review concludes with a forward-looking perspective, addressing current challenges and potential trajectories for future research.

A One Step Strategy Based on Hollow Gold Nanoparticles to Detect C-Reactive Protein with High Sensitivity (Hs-CRP) in Serum for Monitoring Cardiovascular Disease

Purpose

Rapid detection and diagnosis of diseases facilitate timely and effective treatment of cardiovascular diseases (CVD). The establishment of a one-step rapid detection method provides a new method for the initial screening and disease risk assessment of patients with cardiovascular diseases in primary medical units.

Methods

Hollow gold nanoparticles (HGNPs) were synthesized using a cobalt template method followed by use as signal amplification probes for ultra-sensitive quantitative detection of serum C-reactive protein (CRP). To induce the localized surface plasmon resonance (LSPR) and improve protein labeling efficiency, we developed a sensitive detection mode by coating polyvinylpyrrolidone (PVP-K30) on the HGNPs, resulting in a significant improvement in detection performance.

Results

Compared to traditional colloidal GNP-based LFTA, PVP-coated HGNPs exhibit a lower visual detection limit of 1 ng/mL, which a 25-fold decrement compare to using GNPs as the antibody-labeled probe, and the detection limit could be reduced to 0.14 ng/mL under the quantitative instrument.

Conclusion

The one-step method based on HGNP immunochromatographic strips modified with PVP established in this study can be used for the detection of CRP and hs-CRP in biological samples. The performance of the immunochromatographic technique designed in this study was evaluated from the perspective of synthetic markers, and the application conditions of this strip were screened, verifying its high specificity, indicating that it has high sensitivity and strong detection limit compared to colloidal gold. The sensitivity of the hollow gold immunochromatographic test strip in this article has been increased by about 25 times, providing a new method for rapid detection of CVD in clinical diagnosis.

An intelligent readable and capture-antibody-independent lateral flow immunoassay based on Cu2-xSe nanocrystals for point-of-care detection of Escherichia coli O157:H7

Escherichia coli (E. coli) O157:H7 is a common foodborne pathogen which can cause serious harm. It is particularly important to establish a simple and portable method to achieve on-site pathogen detection. In this study, a capture-antibody-independent lateral flow immunoassay (LFIA) was constructed based on Cu2-xSe nanocrystals (Cu2-xSe NCs) for rapid detection of E. coli O157:H7. Cu2-xSe NCs can not only be regarded as the "nano-antibody" for the recognition of E. coli O157:H7 through electrostatic adsorption, but also as nanozymes that show good peroxidase-like catalytic activity. The formed compound of E. coli O157:H7 and Cu2-xSe NCs would be captured by a detection antibody on the T line due to the specific recognition of the antibody and E. coli O157:H7. Then, Cu2-xSe NCs could catalyze the oxidation of TMB by H2O2 to generate oxTMB, thereby generating blue bands. Meanwhile, we developed a mobile app for rapid data analysis. Under the optimal reaction conditions, E. coli O157:H7 could be detected within 70 min. The detection limit of this method was 2.65 × 105 CFU mL-1 with good specificity and stability. Additionally, it could achieve on-site rapid detection of E. coli O157:H7 in environmental water samples, providing a promising biosensor for portable pathogen detection.

Sensitization Strategies of Lateral Flow Immunochromatography for Gold Modified Nanomaterials in Biosensor Development

Gold nanomaterials have become very attractive nanomaterials for biomedical research due to their unique physical and chemical properties, including size dependent optical, magnetic and catalytic properties, surface plasmon resonance (SPR), biological affinity and structural suitability. The performance of biosensing and biodiagnosis can be significantly improved in sensitivity, specificity, speed, contrast, resolution and so on by utilizing multiple optical properties of different gold nanostructures. Lateral flow immunochromatographic assay (LFIA) based on gold nanoparticles (GNPs) has the advantages of simple, fast operation, stable technology, and low cost, making it one of the most widely used in vitro diagnostics (IVDs). However, the traditional colloidal gold (CG)-based LFIA can only achieve qualitative or semi-quantitative detection, and its low detection sensitivity cannot meet the current detection needs. Due to the strong dependence of the optical properties of gold nanomaterials on their shape and surface properties, gold-based nanomaterial modification has brought new possibilities to the IVDs: people have attempted to change the morphology and size of gold nanomaterials themselves or hybrid with other elements for application in LFIA. In this paper, many well-designed plasmonic gold nanostructures for further improving the sensitivity and signal output stability of LFIA have been summarized. In addition, some opportunities and challenges that gold-based LFIA may encounter at present or in the future are also mentioned in this paper. In summary, this paper will demonstrate some feasible strategies for the manufacture of potential gold-based nanobiosensors of post of care testing (POCT) for faster detection and more accurate disease diagnosis.

Recent advances in point-of-care testing of COVID-19

Advances in microfluidic device miniaturization and system integration contribute to the development of portable, handheld, and smartphone-compatible devices. These advancements in diagnostics have the potential to revolutionize the approach to detect and respond to future pandemics. Accordingly, herein, recent advances in point-of-care testing (POCT) of coronavirus disease 2019 (COVID-19) using various microdevices, including lateral flow assay strips, vertical flow assay strips, microfluidic channels, and paper-based microfluidic devices, are reviewed. However, visual determination of the diagnostic results using only microdevices leads to many false-negative results due to the limited detection sensitivities of these devices. Several POCT systems comprising microdevices integrated with portable optical readers have been developed to address this issue. Since the outbreak of COVID-19, effective POCT strategies for COVID-19 based on optical detection methods have been established. They can be categorized into fluorescence, surface-enhanced Raman scattering, surface plasmon resonance spectroscopy, and wearable sensing. We introduced next-generation pandemic sensing methods incorporating artificial intelligence that can be used to meet global health needs in the future. Additionally, we have discussed appropriate responses of various testing devices to emerging infectious diseases and prospective preventive measures for the post-pandemic era. We believe that this review will be helpful for preparing for future infectious disease outbreaks.

Mobile Point-of-Care Device Using Molecularly Imprinted Polymer-Based Chemosensors Targeting Interleukin-1β Biomarker

Molecularly imprinted polymers (MIPs) have garnered significant attention as a promising material for engineering specific biological receptors with superior chemical complementarity to target molecules. In this study, we present an electrochemical biosensing platform incorporating MIP films for the selective detection of the interleukin-1β (IL-1β) biomarker, particularly suitable for mobile point-of-care testing (POCT) applications. The IL-1β-imprinted biosensors were composed of poly(eriochrome black T (EBT)), including an interlayer of poly(3,4-ethylene dioxythiophene) and a 4-aminothiophenol monolayer, which were electrochemically polymerized simultaneously with template proteins (i.e., IL-1β) on custom flexible screen-printed carbon electrodes (SPCEs). The architecture of the MIP films was designed to enhance the sensor sensitivity and signal stability. This approach involved a straightforward sequential-electropolymerization process and extraction for leaving behind cavities (i.e., rebinding sites), resulting in the efficient production of MIP-based biosensors capable of molecular recognition for selective IL-1β detection. The electrochemical behaviors were comprehensively investigated using cyclic voltammograms and electrochemical impedance spectroscopy responses to assess the imprinting effect on the MIP films formed on the SPCEs. In line with the current trend in in vitro diagnostic medical devices, our simple and effective MIP-based analytical system integrated with mobile POCT devices offers a promising route to the rapid detection of biomarkers, with particular potential for periodontitis screening.

Disposable capillary-fill device for the determination of proteases incorporating elimination of light-shielding from the magnetic beads with cleavage of the electrogenerated chemiluminescence label-tagged peptide probe

A novel point-of-care testing (POCT) method for the determination of proteases was developed for the first time using a designed disposable capillary-fill device based on the cleavage of electrogenerated chemiluminescence (ECL)-label-tagged peptide probes and enabling elimination of the light-shielding from the magnetic beads (MBs). As a proof-of-principle, prostate-specific antigen (PSA) was taken as a model analyte, and streptavidin-coated magnetic beads bound with ruthenium-complex-tagged specific peptide (biotin-HSSKLQK) were utilized as MB ECL probes. The capillary-fill device was designed to be divided into a reaction zone and detection zone. In the reaction zone, the bio-cleavage reaction between the PSA analyte with the peptide on the surface of the MB ECL probes occurred, while in the detection zone, ECL emission was produced by a screen-printed carbon electrode, Ag/AgCl reference electrode and carbon counter electrode. When the analyte PSA was introduced into the suspension of MB ECL probes in the reaction zone of the device, biocleavage of the peptide occurred, and the cleaved Ru1 part was released from the surface of the MB ECL probes. The capillary-filled device was tilted 90°, and with the aid of gravity, the solution containing the released Ru1 part flowed to the surface of the working electrode in the detection region of the device, while the MB ECL probes were fixed in the reaction zone by an external magnet. PSA can be determined by the ECL emission from the released Ru1 part in the presence of the co-reactant tri-n-propylamine at the detection zone. Under the optimal conditions, the developed ECL method showed a low detection limit of 0.12 ng mL-1 for PSA. This work demonstrates that the developed ECL biosensing approach can eliminate the MB light-shielding effect and quantify proteases with high sensitivity and selectivity, which could be easily extended to POCT-based ECL biosensing for other proteases.

Electrochromic Sensor Augmented with Machine Learning for Enzyme-Free Analysis of Antioxidants

Our study presents an electrochromic sensor that operates without the need for enzymes or multiple oxidant reagents. This sensor is augmented with machine learning algorithms, enabling the identification, classification, and prediction of six different antioxidants with high accuracy. We utilized polyaniline (PANI), Prussian blue (PB), and copper-Prussian blue analogues (Cu-PBA) at their respective oxidation states as electrochromic materials (ECMs). By designing three readout channels with these materials, we were able to achieve visual detection of antioxidants without relying on traditional "lock and key" specific interactions. Our sensing approach is based on the direct electrochemical reactions between oxidized electrochromic materials (ECMsox) as electron acceptors and various antioxidants, which act as electron donors. This interaction generates unique fingerprint patterns by switching the ECMsox to reduced electrochromic materials (ECMsred), causing their colors to change. Through the application of density functional theory (DFT), we demonstrated the molecular-level basis for the distinct multicolor patterns. Additionally, machine learning algorithms were employed to correlate the optical patterns with RGB data, enabling complex data analysis and the prediction of unknown samples. To demonstrate the practical applications of our design, we successfully used the EC sensor to diagnose antioxidants in serum samples, indicating its potential for the on-site monitoring of antioxidant-related diseases. This advancement holds promise for various applications, including the real-time monitoring of antioxidant levels in biological samples, the early diagnosis of antioxidant-related diseases, and personalized medicine. Furthermore, the success of our electrochromic sensor design highlights the potential for exploring similar strategies in the development of sensors for diverse analytes, showcasing the versatility and adaptability of this approach.

Slippery Viscosity-Sensing Platform with Time Readout for the Detection of Hyaluronidase and Its Inhibitor

Hyaluronidase (HAase) is a biomarker for cancer, and its detection is of great significance for early diagnosis. However, the requirement of sophisticated instruments, tedious operation procedures, and labeled molecules of conventional HAase biosensing methods hampers their widespread applications. Herein, we report a portable slippery viscosity-sensing platform with time readout for the first time and demonstrate HAase and tannic acid (TA, HAase inhibitor) detection as a model system. HAase specifically cleaves hyaluronic acid (HA) and decreases HA solution viscosity, thereby shortening the aqueous droplet's sliding time on a slippery surface. Thus, the HA solution viscosity alteration due to enzymatic hydrolysis is used to quantify the HAase concentration through the difference in the sliding time of the aqueous droplets on a slippery surface. The developed HAase sensing platform exhibits high sensitivity with a minimum detection limit of 0.23 U/mL and excellent specificity without the use of specialized instruments and labeled molecules. HAase detection in actual urine samples by a standard addition method is performed as well. Moreover, the quantitative detection of TA with an IC50 value of 37.68 ± 1.38 μg/mL is achieved. As an equipment-free, label-free, and high-portability sensing platform, this method holds promise in developing a user-friendly and inexpensive point-of-care testing (POCT) device for HAase detection, and its use can be extended to analyze other analytes with different stimuli-responsive polymers for great universality and expansibility in biosensing applications.

Highly Stable Fluorescent-Traffic-Light Sensor for Point-of-Care Detection of Tetracycline

Fluorescent point-of-care (POC) sensors have found great utility in fields like clinical diagnosis, food testing, and environmental monitoring. Herein, we developed a highly stable POC sensor that enabled the visual detection of tetracycline (TC) in a distinct fluorescent-traffic-light manner. In the sensor, a composite material of copper nanoclusters and metal-organic framework (CuNCs@MOF-5) prepared with a facile one-pot synthetic strategy was employed as the core element for target recognition and signal transduction. As evidenced by experiments, the as-prepared CuNCs@MOF-5 exhibited significantly improved fluorescence properties in terms of emission enhancement (about 28-fold) and stability improvement (over 110 days) compared to the CuNCs without confining and protection by MOF-5. More importantly, it was found that TC could uniquely interact with Zn(II) to trigger the disassembly of CuNCs@MOF-5, resulting in green fluorescence emission from the TC-Zn(II) complex and red fluorescence weakening of CuNCs. On the basis of this finding, a simple and stable sensor was proposed for POC detection of TC, which demonstrated high sensitivity, selectivity, and reproducibility. In addition to homogeneous visual detection in a 96-well plate, a CuNCs@MOF-5-contained agarose gel array was easily fabricated to achieve direct detection of TC in milk without any pretreatment, thanks to the size-sieving effect of the gel. Moreover, a test paper array was also put forward for low-cost TC detection, which indicates the extensibility and practicability of this sensing strategy.

Enhanced detection of Listeria monocytogenes using tetraethylenepentamine-functionalized magnetic nanoparticles and LAMP-CRISPR/Cas12a-based biosensor

BACKGROUND

Listeria monocytogenes is a pathogenic bacterium that can lead to severe illnesses, especially among vulnerable populations. Therefore, the development of rapid and sensitive detection methods is vital to prevent and manage foodborne diseases. In this study, we used tetraethylenepentamine (TEPA)-functionalized magnetic nanoparticles (MNPs) and a loop-mediated isothermal amplification (LAMP)-based CRISPR/Cas12a-based biosensor to concentrate and detect, respectively, L. monocytogenes. LAMP enables DNA amplification at a constant temperature, providing a highly suitable approach for point-of-care testing (POCT). The ability of CRISPR/Cas12a to cleave ssDNA reporter, coupled with TEPA-functionalized MNPs effective attachment to negatively charged bacteria, forms a promising biosensor.

RESULTS

The LAMP assay was meticulously developed by selecting specific primers and designing crRNA sequences targeting a specific region within the hly gene of L. monocytogenes. We selected primer and refined the amplification conditions by systematically exploring a temperature range from 59 °C to 69 °C, ensuring the attainment of optimal performance. This process was complemented by systematic optimization of LAMP-CRISPR/Cas12a system parameters. In particular, we successfully established the optimal ssDNA reporter concentrations (0-1.2 μM) and Cas12a-mediated trans-cleavage times (0-20 min), crucial components that underpin the effectiveness of the LAMP-CRISPR/Cas12a-based biosensor. For optimizing parameters in capturing L. monocytogenes using TEPA-functionalized MNPs, capture efficiency was significantly enhanced through adjustments in TEPA-functionalized MNPs concentration, incubation times, and magnetic separation duration. Large-volume (20 mL) magnetic separation exhibited a 10-fold sensitivity improvement over conventional methods. Utilizing TEPA-functionalized MNPs, the LAMP-CRISPR/Cas12a-based biosensor achieved detection limits of 100 CFU mL-1 in pure cultures and 100 CFU g-1 in enoki mushrooms.

SIGNIFICANCE

The integration of this novel technique with the LAMP-CRISPR/Cas12a-based biosensor enhances the accuracy and sensitivity of L. monocytogenes detection in foods, and it can be a promising biosensor for POCT. The 10-fold increase in sensitivity compared to conventional methods makes this approach a groundbreaking advancement in pathogenic bacteria detection for food safety and public health.

Wearable electrochemical sensor based on bimetallic MOF coated CNT/PDMS film electrode via a dual-stamping method for real-time sweat glucose analysis

Non-invasive wearable sweat glucose sensors are expected to be highly desirable for personalized diabetes management. Therefore, developing facile, convenient, and scalable manufacturing method of such wearable sensors is urgently needed. Herein, we report a simple and low-cost stamping-vacuum filtration dry transfer (SVFDT) method for construction of a wearable sweat glucose electrochemical sensor. In this patch, a three-electrode array template was made by using a polyvinyl chloride (PVC) stamp, followed by the preparation of multiwalled carbon nanotubes (MWCNTs)/polydimethylsiloxane (PDMS) (MP) film electrode using the vacuum-filtration dry transfer method. In addition, for further enhancing the conductivity of the electrode, another similar stamp with a raised surface dipping carbon nanotubes (CNTs) conductive coating was stamped on the surface of the MP electrode to obtain CNTs/MWCNTs/PDMS (CMP) electrode. CMP electrode was modified with the enzyme-like Ni-Co metal-organic framework (MOF) material which showed good electro-catalytic activity and achieved high sensitivity for glucose detection with a low detection limit of 6.78 μM and a wide linear range of 20 μM - 1.1 mM. More importantly, the Ni-Co MOF modified CMP (NCMP) electrode also displayed high stability under stretching and bending conditions. Finally, the sweat absorbent cloth was combined with the NCMP film electrode to form a wearable flexible electrochemical sensor patch, which could adhere to the skin to enrich sweat and realize real-time detection of sweat glucose with high accuracy. This SVFDT method can also be applied to the fabrication of other electronic devices.

Progress in wearable acoustical sensors for diagnostic applications

With extensive and widespread uses of miniaturized and intelligent wearable devices, continuously monitoring subtle spatial and temporal changes in human physiological states becomes crucial for daily healthcare and professional medical diagnosis. Wearable acoustical sensors and related monitoring systems can be comfortably applied onto human body with a distinctive function of non-invasive detection. This paper reviews recent advances in wearable acoustical sensors for medical applications. Structural designs and characteristics of the structural components of wearable electronics, including piezoelectric and capacitive micromachined ultrasonic transducer (i.e., pMUT and cMUT), surface acoustic wave sensors (SAW) and triboelectric nanogenerators (TENGs) are discussed, along with their fabrication techniques and manufacturing processes. Diagnostic applications of these wearable sensors for detection of biomarkers or bioreceptors and diagnostic imaging have further been discussed. Finally, main challenges and future research directions in these fields are highlighted.

Soft microfiber-based hollow microneedle array for stretchable microfluidic biosensing patch with negative pressure-driven sampling

Wearable point-of-care testing devices are essential for personalized and decentralized healthcare. They can collect biofluid samples from the human body and use an analyzer to detect biomolecules. However, creating an integrated system is challenging due to the difficulty of achieving conformality to the human body, regulating the collection and transport of biofluids, developing a biosensor patch capable of precise biomolecule detection, and establishing a simple operation protocol that requires minimal wearer attention. In this study, we propose using a hollow microneedle (HMN) based on soft hollow microfibers and a microneedle-integrated microfluidic biosensor patch (MIMBP) capable of integrated blood sampling and electrochemical biosensing of biomolecules. The soft MIMBP includes a stretchable microfluidic device, a flexible electrochemical biosensor, and a HMN array made from flexible hollow microfibers. The HMNs are fabricated by electroplating flexible and mechanically durable hollow microfibers made from a nanocomposite matrix of polyimide, a poly (vinylidene fluoride-co-trifluoroethylene) copolymer, and single-walled carbon nanotubes. The MIMBP uses the negative pressure generated by a single button push to collect blood and deliver it to a flexible electrochemical biosensor modified with a gold nanostructure and Pt nanoparticles. We have demonstrated that glucose can be accurately measured up to the molar range in whole human blood collected through the microneedle. The MIMBP platform with HMNs has great potential as a foundation for the future development of simple, wearable, self-testing systems for minimally invasive biomolecule detection. This platform capable of sequential blood collection and high sensitivity glucose detection, which are ideal for personalized and decentralized healthcare.

Micro interstitial fluid extraction and detection device integrated with the optimal extraction conditions for noninvasive glucose monitoring

Interstitial fluid glucose sensors have promising prospects in noninvasive glucose monitoring. However, the commonly used method of extracting interstitial fluid, reverse iontophoresis (RI), still remains to be optimized to solve problems such as insufficient extraction flux and skin irritation. To find the optimal RI conditions, in this study we explored the effects of multiple factors such as current frequency, duration, duty cycle and their interactions on extraction with the design of experiments (DOE) method. A multifunctional extraction and detection device was designed to control extraction conditions and measure the surface water content of the extraction electrode in situ and real time. A micro glucose monitoring device (MicroTED) combined with a cheap and flexible paper-based electrode was developed under the determined optimal extraction conditions. In on-body continuous glucose monitoring tests carried out to verify the performance of the device, the optimized conditions can facilitate stable extraction of up to 1.0 mg without any skin discomfort. The mean Pearson correlation coefficient between the measurement results of MicroTED and commercial glucometer is above 0.9. In the Clarke error grid analysis, all data points fell within Clarke error grid areas A and B, demonstrating the feasibility of further clinical application of the device.

4D-printed needle panel meters coupled with enzymatic derivatization for reading urea and glucose concentrations in biological samples

On-site analytical techniques continue being developed with advances in modern technology. To demonstrate the applicability of four-dimensional printing (4DP) technologies in the direct fabrication of stimuli-responsive analytical devices for on-site determination of urea and glucose, we used digital light processing three-dimensional printing (3DP) and 2-carboxyethyl acrylate (CEA)-incorporated photocurable resins to fabricate all-in-one needle panel meters. When adding a sample having a value of pH above the pKa of CEA (ca. 4.6-5.0) into the fabricated needle panel meter, the [H+]-responsive layer of the needle, printed using the CEA-incorporated photocurable resins, swelled as a result of electrostatic repulsion among the dissociated carboxyl groups of the copolymer, leading to [H+]-dependent bending of the needle. When coupled with a derivatization reaction (urease-mediated hydrolysis of urea to decrease [H+]; glucose oxidase-mediated oxidization of glucose to increase [H+]), the bending of the needle allowed reliable quantification of urea or glucose when referencing pre-calibrated concentration scales. After method optimization, the method's detection limits for urea and glucose were 4.9 and 7.0 μM, respectively, within a working concentration range from 0.1 to 10 mM. We verified the reliability of this analytical method by determining the concentrations of urea and glucose in samples of human urine, fetal bovine serum, and rat plasma with spike analyses and comparing the results with those obtained using commercial assay kits. Our results confirm that 4DP technologies can allow the direct fabrication of stimuli-responsive devices for quantitative chemical analysis, and that they can advance the development and applicability of 3DP-enabling analytical methods.

New technologies and reagents in lateral flow assay (LFA) designs for enhancing accuracy and sensitivity

Lateral flow assays (LFAs) are a popular method for quick and affordable diagnostic testing because they are easy to use, portable, and user-friendly. However, LFA design has always faced challenges regarding sensitivity, accuracy, and complexity of the operation. By integrating new technologies and reagents, the sensitivity and accuracy of LFAs can be improved while minimizing the complexity and potential for false positives. Surface enhanced Raman spectroscopy (SERS), photoacoustic techniques, fluorescence resonance energy transfer (FRET), and the integration of smartphones and thermal readers can improve LFA accuracy and sensitivity. To ensure reliable and accurate results, careful assay design and validation, appropriate controls, and optimization of assay conditions are necessary. Continued innovation in LFA technology is crucial to improving the reliability and accuracy of rapid diagnostic testing and expanding its applications to various areas, such as food testing, water quality monitoring, and environmental testing.

Enhanced fluorescence detection of miRNA by means of Bloch surface wave-based biochips

We report on the use of biochips based on one-dimensional photonic crystals sustaining Bloch surface waves to specifically detect target miRNA that is characteristic of hemorrhagic stroke (miR-16-5p) at low concentration in a buffer solution. The biochips were functionalized with streptavidin and ssDNA oligonucleotides to enable miRNA detection. To discriminate the target miRNA from a non-specific control (miR-101a-3p), we made use of an optical platform developed to work both in label-free and fluorescence detection modes. We demonstrate that the limit of detection provided when operating in the fluorescence mode allows us to specifically detect the target miRNA down to 1 ng mL-1 (140 pM), which matches the recommendations for diagnostic miRNA assays, 5 ng mL-1. The low costs open the way towards the application of these disposable optical biochips based on 1DPC sustaining Bloch surface waves as a promising tool for early disease detection in a liquid biopsy format.

Point-of-Care Devices for Viral Detection: COVID-19 Pandemic and Beyond

The pandemic of COVID-19 and its widespread transmission have made us realize the importance of early, quick diagnostic tests for facilitating effective cure and management. The primary obstacles encountered were accurately distinguishing COVID-19 from other illnesses including the flu, common cold, etc. While the polymerase chain reaction technique is a robust technique for the determination of SARS-CoV-2 in patients of COVID-19, there arises a high demand for affordable, quick, user-friendly, and precise point-of-care (POC) diagnostic in therapeutic settings. The necessity for available tests with rapid outcomes spurred the advancement of POC tests that are characterized by speed, automation, and high precision and accuracy. Paper-based POC devices have gained increasing interest in recent years because of rapid, low-cost detection without requiring external instruments. At present, microfluidic paper-based analysis devices have garnered public attention and accelerated the development of such POCT for efficient multistep assays. In the current review, our focus will be on the fabrication of detection modules for SARS-CoV-2. Here, we have included a discussion on various strategies for the detection of viral moieties. The compilation of these strategies would offer comprehensive insight into the detection of the causative agent preparedness for future pandemics. We also provide a descriptive outline for paper-based diagnostic platforms, involving the determination mechanisms, as well as a commercial kit for COVID-19 as well as their outlook.

Chiral MOF Derived Wearable Logic Sensor for Intuitive Discrimination of Physiologically Active Enantiomer

Chiral sensors have attracted growing interest due to their application in health monitoring. However, rational design of wearable logic chiral sensors remains a great challenge. In this work, a dual responsive chiral sensor RT@CDMOF is prepared through in situ self-assembly of chiral γ-cyclodextrin metal-organic framework (CDMOF), rhodamine 6G hydrazide (RGH), and tetracyanovinylindane (TCN). The embedded RGH and TCN inherit the chirality of host CDMOF, producing dual changes both in fluorescence and reflectance. RT@CDMOF is explored as a dual channel sensor for chiral discrimination of lactate enantiomers. Comprehensive mechanistic studies reveal the chiral binding process, and carboxylate dissociation is confirmed by impedance and solid-state 1 H nuclear magnetic resonance (NMR). A flexible membrane sensor is successfully fabricated based on RT@CDMOF for wearable health monitoring. Practical evaluation confirms the potential of fabricated membrane sensor in point-of-care health monitoring by indexing the exercise intensity. Based on above, a chiral IMPLICATION logic unit can be successfully achieved, demonstrating the promising potential of RT@CDMOF in design and assembly of novel smart devices. This work may open a new avenue to the rational design of logic chiral sensors for wearable health monitoring applications.

Controllable-Swelling Microneedle-Assisted Ultrasensitive Paper Sensing Platforms for Personal Health Monitoring

Microneedle (MN) patches, which allow the extraction of skin interstitial fluid (ISF) without a pain sensation, are powerful tools for minimally invasive biofluid sampling. Herein, an MN-assisted paper-based sensing platform that enables rapid and painless biofluid analysis with ultrasensitive molecular recognition capacity is developed. First, a controllable-swelling MN patch is constructed through the engineering of a poly(ethylene glycol) diacrylate/methacrylated hyaluronic acid hydrogel; it combines rapid, sufficient extraction of ISF with excellent structural integrity. Notably, the analyte molecules in the needles can be recovered into a moist cellulose paper through spontaneous diffusion. More importantly, the paper can be functionalized with enzymatic colorimetric reagents or a plasmonic array, enabling a desired detection capacity-for example, the use of paper-based surface-enhanced Raman spectroscopy sensors leads to label-free, trace detection (sub-ppb level) of a diverse set of molecules (cefazolin, nicotine, paraquat, methylene blue). Finally, nicotine is selected as a model drug to evaluate the painless monitoring of three human volunteers. The changes in the nicotine levels can be tracked, with the levels varying significantly in response to the metabolism of drug in different volunteers. This as-designed minimally invasive sensing system should open up new opportunities for precision medicine, especially for personal healthcare monitoring.

Perspectives on recent advancements in energy harvesting, sensing and bio-medical applications of piezoelectric gels

The development of next-generation bioelectronics, as well as the powering of consumer and medical devices, require power sources that are soft, flexible, extensible, and even biocompatible. Traditional energy storage devices (typically, batteries and supercapacitors) are rigid, unrecyclable, offer short-lifetime, contain hazardous chemicals and possess poor biocompatibility, hindering their utilization in wearable electronics. Therefore, there is a genuine unmet need for a new generation of innovative energy-harvesting materials that are soft, flexible, bio-compatible, and bio-degradable. Piezoelectric gels or PiezoGels are a smart crystalline form of gels with polar ordered structures that belongs to the broader family of piezoelectric material, which generate electricity in response to mechanical stress or deformation. Given that PiezoGels are structurally similar to hydrogels, they offer several advantages including intrinsic chirality, crystallinity, degree of ordered structures, mechanical flexibility, biocompatibility, and biodegradability, emphasizing their potential applications ranging from power generation to bio-medical applications. Herein, we describe recent examples of new functional PiezoGel materials employed for energy harvesting, sensing, and wound dressing applications. First, this review focuses on the principles of piezoelectric generators (PEGs) and the advantages of using hydrogels as PiezoGels in energy and biomedical applications. Next, we provide a detailed discussion on the preparation, functionalization, and fabrication of PiezoGel-PEGs (P-PEGs) for the applications of energy harvesting, sensing and wound healing/dressing. Finally, this review concludes with a discussion of the current challenges and future directions of P-PEGs.

High-Throughput Screening of Streptavidin-Binding Proteins in Self-Assembled Solid Films for Directed Evolution of Materials

Evolution has shaped the development of proteins with an incredible diversity of properties. Incorporating proteins into materials is desirable for applications including biosensing; however, high-throughput selection techniques for screening protein libraries in materials contexts is lacking. In this work, a high-throughput platform to assess the binding affinity for ordered sensing proteins was established. A library of fusion proteins, consisting of an elastin-like polypeptide block, one of 22 variants of rcSso7d, and a coiled-coil order-directing sequence, was generated. All selected variants had high binding in films, likely due to the similarity of the assay to magnetic bead sorting used for initial selection, while solution binding was more variable. From these results, both the assembly of the fusion proteins in their operating state and the functionality of the binding protein are key factors in the biosensing performance. Thus, the integration of directed evolution with assembled systems is necessary to the design of better materials.

Nanobiosensing Based on Electro-Optically Modulated Technology

At the nanoscale, metals exhibit special electrochemical and optical properties, which play an important role in nanobiosensing. In particular, surface plasmon resonance (SPR) based on precious metal nanoparticles, as a kind of tag-free biosensor technology, has brought high sensitivity, high reliability, and convenient operation to sensor detection. By applying an electrochemical excitation signal to the nanoplasma device, modulating its surface electron density, and realizing electrochemical coupling SPR, it can effectively complete the joint transmission of electrical and optical signals, increase the resonance shift of the spectrum, and further improve the sensitivity of the designed biosensor. In addition, smartphones are playing an increasingly important role in portable mobile sensor detection systems. These systems typically connect sensing devices to smartphones to perceive different types of information, from optical signals to electrochemical signals, providing ideas for the portability and low-cost design of these sensing systems. Among them, electrochemiluminescence (ECL), as a special electrochemically coupled optical technology, has good application prospects in mobile sensing detection due to its strong anti-interference ability, which is not affected by background light. In this review, the SPR is introduced using nanoparticles, and its response process is analyzed theoretically. Then, the mechanism and sensing application of electrochemistry coupled with SPR and ECL are emphatically introduced. Finally, it extends to the relevant research on electrochemically coupled optical sensing on mobile detection platforms.

Mechanistic Elucidation of Nanomaterial-Enhanced First-Generation Biosensors Using Probe Voltammetry of an Enzymatic Reaction

The incorporation of nanomaterials (NMs) into biosensing schemes is a well-established strategy for gaining signal enhancement. With electrochemical biosensors, the enhanced performance achieved from using NMs is often attributed to the specific physical properties of the chosen nanocomponents, such as their high electronic conductivity, size-dependent functionality, and/or higher effective surface-to-volume ratios. First generation amperometric biosensing schemes, typically utilizing NMs in conjunction with immobilized enzyme and semi-permeable membranes, can possess complex sensing mechanisms that are difficult to study and challenging to understand beyond the observable signal enhancement. This study shows the use of an enzymatic reaction between xanthine (XAN) and xanthine oxidase (XOx), involving multiple electroactive species, as an electrochemical redox probe tool for ascertaining mechanistic information at and within the modified electrodes used as biosensors. Redox probing using components of this enzymatic reaction are demonstrated on two oft-employed biosensing approaches and commonly used NMs for modified electrodes: gold nanoparticle doped films and carbon nanotube interfaces. In both situations, the XAN metabolism voltammetry allows for a greater understanding of the functionality of the semipermeable membranes, the role of the NMs, and how the interplay between the two components creates signal enhancement.

Personalised lifestyle recommendations for type 2 diabetes: Design and simulation of a recommender system on UK Biobank Data

Mobile health applications, which employ wireless technology for healthcare, can aid behaviour change and subsequently improve health outcomes. Mobile health applications have been developed to increase physical activity, but are rarely grounded on behavioural theory and employ simple techniques for personalisation, which has been proven effective in promoting behaviour change. In this work, we propose a theoretically driven and personalised behavioural intervention delivered through an adaptive knowledge-based system. The behavioural system design is guided by the Behavioural Change Wheel and the Capability-Opportunity-Motivation behavioural model. The system exploits the ever-increasing availability of health data from wearable devices, point-of-care tests and consumer genetic tests to issue highly personalised physical activity and sedentary behaviour recommendations. To provide the personalised recommendations, the system firstly classifies the user into one of four diabetes clusters based on their cardiometabolic profile. Secondly, it recommends activity levels based on their genotype and past activity history, and finally, it presents the user with their current risk of developing cardiovascular disease. In addition, leptin, a hormone involved in metabolism, is included as a feedback biosignal to personalise the recommendations further. As a case study, we designed and demonstrated the system on people with type 2 diabetes, since it is a chronic condition often managed through lifestyle changes, such as physical activity increase and sedentary behaviour reduction. We trained and simulated the system using data from diabetic participants of the UK Biobank, a large-scale clinical database, and demonstrate that the system could help increase activity over time. These results warrant a real-life implementation of the system, which we aim to evaluate through human intervention.

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.

Organic electrochemical transistors printed from degradable materials as disposable biochemical sensors

Transient electronics hold promise in reducing electronic waste, especially in applications that require only a limited lifetime. While various degradable electronic and physical sensing devices have been proposed, there is growing interest in the development of degradable biochemical sensors. In this work, we present the development of an organic electrochemical transistor (OECT) with degradable electrodes, printed on an eco- and bioresorbable substrate. The influence of the design and materials for the contacts, channel and gate of the transducer, namely poly(3,4-ethylene dioxythiophene):polystyrene sulfonate (PEDOT:PSS) and carbon, is systematically evaluated for the development of OECT-based transient biosensors. The sensing capabilities of the electrochemical transistors are demonstrated with ionic solutions as well as for the enzyme-based detection of glucose. The disposable OECTs show comparable performance to their non-degradable counterparts. Their integration with highly conductive degradable and printable zinc tracks is studied for the realization of interconnects. These eco-friendly OECTs may find applications as disposable and sustainable biochemical sensors, and constitute a step towards bioresorbable biosensors.