Wireless, intraoral hybrid electronics for real-time quantification of sodium intake toward hypertension management

Advances in Electrochemical Biosensors for the Detection of Common Oral Diseases

Limiting and preventing oral diseases remains a major challenge to the health of populations around the world, so finding ways to detect early-stage diseases (e.g., caries, periodontal disease, and oral cancer) and aiding in their prevention has always been an important clinical treatment concept. The development and application of electrochemical detection technology can provide important support for the early detection and non-invasive diagnosis of oral diseases and make up for the shortcomings of traditional diagnostic methods, which are highly sensitive, non-invasive, cost-effective, and less labor-intensive. It detects specific disease markers in body fluids through electrochemical reactions, discovers early warning signals of diseases, and realizes rapid and reliable diagnosis. This paper comprehensively summarizes the development and application of electrochemical biosensors in the detection and diagnosis of common oral diseases in terms of application platforms, sensing types, and disease detection, and discusses the challenges faced by electrochemical biosensors in the detection of oral diseases as well as the great prospects for future applications, in the hope of providing important insights for the future development of electrochemical biosensors for the early detection of oral diseases.

Large-scale smart bioreactor with fully integrated wireless multivariate sensors and electronics for long-term in situ monitoring of stem cell culture

Achieving large-scale, cost-effective, and reproducible manufacturing of stem cells with the existing devices is challenging. Traditional single-use cell-bag bioreactors, limited by their rigid and single-point sensors, struggle with accuracy and scalability for high-quality cell manufacturing. Here, we introduce a smart bioreactor system that enables multi-spatial sensing for real-time, wireless culture monitoring. This scalable system includes a low-profile, label-free thin-film sensor array and electronics integrated with a flexible cell bag, allowing for simultaneous assessment of culture properties such as pH, dissolved oxygen, glucose, and temperature, to receive real-time feedback for up to 30 days. The experimental results show the accurate monitoring of time-dynamic and spatial variations of stem cells and myoblast cells with adjustable carriers from a plastic dish to a 2-liter cell bag. These advances open up the broad applicability of the smart sensing system for large-scale, lower-cost, reproducible, and high-quality engineered cell manufacturing for broad clinical use.

Advances and Opportunities of Mobile Health in the Postpandemic Era: Smartphonization of Wearable Devices and Wearable Deviceization of Smartphones

Mobile health (mHealth) with continuous real-time monitoring is leading the era of digital medical convergence. Wearable devices and smartphones optimized as personalized health management platforms enable disease prediction, prevention, diagnosis, and even treatment. Ubiquitous and accessible medical services offered through mHealth strengthen universal health coverage to facilitate service use without discrimination. This viewpoint investigates the latest trends in mHealth technology, which are comprehensive in terms of form factors and detection targets according to body attachment location and type. Insights and breakthroughs from the perspective of mHealth sensing through a new form factor and sensor-integrated display overcome the problems of existing mHealth by proposing a solution of smartphonization of wearable devices and the wearable deviceization of smartphones. This approach maximizes the infinite potential of stagnant mHealth technology and will present a new milestone leading to the popularization of mHealth. In the postpandemic era, innovative mHealth solutions through the smartphonization of wearable devices and the wearable deviceization of smartphones could become the standard for a new paradigm in the field of digital medicine.

Methods for Assessing Health Outcomes Associated with Food Insecurity in the United States College Student Population: A Narrative Review

In the United States, college students experience disproportionate food insecurity (FI) rates compared to the national prevalence. The experience of acute and chronic FI has been associated with negative physical and mental health outcomes in this population. This narrative review aims to summarize the current methodologies for assessing health outcomes associated with the experience of FI in college students in the United States. To date, assessing the health outcomes of FI has predominately consisted of subjective assessments, such as self-reported measures of dietary intake, perceived health status, stress, depression, anxiety, and sleep behaviors. This review, along with the emergence of FI as an international public health concern, establishes the need for novel, innovative, and objective biomarkers to evaluate the short- and long-term impacts of FI on physical and mental health outcomes in college students. The inclusion of objective biomarkers will further elucidate the relationship between FI and a multitude of health outcomes to better inform strategies for reducing the pervasiveness of FI in the United States college student population.

Implantable Flexible Sensors for Health Monitoring

Flexible sensors, as a significant component of flexible electronics, have attracted great interest the realms of human-computer interaction and health monitoring due to their high conformability, adjustable sensitivity, and excellent durability. In comparison to wearable sensor-based in vitro health monitoring, the use of implantable flexible sensors (IFSs) for in vivo health monitoring offers more accurate and reliable vital sign information due to their ability to adapt and directly integrate with human tissue. IFSs show tremendous promise in the field of health monitoring, with unique advantages such as robust signal reading capabilities, lightweight design, flexibility, and biocompatibility. Herein, a review of IFSs for vital signs monitoring is detailly provided, highlighting the essential conditions for in vivo applications. As the prerequisites of IFSs, the stretchability and wireless self-powered properties of the sensor are discussed, with a special attention paid to the sensing materials which can maintain prominent biosafety (i.e., biocompatibility, biodegradability, bioresorbability). Furthermore, the applications of IFSs monitoring various parts of the body are described in detail, with a summary in brain monitoring, eye monitoring, and blood monitoring. Finally, the challenges as well as opportunities in the development of next-generation IFSs are presented.

Bioadhesive Technology Platforms

Bioadhesives have emerged as transformative and versatile tools in healthcare, offering the ability to attach tissues with ease and minimal damage. These materials present numerous opportunities for tissue repair and biomedical device integration, creating a broad landscape of applications that have captivated clinical and scientific interest alike. However, fully unlocking their potential requires multifaceted design strategies involving optimal adhesion, suitable biological interactions, and efficient signal communication. In this Review, we delve into these pivotal aspects of bioadhesive design, highlight the latest advances in their biomedical applications, and identify potential opportunities that lie ahead for bioadhesives as multifunctional technology platforms.

Salivary biomarkers: novel noninvasive tools to diagnose chronic inflammation

Several chronic disorders including type 2 diabetes (T2D), obesity, heart disease and cancer are preceded by a state of chronic low-grade inflammation. Biomarkers for the early assessment of chronic disorders encompass acute phase proteins (APP), cytokines and chemokines, pro-inflammatory enzymes, lipids and oxidative stress mediators. These substances enter saliva through the blood flow and, in some cases, there is a close relation between their salivary and serum concentration. Saliva can be easily collected and stored with non-invasive and cost-saving procedures, and it is emerging the concept to use it for the detection of inflammatory biomarkers. To this purpose, the present review aims to discuss the advantages and challenges of using standard and cutting-edge techniques to discover salivary biomarkers which may be used in diagnosis/therapy of several chronic diseases with inflammatory consequences with the pursuit to possibly replace conventional paths with detectable soluble mediators in saliva. Specifically, the review describes the procedures used for saliva collection, the standard approaches for the measurement of salivary biomarkers and the novel methodological strategies such as biosensors to improve the quality of care for chronically affected patients.

Wearable Microfluidics for Continuous Assay

The development of wearable devices provides approaches for the realization of self-health care. Easily carried wearable devices allow individual health monitoring at any place whenever necessary. There are various interesting monitoring targets, including body motion, organ pressure, and biomarkers. An efficient use of space in one small device is a promising resolution to increase the functions of wearable devices. Through integration of a microfluidic system into wearable devices, embedding complicated structures in one design becomes possible and can enable multifunction analyses within a limited device volume. This article reviews the reported microfluidic wearable devices, introduces applications to different biofluids, discusses characteristics of the design strategies and sensing principles, and highlights the attractive configurations of each device. This review seeks to provide a detailed summary of recent advanced microfluidic wearable devices. The overview of advanced key components is the basis for the development of future microfluidic wearable devices.

A Flexible Piezocapacitive Pressure Sensor with Microsphere-Array Electrodes

Flexible pressure sensors that emulate the sensation and characteristics of natural skins are of great importance in wearable medical devices, intelligent robots, and human-machine interfaces. The microstructure of the pressure-sensitive layer plays a significant role in the sensor's overall performance. However, microstructures usually require complex and costly processes such as photolithography or chemical etching for fabrication. This paper proposes a novel approach that combines self-assembled technology to prepare a high-performance flexible capacitive pressure sensor with a microsphere-array gold electrode and a nanofiber nonwoven dielectric material. When subjected to pressure, the microsphere structures of the gold electrode deform via compressing the medium layer, leading to a significant increase in the relative area between the electrodes and a corresponding change in the thickness of the medium layer, as simulated in COMSOL simulations and experiments, which presents high sensitivity (1.807 kPa^-1). The developed sensor demonstrates excellent performance in detecting signals such as slight object deformations and human finger bending.

Peri-implant diseases diagnosis, prognosis and dental implant monitoring: a narrative review of novel strategies and clinical impact

BACKGROUND

The diagnosis of peri-implantar and periodontal relies mainly on a set of clinical measures and the evaluation of radiographic images. However, these clinical settings alone are not sufficient to determine, much less predict, periimplant bone loss or future implant failure. Early diagnosis of periimplant diseases and its rate of progress may be possible through biomarkers assessment. Once identified, biomarkers of peri-implant and periodontal tissue destruction may alert the clinicians before clinical signs show up. Therefore, it is important to consider developing chair-side diagnostic tests with specificity for a particular biomarker, indicating the current activity of the disease.

METHODS

A search strategy was created at Pubmed and Web of Science to answer the question: "How the molecular point-of-care tests currently available can help in the early detection of peri-implant diseases and throws light on improvements in point of care diagnostics devices?"

RESULTS

The PerioSafe® PRO DRS (dentognostics GmbH, Jena) and ImplantSafe® DR (dentognostics GmbH, Jena ORALyzer® test kits, already used clinically, can be a helpful adjunct tool in enhancing the diagnosis and prognosis of periodontal/peri-implantar diseases. With the advances of sensor technology, the biosensors can perform daily monitoring of dental implants or periodontal diseases, making contributions to personal healthcare and improve the current status quo of health management and human health.

CONCLUSIONS

Based on the findings, more emphasis is given to the role of biomarkers in diagnosing and monitoring periodontal and peri-implant diseases. By combining these strategies with traditional protocols, professionals could increase the accuracy of early detection of peri-implant and periodontal diseases, predicting disease progression, and monitoring of treatment outcomes.

Reshaping healthcare with wearable biosensors

Wearable health sensors could monitor the wearer's health and surrounding environment in real-time. With the development of sensor and operating system hardware technology, the functions of wearable devices have been gradually enriched with more diversified forms and more accurate physiological indicators. These sensors are moving towards high precision, continuity, and comfort, making great contributions to improving personalized health care. At the same time, in the context of the rapid development of the Internet of Things, the ubiquitous regulatory capabilities have been released. Some sensor chips are equipped with data readout and signal conditioning circuits, and a wireless communication module for transmitting data to computer equipment. At the same time, for data analysis of wearable health sensors, most companies use artificial neural networks (ANN). In addition, artificial neural networks could help users effectively get relevant health feedback. Through the physiological response of the human body, various sensors worn could effectively transmit data to the control unit, which analyzes the data and provides feedback of the health value to the user through the computer. This is the working principle of wearable sensors for health. This article focuses on wearable biosensors used for healthcare monitoring in different situations, as well as the development, technology, business, ethics, and future of wearable sensors for health monitoring.

A Wide-Range-Response Piezoresistive-Capacitive Dual-Sensing Breathable Sensor with Spherical-Shell Network of MWCNTs for Motion Detection and Language Assistance

It is still a challenge for flexible electronic materials to realize integrated strain sensors with a large linear working range, high sensitivity, good response durability, good skin affinity and good air permeability. In this paper, we present a simple and scalable porous piezoresistive/capacitive dual-mode sensor with a porous structure in polydimethylsiloxane (PDMS) and with multi-walled carbon nanotubes (MWCNTs) embedded on its internal surface to form a three-dimensional spherical-shell-structured conductive network. Thanks to the unique spherical-shell conductive network of MWCNTs and the uniform elastic deformation of the cross-linked PDMS porous structure under compression, our sensor offers a dual piezoresistive/capacitive strain-sensing capability, a wide pressure response range (1-520 kPa), a very large linear response region (95%), excellent response stability and durability (98% of initial performance after 1000 compression cycles). Multi-walled carbon nanotubes were coated on the surface of refined sugar particles by continuous agitation. Ultrasonic PDMS solidified with crystals was attached to the multi-walled carbon nanotubes. After the crystals were dissolved, the multi-walled carbon nanotubes were attached to the porous surface of the PDMS, forming a three-dimensional spherical-shell-structure network. The porosity of the porous PDMS was 53.9%. The large linear induction range was mainly related to the good conductive network of the MWCNTs in the porous structure of the crosslinked PDMS and the elasticity of the material, which ensured the uniform deformation of the porous structure under compression. The porous conductive polymer flexible sensor prepared by us can be assembled into a wearable sensor with good human motion detection ability. For example, human movement can be detected by responding to stress in the joints of the fingers, elbows, knees, plantar, etc., during movement. Finally, our sensors can also be used for simple gesture and sign language recognition, as well as speech recognition by monitoring facial muscle activity. This can play a role in improving communication and the transfer of information between people, especially in facilitating the lives of people with disabilities.

Wearables in Nephrology: Fanciful Gadgetry or Prêt-à-Porter?

Telemedicine and digitalised healthcare have recently seen exponential growth, led, in part, by increasing efforts to improve patient flexibility and autonomy, as well as drivers from financial austerity and concerns over climate change. Nephrology is no exception, and daily innovations are underway to provide digitalised alternatives to current models of healthcare provision. Wearable technology already exists commercially, and advances in nanotechnology and miniaturisation mean interest is also garnering clinically. Here, we outline the current existing wearable technology pertaining to the diagnosis and monitoring of patients with a spectrum of kidney disease, give an overview of wearable dialysis technology, and explore wearables that do not yet exist but would be of great interest. Finally, we discuss challenges and potential pitfalls with utilising wearable technology and the factors associated with successful implementation.

Emerging biotransduction strategies on soft interfaces for biosensing

As a lab-on-soft biochip providing accurate and timely biomarker information, wearable biosensors can satisfy the increasing demand for intelligent e-health services, active disease diagnosis/therapy, and huge bioinformation data. As biomolecules generally could not directly produce detectable signals, biotransducers that specifically convert biomolecules to electrical or optical signals are involved, which determines the pivotal sensing performance including 3S (sensitivity, selectivity, and stability), reversibility, etc. The soft interface poses new requirements for biotransducers, especially equipment-free, facile operation, mechanical tolerance, and high sensing performance. In this review, we discussed the emerging electrochemical and optical biotransduction strategies on wearables from the aspects of the transduction mechanism, amplification strategies, biomaterial selection, and device fabrication procedures. Challenges and perspectives regarding future biotransducers for monitoring trace amounts of biomolecules with high fidelity, sensitivity, and multifunctionality are also discussed. It is expected that through fusion with functional electronics, wearable biosensors can provide possibilities to further decentralize the healthcare system and even build biomolecule-based intelligent cyber-physical systems and new modalities of cyborgs.

Electrochemical biosensors based on saliva electrolytes for rapid detection and diagnosis

In recent years, electrochemical biosensors (ECBSs) have shown significant potential for real-time disease diagnosis and in situ physical condition monitoring. As a multi-constituent oral fluid comprising various disease signaling biomarkers, saliva has drawn much attention in the field of point-of-care (POC) testing. In particular, during the outbreak of the COVID-19 pandemic, ECBSs which hold the simplicity of a single-step assay compared with the multi-step assay of traditional testing methods are expected to relieve the human and economic burden caused by the massive and long-term sample testing process. Noteworthily, ECBSs for the detection of SARS-CoV-2 in saliva have already been developed and may replace current testing methods. Furthermore, the detection scope has expanded from routine indices such as sugar and uric acid to abnormal biomarkers for early-stage disease detection and drug level monitoring, which further facilitated the evolution of ECBSs in the last 5 years. This review is divided into several main sections. First, we discussed the latest advancements and representative research on ECBSs for saliva testing. Then, we focused on a novel kind of ECBS, organic electrochemical transistors (OECTs), which hold great advantages of high sensitivity and signal-to-noise ratio and on-site detection. Finally, application of ECBSs with integrated portable platforms in oral cavities, which lead to powerful auxiliary testing means for telemedicine, has also been discussed.

The development of wearable technologies and their potential for measuring nutrient intake: Towards precision nutrition

Appropriate food intake and nutritional status are crucial for the maintenance of health and disease prevention. Conventional dietary assessment is mainly based on comparisons of nutrient intakes with reference intakes, failing to meet the needs of personalised nutritional guidance based on individual nutritional status. Given their capability of providing insights into health information non-invasively in real time, wearable technologies offer great opportunities for nutrition monitoring. Nutrient metabolic profiles can be monitored immediately and continuously which could potentially offer the possibility for the tracking and guiding of nutrient intake. Here, we review and highlight the recent advances in wearable sensors from the perspective of sensing technologies for nutrient detection in biofluids. The integration of biosensors with wearable devices serves as an ideal platform for the analysis of biofluids including sweat, saliva and tears. The wearable sensing systems applied to the analysis of typical nutrients and important metabolites are demonstrated in terms of carbohydrates, proteins, lipids, vitamins, minerals and others. Taking advantage of their high flexibility and lightweight, wearable sensors have been widely developed for the in situ quantitative detection of metabolic biomarkers. The technical principles, detection methods and applications are summarised. The challenges and future perspectives for wearable nutrition monitoring devices are discussed including the need to better determine relationships among nutrient metabolic profile, nutrient intake and food intake. With the development of materials, sensing techniques and manufacturing processes, wearable technologies are paving the way towards personalised precision nutrition, although there is still a long way to go before they can be utilised for practical clinical applications. Joint research efforts between nutrition scientists, doctors, engineers and sensor researchers are essential to further accelerate the realisation of reliable and practical wearable nutrition monitoring platforms.

A Multicalibration Urea Potentiometric Sensing Array Based on Au@urease Nanoparticles and Its Application in Home Detection

Home potentiometric sensing devices can real-time monitor personal health status and are widely used in the prevention and management of related diseases. However, variations in the composition and the pH of the sample matrix tend to change the basic potential and response slope of some potentiometric sensors, thus affecting detection reliability. Therefore, this work uses the detection of urea in urine as a model to improve reliability of the potentiometric sensor in home detection. Au@urease nanoparticles were synthesized as the sensing material to improve the stability of the urease-based potentiometric sensor. Meanwhile, a multicalibrated urea potential (MCUP) sensing array was designed, which consists of a urea electrode group, a pH electrode group, and a reference channel. The urea electrode group and the pH electrode group contain respectively a sensing channel and a calibration channel. The basic potential of sensing channels can be calibrated through the corresponding calibration channels. Moreover, the pH electrode group can not only measure the pH values of the samples but also calibrate the response slope of the urea electrode group through the calibration coefficient, thus improving the reliability of home detection. Consequently, the potentiometric sensing array based on the enzyme reaction can be applied in body fluids with a wide pH range.

Ultra-Thin Flexible Encapsulating Materials for Soft Bio-Integrated Electronics

Recently, bioelectronic devices extensively researched and developed through the convergence of flexible biocompatible materials and electronics design that enables  more precise diagnostics and therapeutics in human health care and opens up the potential to expand into various fields, such as clinical medicine and biomedical research. To establish an accurate and stable bidirectional bio-interface, protection against the external environment and high mechanical deformation is essential for wearable bioelectronic devices. In the case of implantable bioelectronics, special encapsulation materials and optimized mechanical designs and configurations that provide electronic stability and functionality are required for accommodating various organ properties, lifespans, and functions in the biofluid environment. Here, this study introduces recent developments of ultra-thin encapsulations with novel materials that can preserve or even improve the electrical performance of wearable and implantable bio-integrated electronics by supporting safety and stability for protection from destruction and contamination as well as optimizing the use of bioelectronic systems in physiological environments. In addition, a summary of the materials, methods, and characteristics of the most widely used encapsulation technologies is introduced, thereby providing a strategic selection of appropriate choices of recently developed flexible bioelectronics.

A Focused Review on the Flexible Wearable Sensors for Sports: From Kinematics to Physiologies

As an important branch of wearable electronics, highly flexible and wearable sensors are gaining huge attention due to their emerging applications. In recent years, the participation of wearable devices in sports has revolutionized the way to capture the kinematical and physiological status of athletes. This review focuses on the rapid development of flexible and wearable sensor technologies for sports. We identify and discuss the indicators that reveal the performance and physical condition of players. The kinematical indicators are mentioned according to the relevant body parts, and the physiological indicators are classified into vital signs and metabolisms. Additionally, the available wearable devices and their significant applications in monitoring these kinematical and physiological parameters are described with emphasis. The potential challenges and prospects for the future developments of wearable sensors in sports are discussed comprehensively. This review paper will assist both athletic individuals and researchers to have a comprehensive glimpse of the wearable techniques applied in different sports.

Continuously Quantifying Oral Chemicals Based on Flexible Hybrid Electronics for Clinical Diagnosis and Pathogenetic Study

Simultaneous monitoring of diverse salivary parameters can reveal underlying mechanisms of intraoral biological processes and offer profound insights into the evolution of oral diseases. However, conventional analytical devices with bulky volumes, rigid formats, and discrete sensing mechanisms deviate from the requirements of continuous biophysiological quantification, resulting in huge difficulty in precise clinical diagnosis and pathogenetic study. Here, we present a flexible hybrid electronic system integrated with functional nanomaterials to continuously sense Ca2+, pH, and temperature for wireless real-time oral health monitoring. The miniaturized system with an island-bridge structure that is designed specifically to fit the teeth is only 0.4 g in weight and 31.5×8.5×1.35 mm3 in dimension, allowing effective integration with customized dental braces and comfort attachment on teeth. Characterization results indicate high sensitivities of 30.3 and 60.6 mV/decade for Ca2+ and pH with low potential drifts. The system has been applied in clinical studies to conduct Ca2+ and pH mappings on carious teeth, biophysiological monitoring for up to 12 h, and outcome evaluation of dental restoration, providing quantitative data to assist in the diagnosis and understanding of oral diseases. Notably, caries risk assessment of 10 human subjects using the flexible system validates the important role of saliva buffering capacity in caries pathogenesis. The proposed flexible system may offer an open platform to carry diverse components to support both clinical diagnosis and treatment as well as fundamental research for oral diseases and induced systemic diseases.

Detecting Ion Levels, Changes to Monitor Health

Ions can say a lot about a baby's health. High levels of chloride in sweat can indicate cystic fibrosis (CF), a disorder that causes respiratory and digestive problems; abnormal sodium levels are signs of increased risk for seizure or muscle problems; and too-high or too-low potassium concentrations can cause heart arrhythmias or other muscle issues. These ions-commonly called electrolytes- are also important throughout life. For instance, too much or too little sodium can lead to confusion, seizures, and muscle weakness or cramping.

Recent Advances in Intelligent Wearable Medical Devices Integrating Biosensing and Drug Delivery

The primary roles of precision medicine are to perform real-time examination, administer on-demand medication, and apply instruments continuously. However, most current therapeutic systems implement these processes separately, leading to treatment interruption and limited recovery in patients. Personalized healthcare and smart medical treatment have greatly promoted research on and development of biosensing and drug-delivery integrated systems, with intelligent wearable medical devices (IWMDs) as typical systems, which have received increasing attention because of their non-invasive and customizable nature. Here, the latest progress in research on IWMDs is reviewed, including their mechanisms of integrating biosensing and on-demand drug delivery. The current challenges and future development directions of IWMDs are also discussed.

Salivary biomarkers of neurodegenerative and demyelinating diseases and biosensors for their detection

Salivary analysis is gaining increasing interest as a novel and promising field of research for the diagnosis of neurodegenerative and demyelinating diseases related to aging. The collection of saliva offers several advantages, being noninvasive, stress-free, and repeatable. Moreover, the detection of biomarkers directly in saliva could allow an early diagnosis of the disease, leading to timely treatments. The aim of this manuscript is to highlight the most relevant researchers' findings relatively to salivary biomarkers of neurodegenerative and demyelinating diseases, and to describe innovative and advanced biosensing strategies for the detection of salivary biomarkers. This review is focused on five relevant aging-related neurodegenerative disorders (Alzheimer's disease, Parkinson's disease, Amyotrophic Lateral Sclerosis, Huntington's disease, Multiple Sclerosis) and the salivary biomarkers most commonly associated with them. Advanced biosensors enabling molecular diagnostics for the detection of salivary biomarkers are presented, in order to stimulate future research in this direction and pave the way for their clinical application.

A New Class of Electronic Devices Based on Flexible Porous Substrates

With the advent of the Internet of Things era, the connection between electronic devices and humans is getting closer and closer. New-concept electronic devices including e-skins, nanogenerators, brain-machine interfaces, and implantable medical devices, can work on or inside human bodies, calling for wearing comfort, super flexibility, biodegradability, and stability under complex deformations. However, conventional electronics based on metal and plastic substrates cannot effectively meet these new application requirements. Therefore, a series of advanced electronic devices based on flexible porous substrates (e.g., paper, fabric, electrospun nanofibers, wood, and elastic polymer sponge) is being developed to address these challenges by virtue of their superior biocompatibility, breathability, deformability, and robustness. The porous structure of these substrates can not only improve device performance but also enable new functions, but due to their wide variety, choosing the right porous substrate is crucial for preparing high-performance electronics for specific applications. Herein, the properties of different flexible porous substrates are summarized and their basic principles of design, manufacture, and use are highlighted. Subsequently, various functionalization methods of these porous substrates are briefly introduced and compared. Then, the latest advances in flexible porous substrate-based electronics are demonstrated. Finally, the remaining challenges and future directions are discussed.

Water - A life-giving toxin - A nephrological oxymoron. Health consequences of water and sodium balance disorders. A review article

BACKGROUND

This article aims to reveal misconceptions about methods of assessment of hydration status and impact of the water disorders on the progression of kidney disease or renal dysfunction.

MATERIALS AND METHODS

The PubMed database was searched for reviews, meta-analyses and original articles on hydration, volume depletion, fluid overload and diagnostic methods of hydration status, which were published in English.

RESULTS

Based on the results of available literature the relationship between the amount of fluid consumed, and the rate of progression of chronic kidney disease, autosomal dominant polycystic kidney disease, and kidney stones disease was discussed. Selected aspects of the assessment of the hydration level in clinical practice based on physical examination, laboratory tests, and imaging are presented. The subject of in-hospital fluid therapy is discussed. Based on available randomized studies, an attempt was made to assess, which fluids should be selected for intravenous treatment.

CONCLUSIONS

There is some evidence for the beneficial effect of increased water intake in preventing recurrent cystitis and kidney stones, but there are still no convincing data for chronic kidney disease and autosomal dominant polycystic kidney disease. Further studies are needed to clarify the aforementioned issues and establish a reliable way to assess the volemia and perform suitable fluid therapy.

Recent Advances in Electronic Skins with Multiple-Stimuli-Responsive and Self-Healing Abilities

Wearable electronic skin (e-skin) has provided a revolutionized way to intelligently sense environmental stimuli, which shows prospective applications in health monitoring, artificial intelligence and prosthetics fields. Drawn inspiration from biological skins, developing e-skin with multiple stimuli perception and self-healing abilities not only enrich their bionic multifunctionality, but also greatly improve their sensory performance and functional stability. In this review, we highlight recent important developments in the material structure design strategy to imitate the fascinating functionalities of biological skins, including molecular synthesis, physical structure design, and special biomimicry engineering. Moreover, their specific structure-property relationships, multifunctional application, and existing challenges are also critically analyzed with representative examples. Furthermore, a summary and perspective on future directions and challenges of biomimetic electronic skins regarding function construction will be briefly discussed. We believe that this review will provide valuable guidance for readers to fabricate superior e-skin materials or devices with skin-like multifunctionalities and disparate characteristics.

Recent Advances of Point-of-Care Devices Integrated with Molecularly Imprinted Polymers-Based Biosensors: From Biomolecule Sensing Design to Intraoral Fluid Testing

Recent developments of point-of-care testing (POCT) and in vitro diagnostic medical devices have provided analytical capabilities and reliable diagnostic results for rapid access at or near the patient's location. Nevertheless, the challenges of reliable diagnosis still remain an important factor in actual clinical trials before on-site medical treatment and making clinical decisions. New classes of POCT devices depict precise diagnostic technologies that can detect biomarkers in biofluids such as sweat, tears, saliva or urine. The introduction of a novel molecularly imprinted polymer (MIP) system as an artificial bioreceptor for the POCT devices could be one of the emerging candidates to improve the analytical performance along with physicochemical stability when used in harsh environments. Here, we review the potential availability of MIP-based biorecognition systems as custom artificial receptors with high selectivity and chemical affinity for specific molecules. Further developments to the progress of advanced MIP technology for biomolecule recognition are introduced. Finally, to improve the POCT-based diagnostic system, we summarized the perspectives for high expandability to MIP-based periodontal diagnosis and the future directions of MIP-based biosensors as a wearable format.

A Mechanically Interlocking Strategy Based on Conductive Microbridges for Stretchable Electronics

Stretchable electronics incorporating critical sensing, data transmission, display and powering functionalities, is crucial to emerging wearable healthcare applications. To date, methods to achieve stretchability of individual functional devices have been extensively investigated. However, integration strategies of these stretchable devices to achieve all-stretchable systems are still under exploration, in which the reliable stretchable interconnection is a key element. Here, solderless stretchable interconnections based on mechanically interlocking microbridges are developed to realize the assembly of individual stretchable devices onto soft patternable circuits toward multifunctional all-stretchable platforms. This stretchable interconnection can effectively bridge interlayer conductivity with tight adhesion through both conductive microbridges and selectively distributed adhesive polymer. Consequently, enhanced stretchability up to a strain of 35% (R/R₀  ≤ 5) is shown, compared with conventional solder-assisted connections which lose electrical conduction at a strain of less than 5% (R/R₀  ≈ 30). As a proof of concept, a self-powered all-stretchable data-acquisition platform is fabricated by surface mounting a stretchable strain sensor and a supercapacitor onto a soft circuit through solderless interconnections. This solderless interconnecting strategy for surface-mountable devices can be utilized as a valuable technology for the integration of stretchable devices to achieve all-soft multifunctional systems.

Electrochemical Devices to Monitor Ionic Analytes for Healthcare and Industrial Applications

Recent advances in electrochemical devices have sparked exciting opportunities in the healthcare, environment, and food industries. These devices can be fabricated at low costs and are capable of multiplex monitoring. This overcomes challenges presnted in traditional sensors for biomolecules and provides us a unique gateway toward comprehensive analyses. The advantages of electrochemical sensors are derived from their direct integration with electronics and their high selectivity along with sensitivity to sense a wide range of ionic analytes at an economical cost. This review paper aims to summarize recent innovations of a wide variety of electrochemical sensors for ionic analytes for health care and industrial applications. Many of these ionic analytes are important biomarkers to target for new diagnostic tools for medicine, food quality monitoring, and pollution detection. In this paper, we will examine various fabrication techniques, sensing mechanisms, and will also discuss various future opportunities in this research direction.

Cavitas electrochemical sensors for the direct determination of salivary thiocyanate levels

Noninvasive diagnosis using salivary samples to detect thiocyanate provides vital information on individual health. This article demonstrates the first example of a wearable sensing device to noninvasively assess thiocyanate levels. The customized screen-printed electrode system is integrated into a form of a mouthguard squarewave-voltammetric sensor toward the convenient and fast detection of the salivary biomarker within 15 s. The sensor with a protective film to mitigate the effect of biofouling offers high sensitivity and selectivity toward the detection of thiocyanate ions. Partial least square regression is applied to analyze the high-order squarewave-voltammetric data over the applied potential range of 0-1.75 V vs Ag/AgCl and quantify the thiocyanate concentration in a complex matrix. The mouthguard sensor operating under physiological conditions can monitor a wide range of thiocyanate (up to 11 mM) with a low detection limit of 30 µM. The demonstration introduces a unique approach, that obviates the requirement for blood sampling, to study thiocyanate levels of healthy people, cigarette smokers, or people with other health conditions. It is envisioned that the new cavitas device possesses a substantial promise for diverse biomedical diagnosis applications.

Wearable chem-biosensing devices: from basic research to commercial market

Wearable chem-biosensors have been garnering tremendous interest due to the significant potential in tailored healthcare diagnostics and therapeutics. With the development of the medical diagnostics revolution, wearable chem-biosensors as a rapidly emerging wave allow individuals to perform on-demand detection and obtain the required in-depth information. In contrast to commercial wearables, which tend to be miniaturized for measuring physical activities, the recent progressive wearable chem-biosensing device have mainly focused on non-invasive or minimally invasive monitoring biomarkers at the molecular level. Wearables is a multidisciplinary subject, and chem-biosensing is one of the most significant technologies. In this review, the currently basic academic research of wearable chem-biosensing devices and its commercial transformation were summarized and highlighted. Moreover, some representative wearable products on the market for individual health managements are presented. Strategies for the identification and sensing of biomarkers are discussed to further promote the development of wearable chem-biosensing devices. We also shared the limitations and breakthroughs of the next generation of chemo-biosensor wearables, from home use to clinical diagnosis.

Malignancies and Biosensors: A Focus on Oral Cancer Detection through Salivary Biomarkers

Oral cancer is among the deadliest types of malignancy due to the late stage at which it is usually diagnosed, leaving the patient with an average five-year survival rate of less than 50%. The booming field of biosensing and point of care diagnostics can, in this regard, play a major role in the early detection of oral cancer. Saliva is gaining interest as an alternative biofluid for non-invasive diagnostics, and many salivary biomarkers of oral cancer have been proposed. While these findings are promising for the application of salivaomics tools in routine practice, studies on larger cohorts are still needed for clinical validation. This review aims to summarize the most recent development in the field of biosensing related to the detection of salivary biomarkers commonly associated with oral cancer. An introduction to oral cancer diagnosis, prognosis and treatment is given to define the clinical problem clearly, then saliva as an alternative biofluid is presented, along with its advantages, disadvantages, and collection procedures. Finally, a brief paragraph on the most promising salivary biomarkers introduces the sensing technologies commonly exploited to detect oral cancer markers in saliva. Hence this review provides a comprehensive overview of both the clinical and technological advantages and challenges associated with oral cancer detection through salivary biomarkers.

Microneedle-Based Potentiometric Sensing System for Continuous Monitoring of Multiple Electrolytes in Skin Interstitial Fluids

Electrolytes play a pivotal role in regulating cardiovascular functions, hydration, and muscle activation. The current standards for monitoring electrolytes involve periodic sampling of blood and measurements using laboratory techniques, which are often uncomfortable/inconvenient to the subjects and add considerable expense to the management of their underlying disease conditions. The wide range of electrolytes in skin interstitial fluids (ISFs) and their correlations with those in plasma create exciting opportunities for applications such as electrolyte and circadian metabolism monitoring. However, it has been challenging to monitor these electrolytes in the skin ISFs. In this study, we report a minimally invasive microneedle-based potentiometric sensing system for multiplexed and continuous monitoring of Na⁺ and K⁺ in the skin ISFs. The potentiometric sensing system consists of a miniaturized stainless-steel hollow microneedle to prevent sensor delamination and a set of modified microneedle electrodes for multiplex monitoring. We demonstrate the measurement of Na⁺ and K⁺ in artificial ISFs with a fast response time, excellent reversibility and repeatability, adequate selectivity, and negligible potential interferences upon the addition of a physiologically relevant concentration of metabolites, dietary biomarkers, and nutrients. In addition, the sensor maintains the sensitivity after multiple insertions into the chicken skin model. Furthermore, the measurements in artificial ISFs using calibrated sensors confirm the accurate measurements of physiological electrolytes in artificial ISFs. Finally, the skin-mimicking phantom gel and chicken skin model experiments demonstrate the sensor's potential for minimally invasive monitoring of electrolytes in skin ISFs. The developed sensor platform can be adapted for a wide range of other applications, including real-time monitoring of nutrients, metabolites, and proteins.

Home Detection Technique for Na+ and K+ in Urine Using a Self-Calibrated all-Solid-State Ion-Selective Electrode Array Based on Polystyrene-Au Ion-Sensing Nanocomposites

An all-solid-state ion-selective electrode (ASS-ISE) array that is portable and easily miniaturized can meet the needs of home sensing devices for long-term health monitoring. However, their stability and accuracy are affected by the multistep modification required for ASS-ISE manufacturing and the complex background signal of real samples. In this study, a four-channel ISE array with the integration of a calibration channel has been developed based on polystyrene-Au (PS-Au) ion-sensing nanocomposites (PS-Au ISE array) for the home detection of Na⁺ and K⁺. The nanocomposites combine target recognition function and ion-electron transduction function and could be modified on the channel surface by direct drop-casting, thus simplifying the preparation process and then improving the stability. Meanwhile, the integrated calibration channel could automatically deduct complex background signals in real sample analysis and thus improve the accuracy. As a result, the proposed self-calibrated PS-Au ISE array showed a near Nernstian behavior for Na⁺ and K⁺ in the range of 1 × 10^-2 M-1 × 10^-4 M, and the detection limits were 6.8 × 10^-5 M and 5.5 × 10^-5 M in artificial urine. The linear equations can be obtained according to the slopes and intercepts of Na⁺ and K⁺, and thus, the concentration of the target ions can be directly read out by combining this PS-Au ISE array with the smart electronic device. Furthermore, the detection results of Na⁺ and K⁺ in human urine agreed well with those obtained by ICP-AES, suggesting that this proposed self-calibrated PS-Au ISE array is very suitable for home smart sensing devices, facilitating the health monitoring.

Wearable and Mobile Sensors for Personalized Nutrition

While wearable and mobile chemical sensors have experienced tremendous growth over the past decade, their potential for tracking and guiding nutrition has emerged only over the past three years. Currently, guidelines from doctors and dietitians represent the most common approach for maintaining optimal nutrition status. However, such recommendations rely on population averages and do not take into account individual variability in responding to nutrients. Precision nutrition has recently emerged to address the large heterogeneity in individuals' responses to diet, by tailoring nutrition based on the specific requirements of each person. It aims at preventing and managing diseases by formulating personalized dietary interventions to individuals on the basis of their metabolic profile, background, and environmental exposure. Recent advances in digital nutrition technology, including calories-counting mobile apps and wearable motion tracking devices, lack the ability of monitoring nutrition at the molecular level. The realization of effective precision nutrition requires synergy from different sensor modalities in order to make timely reliable predictions and efficient feedback. This work reviews key opportunities and challenges toward the successful realization of effective wearable and mobile nutrition monitoring platforms. Non-invasive wearable and mobile electrochemical sensors, capable of monitoring temporal chemical variations upon the intake of food and supplements, are excellent candidates to bridge the gap between digital and biochemical analyses for a successful personalized nutrition approach. By providing timely (previously unavailable) dietary information, such wearable and mobile sensors offer the guidance necessary for supporting dietary behavior change toward a managed nutritional balance. Coupling of the rapidly emerging wearable chemical sensing devices-generating enormous dynamic analytical data-with efficient data-fusion and data-mining methods that identify patterns and make predictions is expected to revolutionize dietary decision-making toward effective precision nutrition.

Functional Fibers and Fabrics for Soft Robotics, Wearables, and Human-Robot Interface

Soft robotics inspired by the movement of living organisms, with excellent adaptability and accuracy for accomplishing tasks, are highly desirable for efficient operations and safe interactions with human. With the emerging wearable electronics, higher tactility and skin affinity are pursued for safe and user-friendly human-robot interactions. Fabrics interlocked by fibers perform traditional static functions such as warming, protection, and fashion. Recently, dynamic fibers and fabrics are favorable to deliver active stimulus responses such as sensing and actuating abilities for soft-robots and wearables. First, the responsive mechanisms of fiber/fabric actuators and their performances under various external stimuli are reviewed. Fiber/yarn-based artificial muscles for soft-robots manipulation and assistance in human motion are discussed, as well as smart clothes for improving human perception. Second, the geometric designs, fabrications, mechanisms, and functions of fibers/fabrics for sensing and energy harvesting from the human body and environments are summarized. Effective integration between the electronic components with garments, human skin, and living organisms is illustrated, presenting multifunctional platforms with self-powered potential for human-robot interactions and biomedicine. Lastly, the relationships between robotic/wearable fibers/fabrics and the external stimuli, together with the challenges and possible routes for revolutionizing the robotic fibers/fabrics and wearables in this new era are proposed.

Strain-Insensitive Hierarchically Structured Stretchable Microstrip Antennas for Robust Wireless Communication

As the key component of wireless data transmission and powering, stretchable antennas play an indispensable role in flexible/stretchable electronics. However, they often suffer from frequency detuning upon mechanical deformations; thus, their applications are limited to wireless sensing with wireless transmission capabilities remaining elusive. Here, a hierarchically structured stretchable microstrip antenna with meshed patterns arranged in an arched shape showcases tunable resonance frequency upon deformations with improved overall stretchability. The almost unchanged resonance frequency during deformations enables robust on-body wireless communication and RF energy harvesting, whereas the rapid changing resonance frequency with deformations allows for wireless sensing. The proposed stretchable microstrip antenna was demonstrated to communicate wirelessly with a transmitter (input power of - 3 dBm) efficiently (i.e., the receiving power higher than - 100 dBm over a distance of 100 m) on human bodies even upon 25% stretching. The flexibility in structural engineering combined with the coupled mechanical-electromagnetic simulations, provides a versatile engineering toolkit to design stretchable microstrip antennas and other potential wireless devices for stretchable electronics.

Layer-Scale and Chip-Scale Transfer Techniques for Functional Devices and Systems: A Review

Hetero-integration of functional semiconductor layers and devices has received strong research interest from both academia and industry. While conventional techniques such as pick-and-place and wafer bonding can partially address this challenge, a variety of new layer transfer and chip-scale transfer technologies have been developed. In this review, we summarize such transfer techniques for heterogeneous integration of ultrathin semiconductor layers or chips to a receiving substrate for many applications, such as microdisplays and flexible electronics. We showed that a wide range of materials, devices, and systems with expanded functionalities and improved performance can be demonstrated by using these technologies. Finally, we give a detailed analysis of the advantages and disadvantages of these techniques, and discuss the future research directions of layer transfer and chip transfer techniques.

Textile-based wearable solid-contact flexible fluoride sensor: Toward biodetection of G-type nerve agents

Rising global concerns posed by chemical and biological threat agents highlight the critical need to develop reliable strategies for the real-time detection of such threats. While wearable sensing technology is well suited to fulfill this task, the use of on-body devices for rapid and selective field identification of chemical agents is relatively a new area. This work describes a flexible printed textile-based solid-contact potentiometric sensor for the selective detection of fluoride anions liberated by the biocatalytic hydrolysis of fluorine-containing G-type nerve agents (such as sarin or soman). The newly developed solid-contact textile fluoride sensor relies on a fluoride-selective bis(fluorodioctylstannyl)methane ionophore to provide attractive analytical performance with near-Nernstian sensitivity and effective discrimination against common anions, along with excellent reversibility and repeatability for dynamically changing fluoride concentrations. By using stress-enduring printed inks and serpentine structures along with stretchable textile substrates, the resulting textile-based fluoride sensor exhibits robust mechanical resiliency under severe mechanical strains. Such realization of an effective textile-based fluoride-selective electrode allowed biosensing of the nerve-agent simulant diisopropyl fluorophosphate (DFP), in connection to immobilized organophosphorus acid anhydrolylase (OPAA) or organophosphorus hydrolase (OPH) enzymes. A user-friendly portable electronic module transmits data from the new textile-based potentiometric biosensor wirelessly to a nearby smartphone for alerting the wearer instantaneously about potential chemical threats. While expanding the scope of wearable solid-contact anion sensors, such a textile-based potentiometric fluoride electrode transducer offers particular promise for effective discrimination of G-type neurotoxins from organophosphate (OP) pesticides, toward specific field detection of these agents in diverse defense settings.

Emerging intraoral biosensors

Biomedical devices that involved continuous and real-time health-care monitoring have drawn much attention in modern medicine, of which skin electronics and implantable devices are widely investigated. Skin electronics are characterized for their non-invasive access to the physiological signals, and implantable devices are superior at the diagnosis and therapy integration. Despite the significant progress achieved, many gaps remain to be explored to provide a more comprehensive overview of human health. As the connecting point of the outer environment and human systems, the oral cavity contains many unique biomarkers that are absent in skin or inner organs, and hence, this could become a promising alternative locus for designing health-care monitoring devices. In this review, we outline the status of the oral cavity during the communication of the environment and human systems and compare the intraoral devices with skin electronics and implantable devices from the biophysical and biochemical aspects. We further summarize the established diagnosis database and technologies that could be adopted to design intraoral biosensors. Finally, the challenges and potential opportunities for intraoral biosensors are discussed. Intraoral biosensors could become an important complement for existing biomedical devices to constitute a more reliable health-care monitoring system.

Development of Flexible Ion-Selective Electrodes for Saliva Sodium Detection

Saliva can be used for health monitoring with non-invasive wearable systems. Such devices, including electrochemical sensors, may provide a safe, fast, and cost-efficient way of detecting target ions. Although salivary ions are known to reflect those in blood, no available clinical device can detect essential ions directly from saliva. Here, we introduce an all-solid-state, flexible film sensor that allows highly accurate detection of sodium levels in saliva, comparable to those in blood. The wireless film sensor system can successfully measure sodium ions from a small volume of infants' saliva (<400 µL), demonstrating its potential as a continuous health monitor. This study includes the structural characterization and error analysis of a carbon/elastomer-based ion-selective electrode and a reference electrode to confirm the signal reliability. The sensor, composed of a pair of the electrodes, shows good sensitivity (58.9 mV/decade) and selectivity (log K = -2.68 for potassium), along with a broad detection range of 5 × 10^-5 ≈ 1 M with a low detection limit of 4.27 × 10^-5 M. The simultaneous comparison between the film sensor and a commercial electrochemical sensor demonstrates the accuracy of the flexible sensor and a positive correlation in saliva-to-blood sodium levels. Collectively, the presented study shows the potential of the wireless ion-selective sensor system for a non-invasive, early disease diagnosis with saliva.