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

Electrochemical biosensors in early detection of Parkinson disease

Parkinson's disease (PD) is a progressive neurodegenerative disorder affecting the motor system, with symptoms including tremors, rigidity, bradykinesia, and postural instability. Affecting over six million people globally, PD's pathophysiology is marked by the loss of dopaminergic neurons in the substantia nigra. Early diagnosis is crucial for effective management, yet current methods are limited by low sensitivity, high cost, and the need for advanced equipment. Electrochemical biosensors have emerged as promising tools for early PD diagnosis, converting biological reactions into measurable electrical signals for evaluating PD biomarkers. Advances in nanotechnology and material science have led to innovative sensing platforms with enhanced sensitivity and selectivity. Key biomarkers such as alpha-synuclein (α-syn), dopamine (DA), and microRNAs (miRNAs) have been targeted using these biosensors. For instance, gold nanoparticle-modified graphene immunosensors have shown ultra-sensitive detection of α-syn, while graphene-based biosensors have demonstrated high sensitivity for DA detection. Additionally, nanobiosensors for miR-195 and electrochemical aptasensors have shown potential for early PD diagnosis. The integration of nanomaterials like gold nanoparticles, quantum dots, and carbon nanotubes has further advanced the field, enhancing electrochemical activity and sensitivity. These developments offer a reliable, rapid, and cost-effective approach for early PD diagnosis, paving the way for better management and treatment. Continued research is essential for the commercialization and clinical integration of these biosensors, ultimately improving patient outcomes.

Effects of Surface Oxygen Vacancies and Hydroxy Groups on Electrical Characteristics in Solution-Gated One-Piece Indium-Tin-Oxide-Based Field-Effect Transistors

A solution-gated indium-tin-oxide (ITO)-based field effect transistor (FET) without interfaces among the source, channel, and drain electrodes, which is called the one-piece ITO-FET, can be simply fabricated from a single sheet of ITO by etching the channel region. The direct contact of the ITO channel surface with a sample solution contributes to a steep subthreshold slope and a high on/off ratio. In this study, we have examined the effects of oxygen vacancies and hydroxy groups at the ITO channel surface on the electrical characteristics of the one-piece ITO-FET. In the transfer characteristics, the turn-on voltage gradually increased over the days of storage in deionized water and then recovered after the heat treatment at 200 °C in vacuum. This resulted from the finding that the densities of oxygen vacancies as a source of carriers and hydroxy groups as charged species at the ITO channel surface changed under each condition, which were analyzed by X-ray photoelectron spectroscopy. In particular, the pH responsivity of the one-piece ITO-FET was improved and maintained with increasing the density of hydroxy groups at the ITO channel surface. Therefore, the control of the densities of oxygen vacancies and hydroxy groups at the ITO channel contributes to the improvement of the detection stability of devices when targets are actually measured.

Parental Perceptions of Early Childhood In-Home Research with Monitoring: A Qualitative Study

OBJECTIVE

To explore perceptions, concerns, and enthusiasm from a diverse group of parents regarding early childhood research that involves home monitoring technologies for collecting environmental exposure data.

STUDY DESIGN

A diverse group of new and expecting parents participated in semi-structured interviews. A single interviewer conducted all sessions and introduced a hypothetical longitudinal early childhood research study, which included novel home monitoring approaches: 1) wearable devices, 2) audio monitoring, and 3) environmental sampling. Interviews were audio-recorded, transcribed, and coded. Qualitative description guided the study, and a constant comparative approach was used to identify themes from transcripts.

RESULTS

Twenty-four interviews were completed. Emerging themes included 1) Ready and Willing to Participate; 2) Helping Others, Helping Ourselves: Motivation for Participation; 3) Trust and Transparency: Understanding the "What?" and the "Why?"; 4) Data Privacy and Security: "What If It Gets into the Wrong Hands?"; 5) It's a Lot to Juggle: Logistical Realities. Perceptions were similar across racial, ethnic, and socioeconomic groups. Perceptions were positive, and participants desired additional information about study feasibility and purpose. Many had concerns related to wearable device safety and data privacy; a trusting relationship with the research team was a priority.

CONCLUSION

Participants had positive sentiments regarding longitudinal observational studies involving pregnancy and infancy yet expressed concerns about safety, privacy, feasibility, and transparency. These findings can inform future early childhood research study design to ensure protocols are transparent, inclusive, and appealing to parents.

StressFit: a hybrid wearable physicochemical sensor suite for simultaneously measuring electromyogram and sweat cortisol

This study introduces StressFit, a novel hybrid wearable sensor system designed to simultaneously monitor electromyogram (EMG) signals and sweat cortisol levels. Our approach involves the development of a noninvasive skin patch capable of monitoring skin temperature, sweat pH, cortisol levels, and corresponding EMG signals using a combination of physical and electrochemical sensors integrated with EMG electrodes. StressFit was optimized by enhancing sensor output and mechanical resilience for practical application on curved body surfaces, ensuring accurate acquisition of cortisol, pH, body temperature, and EMG data without sensor interference. In addition, we integrated an onboard data processing unit with Internet of Things (IoT) capabilities for real-time acquisition, processing, and wireless transmission of sensor measurements. Sweat cortisol and EMG signals were measured during cycling exercises to evaluate the sensor suite's performance. Our results demonstrate an increase in sweat cortisol levels and decrease in the EMG signal's power spectral density following exercise. These findings suggest that combining sweat cortisol levels with EMG signals in real-time could serve as valuable indicators for stress assessment and early detection of abnormal physiological changes.

Medication Management Initiatives Using Wearable Devices: Scoping Review

Background

Wearable devices (WDs) have evolved beyond simple fitness trackers to sophisticated health monitors capable of measuring vital signs, such as heart rate and blood oxygen levels. Their application in health care, particularly medication management, is an emerging field poised to significantly enhance patient adherence to treatment regimens. Despite their widespread use and increasing incorporation into clinical trials, a comprehensive review of WDs in terms of medication adherence has not been conducted.

Objective

This study aimed to conduct a comprehensive scoping review to evaluate the impact of WDs on medication adherence across a variety of diseases, summarizing key research findings, outcomes, and challenges encountered.

Methods

Adhering to PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines, a structured search was conducted across MEDLINE, Web of Science, and Embase databases, covering the literature from January 1, 2010, to September 30, 2022. The search strategy was based on terms related to WDs and medication adherence, specifically focusing on empirical studies to ensure the inclusion of original research findings. Studies were selected based on their relevance to medication adherence, usage of WDs in detecting medication-taking actions, and their role in integrated medication management systems.

Results

We screened 657 articles and identified 18 articles. The identified studies demonstrated the diverse applications of WDs in enhancing medication adherence across diseases such as Parkinson disease, diabetes, and cardiovascular conditions. The geographical distribution and publication years of these studies indicate a growing interest in this research area. The studies were divided into three types: (1) studies reporting a correlation between data from WDs or their usage and medication adherence or drug usage as outcomes, (2) studies using WDs to detect the act of medication-taking itself, and (3) studies proposing an integrated medication management system that uses WDs in managing medication.

Conclusions

WDs are increasingly being recognized for their potential to enhance medication management and adherence. This review underscores the need for further empirical research to validate the effectiveness of WDs in real-life settings and explore their use in predicting adherence based on activity rhythms and activities. Despite technological advancements, challenges remain regarding the integration of WDs into routine clinical practice. Future research should focus on leveraging the comprehensive data provided by WDs to develop personalized medication management strategies that can improve patient outcomes.

Advances in Wearable Biosensors for Healthcare: Current Trends, Applications, and Future Perspectives

Wearable biosensors are a fast-evolving topic at the intersection of healthcare, technology, and personalized medicine. These sensors, which are frequently integrated into clothes and accessories or directly applied to the skin, provide continuous, real-time monitoring of physiological and biochemical parameters such as heart rate, glucose levels, and hydration status. Recent breakthroughs in downsizing, materials science, and wireless communication have greatly improved the functionality, comfort, and accessibility of wearable biosensors. This review examines the present status of wearable biosensor technology, with an emphasis on advances in sensor design, fabrication techniques, and data analysis algorithms. We analyze diverse applications in clinical diagnostics, chronic illness management, and fitness tracking, emphasizing their capacity to transform health monitoring and facilitate early disease diagnosis. Additionally, this review seeks to shed light on the future of wearable biosensors in healthcare and wellness by summarizing existing trends and new advancements.

Functionalisation of polyhydroxybutyrate for diagnostic uses

Polyhydroxybutyrate (PHB) is a biodegradable and biocompatible biopolyester, naturally produced and self-assembled as spherical inclusions inside bacteria. These PHB particles contain a hydrophobic PHB core covalently coated with PHB synthase (PhaC), which serves as an anchoring linker for foreign proteins of interest. Protein engineering of PhaC enables the display of biologically active protein functions on the surface of PHB particles suitable for different applications. Many biomolecules, such as e.g. antigens, enzymes, fluorescent proteins were immobilized to PHB particles and exhibited superior functionalities when compared to their respective soluble counterparts. Recently, PHB particles have been successfully applied for various diagnostics applications. This mini review provides an overview of the unique design space of PHB particles towards the development of safe and cost-effective diagnostic tools, and highlights the important research progresses of manufacturing PHB particles-based diagnostics.

Biological and technical factors affecting the point-of-care diagnostics in not-oncological chronic diseases

Inexpensive point-of-care (POC) analytical solutions have the potential to allow the implementation of large-scale screening campaigns aimed at identifying the initial stages of pathologies in the population, reducing morbidity, mortality and, indirectly, also the costs for the healthcare system. At global level, the most common preventive screening schemes address some cancer pathologies or are used to monitor the spread of some infective diseases. However, systematic testing might become decisive to improve the care response even in the case of chronic pathologies and, in this review, we analyzed the state-of-the-art of the POC diagnostics for Chronic Kidney Disease, Chronic Obstructive Pulmonary Disease and Multiple Sclerosis. The different technological options used to manufacture the biosensors and evaluate the produced data have been described and this information has been integrated with the present knowledge relatively to the biomarkers that have been proposed to monitor such diseases, namely their availability and reliability. Finally, the nature of the macromolecules used to capture the biomarkers has been discussed in relation to the biomarker nature.

Biosensing and Biosensors-Terminologies, Technologies, Theories and Ethics

Which biosensing technologies are geographers using in their research, and what exactly do they measure? What are the theoretical origins of geographic interests in biosensing? This article provides an overview of the variety of biosensors applied in biosensing research, tracks the theoretical debates and roots of geographic engagement with biosensing, and discusses the potentials, limitations and ethical implications of applying biosensors. We critically reflect on the varied terminologies that have been used to describe a rapidly evolving array of biosensing technologies and methodologies and suggest a common understanding for key terms such as "biosensing" (technologies or methodologies), "biosensors," "wearable biosensors" and "biosignals." We offer an overview of the broader theoretical debates that have inspired geographers turn to biosensing, including behavioral geography, more-than-representational theory, critical neurogeography, the mobilities and biosociality paradigms, and visual geographies. These have called for methodologies that can capture affects neglected in representational research, follow people, things and technologies as they are mobile in space and time, investigate the links between brain, cognition and biopolitics or attend to visualities in everyday life. Although geographers have so far engaged with a limited number of the ever-growing variety of available (bio-)sensors, the development and application of biosensing methodologies is vibrant, highly diverse and very promising for diverse geographical research questions and fields. Going forward, we particularly encourage experimentation with eye-trackers, which come closest to measuring instantaneous responses to environmental stimuli and offer interesting opportunities for the analysis of social and material environments through the visual data they create. Finally, we conclude with a call for a stronger emphasis on data ethics, procedural ethics and ethics of care in biosensing, which have so far received too little attention in these often interdisciplinary and complex biosensing research endeavors.

AI-Reinforced Wearable Sensors and Intelligent Point-of-Care Tests

Artificial intelligence (AI) techniques offer great potential to advance point-of-care testing (POCT) and wearable sensors for personalized medicine applications. This review explores the recent advances and the transformative potential of the use of AI in improving wearables and POCT. The integration of AI significantly contributes to empowering these tools and enables continuous monitoring, real-time analysis, and rapid diagnostics, thus enhancing patient outcomes and healthcare efficiency. Wearable sensors powered by AI models offer tremendous opportunities for precise and non-invasive tracking of physiological conditions that are essential for early disease detection and personalized treatments. AI-empowered POCT facilitates rapid, accurate diagnostics, making these medical testing kits accessible and available even in resource-limited settings. This review discusses the key advances in AI applications for data processing, sensor fusion, and multivariate analytics, highlighting case examples that exhibit their impact in different medical scenarios. In addition, the challenges associated with data privacy, regulatory approvals, and technology integrations into the existing healthcare system have been overviewed. The outlook emphasizes the urgent need for continued innovation in AI-driven health technologies to overcome these challenges and to fully achieve the potential of these techniques to revolutionize personalized medicine.

Tear-Based Ocular Wearable Biosensors for Human Health Monitoring

Wearable tear-based biosensors have garnered substantial interest for real time monitoring with an emphasis on personalized health care. These biosensors utilize major tear biomarkers such as proteins, lipids, metabolites, and electrolytes for the detection and recording of stable biological signals in a non-invasive manner. The present comprehensive review delves deep into the tear composition along with potential biomarkers that can identify, monitor, and predict certain ocular diseases such as dry eye disease, conjunctivitis, eye-related infections, as well as diabetes mellitus. Recent technologies in tear-based wearable point-of-care medical devices, specifically the state-of-the-art and prospects of glucose, pH, lactate, protein, lipid, and electrolyte sensing from tear are discussed. Finally, the review addresses the existing challenges associated with the widespread application of tear-based sensors, which will pave the way for advanced scientific research and development of such non-invasive health monitoring devices.

A Current Development of Energy Harvesting Systems for Energy-Independent Bioimplantable Biosensors

Biosensors have emerged as vital tools for the detection and monitoring of essential biological information. However, their efficiency is often constrained by limitations in the power supply. To address this challenge, energy harvesting systems have gained prominence. These off-grid, independent systems harness energy from the surrounding environment, providing a sustainable solution for powering biosensors autonomously. This continuous power source overcomes critical constraints, ensuring uninterrupted operation and seamless data collection. In this article, a comprehensive review of recent literature on energy harvesting-based biosensors is presented. Various techniques and technologies are critically examined, including optical, mechanical, thermal, and wireless power transfer, focusing on their applications and optimization. Furthermore, the immense potential of these energy harvesting-driven biosensors is highlighted across diverse fields, such as medicine, environmental surveillance, and biosignal analysis. By exploring the integration of energy harvesting systems, this review underscores their pivotal role in advancing biosensor technology. These innovations promise improved efficiency, reduced environmental impact, and broader applicability, marking significant progress in the field of biosensors.

Smart solutions in hypertension diagnosis and management: a deep dive into artificial intelligence and modern wearables for blood pressure monitoring

Hypertension, a widespread cardiovascular issue, presents a major global health challenge. Traditional diagnosis and treatment methods involve periodic blood pressure monitoring and prescribing antihypertensive drugs. Smart technology integration in healthcare offers promising results in optimizing the diagnosis and treatment of various conditions. We investigate its role in improving hypertension diagnosis and treatment effectiveness using machine learning algorithms for early and accurate detection. Intelligent models trained on diverse datasets (encompassing physiological parameters, lifestyle factors, and genetic information) to detect subtle hypertension risk patterns. Adaptive algorithms analyze patient-specific data, optimizing treatment plans based on medication responses and lifestyle habits. This personalized approach ensures effective, minimally invasive interventions tailored to each patient. Wearables and smart sensors provide real-time health insights for proactive treatment adjustments and early complication detection.

Recent advancements in non-invasive wearable electrochemical biosensors for biomarker analysis - A review

A biomarker is a molecular indicator that can be used to identify the presence or severity of a disease. It may be produced due to biochemical or molecular changes in normal biological processes. In some cases, the presence of a biomarker itself is an indication of the disease, while in other cases, the elevated or depleted level of a particular protein or chemical substance aids in identifying a disease. Biomarkers indicate the progression of the disease in response to therapeutic interventions. Identifying these biomarkers can assist in diagnosing the disease early and providing proper therapeutic treatment. In recent years, wearable electrochemical (EC) biosensors have emerged as an important tool for early detection due to their excellent selectivity, low cost, ease of fabrication, and improved sensitivity. There are several challenges in developing a fully integrated wearable sensor, such as device miniaturization, high power consumption, incorporation of a power source, and maintaining the integrity and durability of the biomarker for long-term continuous monitoring. This review covers the recent advancements in the fabrication techniques involved in device development, the types of sensing platforms utilized, different materials used, challenges, and future developments in the field of wearable biosensors.

Advances in Portable and Wearable Acoustic Sensing Devices for Human Health Monitoring

The practice of auscultation, interpreting body sounds to assess organ health, has greatly benefited from technological advancements in sensing and electronics. The advent of portable and wearable acoustic sensing devices marks a significant milestone in telemedicine, home health, and clinical diagnostics. This review summarises the contemporary advancements in acoustic sensing devices, categorized based on varied sensing principles, including capacitive, piezoelectric, and triboelectric mechanisms. Some representative acoustic sensing devices are introduced from the perspective of portability and wearability. Additionally, the characteristics of sound signals from different human organs and practical applications of acoustic sensing devices are exemplified. Challenges and prospective trends in portable and wearable acoustic sensors are also discussed, providing insights into future research directions.

Cortisol: Biosensing and detection strategies

Cortisol, a crucial steroid hormone synthesized by the adrenal glands, has diverse impacts on multiple physiological processes, such as metabolism, immune function, and stress management. Disruption in cortisol levels can result in conditions like Cushing's syndrome and Addison's disease. This review provides an in-depth exploration of cortisol, covering its structure, various forms in the body, detection methodologies, and emerging trends in cancer treatment and detection. Various techniques for cortisol detection, including electrochemical, chromatographic, and immunoassay methods were discussed and highlighted for their merits and applications. Electrochemical immunosensing emerges as a promising approach, which offered high sensitivity and low detection limits. Moreover, the review delves into the intricate relationship between cortisol and cancer, emphasizing cortisol's role in cancer progression and treatment outcomes. Lastly, the utilization of biomarkers, in-silico modeling, and machine learning for electrochemical cortisol detection were explored, which showcased innovative strategies for stress monitoring and healthcare advancement.

Advances in biosensors for major depressive disorder diagnostic biomarkers

Depression is one of the most common mental disorders and is mainly characterized by low mood or lack of interest and pleasure. It can be accompanied by varying degrees of cognitive and behavioral changes and may lead to suicide risk in severe cases. Due to the subjectivity of diagnostic methods and the complexity of patients' conditions, the diagnosis of major depressive disorder (MDD) has always been a difficult problem in psychiatry. With the discovery of more diagnostic biomarkers associated with MDD in recent years, especially emerging non-coding RNAs (ncRNAs), it is possible to quantify the condition of patients with mental illness based on biomarker levels. Point-of-care biosensors have emerged due to their advantages of convenient sampling, rapid detection, miniaturization, and portability. After summarizing the pathogenesis of MDD, representative biomarkers, including proteins, hormones, and RNAs, are discussed. Furthermore, we analyzed recent advances in biosensors for detecting various types of biomarkers of MDD, highlighting representative electrochemical sensors. Future trends in terms of new biomarkers, new sample processing methods, and new detection modalities are expected to provide a complete reference for psychiatrists and biomedical engineers.

Identifying Future Study Designs and Indicators for Somatic Health Associated with Diets of Cohorts Living in Eco-Regions: Findings from the INSUM Expert Workshop

Diets, but also overall food environments, comprise a variety of significant factors with direct and indirect impacts on human health. Eco-Regions are geographical areas with a territorial approach to rural development, utilizing organic food and farming practices, and principles and promoting sustainable communities and food systems. However, so far, little attention has been given to quantifying aspects of the health of citizens living in these sustainable transition territories. The project "Indicators for Assessment of Health Effects of Consumption of Sustainable, Organic School Meals in Eco-Regions" (INSUM) aims to identify and discuss research approaches and indicators that could be applied to effectively measure the somatic, mental, and social health dimensions of citizens in Eco-Regions, linked to the intake of organic foods in their diets. In this paper, we focus on the somatic (physical) health dimension. A two-day workshop was held to discuss suitable methodology with an interdisciplinary, international group of experts. The results showed the limitations of commonly used tools for measuring dietary intake (e.g., relying on the memory of participants), and nutritional biomarkers (e.g., variations in correlations with specific intakes) for research understanding dietary intake and the health effects of diets. To investigate the complexity of this issue, the most suitable approach seems to be the combination of traditional markers of physical and mental health alongside emerging indicators such as the microbiome, nutrigenomics, metabolomics, or inflammatory biomarkers. Using new, digital, non-invasive, and wearable technologies to monitor indicators could complement future research. We conclude that future studies should adopt systemic, multidisciplinary approaches by combining not only indicators of somatic and mental health and social wellbeing (MHSW) but also considering the potential benefits of organic diets for health as well as aspects of sustainability connected to food environments.

Assessing the current utilization status of wearable devices in clinical research

BACKGROUND/AIMS

Information regarding the use of wearable devices in clinical research, including disease areas, intervention techniques, trends in device types, and sample size targets, remains elusive. Therefore, we conducted a comprehensive review of clinical research trends related to wristband wearable devices in research planning and examined their applications in clinical investigations.

METHODS

As this study identified trends in the adoption of wearable devices during the planning phase of clinical research, including specific disease areas and targeted number of intervention cases, we searched ClinicalTrials.gov-a prominent platform for registering and disseminating clinical research. Since wrist-worn devices represent a large share of the market, we focused on wrist-worn devices and selected the most representative models among them. The main analysis focused on major wearable devices to facilitate data analysis and interpretation, but other wearables were also surveyed for reference. We searched ClinicalTrials.gov with the keywords "ActiGraph,""Apple Watch,""Empatica,""Fitbit,""Garmin," and "wearable devices" to obtain studies published up to 21 August 2022. This initial search yielded 3214 studies. After excluding duplicate National Clinical Trial studies (the overlap was permissible among different device types except for wearable devices), our analysis focused on 2930 studies, including simple, time-series, and type-specific assessments of various variables.

RESULTS

Overall, an increasing number of clinical studies have incorporated wearable devices since 2012. While ActiGraph and Fitbit initially dominated this landscape, the use of other devices has steadily increased, constituting approximately 10% of the total after 2015. Observational studies outnumbered intervention studies, with behavioral and device-based interventions being particularly prevalent. Regarding disease types, cancer and cardiovascular diseases accounted for approximately 20% of the total. Notably, 114 studies adopted multiple devices simultaneously within the context of their clinical investigations.

CONCLUSIONS

Our findings revealed that the utilization of wearable devices for data collection and behavioral interventions in various disease areas has been increasing over time since 2012. The increase in the number of studies over the past 3 years has been particularly significant, suggesting that this trend will continue to accelerate in the future. Devices and their evaluation methods that have undergone thorough validation, confirmed their accuracy, and adhered to established legal regulations will likely assume a pivotal role in evaluations, allowing for remote clinical trials. Moreover, behavioral intervention therapy utilizing apps is becoming more extensive, and we expect to see more examples that will lead to their approval as programmed medical devices in the future.

Wearable Smart Silicone Belt for Human Motion Monitoring and Power Generation

Human physical activity monitoring plays a crucial role in promoting personalized health management. In this work, inspired by an ancient Chinese belt, a belt-type wearable sensor (BWS) based on a triboelectric nanogenerator (TENG) is presented to monitor daily movements and collect the body motion mechanical energy. The developed BWS consists of a soft silicone sheet and systematically connected sensing units made from triboelectric polymer materials including polytetrafluoroethylene (PTFE) and polyamide (PA). A parameter study of the sensing units is firstly conducted to optimize the structure of BWS. The experimental studies indicate that the parameter-optimized BWS unit achieves a maximum output voltage of 47 V and a maximum current of 0.17 μA. A BWS with five sensing units is manufactured to record body movements, and it is able to distinguish different physical activities including stillness, walking, running, jumping, normal breathing, cessation of breathing, and deep breathing. In addition, the developed BWS successfully powers electronic devices including a smartphone, digital watch, and LED lights. We hope this work provides a new strategy for the development of wearable self-powered intelligent devices.

Wearable biosensors in cardiovascular disease

This review provides a comprehensive overview of the latest advancements in wearable biosensors, emphasizing their applications in cardiovascular disease monitoring. Initially, the key sensing signals and biomarkers crucial for cardiovascular health, such as electrocardiogram, phonocardiography, pulse wave velocity, blood pressure, and specific biomarkers, are highlighted. Following this, advanced sensing techniques for cardiovascular disease monitoring are examined, including wearable electrophysiology devices, optical fibers, electrochemical sensors, and implantable cardiac devices. The review also delves into hydrogel-based wearable electrochemical biosensors, which detect biomarkers in sweat, interstitial fluids, saliva, and tears. Further attention is given to flexible electronics-based biosensors, including resistive, capacitive, and piezoelectric force sensors, as well as resistive and pyroelectric temperature sensors, flexible biochemical sensors, and sensor arrays. Moreover, the discussion extends to polymer-based wearable sensors, focusing on innovations in contact lens, textile-type, patch-type, and tattoo-type sensors. Finally, the review addresses the challenges associated with recent wearable biosensing technologies and explores future perspectives, highlighting potential groundbreaking avenues for transforming wearable sensing devices into advanced diagnostic tools with multifunctional capabilities for cardiovascular disease monitoring and other healthcare applications.

Neuro Receptor Signal Detecting and Monitoring Smart Devices for Biological Changes in Cognitive Health Conditions

Background

Currently, wearable sensors significantly impact health care through continuous monitoring and event prediction. The types and clinical applications of wearable technology for the prevention of mental illnesses, as well as associated health authority rules, are covered in the current review.

Summary

The technologies behind wearable ECG monitors, biosensors, electronic skin patches, neural interfaces, retinal prosthesis, and smart contact lenses were discussed. We described how sensors will examine neuronal impulses using verified machine-learning algorithms running in real-time. These sensors will closely monitor body signals and demonstrate continuous sensing with wireless functionality. The wearable applications in the following medical fields were covered in our review: sleep, neurology, mental health, anxiety, depression, Parkinson's disease, epilepsy, seizures, and schizophrenia. These mental health conditions can cause serious issues, even death. Inflammation brought on by mental health problems can worsen hypothalamic-pituitary-adrenal axis dysfunction and interfere with certain neuroregulatory systems such as the neural peptide Y, serotonergic, and cholinergic systems. Severe depressive disorder symptoms are correlated with elevated Interleukin (IL-6) levels. On the basis of previous and present data collected utilizing a variety of sensory modalities, researchers are currently investigating ways to identify or detect the current mental state.

Key message

This review explores the potential of various mental health monitoring technologies. The types and clinical uses of wearable technology, such as ECG monitors, biosensors, electronic skin patches, brain interfaces, retinal prostheses, and smart contact lenses, were covered in the current review will be beneficial for patients with mental health problems like Alzheimer, epilepsy, dementia. The sensors will closely monitor bodily signals with wireless functionality while using machine learning algorithms to analyse neural impulses in real time.

The effectiveness of continuing professional development for the residential long-term care workforce: A systematic review

OBJECTIVES

To investigate the effectiveness of continuing professional development in residential long-term care.

DESIGN

Systematic review.

DATA SOURCES

PubMed, Cumulative Index to Nursing & Allied Health (CINAHL), and Web of Science.

REVIEW METHODS

Empirical studies published between 2003 and 2023 describing the effectiveness of continuing professional development in long-term care were selected according to PRISMA guidelines. The type, topic, and effectiveness of continuing professional development activities in long-term care were analysed, in addition to facilitators and barriers. The protocol of this review is registered in PROSPERO.

RESULTS

A total of 155 studies were selected, including over 17,000 participants the majority of whom were nurses. The most common topics were 'dementia care' (n = 22; 14.2 %), and restraint use (n = 14; 9 %). The impact of continuing professional development was mainly evaluated in terms of 'participant satisfaction with continuing professional development' (n = 5; 3 %), 'staff knowledge' (n = 57; 37 %), 'staff competencies and skills' (n = 35; 23 %), 'resident outcomes' (n = 45; 29 %), and 'staff wellbeing' (n = 12; 8 %). A total of 64 (41 %) studies evaluated if impact of continuing professional development was sustained over time. 'Good organisation', 'a supportive learning environment', 'expressing personal preferences', and 'management support' were described as facilitators of continuing professional development.

CONCLUSIONS

Increasing numbers of long-term care residents with complex health conditions require nurses with advanced skills, such as dementia care. To improve the effectiveness of continuing professional development, support from managers, who adopt relational leadership styles, is instrumental to integrate new knowledge and skills into practice. This needs to be linked to career progression, and consequently increase the attractiveness of working in the long-term care sector. This could meet the dual goal of improving outcomes for residents and nurses' job satisfaction.

Challenges in IBD Research 2024: Environmental Triggers

Environmental factors play an important role in inflammatory bowel diseases (IBD; Crohn's disease, [CD], ulcerative colitis [UC]). As part of the Crohn's & Colitis Challenges 2024 agenda, the Environmental Triggers workgroup summarized the progress made in the field of environmental impact on IBD since the last Challenges cycle in this document. The workgroup identified 4 unmet gaps in this content area pertaining to 4 broad categories: (1) Epidemiology; (2) Exposomics and environmental measurement; (3) Biologic mechanisms; and (4) Interventions and Implementation. Within epidemiology, the biggest unmet gaps were in the study of environmental factors in understudied populations including racial and ethnic minority groups and in populations witnessing rapid rise in disease incidence globally. The workgroup also identified a lack of robust knowledge of how environmental factors may impact difference stages of the disease and for different disease-related end points. Leveraging existing cohorts and targeted new prospective studies were felt to be an important need for the field. The workgroup identified the limitations of traditional questionnaire-based assessment of environmental exposure and placed high priority on the identification of measurable biomarkers that can quantify cross-sectional and longitudinal environmental exposure. This would, in turn, allow for identifying the biologic mechanisms of influence of environmental factors on IBD and understand the heterogeneity in effect of such influences. Finally, the working group emphasized the importance of generating high-quality data on effective environmental modification on an individual and societal level, and the importance of scalable and sustainable methods to deliver such changes.

Recent advances in smart wearable sensors for continuous human health monitoring

In recent years, the biochemical and biological research areas have shown great interest in a smart wearable sensor because of its increasing prevalence and high potential to monitor human health in a non-invasive manner by continuous screening of biomarkers dispersed throughout the biological analytes, as well as real-time diagnostic tools and time-sensitive information compared to conventional hospital-centered system. These smart wearable sensors offer an innovative option for evaluating and investigating human health by incorporating a portion of recent advances in technology and engineering that can enhance real-time point-of-care-testing capabilities. Smart wearable sensors have emerged progressively with a mixture of multiplexed biosensing, microfluidic sampling, and data acquisition systems incorporated with flexible substrate and bodily attachments for enhanced wearability, portability, and reliability. There is a good chance that smart wearable sensors will be relevant to the early detection and diagnosis of disease management and control. Therefore, pioneering smart wearable sensors into reality seems extremely promising despite possible challenges in this cutting-edge technology for a better future in the healthcare domain. This review presents critical viewpoints on recent developments in wearable sensors in the upcoming smart digital health monitoring in real-time scenarios. In addition, there have been proactive discussions in recent years on materials selection, design optimization, efficient fabrication tools, and data processing units, as well as their continuous monitoring and tracking strategy with system-level integration such as internet-of-things, cyber-physical systems, and machine learning algorithms.

Comparative analysis of electrochemical and optical sensors for detection of chronic wounds biomarkers: A review

Chronic wounds (CW) present a significant healthcare challenge due to their prolonged healing time and associated complications. To effectively treat these wounds and prevent further deterioration, monitoring their healing progress is crucial. Traditional wound assessment methods relying on visual inspection and subjective evaluation are prone to inter-observer variability. Biomarkers play a critical role in objectively evaluating wound status and predicting healing outcomes, providing quantitative measures of wound healing progress, inflammation, infection, and tissue regeneration. Recent attention has been devoted to identifying and validating CW biomarkers. Various studies have investigated potential biomarkers, including growth factors, cytokines, proteases, and extracellular matrix components, shedding light on the complex molecular and cellular processes within CW. This knowledge enables a more targeted and personalized approach to wound management. Accurate and sensitive techniques are necessary for detecting CW biomarkers. Thus, this review compares and discusses the use of electrochemical and optical sensors for biomarker determination. The advantages and disadvantages of these sensors are highlighted. Differences in detection capabilities and characteristics such as non-invasiveness, portability, high sensitivity, specificity, simplicity, cost-effectiveness, compatibility with point-of-care applications, and real-time monitoring of wound biomarkers will be pointed out and compared. In summary, this work provides an overview of CW, explores the emerging field of CW biomarkers, and discusses methods for detecting these biomarkers, with a specific focus on optical and electrochemical sensors. The potential of further research and development in this field for advancing wound care and improving patient outcomes will also be noted.

Internet of Things-Enabled Patch With Built-in Microsensors and Wireless Chip: Real-Time Remote Monitoring of Patch Treatment

Purpose

We aimed to design, develop, and evaluate an internet of things-enabled patch (IoT patch) for real-time remote monitoring of adherence (or patch wear time) during patch treatment in child participants in clinical trials. This study provides healthcare providers with a tool for objective, real-time, and remote assessment of adherence and for making required adjustments to treatment plans.

Methods

The IoT patch had two temperature microsensors and a wireless chip. One sensor was placed closer to the skin than the other, resulting in a temperature difference depending on whether the patch was worn. When the patch was worn, it measured temperatures every 30 seconds and transmitted temperature data to a cloud server via a mobile application every 15 seconds. The patch was evaluated via 2 experiments with 30 healthy adults and 40 children with amblyopia.

Results

Excellent monitoring accuracy was observed in both adults (mean delay of recorded time data, 0.4 minutes) and children (mean, 0.5 minutes). The difference between manually recorded and objectively recorded patch wear times showed good agreement in both groups. Experiment 1 showed accurate monitoring over a wide range of temperatures (from 0 to 30°C). Experiment 2 showed no significant differences in wearability (ease-of-use and comfort scores) between the IoT and conventional patches.

Conclusions

The IoT patch offers an accurate, real-time, and remote system to monitor adherence to patch treatment. The patch is comfortable and easy to use. The utilization of an IoT patch may increase adherence to patch treatment based on accurate monitoring.

Translational Relevance

Results show that the IoT patch can enable real-time adherence monitoring in clinical trials, improving treatment precision, and patient compliance to enhance outcomes.

Recent Advances in Wearable Healthcare Devices: From Material to Application

In recent years, the proliferation of wearable healthcare devices has marked a revolutionary shift in the personal health monitoring and management paradigm. These devices, ranging from fitness trackers to advanced biosensors, have not only made healthcare more accessible, but have also transformed the way individuals engage with their health data. By continuously monitoring health signs, from physical-based to biochemical-based such as heart rate and blood glucose levels, wearable technology offers insights into human health, enabling a proactive rather than a reactive approach to healthcare. This shift towards personalized health monitoring empowers individuals with the knowledge and tools to make informed decisions about their lifestyle and medical care, potentially leading to the earlier detection of health issues and more tailored treatment plans. This review presents the fabrication methods of flexible wearable healthcare devices and their applications in medical care. The potential challenges and future prospectives are also discussed.

Microfluidics-Based Nanobiosensors for Healthcare Monitoring

Efficient healthcare management demands prompt decision-making based on fast diagnostics tools, astute data analysis, and informatics analysis. The rapid detection of analytes at the point of care is ensured using microfluidics in synergy with nanotechnology and biotechnology. The nanobiosensors use nanotechnology for testing, rapid disease diagnosis, monitoring, and management. In essence, nanobiosensors detect biomolecules through bioreceptors by modulating the physicochemical signals generating an optical and electrical signal as an outcome of the binding of a biomolecule with the help of a transducer. The nanobiosensors are sensitive and selective and play a significant role in the early identification of diseases. This article reviews the detection method used with the microfluidics platform for nanobiosensors and illustrates the benefits of combining microfluidics and nanobiosensing techniques by various examples. The fundamental aspects, and their application are discussed to illustrate the advancement in the development of microfluidics-based nanobiosensors and the current trends of these nano-sized sensors for point-of-care diagnosis of various diseases and their function in healthcare monitoring.

Comprehensive Geriatric Assessment in the era of telemedicine

The aging global population poses significant medical and social challenges, necessitating efforts to promote healthy aging. Comprehensive Geriatric Assessment (CGA) is a multidimensional diagnostic approach for older adults that aims to improve overall health. Remote CGA, facilitated by technological advancements, offers convenience and other potential advantages. It enables early disease detection, monitors chronic disease progression, delivers personalized care, and optimizes healthcare resources for better health outcomes in older individuals. However, remote CGA also has limitations, including technological requirements, data security, and the need for comprehensive evaluation and simplicity. Collaborative efforts are essential to developing a digital home-based CGA platform that addresses accessibility issues and tailors the assessment process to meet the needs of older adults. Continuous optimization of remote CGA can become a pivotal tool for advancing geriatric care and ensuring the well-being of the aging population. Geriatr Gerontol Int 2024; 24: 67-73.

Non-toxic flexible screen-printed MWCNT-based electrodes for non-invasive biomedical applications

Here, a non-toxic, flexible, low-cost, and disposable multiwalled carbon nanotube (MWCNT)-based screen-printed electrode (SPE) was developed for non-invasive health monitoring applications. A novel MWCNT-based conductive paste formulation was prepared and optimized for printing SPEs using a computer numerical control (CNC)-made stencil. The electrodes were electrochemically characterized and subjected to physical stress to investigate their mechanical durability in extreme situations such as heavy exercise. The reproducibility of the fabrication approach and the stability of the electrodes were also demonstrated. The electrochemical performance of the electrodes was tested with first dopamine (DA) and then glucose. The SPE displayed a linear response in the DA concentration range of 5-500 μM with a limit-of-detection (LOD) of 0.87 μM. Detection of glucose was carried out based on electrochemical-enzymatic redox cycling in artificial sweat; wherein the flexible SPE-based biosensor exhibited a linear response, particularly up to 1 mM with an LOD of 31.7 μM. It is likely that the high sensitivity was achieved due to the large surface-to-volume ratio of MWCNTs and micro/nanoporous network morphology of the electrode surface which was observed in scanning electron microscopy (SEM). Cytotoxicity tests confirmed that the flexible MWCNT-SPEs are non-toxic and therefore safe for non-invasive health monitoring. As a result, the electrodes displayed excellent electrochemical behavior and are expected to contribute to wearable sensor technology due to features such as high stability, sensitivity, flexibility, and non-toxicity.

Improving the design of patient-generated health data visualizations: design considerations from a Fitbit sleep study

Interactive data visualization can be a viable way to discover patterns in patient-generated health data and enable health behavior changes. However, very few studies have investigated the design and usability of such data visualization. The present study aimed to (1) explore user experiences with sleep data visualizations in the Fitbit app, and (2) focus on end users' perspectives to identify areas of improvement and potential solutions. The study recruited eighteen pre-medicine college students, who wore Fitbit watches for a two-week sleep data collection period and participated in an exit semi-structured interview to share their experience. A focus group was conducted subsequently to ideate potential solutions. The qualitative analysis identified six pain points (PPs) from the interview data using affinity mapping. Four design solutions were proposed by the focus group to address these PPs and illustrated by a set of mock-ups. The study findings informed four design considerations: (1) usability, (2) transparency and explainability, (3) understandability and actionability, and (4) individualized benchmarking. Further research is needed to examine the design guidelines and best practices of sleep data visualization, to create well-designed visualizations for the general population that enables health behavior changes.

Wearable biosensors for human health: A bibliometric analysis from 2007 to 2022

Objective

This study aimed to determine the status of scientific production on biosensor usage for human health monitoring.

Methods

We used bibliometrics based on the data and metadata retrieved from the Web of Science between 2007 and 2022. Articles unrelated to health and medicine were excluded. The databases were processed using the VOSviewer software and auxiliary spreadsheets. Data extraction yielded 275 articles published in 161 journals, mainly concentrated on 13 journals and 881 keywords plus.

Results

The keywords plus of high occurrences were estimated at 27, with seven to 30 occurrences. From the 1595 identified authors, 125 were consistently connected in the coauthorship network in the total set and were grouped into nine clusters. Using Lotka's law, we identified 24 prolific authors, and Hirsch index analysis revealed that 45 articles were cited more than 45 times. Crosses were identified between 17 articles in the Hirsch index and 17 prolific authors, highlighting the presence of a large set of prolific authors from various interconnected clusters, a triad, and a solitary prolific author.

Conclusion

An exponential trend was observed in biosensor research for health monitoring, identifying areas of innovation, collaboration, and technological challenges that can guide future research on this topic.

Recent Advances in Metallic Nanostructures-assisted Biosensors for Medical Diagnosis and Therapy

The field of nanotechnology has witnessed remarkable progress in recent years, particularly in its application to medical diagnosis and therapy. Metallic nanostructures-assisted biosensors have emerged as a powerful and versatile platform, offering unprecedented opportunities for sensitive, specific, and minimally invasive diagnostic techniques, as well as innovative therapeutic interventions. These biosensors exploit the molecular interactions occurring between biomolecules, such as antibodies, enzymes, aptamers, or nucleic acids, and metallic surfaces to induce observable alterations in multiple physical attributes, encompassing electrical, optical, colorimetric, and electrochemical signals. These interactions yield measurable data concerning the existence and concentration of particular biomolecules. The inherent characteristics of metal nanostructures, such as conductivity, plasmon resonance, and catalytic activity, serve to amplify both sensitivity and specificity in these biosensors. This review provides an in-depth exploration of the latest advancements in metallic nanostructures-assisted biosensors, highlighting their transformative impact on medical science and envisioning their potential in shaping the future of personalized healthcare.

Bioinspired nanoplatforms for human-machine interfaces: Recent progress in materials and device applications

The panoramic characteristics of human-machine interfaces (HMIs) have prompted the needs to update the biotechnology community with the recent trends, developments, and future research direction toward next-generation bioelectronics. Bioinspired materials are promising for integrating various bioelectronic devices to realize HMIs. With the advancement of scientific biotechnology, state-of-the-art bioelectronic applications have been extensively investigated to improve the quality of life by developing and integrating bioinspired nanoplatforms in HMIs. This review highlights recent trends and developments in the field of biotechnology based on bioinspired nanoplatforms by demonstrating recently explored materials and cutting-edge device applications. Section 1 introduces the recent trends and developments of bioinspired nanomaterials for HMIs. Section 2 reviews various flexible, wearable, biocompatible, and biodegradable nanoplatforms for bioinspired applications. Section 3 furnishes recently explored substrates as carriers for advanced nanomaterials in developing HMIs. Section 4 addresses recently invented biomimetic neuroelectronic, nanointerfaces, biointerfaces, and nano/microfluidic wearable bioelectronic devices for various HMI applications, such as healthcare, biopotential monitoring, and body fluid monitoring. Section 5 outlines designing and engineering of bioinspired sensors for HMIs. Finally, the challenges and opportunities for next-generation bioinspired nanoplatforms in extending the potential on HMIs are discussed for a near-future scenario. We believe this review can stimulate the integration of bioinspired nanoplatforms into the HMIs in addition to wearable electronic skin and health-monitoring devices while addressing prevailing and future healthcare and material-related problems in biotechnologies.

Development of biosensors for detection of fibrinogen: a review

Fibrinogen as a major inflammation marker and blood coagulation factor has a direct impact on the health of humanity. The variations in fibrinogen content lead to risky conditions such as bleeding and cardiovascular diseases. So, accurate methods for monitoring of this glycoprotein are of high importance. The conventional methods, such as the Clauss method, are time consuming and require highly specialized expert analysts. The development of fast, simple, easy to use, and inexpensive methods is highly desired. In this way, biosensors have gained outstanding attention since they offer means for performing analyses at the points-of-care using self-testing devices, which can be applied outside of clinical laboratories or hospital. This review indicates that different electrochemical and optical sensors have been successfully implemented for the detection of fibrinogen under normal levels of fibrinogen in plasma. The biosensors for the detection of fibrinogen have been designed based on the quartz crystal microbalance, field-effect transistor, electrochemical impedance spectroscopy, amperometry, surface plasmon resonance, localized surface plasmon resonance, and colorimetric techniques. Also, this review demonstrates the utility of the application of nanoparticles in different detection techniques.

The 3D Printing of Nanocomposites for Wearable Biosensors: Recent Advances, Challenges, and Prospects

Notably, 3D-printed flexible and wearable biosensors have immense potential to interact with the human body noninvasively for the real-time and continuous health monitoring of physiological parameters. This paper comprehensively reviews the progress in 3D-printed wearable biosensors. The review also explores the incorporation of nanocomposites in 3D printing for biosensors. A detailed analysis of various 3D printing processes for fabricating wearable biosensors is reported. Besides this, recent advances in various 3D-printed wearable biosensors platforms such as sweat sensors, glucose sensors, electrocardiography sensors, electroencephalography sensors, tactile sensors, wearable oximeters, tattoo sensors, and respiratory sensors are discussed. Furthermore, the challenges and prospects associated with 3D-printed wearable biosensors are presented. This review is an invaluable resource for engineers, researchers, and healthcare clinicians, providing insights into the advancements and capabilities of 3D printing in the wearable biosensor domain.

Five-day evaluation of the acceptability and comfort of wearable technology at four anatomical locations during military training

INTRODUCTION

Wearable sensor technologies enable Defence to optimise human performance, remotely identify physiological abnormalities and enhance medical support. Maximising the acceptability of devices will ensure they are worn alongside other equipment. This study assessed the acceptability and comfort of four devices at different anatomical locations during military training.

METHOD

A cross-sectional pilot study during a live firing infantry exercise or adventurous training assessed four anatomical locations concurrently over 5 days: finger, wrist, upper arm and chest. Participants rated comfort, acceptability and preference using a standardised questionnaire after 12 hours and 5 days of wear.

RESULTS

Twenty-one regular British Army personnel soldiers participated, aged 24.4 (4.3) years. The upper arm location received the highest rating by participants for comfort, followed in order by wrist, finger and chest (p=0.002, Χ2=40.0). The finger was most commonly identified as uncomfortable during specific activities (76%), followed by chest (48%), wrist (23%) and upper arm devices (14%). There was no significant difference in participant confidence in the devices to collect data or allow movement, but there was a trend towards greater confidence in upper arm and wrist locations to stay in position than the others (p=0.059, Χ2=28.0). After 5 days of wear, 43% of participants said they preferred the upper arm for comfort, followed by wrist (36%), finger (24%) and chest (10%). 73% and 71% would wear the wrist and upper arm devices on deployed operations, compared with 29% and 24% for chest and finger devices, respectively.

CONCLUSION

The upper arm location offered greater acceptability and comfort than finger, wrist or chest locations. It is essential to consider such findings from occupationally relevant settings when selecting wearable technology. A larger service evaluation in diverse settings is recommended to guide the choice of the most acceptable wearable devices across different equipment, roles and environments.

Frontiers of Wearable Biosensors for Human Health Monitoring

Wearable biosensors offer noninvasive, real-time, and continuous monitoring of diverse human health data, making them invaluable for remote patient tracking, early diagnosis, and personalized medicine [...].

An Update on the Use of Wearable Devices in Men's Health

Men's health represents an often-overlooked aspect of public health. Men have higher mortality rates worldwide and are more negatively affected by chronic conditions such as obesity and heart disease, as well as addiction to alcohol and tobacco. Men also have health issues such as prostate cancer and male sexual dysfunction which only affect them. Because of the skewed burden of morbidity and mortality on men, it is imperative from a public health perspective to make a concerted effort to specifically improve men's health. The use of wearable devices in medical practice presents a novel avenue to invest in men's health in a safe, easily scalable, and economic fashion. Wearable devices are now ubiquitous in society, and their use in the healthcare setting is only increasing with time. There are commercially available devices such as smart watches which are available to lay people and healthcare professionals alike to improve overall health and wellness, and there are also purpose-built wearable devices which are used to track or treat a specific disease. In our review of the literature, we found that while research in the field of wearable devices is still in its early stages, there is ample evidence that wearable devices can greatly improve men's health in the long-term.

The Constrained-Disorder Principle Assists in Overcoming Significant Challenges in Digital Health: Moving from "Nice to Have" to Mandatory Systems

The success of artificial intelligence depends on whether it can penetrate the boundaries of evidence-based medicine, the lack of policies, and the resistance of medical professionals to its use. The failure of digital health to meet expectations requires rethinking some of the challenges faced. We discuss some of the most significant challenges faced by patients, physicians, payers, pharmaceutical companies, and health systems in the digital world. The goal of healthcare systems is to improve outcomes. Assisting in diagnosing, collecting data, and simplifying processes is a "nice to have" tool, but it is not essential. Many of these systems have yet to be shown to improve outcomes. Current outcome-based expectations and economic constraints make "nice to have," "assists," and "ease processes" insufficient. Complex biological systems are defined by their inherent disorder, bounded by dynamic boundaries, as described by the constrained disorder principle (CDP). It provides a platform for correcting systems' malfunctions by regulating their degree of variability. A CDP-based second-generation artificial intelligence system provides solutions to some challenges digital health faces. Therapeutic interventions are held to improve outcomes with these systems. In addition to improving clinically meaningful endpoints, CDP-based second-generation algorithms ensure patient and physician engagement and reduce the health system's costs.

Remote patient monitoring strategies and wearable technology in chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) is highly prevalent and is associated with a heavy burden on patients and health systems alike. Exacerbations of COPD (ECOPDs) are a leading cause of acute hospitalization among all adult chronic diseases. There is currently a paradigm shift in the way that ECOPDs are conceptualized. For the first time, objective physiological parameters are being used to define/classify what an ECOPD is (including heart rate, respiratory rate, and oxygen saturation criteria) and therefore a mechanism to monitor and measure their changes, particularly in an outpatient ambulatory setting, are now of great value. In addition to pre-existing challenges on traditional 'in-person' health models such as geography and seasonal (ex. winter) impacts on the ability to deliver in-person visit-based care, the COVID-19 pandemic imposed additional stressors including lockdowns, social distancing, and the closure of pulmonary function labs. These health system stressors, combined with the new conceptualization of ECOPDs, rapid advances in sophistication of hardware and software, and a general openness by stakeholders to embrace this technology, have all influenced the propulsion of remote patient monitoring (RPM) and wearable technology in the modern care of COPD. The present article reviews the use of RPM and wearable technology in COPD. Context on the influences, factors and forces which have helped shape this health system innovation is provided. A focused summary of the literature of RPM in COPD is presented. Finally, the practical and ethical principles which must guide the transition of RPM in COPD into real-world clinical use are reviewed.

Electrochemical Wearable Biosensors and Bioelectronic Devices Based on Hydrogels: Mechanical Properties and Electrochemical Behavior

Hydrogel-based wearable electrochemical biosensors (HWEBs) are emerging biomedical devices that have recently received immense interest. The exceptional properties of HWEBs include excellent biocompatibility with hydrophilic nature, high porosity, tailorable permeability, the capability of reliable and accurate detection of disease biomarkers, suitable device-human interface, facile adjustability, and stimuli responsive to the nanofiller materials. Although the biomimetic three-dimensional hydrogels can immobilize bioreceptors, such as enzymes and aptamers, without any loss in their activities. However, most HWEBs suffer from low mechanical strength and electrical conductivity. Many studies have been performed on emerging electroactive nanofillers, including biomacromolecules, carbon-based materials, and inorganic and organic nanomaterials, to tackle these issues. Non-conductive hydrogels and even conductive hydrogels may be modified by nanofillers, as well as redox species. All these modifications have led to the design and development of efficient nanocomposites as electrochemical biosensors. In this review, both conductive-based and non-conductive-based hydrogels derived from natural and synthetic polymers are systematically reviewed. The main synthesis methods and characterization techniques are addressed. The mechanical properties and electrochemical behavior of HWEBs are discussed in detail. Finally, the prospects and potential applications of HWEBs in biosensing, healthcare monitoring, and clinical diagnostics are highlighted.

Saliva biomarkers in oral disease

Saliva is a versatile biofluid that contains a wide variety of biomarkers reflecting both physiologic and pathophysiologic states. Saliva collection is noninvasive and highly applicable for tests requiring serial sampling. Furthermore, advances in test accuracy, sensitivity and precision for saliva has improved diagnostic performance as well as the identification of novel markers especially in oral disease processes. These include dental caries, periodontitis, oral squamous cell carcinoma (OSCC) and Sjögren's syndrome (SS). Numerous growth factors, enzymes, interleukins and cytokines have been identified and are the subject of much research investigation. This review highlights current procedures for successful determination of saliva biomarkers including preanalytical factors associated with sampling, storage and pretreatment as well as subsequent analysis. Moreover, it provides an overview of the diagnostic applications of these salivary biomarkers in common oral diseases.

Epidermal Wearable Biosensors for the Continuous Monitoring of Biomarkers of Chronic Disease in Interstitial Fluid

Healthcare technology has allowed individuals to monitor and track various physiological and biological parameters. With the growing trend of the use of the internet of things and big data, wearable biosensors have shown great potential in gaining access to the human body, and providing additional functionality to analyze physiological and biochemical information, which has led to a better personalized and more efficient healthcare. In this review, we summarize the biomarkers in interstitial fluid, introduce and explain the extraction methods for interstitial fluid, and discuss the application of epidermal wearable biosensors for the continuous monitoring of markers in clinical biology. In addition, the current needs, development prospects and challenges are briefly discussed.

Emerging trends in wearable glove-based sensors: A review

Glove-based wearable chemical sensors are universal analytical tools that provide surface analysis for various samples in dry or liquid form by swiping glove sensors on the sample surface. They are useful in crime scene investigation, airport security, and disease control for detecting illicit drugs, hazardous chemicals, flammables, and pathogens on various surfaces, such as foods and furniture. It overcomes the inability of most portable sensors to monitor solid samples. It outperforms most wearable sensors (e.g., contact lenses and mouthguard sensors) for healthcare monitoring by providing comfort that does not interfere with daily activities and reducing the risk of infection or other adverse health effects caused by prolonged usage. Detailed information is provided regarding the challenges and selection criteria for the desired glove materials and conducting nanomaterials for developing glove-based wearable sensors. Focusing on nanomaterials, various transducer modification techniques for various real-world applications are discussed. The steps taken by each study platform to address the existing issues are revealed, as are their benefits and drawbacks. The Sustainable Development Goals (SDGs) and strategies for properly disposing of used glove-based wearable sensors are critically evaluated. A glance at all the provided tables provides insight into the features of each glove-based wearable sensor and enables a quick comparison of their functionalities.

Electrochemical biosensors in healthcare services: bibliometric analysis and recent developments

Biosensors are nowadays being used in various fields including disease diagnosis and clinical analysis. The ability to detect biomolecules associated with disease is vital not only for accurate diagnosis of disease but also for drug discovery and development. Among the different types of biosensors, electrochemical biosensor is most widely used in clinical and health care services especially in multiplex assays due to its high susceptibility, low cost and small in size. This article includes comprehensive review of biosensors in medical field with special emphasis on electrochemical biosensors for multiplex assays and in healthcare services. Also, the publications on electrochemical biosensors are increasing rapidly; therefore, it is crucial to be aware of any latest developments or trends in this field of research. We used bibliometric analyses to summarize the progress of this research area. The study includes global publication counts on electrochemical biosensors for healthcare along with various bibliometric data analyses by VOSviewer software. The study also recognizes the top authors and journals in the related area, and determines proposal for monitoring research.