Naked-Eye Detection of Glucose in Saliva with Bienzymatic Paper-Based Sensor

Microfluidic-based systems for the management of diabetes

Diabetes currently affects approximately 500 million people worldwide and is one of the most common causes of mortality in the United States. To diagnose and monitor diabetes, finger-prick blood glucose testing has long been used as the clinical gold standard. For diabetes treatment, insulin is typically delivered subcutaneously through cannula-based syringes, pens, or pumps in almost all type 1 diabetic (T1D) patients and some type 2 diabetic (T2D) patients. These painful, invasive approaches can cause non-adherence to glucose testing and insulin therapy. To address these problems, researchers have developed miniaturized blood glucose testing devices as well as microfluidic platforms for non-invasive glucose testing through other body fluids. In addition, glycated hemoglobin (HbA1c), insulin levels, and cellular biomechanics-related metrics have also been considered for microfluidic-based diabetes diagnosis. For the treatment of diabetes, insulin has been delivered transdermally through microdevices, mostly through microneedle array-based, minimally invasive injections. Researchers have also developed microfluidic platforms for oral, intraperitoneal, and inhalation-based delivery of insulin. For T2D patients, metformin, glucagon-like peptide 1 (GLP-1), and GLP-1 receptor agonists have also been delivered using microfluidic technologies. Thus far, clinical studies have been widely performed on microfluidic-based diabetes monitoring, especially glucose sensing, yet technologies for the delivery of insulin and other drugs to diabetic patients with microfluidics are still mostly in the preclinical stage. This article provides a concise review of the role of microfluidic devices in the diagnosis and monitoring of diabetes, as well as the delivery of pharmaceuticals to treat diabetes using microfluidic technologies in the recent literature.

Optical blood glucose non-invasive detection and its research progress

Blood glucose concentration is an important index for the diagnosis of diabetes, its self-monitoring technology is the method for scientific diabetes management. Currently, the typical household blood glucose meters have achieved great success in diabetes management, but they are discrete detection methods, and involve invasive blood sampling procedures. Optical detection technologies, which use the physical properties of light to detect the glucose concentration in body fluids non-invasively, have shown great potential in non-invasive blood glucose detection. This article summarized and analyzed the basic principles, research status, existing problems, and application prospects of different optical glucose detection technologies. In addition, this article also discusses the problems of optical detection technology in wearable sensors and perspectives on the future of non-invasive blood glucose detection technology to improve blood glucose monitoring in diabetic patients.

Paper-based sensors: affordable, versatile, and emerging analyte detection platforms

Paper-based sensors, often referred to as paper-based analytical devices (PADs), stand as a transformative technology in the field of analytical chemistry. They offer an affordable, versatile, and accessible solution for diverse analyte detection. These sensors harness the unique properties of paper substrates to provide a cost-effective and adaptable platform for rapid analyte detection, spanning chemical species, biomolecules, and pathogens. This review highlights the key attributes that make paper-based sensors an attractive choice for analyte detection. PADs demonstrate their versatility by accommodating a wide range of analytes, from ions and gases to proteins, nucleic acids, and more, with customizable designs for specific applications. Their user-friendly operation and minimal infrastructure requirements suit point-of-care diagnostics, environmental monitoring, food safety, and more. This review also explores various fabrication methods such as inkjet printing, wax printing, screen printing, dip coating, and photolithography. Incorporating nanomaterials and biorecognition elements promises even more sophisticated and sensitive applications.

Smartphone-integrated paper-based biosensor for sensitive fluorometric ethanol quantification

The development of fluorometric paper-based analytical devices (fPADs) integrated with smartphone for fluorometric quantification of ethanol in an instrument-free and portable setup is described. The NAD+-dependent alcohol dehydrogenase immobilized within chitosan modified paper substate was utilized as a bio-recognition element and enzymatically generated NADH was used as a fluorescent probe. 3D-printed imaging setup which houses a paper chip holder and UV-light emitting device (LED) was developed for rapid, accurate capture of the fluorescent images. The biocompatible chitosan layer covering the paper provides a feasible environment for enzyme immobilization and enhances the fluorescence signal. The developed fPADs exhibited high sensitivity for ethanol detection and has a linear range for ethanol detection from 17 µM to 8.75 mM (R2 =0.99). Additionally, the fPADs were applied to quantify ethanol in four different wine samples including red, white, rose, and sparkling wines successfully. Moreover, the fPADs produce reproducible signals without loss of enzyme activity for at least 14 days and ~80% activity remained till 28 days. Thus, the proposed approach can provide a facile, affordable, portable, and instrument-free tool for the onsite quantification of ethanol in real samples and is applicable for food quality controls.

Non-invasive, ultrasensitive detection of glucose in saliva using metal oxide transistors

Transistor-based biosensors represent an emerging technology for inexpensive point-of-care testing (POCT) applications. However, the limited sensitivity of the current transistor technologies hinders their practical deployment. In this study, we developed tri-channel In2O3/ZnO heterojunction thin-film transistors (TFTs) featuring the surface-immobilized enzyme glucose oxidase to detect glucose in various biofluids. This unusual channel design facilitates strong coupling between the electrons transported along the buried In2O3/ZnO heterointerface and the electrostatic perturbations caused by the interactions between glucose and surface-immobilized glucose oxidase. The enzyme selectively binds to glucose, causing a change in charge density on the channel surface. By exploring this effect, the solid-state biosensing TFT (BioTFT) can selectively detect glucose in artificial and real saliva over a wide range of concentrations from 500 nM to 20 mM with limits of detection of ∼365 pM (artificial saliva) and ∼416 nM (real saliva) in less than 60 s. The specificity of the sensor towards glucose has been demonstrated against various interfering species in artificial saliva, further highlighting its unique capabilities. Moreover, the BioTFTs exhibited good operating stability upon storage for up to two weeks, with relative standard deviation (RSD) values ranging from 2.36% to 6.39% for 500 nM glucose concentration. Our BioTFTs are easy to manufacture with reliable operation, making them ideal for non-invasive POCT applications.

Monitoring saliva compositions for non-invasive detection of diabetes using a colorimetric-based multiple sensor

The increasing population of diabetic patients, especially in developing countries, has posed a serious risk to the health sector, so that the lack of timely diagnosis and treatment process of diabetes can lead to threatening complications for the human lifestyle. Here, a multiple sensor was fabricated on a paper substrate for rapid detection and controlling the progress of the diabetes disease. The proposed sensor utilized the sensing ability of porphyrazines, pH-sensitive dyes and silver nanoparticles in order to detect the differences in saliva composition of diabetic and non-diabetic patients. A unique color map (sensor response) was obtained for each studied group, which can be monitored by a scanner. Moreover, a good correlation was observed between the colorimetric response resulting from the analysis of salivary composition and the fasting blood glucose (FBG) value measured by standard laboratory instruments. It was also possible to classify participants into two groups, including patients caused by diabetes and those were non-diabetic persons with a total accuracy of 88.9%. Statistical evaluations show that the multiple sensor can be employed as an effective and non-invasive device for continuous monitoring of diabetes, substantially in the elderly.

Advances on microfluidic paper-based electroanalytical devices

Since the inception of the first electrochemical devices on paper substrates, many different reports of microfluidic paper-based electroanalytical devices (μPEDs), innovative hydrophobic barriers and electrode fabrication processes have allowed the incorporation of diverse materials, resulting in different applications and a boost in performance. These advancements have led to the creation of paper-based devices with comparable performance to many standard conventional devices, with the added benefits of pumpless fluidic transport, component separation and reagent storage that can be exploited to automate and handle sample preprocessing. Herein, we review μPEDs, summarize the characteristics and functionalities of μPEDs, such as separation, fluid flow control and storage, and outline the conventional and emerging fabrication and modification approaches for μPEDs. We also examine the recent application of μPEDs in biomedicine, the environment, and food and water safety, as well as some limitations and challenges that must be addressed.

Saliva-based microfluidic point-of-care diagnostic

There has been a long-standing interest in point-of-care (POC) diagnostics as a tool to improve patient care because it can provide rapid, actionable results near the patient. Some of the successful examples of POC testing include lateral flow assays, urine dipsticks, and glucometers. Unfortunately, POC analysis is somewhat limited by the ability to manufacture simple devices to selectively measure disease specific biomarkers and the need for invasive biological sampling. Next generation POCs are being developed that make use of microfluidic devices to detect biomarkers in biological fluids in a non-invasive manner, addressing the above-mentioned limitations. Microfluidic devices are desirable because they can provide the ability to perform additional sample processing steps not available in existing commercial diagnostics. As a result, they can provide more sensitive and selective analysis. While most POC methods make use of blood or urine as a sample matrix, there has been a growing push to use saliva as a diagnostic medium. Saliva represents an ideal non-invasive biofluid for detecting biomarkers because it is readily available in large quantities and analyte levels reflect those in blood. However, using saliva in microfluidic devices for POC diagnostics is a relatively new and an emerging field. The overarching aim of this review is to provide an update on recent literature focused on the use of saliva as a biological sample matrix in microfluidic devices. We will first cover the characteristics of saliva as a sample medium and then review microfluidic devices that are developed for the analysis of salivary biomarkers.

Advances in the Measurement of Polymeric Colorimetric Sensors Using Portable Instrumentation: Testing the Light Influence

Sustainable and green sensors based on polydimethyl siloxane (PDMS) or cellulose polymers, as a case of study of the use of portable instrumentation joined to a smartphone, have been tested. A smartphone camera was used to obtain images and was also coupled to a minispectrometer, without and with an optical fiber probe to register spectra. To study light influence on the analytical signal, light-emitting diode (LED), halogen light and daylight have been assayed. A corrective palette of 24 colors and a set with 45 colors from different color ranges were used as the validation set. The results indicated that halogen light was the best option to obtain the spectra. However, for digital image analysis, it was the LED light that gave a greater approximation of the RGB values of the real colors. Based on these results, the spectra and the RGB components of PDMS solid sensors doped with 1,2-naphtoquinone-4-sulfonate (NQS) for the determination of ammonium in water or urea in urine, PDMS doped with Griess reagent for developing the assay of nitrite in waters and cellulose sensors for the determination of hydrogen sulfide in the atmospheres have been obtained. The results achieved were good in terms of sensitivity and linearity and were comparable to those obtained using a laboratory benchtop instrument. Several rules for selecting the most suitable light source to obtain the spectra and/or images have been established and an image correction method has been introduced.

Recent Advancement in Biofluid-Based Glucose Sensors Using Invasive, Minimally Invasive, and Non-Invasive Technologies: A Review

Biosensors have potentially revolutionized the biomedical field. Their portability, cost-effectiveness, and ease of operation have made the market for these biosensors to grow rapidly. Diabetes mellitus is the condition of having high glucose content in the body, and it has become one of the very common conditions that is leading to deaths worldwide. Although it still has no cure or prevention, if monitored and treated with appropriate medication, the complications can be hindered and mitigated. Glucose content in the body can be detected using various biological fluids, namely blood, sweat, urine, interstitial fluids, tears, breath, and saliva. In the past decade, there has been an influx of potential biosensor technologies for continuous glucose level estimation. This literature review provides a comprehensive update on the recent advances in the field of biofluid-based sensors for glucose level detection in terms of methods, methodology and materials used.

Colorimetric and Electrochemical Screening for Early Detection of Diabetes Mellitus and Diabetic Retinopathy-Application of Sensor Arrays and Machine Learning

In this review, a selection of works on the sensing of biomarkers related to diabetes mellitus (DM) and diabetic retinopathy (DR) are presented, with the scope of helping and encouraging researchers to design sensor-array machine-learning (ML)-supported devices for robust, fast, and cost-effective early detection of these devastating diseases. First, we highlight the social relevance of developing systematic screening programs for such diseases and how sensor-arrays and ML approaches could ease their early diagnosis. Then, we present diverse works related to the colorimetric and electrochemical sensing of biomarkers related to DM and DR with non-invasive sampling (e.g., urine, saliva, breath, tears, and sweat samples), with a special mention to some already-existing sensor arrays and ML approaches. We finally highlight the great potential of the latter approaches for the fast and reliable early diagnosis of DM and DR.

A Distance-Based Microfluidic Paper-Based Biosensor for Glucose Measurements in Tear Range

The prevalence of diabetes has increased over the past years. Therefore, developing minimally invasive, user-friendly, and cost-effective glucose biosensors is necessary especially in low-income and developing countries. Cellulose paper-based analytical devices have attracted the attention of many researchers due to affordability, not requiring trained personnel, and complex equipment. This paper describes a microfluidic paper-based analytical device (μPAD) for detecting glucose concentration in tear range with the naked eye. The paper-based biosensor fabricated by laser CO2; and glucose oxidase/horseradish peroxidase (GOx/HRP) enzyme solution coupled with tetramethylbenzidine (TMB) were utilized as reagents. A sample volume of 10 μl was needed for the biosensor operation and the results were observable within 5 min. The color intensity-based and distance-based results were analyzed by ImageJ and Tracker to evaluate the device performance. Distance-based results showed a linear behavior in 0.1-1.2 mM with an R² = 0.9962 and limit of detection (LOD) of 0.1 mM. The results could be perceived by the naked eye without needing additional equipment or trained personnel in a relatively short time (3-5 min).

Fabrication of stable electrospun blended chitosan-poly(vinyl alcohol) nanofibers for designing naked-eye colorimetric glucose biosensor based on GOx/HRP

In this study, designing of a stable electrospun blended chitosan (CS)-poly(vinyl alcohol) (PVA) nanofibers for colorimetric glucose biosensing in an aqueous medium was investigated. CS and PVA solutions were blended to acquire an optimum content (CS/PVA:1/4) and electrospunned to obtain uniform and bead-free CS/PVA nanofiber structures following the optimization of the electrospinning parameters (33 kV, 20 cm, and 1.2 ml.h^-1). Crosslinking process applied subsequently provided mechanically and chemically stable nanofibers with an average diameter of 378 nm. The morphological homogeneity, high fluid absorption ability (>%50), thermal (<230 °C) and morphological stability, surface hydrophilicity and degrability properties of cross-linked CS/PVA nanofiber demonstrated their great potential to be developed as an eye-readable strip for biosensing applications. The glucose oxidase (GOx) and horseradish peroxidase (HRP) was immobilized by physical adsorption on the cross-linked CS/PVA nanofiber. The glucose assay analysis by ultraviolet-visible (UV-Vis) spectrophotometry using the same enzymatic system of the proposed glucose strips in form of absorbance versus concentration plot was found to be linear over a glucose concentration range of 2.7 to 13.8 mM. The prepared naked eye colorimetric glucose detection strips, with lower detection limit of 2.7 mM, demonstrated dramatic color change from white (0 mM) to brownish-orange (13.8 mM). The developed cross-linked CS/PVA nanofiber strips, prepared by electrospinnig procedure, could be easily adapted to a color map, as an alternative material for glucose sensing. Design of a practical, low-cost, and environmental-friendly bio-based CS/PVA testing strips for eye readable detection were presented and suggested as an applicable medium for a wide range of glucose concentrations.

Current Challenges and Future Trends of Enzymatic Paper-Based Point-of-Care Testing for Diabetes Mellitus Type 2

A point-of-care (POC) can be defined as an in vitro diagnostic test that can provide results within minutes. It has gained enormous attention as a promising tool for biomarkers detection and diagnosis, as well as for screening of chronic noncommunicable diseases such as diabetes mellitus. Diabetes mellitus type 2 is one of the metabolic disorders that has grown exponentially in recent years, becoming one of the greatest challenges to health systems. Early detection and accurate diagnosis of this disorder are essential to provide adequate treatments. However, efforts to reduce incidence should remain not only in these stages but in developing continuous monitoring strategies. Diabetes-monitoring tools must be accessible and affordable; thus, POC platforms are attractive, especially paper-based ones. Paper-based POCs are simple and portable, can use different matrixes, do not require highly trained staff, and are less expensive than other platforms. These advantages enhance the viability of its application in low-income countries and hard-to-reach zones. This review aims to present a critical summary of the main components required to create a sensitive and affordable enzymatic paper-based POC, as well as an oriented analysis to highlight the main limitations and challenges of current POC devices for diabetes type 2 monitoring and future research opportunities in the field.

Low-fouling CNT-PEG-hydrogel coated quartz crystal microbalance sensor for saliva glucose detection

Saliva glucose detection based on a quartz crystal microbalance (QCM) sensor has emerged as a promising tool and a non-invasive diagnostic technique for diabetes. However, the low glucose concentration and strong protein interference in the saliva hinder the QCM sensors from practical applications. In this study, we present a robust and simple anti-fouling CNT-PEG-hydrogel film-coated QCM sensor for the detection of saliva glucose with high sensitivity. The CNT-PEG-hydrogel film consists of two layers; the bottom base PBA-hydrogel film is designed to recognize the glucose while the top CNT-PEG layer is used to restrict protein adsorption and improve the biocompatibility. Our results show that this CNT-PEG-hydrogel film exhibited a 10-fold enhancement on the detection limit compared to the PBA-hydrogel. Meanwhile, the adsorption of proteins on the surface of the CNT-PEG-hydrogel film, including bovine serum albumin (BSA), mucin (MUC), and fibrinogen (FIB), were reduced by 99.1%, 77.8%, and 83.7%, respectively. The CNT-PEG-hydrogel film could detect the typical saliva glucose level (0-50 mg L-1) in 10% saliva with a good responsivity. To sum up, this new tool with low-fouling film featuring high stability, specificity, and selectivity holds great potential for non-invasive monitoring of saliva glucose in human physiological levels.

Barrier-Free Microfluidic Paper Analytical Devices for Multiplex Colorimetric Detection of Analytes

In recent years, microfluidic paper analytical devices (μPADs) have been extensively utilized to conduct multiplex colorimetric assays. Despite their simple and user-friendly operation, the need for patterning paper with wax or other physical barriers to create flow channels makes large-scale manufacturing cumbersome. Moreover, convection of rehydrated reagents in the test zones leads to nonuniform colorimetric signals, which makes quantification difficult. To overcome these challenges, we present a device called a barrier-free μPAD (BF-μPAD) that consists of a stack of two paper membranes having different wicking rates-the top layer acting as a fluid distributing layer and the bottom layer containing reagents for colorimetric detection. Multiple analytes can be detected using this assembly without the need to pattern either layer with wax or other barriers. In one embodiment, a device is capable of delivering the sample fluid to 20 distinct dried reagent spots stored on an 8 cm × 2 cm membrane in as few as 30 s. The multiplexing feature of the BF-μPAD is demonstrated for colorimetric detection of salivary thiocyanate, protein, glucose, and nitrite. Most importantly, the device improves the limit of detection of colorimetric assays performed on conventional μPADs by more than 3.5×. To understand fluid imbibition in the paper assembly, the device geometry is modeled in COMSOL Multiphysics using the Richards equation; the results obtained provide insights into the nonintuitive flow pattern producing perfectly uniform signals in the barrier-free assembly.

Optical glucose biosensor built-in disposable strips and wearable electronic devices

On-demand screening, real-time monitoring and rapid diagnosis of ubiquitous diseases, such as diabetes, at early stages are indispensable in personalised treatment. Emerging impacts of nano/microscale materials on optical and portable biosensor strips and devices have become increasingly important in the remarkable development of sensitive visualisation (i.e. visible inspection by the human eye) assays, low-cost analyses and personalised home testing of patients with diabetes. With the increasing public attention regarding the self-monitoring of diabetes, the development of visual readout, easy-to-use and wearable biosensors has gained considerable interest. Our comprehensive review bridges the practical assessment gap between optical bio-visualisation assays, disposable test strips, sensor array designs and full integration into flexible skin-based or contact lens devices with the on-site wireless signal transmission of glucose detection in physiological fluids. To date, the fully modulated integration of nano/microscale optical biosensors into wearable electronic devices, such as smartphones, is critical to prolong periods of indoor and outdoor clinical diagnostics. Focus should be given to the improvements of invasive, wireless and portable sensing technologies to improve the applicability and reliability of screen display, continuous monitoring, dynamic data visualisation, online acquisition and self and in-home healthcare management of patients with diabetes.

Nanosensors for Visual Detection of Glucose in Biofluids: Are We Ready for Instrument-Free Home-Testing?

Making frequent large-scale screenings for several diseases economically affordable would represent a real breakthrough in healthcare. One of the most promising routes to pursue such an objective is developing rapid, non-invasive, and cost-effective home-testing devices. As a first step toward a diagnostic revolution, glycemia self-monitoring represents a solid base to start exploring new diagnostic strategies. Glucose self-monitoring is improving people's life quality in recent years; however, current approaches still present vast room for improvement. In most cases, they still involve invasive sampling processes (i.e., finger-prick), quite discomforting for frequent measurements, or implantable devices which are costly and commonly dedicated to selected chronic patients, thus precluding large-scale monitoring. Thanks to their unique physicochemical properties, nanoparticles hold great promises for the development of rapid colorimetric devices. Here, we overview and analyze the main instrument-free nanosensing strategies reported so far for glucose detection, highlighting their advantages/disadvantages in view of their implementation as cost-effective rapid home-testing devices, including the potential use of alternative non-invasive biofluids as samples sources.

Scaling the Analytical Information Given by Several Types of Colorimetric and Spectroscopic Instruments Including Smartphones: Rules for Their Use and Establishing Figures of Merit of Solid Chemosensors

The analytical information given by different types of instruments was scaled in order to establish suitably the figures of merit of a given methodology based on color measurements. Different lab and portable instruments, including smartphones with and without a miniaturized spectrophotometer accessory, have been tested. In order to obtain broad information and using objective criteria, these instruments have been compared from (1) the analytical point of view, considering mainly the detection limit (limits of detection [LODs]), selectivity, accuracy and intra- and interday precision, size, components, and costs; and (2) the environmental point of view, based on their footprint as kilograms of CO₂. No significant differences in the precision were obtained with RSD (%) values lower than 10% for all of the instruments, but the achieved values of LOD, selectivity, accuracy, and cost were different. Footprints of CO₂ were better for portable instrumentation, especially for smartphones. Three solid chemosensors made of different materials (PDMS, paper, or nylon) have been tested for the determination of ammonia and hydrogen sulfide at different concentration levels (ppb levels). As a result of this study, some rules for selecting the instrument for obtaining the required information have been established. Two apps have been developed for quantitation by smartphones, one for working with RGB values and the other for spectra obtained by the miniaturized spectrophotometer coupled to a smartphone.

Enzyme embedded microfluidic paper-based analytic device (μPAD): a comprehensive review

Low-cost paper-based analytical devices are the latest generation of portable lab-on-chip designs that offers an innovative platform for the on/off-site analysis (biosensing) of target analytes, especially in rural and remote areas. Recently, microfluidic paper-based analytical devices (μPADs) have attained significant recognition owing to their exciting fundamental features such as: ease of fabrication, rapid operation, and precise interpretations. The incorporation of enzymes with paper-based analytical devices significantly improves analytical performance while exhibiting excellent chemical and storage stability. In addition to that, these devices are highly compact, portable, easy-to-use, and do not require any additional sophisticated equipment for the detection and quantification of target analytes. This review provides a holistic insight into design, fabrication, and enzyme immobilization strategies for the development of enzyme-μPADs, which enables them to be widely implemented for in-field analysis. It also highlights the recent application of enzyme-μPADs in the area of: biomedical, food safety, and environmental monitoring while exploring the mechanisms of detection involved. Further, in order to improve the accuracy of analysis, researchers have designed a smartphone-based scanning tool for multi-variant point-of-care devices, which is summarized in the latter part of the review. Finally, the future perspectives and outlook of major challenges associated with enzyme-μPADs are discussed with their possible solutions. The development of enzyme integrated μPADs will open a new avenue as an exceptional analytical tool to explore various applications.HIGHLIGHTSEnzyme embedded paper-based analytical devices are a revolution in the field of biosensing.The design, fabrication, and enzyme immobilization on μPADs have been comprehensively discussed.The application of enzyme-μPADs food safety, environmental monitoring, and clinical diagnostic have been reviewed.Smartphones can be used as an on-site, user-friendly, and compact next-gen scanning tool for biosensing.

A long-term stable paper-based glucose sensor using a glucose oxidase-loaded, Mn2BPMP-conjugated nanocarrier with a smartphone readout

A simple paper-based analytical device (PAD) for the one-pot detection of glucose was developed herein using an artificial peroxidase-functionalized and glucose oxidase (GOx)-loaded pluronic-based nanocarrier (PNC). Mn₂BPMP (BPMP; 2,6-bis[(bis(2-pyridylmethyl)amino)-methyl]-4-methylphenolate), an artificial peroxidase, was conjugated to PNC, allowing GOx to be loaded with a very high encapsulation efficiency. In solution, Mn₂BPMP-PNC showed higher peroxidase-like catalytic efficiency than did Mn₂BPMP at physiological pH. In addition, glucose detection via enzyme cascade reaction between GOx and Mn₂BPMP in the GOx loaded-Mn₂BPMP-PNC was more sensitive than the simple combination of Mn₂BPMP and GOx with excellent selectivity. Subsequently, a PAD was fabricated using a laser printer with an assay substance containing GOx loaded-Mn₂BPMP-PNC and peroxidase chromogenic substrate. The prepared Mn₂BPMP-PNC-based PAD quantitatively measured glucose in human serum ranging from normal levels to those typical for diabetics as well as in buffer by obtaining RGB (red, green, and blue) color values through smartphone readout or the naked eye. Importantly, the present PNC-based PAD maintained the detection efficiency during storage at room temperature for 6 weeks in contrast to the rapid decrease in detection efficiency obtained for PAD containing Mn₂BPMP and GOx without PNC.

'Urease immobilized single-kit' for sensing of thiourea-glucose pair employing fluorescence 'Turn off - Turn on' and as an efficient sorbent for selective sample cleanup of thiourea

The tenfold lowering in binding energy for TU-Tyrosine in immobilized urease (K_b: 4.7 × 10³) with respect to the native enzyme (K_b: 6.5 × 10⁴) begets easy desorption of thiourea (TU) by glucose (GL) with an eventual formation of a more strong TU- GL adduct; that rejuvenates the kit-material ready for the subsequent cycle(s). The sorption-desorption heeds fluorescence turn-off and turn-on in DCM for selective sensing of TU- GL pair at their respective linear range of concentration 2.5-26.1 ppm and 2.36-11.57 ppm. The process was found to be static (K_SV ≥ 2.25 × 10³ L mol^-1), exothermic (ΔH: -0.08 kJ mol^-1), spontaneous (ΔG: -21.1 kJ mol^-1) and marginally entropy gaining (ΔS: 0.07 kJ mol^-1 K^-1). The 'bulk material' (200 ± 20 μm) brilliantly preconcentrates TU with an enrichment factor of 106.2 after its selective extraction at near-neutral pH from a large volume sample (800 mL) of low concentration (30 ppm). A very dilute solution (0.05 mmol L^-1) of GL at minimum volume (6 mL) acts as a stripping agent and provides a longer life (200 cycles with good extraction efficiency) to the material. The method was found to be efficient in the analysis of fruit juice as a real sample.

Survey of Saliva Components and Virus Sensors for Prevention of COVID-19 and Infectious Diseases

The United States Centers for Disease Control and Prevention considers saliva contact the lead transmission means of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease 2019 (COVID-19). Saliva droplets or aerosols expelled by heavy breathing, talking, sneezing, and coughing may carry this virus. People in close distance may be exposed directly or indirectly to these droplets, especially those droplets that fall on surrounding surfaces and people may end up contracting COVID-19 after touching the mucosa tissue on their faces. It is of great interest to quickly and effectively detect the presence of SARS-CoV-2 in an environment, but the existing methods only work in laboratory settings, to the best of our knowledge. However, it may be possible to detect the presence of saliva in the environment and proceed with prevention measures. However, detecting saliva itself has not been documented in the literature. On the other hand, many sensors that detect different organic components in saliva to monitor a person's health and diagnose different diseases that range from diabetes to dental health have been proposed and they may be used to detect the presence of saliva. This paper surveys sensors that detect organic and inorganic components of human saliva. Humidity sensors are also considered in the detection of saliva because a large portion of saliva is water. Moreover, sensors that detect infectious viruses are also included as they may also be embedded into saliva sensors for a confirmation of the virus' presence. A classification of sensors by their working principle and the substance they detect is presented. This comparison lists their specifications, sample size, and sensitivity. Indications of which sensors are portable and suitable for field application are presented. This paper also discusses future research and challenges that must be resolved to realize practical saliva sensors. Such sensors may help minimize the spread of not only COVID-19 but also other infectious diseases.

Non-Invasive Electrochemical Biosensors Operating in Human Physiological Fluids

Non-invasive healthcare technologies are an important part of research and development nowadays due to the low cost and convenience offered to both healthcare receivers and providers. This work overviews the recent advances in the field of non-invasive electrochemical biosensors operating in secreted human physiological fluids, viz. tears, sweat, saliva, and urine. Described electrochemical devices are based on different electrochemical techniques, viz. amperometry, coulometry, cyclic voltammetry, and impedance spectroscopy. Challenges that confront researchers in this exciting area and key requirements for biodevices are discussed. It is concluded that the field of non-invasive sensing of biomarkers in bodily fluid is highly convoluted. Nonetheless, if the drawbacks are appropriately addressed, and the pitfalls are adroitly circumvented, the approach will most certainly disrupt current clinical and self-monitoring practices.

Fluorescent carbonaceous materials isolated from cigarette ashes for the determination of iron(iii) in water samples

In the present work, ready-to-use fluorescent carbonaceous materials (CMs) were isolated from cigarette ashes by following a simple procedure based on the dispersion of ashes in water and subsequent filtration. The isolated raw material was characterized by fluorescence microscopy, Fourier transform infrared (FT-IR) spectroscopy, and dynamic light scattering (DLS) analysis. The isolated CMs displayed excitation-dependent fluorescence emission, which enables them to be used as a fluorescent probe. The developed fluorescent probe possesses high potential for sensitive and selective detection of Fe(iii) via a quenching mechanism. The decrease in fluorescence intensity was in linear relationship with the concentrations of Fe(iii) within the range of 0-89.6 μM. The fluorescent probe was successfully applied to the determination of Fe(iii) in tap and well waters with an average recovery of 87% with an excellent relative standard deviation (RSD) of 0.63%, regardless of the water sample analyzed. Besides, fluorescence variation in the presence of Fe(iii) was evaluated by analyzing red, green, and blue (RGB) channels of the fluorescence colors. Finally, the possibility of semi-quantitative determination of Fe(iii) in water by the naked eye using the proposed fluorescent probe was also evaluated.

Recent Developments of Flexible and Stretchable Electrochemical Biosensors

The skyrocketing popularity of health monitoring has spurred increasing interest in wearable electrochemical biosensors. Compared with the traditionally rigid and bulky electrochemical biosensors, flexible and stretchable devices render a unique capability to conform to the complex, hierarchically textured surfaces of the human body. With a recognition element (e.g., enzymes, antibodies, nucleic acids, ions) to selectively react with the target analyte, wearable electrochemical biosensors can convert the types and concentrations of chemical changes in the body into electrical signals for easy readout. Initial exploration of wearable electrochemical biosensors integrates electrodes on textile and flexible thin-film substrate materials. A stretchable property is needed for the thin-film device to form an intimate contact with the textured skin surface and to deform with various natural skin motions. Thus, stretchable materials and structures have been exploited to ensure the effective function of a wearable electrochemical biosensor. In this mini-review, we summarize the recent development of flexible and stretchable electrochemical biosensors, including their principles, representative application scenarios (e.g., saliva, tear, sweat, and interstitial fluid), and materials and structures. While great strides have been made in the wearable electrochemical biosensors, challenges still exist, which represents a small fraction of opportunities for the future development of this burgeoning field.

Paper Stacks for Uniform Rehydration of Dried Reagents in Paper Microfluidic Devices

Spatially uniform reconstitution of dried reagents is critical to the function of paper microfluidic devices. Advancing fluid fronts in paper microfluidic devices drive (convect) and concentrate rehydrated reagents to the edges, causing steep chemical gradients and imperfect mixing. This largely unsolved problem in paper microfluidics is exacerbated by increasing device dimensions. In this article, we demonstrate that mixing of dried reagents with a rehydrating fluid in paper microfluidics may be significantly enhanced by stacking paper layers having different wicking rates. Compared to single-layer paper membranes, stacking reduced the “non-reactive area”, i.e. area in which the reconstituted reagents did not interact with the rehydrating fluid, by as much as 97% in large (8 cm × 2 cm) paper membranes. A paper stack was designed to collect ~0.9 ml liquid sample and uniformly mix it with dried reagents. Applications of this technology are demonstrated in two areas: (i) collection and dry storage of sputum samples for tuberculosis testing, and (ii) salivary glucose detection using an enzymatic assay and colorimetric readout. Maximizing the interaction of liquids with dried reagents is central to enhancing the performance of all paper microfluidic devices; this technique is therefore likely to find important applications in paper microfluidics.

Simultaneous quantification of multiple biomarkers on a self-calibrating microfluidic paper-based analytic device

In this study, we developed a point-of-care assay platform with simultaneous detection and self-calibration capabilities for multiple targets based on a microfluidic paper-based analytical device (μPAD). This system is easily manufactured using a wax printing method on chromatographic paper. The design pattern consists of a zone of detection and a calibrant zone for controlled loading using wax barriers with different thicknesses. We showed the utility and applicability of this approach by a proof-of-concept study for two clinically important markers: glucose and lactate. With the naked eye, the results could be fully distinguished and recorded to evaluate the analytical performance with a flatbed scanner. The detection limits of glucose and lactate were 0.3125 mM and 0.2975 mM, respectively, and simultaneous detection was possible from a small sample (0.4 μL) with high sensitivity. Furthermore, this device has a self-calibration function, which minimizes the influence of environmental conditions (i.e., ambient light intensity, temperature, humidity, and pressure). Therefore, the developed multiplex paper-based device is promising for clinical multianalyte point-of-care testing since it is easy to manufacture, cost-effective, user-friendly, and highly sensitive.

Development of a Paper-Based Sensor Compatible with a Mobile Phone for the Detection of Common Iron Formulas Used in Fortified Foods within Resource-Limited Settings

A lack of quality control tools limits the enforcement of fortification policies. In alignment with the World Health Organization’s ASSURED criteria (affordable, sensitive, specific, user-friendly, rapid and robust, equipment-free, and deliverable), a paper-based assay that interfaces with a smartphone application for the quantification of iron fortificants is presented. The assay is based on the Ferrozine colorimetric method. The reaction started after deposition of the 5 µL aqueous sample and drying. After developing color, pixel intensity values were obtained using a smartphone camera and image processing software or a mobile application, Nu3px. From these values, the actual iron concentration from ferrous sulfate and ferrous fumarate was calculated. The limits of detection, quantification, linearity, range, and errors (systematic and random) were ascertained. The paper-based values from real samples (wheat flour, nixtamalized corn flour, and infant formula) were compared against atomic emission spectroscopy. The comparison of several concentrations of atomic iron between the spectrophotometric and paper-based assays showed a strong positive linear correlation (y = 47.01x + 126.18; R² = 0.9932). The dynamic range (5.0–100 µg/mL) and limit of detection (3.691 µg/mL) of the paper-based assay are relevant for fortified food matrices. Random and systematic errors were 15.9% and + 8.65 µg/g food, respectively. The concept can be applied to limited-resource settings to measure iron in fortified foods.

Advanced Colorimetric Paper Sensors Using Color Focusing Effect Based on Asymmetric Flow of Fluid

Although paper-based colorimetric sensors utilizing enzymatic reactions are well suited for real-field diagnosis, their widespread use is hindered by signal blurring at the detection spot due to the action of capillary forces on the liquid and the corresponding membrane. In this study, we eliminated signal losses commonly observed during enzyme-mediated colorimetric sensing and achieved pattern-free quantitative analysis of glucose and uric acid by mixing enzymes and color-forming reagents with chitosan oligosaccharide lactate (COL), which resulted in perfectly focused colorimetric signals at the detection spot, using asymmetric flow induced by changing the flow rate of the COL-treated paper. The targets were calibrated with 0-500 mg/dL of glucose and 0-200 mg/dL of uric acid, and the limit of detection was calculated to be 0.6 and 0.03 mg/dL, respectively. In human urine, the correlation has a high response between the measured and spiked concentrations, and the stability of the enzyme mixture including COL increased by 41% for glucose oxidase mixture and 29% for uricase mixture, compared to the corresponding mixtures without COL. Thus, the color focusing and pattern-free sensor, which have the advantages of easy fabrication, easy handling, and high stability, should be applied to real-field diagnosis.

Graphene-based fully integrated portable nanosensing system for on-line detection of cytokine biomarkers in saliva

Saliva has been reported to contain various cytokine biomarkers which are associated with some severe diseases such as cancers. Non-invasive saliva diagnosis using wearable or portable devices may pave a new avenue for monitoring conditions of the high risk population. Here, a graphene-based fully integrated portable nanosensing system, the entire size of which is smaller than a smart-phone and can be handheld, is presented for on-line detection of cytokine biomarkers in saliva. This miniaturized system employs an aptameric graphene-based field effect transistor (GFET) using a buried-gate geometry with HfO₂ as the dielectric layer and on-line signal processing circuits to realize the transduction and processing of signals which reflect cytokine concentrations. The signal can be wirelessly transmitted to a smart-phone or cloud sever through the Wi-Fi connection for visualizing the trend of the cytokine concentration change. Interleukin-6 (IL-6) is used as a representative to examine the sensing capability of the system. Experimental results demonstrate that the nanosensing system responds to the change of IL-6 concentration within 400s in saliva with a detection limit down to 12 pM. Therefore, this portable system offers the practicality to be potentially used for non-invasive saliva diagnosis of diseases at early stage.

Saliva, a Magic Biofluid Available for Multilevel Assessment and a Mirror of General Health-A Systematic Review

Background: Saliva has been recently proposed as an alternative to classic biofluid analyses due to both availability and reliability regarding the evaluation of various biomarkers. Biosensors have been designed for the assessment of a wide spectrum of compounds, aiding in the screening, diagnosis, and monitoring of pathologies and treatment efficiency. This literature review aims to present the development in the biosensors research and their utility using salivary assessment. Methods: a comprehensive literature search has been conducted in the PubMed database, using the keywords “saliva” and “sensor”. A two-step paper selection algorithm was devised and applied. Results: The 49 papers selected for the present review focused on assessing the salivary biomarkers used in general diseases, oral pathologies, and pharmacology. The biosensors proved to be reliable tools for measuring the salivary levels of biochemical metabolic compounds such as glucose, proteinases and proteins, heavy metals and various chemical compounds, microorganisms, oncology markers, drugs, and neurotransmitters. Conclusions: Saliva is a biofluid with a significant clinical applicability for the evaluation and monitoring of a patient’s general health. Biosensors designed for assessing a wide range of salivary biomarkers are emerging as promising diagnostic or screening tools for improving the patients’ quality of life.

Cobalt Phosphate Nanostructures for Non-Enzymatic Glucose Sensing at Physiological pH

Nanostructured materials have potential as platforms for analytical assays and catalytic reactions. Herein, we report the synthesis of electrocatalytically active cobalt phosphate nanostructures (CPNs) using a simple, low-cost, and scalable preparation method. The electrocatalytic properties of CPNs toward the electrooxidation of glucose (Glu) were studied by cyclic voltammetry and chronoamperometry in relevant biological electrolytes, such as phosphate-buffered saline (PBS), at physiological pH (7.4). Using CPNs, Glu detection could be achieved over a wide range of biologically relevant concentrations, from 1 to 30 mM Glu in PBS, with a sensitivity of 7.90 nA/mM cm² and a limit of detection of 0.3 mM, thus fulfilling the necessary requirements for human blood Glu detection. In addition, CPNs showed a high structural and functional stability over time at physiological pH. The CPN-coated electrodes could also be used for Glu detection in the presence of interfering agents (e.g., ascorbic acid and dopamine) and in human serum. Density functional theory calculations were performed to evaluate the interaction of Glu with different faceted cobalt phosphate surfaces; the results revealed that specific surface presentations of under-coordinated cobalt led to the strongest interaction with Glu, suggesting that enhanced detection of Glu by CPNs can be achieved by lowering the surface coordination of cobalt. Our results highlight the potential use of phosphate-based nanostructures as catalysts for electrochemical sensing of biochemical analytes.

A Portable Smartphone-Based Sensing System Using a 3D-Printed Chip for On-Site Biochemical Assays

Recently, smartphone-based chromogenic sensing with paper-based microfluidic technology has played an increasingly important role in biochemical assays. However, generally there were three defects: (i) the paper-based chips still required complicated fabrication, and the hydrophobic boundaries on the chips were not clear enough; (ii) the chromogenic signals could not be steadily captured; (iii) the smartphone apps were restricted to the detection of specific target analytes and could not be extended for different assays unless reprogrammed. To solve these problems, in this study, a portable smartphone-based sensing system with a 3D-printed chip was developed. A 3D-printed imaging platform was designed to significantly reduce sensing errors generated during signal capture, and a brand-new strategy for signal processing in downloadable apps was established. As a proof-of-concept, the system was applied for detection of organophosphorus pesticides and multi-assay of fruit juice, showing excellent sensing performance. For different target analytes, the most efficient color channel could be selected for signal analysis, and the calibration equation could be directly set in user interface rather than programming environment, thus the developed system could be flexibly extended for other biochemical assays. Consequently, this study provides a novel methodology for smartphone-based biochemical sensing.