Integrated Smart Janus Textile Bands for Self-Pumping Sweat Sampling and Analysis

An epidermal wearable microfluidic patch for simultaneous sampling, storage, and analysis of biofluids with counterion monitoring

Simultaneous access to different biofluids enables an accurate analysis of multiple analytes, leading to a precision diagnosis and appropriate medication. Additionally, establishing a relationship between various markers in different biofluids and their correlation to biomarkers in blood allows the development of an algorithmic approach, which aids non-invasive diagnosis through single parameter monitoring. However, the main bottleneck that exists in multiple biofluid analyses for its clinical implementation is the requirement of an advanced microfluidic coupled device design, which empowers simultaneous collection and monitoring. To tackle this challenge, an epidermal wearable bio-fluidic patch that facilitates simultaneous on-demand extraction, sampling, and storage of sweat and interstitial fluid (ISF) together with monitoring of their corresponding counterions is presented. The clean room free development of a biofluidic patch is realized through 3D integration of laser patterned optimized microfluidic structures, a low-cost screen-printed stimulation module, and a potentiometric chloride (Cl^-) and calcium (Ca²⁺) ion sensing module for adequate dual biofluid sampling and analysis. The developed Cl^- and Ca²⁺ ion-selective sensors exhibit good repeatability, selectivity, acceptable stability, and sensitivity. The proof-of-concept demonstration of the fabricated patch for simultaneous dual-sampling, storage, and monitoring of the sweat Cl^- and ISF Ca²⁺ on a healthy volunteer during different periods of the day leverages its potential in real-time personalized healthcare clinical usages. Furthermore, the patch's electronic interface and use of wireless transmission facilitates a point-of-care non-invasive lab-on-skin application for monitoring the health status of individuals.

Validation of the Application of Solid Contact Ion-Selective Electrode for Off-Body Sweat Ion Monitoring

The solid contact ion-selective electrode (ISE) is a promising skin-interfaced monitoring system for sweat ions. Despite a growing number of on-body usages of ISE with fancy new materials and device fabrications, there are very few reports attempting to validate ISE results with a gold standard technique. For this purpose, this work uses inductively coupled plasma-optical emission spectrometry (ICP-OES) as a reference technique to conduct a direct evaluation of the sweat sodium and potassium ion levels obtained by ISE in an off-body approach. Eight healthy male subjects were recruited to collect exercise-induced sweat. It was found that sweat sodium and potassium ions present a rather wide concentration range. The sweat sodium concentration did not vary greatly in an exercise period of half an hour, while the sweat potassium concentration typically decreased with exercise. Mineral drink intake had no clear impact on the sweat sodium level, but increased the sweat potassium level. A paired t-test and mean absolute relative difference (MARD) analysis, a method typically used for evaluating the performance of glucometers, was employed to compare the results of ISE and ICP-OES. The statistical analysis validated the feasibility of ISE for measuring sweat ions, although better accuracy is required. Our data suggests that overweight subjects are likely to possess a higher sweat sodium level.

Smart Electronic Textiles for Wearable Sensing and Display

Increasing demand of using everyday clothing in wearable sensing and display has synergistically advanced the field of electronic textiles, or e-textiles. A variety of types of e-textiles have been formed into stretchy fabrics in a manner that can maintain their intrinsic properties of stretchability, breathability, and wearability to fit comfortably across different sizes and shapes of the human body. These unique features have been leveraged to ensure accuracy in capturing physical, chemical, and electrophysiological signals from the skin under ambulatory conditions, while also displaying the sensing data or other immediate information in daily life. Here, we review the emerging trends and recent advances in e-textiles in wearable sensing and display, with a focus on their materials, constructions, and implementations. We also describe perspectives on the remaining challenges of e-textiles to guide future research directions toward wider adoption in practice.

Wearable Microfluidic Sensor for the Simultaneous and Continuous Monitoring of Local Sweat Rates and Electrolyte Concentrations

Temperature elevation due to global warming increases the risks of dehydration, which can induce heat-related illness. Proper rehydration with appropriate amounts of water and electrolytes is essential to aid body fluid homeostasis. Wearable sweat sensors which can monitor both the sweat rate and sweat electrolyte concentration may be an effective tool for determining appropriate rehydration. Here, we developed a novel potentially wearable sensor that can monitor both the local sweat rate and sweat electrolyte concentration continuously. The new device includes a system with a short microfluidic pathway that guides the sweat appearing on the skin to a small space in the device to form a quantifiable droplet. The sweat rate is assessed from the time for the droplet to appear and droplet volume, while an integrated electric sensor detects the sodium chloride concentration in each sweat droplet. We demonstrated that this new device could record both the flow rates of artificial sweat and its sodium chloride concentration in ranges of human sweating with an accuracy within ±10%. This is equivalent to the accuracy of commercially available sweat rate meters and sweat ion sensors. The present study provides a new perspective for the design of wearable sensors that can continuously monitor sweat rates and sweat electrolyte concentrations for potential application to a healthcare device.

Textile-based electrochemical sensors and their applications

Textile and their composite-based functional sensors are extensively acknowledged and preferred detection platforms in recent times. Developing suitable methodologies for fabricating textile sensors can be achieved either by integration of conductive fibers and yarns into textiles using technologies such as weaving, knitting and embroidery; or by functionalization of textile materials with conductive nanomaterials/inks using printing or coating methods. Textile materials are gaining enormous attention for fabricating soft lab-on-fabric devices due to their unique features such as high flexibility, wear and wash resistance, mechanical strength and promising sensing performances. Owing to these collective properties, textile-based electrochemical transducers are now showcasing rapid and accurate electrical measurements towards real time point-of-care diagnostics and environmental monitoring applications. The present review provides a brief overview of key progress made in the field of developing textile materials and their composites-based electrochemical sensors and biosensors in recent years where electrode configurations are specifically based on either natural or synthetic fabrics. Different ways to fabricate and functionalize textiles for their application in electrochemical analysis are briefly discussed. The review ends with a conclusive note focusing on the current challenges in the fabrication of textile-based stable electrochemical sensors and biosensors.

Photosensitive-Stamp-Inspired Scalable Fabrication Strategy of Wearable Sensing Arrays for Noninvasive Real-Time Sweat Analysis

Wearable sweat sensing is essential to the development of personalized health monitoring in a noninvasive manner with molecular-level insight. Hence, there is an increasing demand for convenient, facile, and efficient fabrication of wearable sensing arrays. Inspired by a photosensitive stamp (PS), we present herein a simple, low-cost, and eco-friendly vacuum filtration-transfer printing method (termed PS-VFTP) for the scalable preparation of single-walled carbon nanotube (SWCNT) based flexible electrode arrays. This method can economically yield customized flexible SWCNT arrays with praiseworthy performance, such as high reproducibility, precision, uniformity, conductivity, and mechanical stability. In addition, the flexible SWCNT arrays can be easily functionalized into high-performance electrochemical sensors for the simultaneous monitoring of sweat metabolites (glucose, lactate) and electrolytes (Na⁺, K⁺). The integration of wearable sensing arrays with a signal acquisition and processing circuit system in the intelligent wearable sensors empowers them to realize noninvasive, real-time, and in situ sweat analysis during exercise. More meaningfully, such a PS-VFTP strategy can be easily expanded to the economical manufacturing of other flexible electronic devices.

Dissolvable Polymer Valves for Sweat Chrono-Sampling in Wearable Paper-Based Analytical Devices

Paper sensors with colorimetric signal transduction mechanisms are promising for developing single-use wearable patches that only require a smartphone to quantify signals. However, measuring biomarker fluctuations with colorimetric wearable sensors requires implementing a chrono-sampling method for performing sequential measurements. In this article, we report on a chrono-sampling method that enables the fabrication of wearable devices made entirely of filter paper. It consists of using dried polymers as closed valves that deflect the flow of liquids to different transducers of a multisensor. As time passes by, the polymer dissolves and the valve opens. The sequential opening of the valves results in a succession of measurements that reveals fluctuations in the concentration of the target analyte. This concept was demonstrated with a paper multisensor capable of performing nine consecutive pH measurements. The device was also adapted for developing a urea biosensor that detects pH measurements generated by the hydrolysis of the analyte catalyzed by urease. The proposed analytical platform could monitor the pH of sweat with an accuracy and precision comparable to a laboratory-based method when worn during an exercise routine. The results shown here pave the way for developing colorimetric wearable biosensors that measure variations in the concentration of biomarkers such as glucose, lactate, creatinine, or uric acid over time.

Review on the Development and Application of Directional Water Transport Textile Materials

Moisture (sweat) management in textile products is crucial to regulate human thermo-physiological comfort. Traditional hydrophilic textiles, such as cotton, can absorb sweat, but they retain it, leading to undesired wet adhesion sensation and even excessive cooling. To address such issues, the development of functional textiles with directional water transport (DWT) has garnered great deal of interest. DWT textile materials can realize directional water transport and prevent water penetration in the reverse direction, which is a great application for sweat release in daily life. In this review article, the mechanism of directional water transport is analyzed. Then, three key methods to achieve DWT performance are reviewed, including the design of the fabric structure, surface modification and electrospinning. In addition, the applications of DWT textile materials in functional clothing, electronic textiles, and wound dressing are introduced. Finally, the challenges and future development trends of DWT textile materials in the textile field are discussed.

Hybrid Janus Membrane with Dual-Asymmetry Integration of Wettability and Conductivity for Ultra-Low-Volume Sweat Sensing

Highly sensitive and selective analysis of sweat at ultra-low sample volume remains a major challenge in the field of biosensing. Manipulation of small volumes of liquid for efficient sampling is essential to address this challenge. A hybrid Janus membrane with dual-asymmetry integration of wettability and conductivity is developed for regulated micro-volume liquid transport in wearable sweat biosensing. Unlike the uncontrollable liquid diffusion in a conventional porous membrane, the asymmetric wettability of porous Janus membrane leads to unique unidirectional liquid transport with high breakthrough pressure (1737.66 Pa) and fast self-pumping rate (35.94 μL/min) for micro-volume liquid sampling. The asymmetric conductive layer shows excellent flexible conductivity, anti-interference of friction, and efficient electrochemical interface due to the in situ generation of gold nanoparticles on one side of the membrane. The fabricated Pt-enzyme electrodes on the membrane promises effective testing range, great selectivity, and high sensitivity and accuracy (correlation efficiency, glucose: R² = 0.999, lactate: R² = 0.997), enabling ultra-low volume (∼0.15 μL) real time measurements on the skin surface. The innovative Janus membrane with unidirectional, self-pumping, and anti-interference performance provides a new strategy for miniaturized wearable microfluidic sweat electrochemical biosensor preparation in athletic performance evaluation, health monitoring, disease diagnosis, intelligent medicine, and so forth.

An integrated and conductive hydrogel-paper patch for simultaneous sensing of Chemical-Electrophysiological signals

Simultaneous monitoring of electrophysiological and biochemical signals is of great importance in healthcare and fitness management, while the fabrication of highly integrated and flexible devices is crucial to these applications. Herein, we devised a multifunctional and flexible hydrogel-paper patch (HPP) that was capable of simultaneously real-time monitoring of electrocardiogram (ECG) signal and biochemical signal (glucose content) in sweat during exercise. The self-assembly of the highly porous PEDOT:PSS hydrogel on paper fiber provided the HPP with good conductivity and hydrophilic wettability for efficient electron transmission and substance diffusion, thereby enabling it to serve as a low-impedance ECG electrode and a highly sensitive glucose sensor. Additionally, the spontaneous capillary flow effect allows the paper patch to be used as microfluidic channels for the collect and analysis of sweat. Moreover, the HPP is integrated with a flexible printed circuit board (FPCB) and works as a multifunctional wearable device mounted on the chest for real-time monitoring of electrophysiological and biochemical signals during exercise.

Differential Amperometric Microneedle Biosensor for Wearable Levodopa Monitoring of Parkinson's Disease

Levodopa (L-Dopa) is considered to be one of the most effective therapies available for Parkinson's disease (PD) treatment. The therapeutic window of L-Dopa is narrow due to its short half-life, and long-time L-Dopa treatment will cause some side effects such as dyskinesias, psychosis, and orthostatic hypotension. Therefore, it is of great significance to monitor the dynamic concentration of L-Dopa for PD patients with wearable biosensors to reduce the risk of complications. However, the high concentration of interferents in the body brings great challenges to the in vivo monitoring of L-Dopa. To address this issue, we proposed a minimal-invasive L-Dopa biosensor based on a flexible differential microneedle array (FDMA). One working electrode responded to L-Dopa and interfering substances, while the other working electrode only responded to electroactive interferences. The differential current response of these two electrodes was related to the concentration of L-Dopa by eliminating the common mode interference. The differential structure provided the sensor with excellent anti-interference performance and improved the sensor's accuracy. This novel flexible microneedle sensor exhibited favorable analytical performance of a wide linear dynamic range (0-20 μM), high sensitivity (12.618 nA μM^-1 cm^-2) as well as long-term stability (two weeks). Ultimately, the L-Dopa sensor displayed a fast response to in vivo L-Dopa dynamically with considerable anti-interference ability. All these attractive performances indicated the feasibility of this FDMA for minimal invasive and continuous monitoring of L-Dopa dynamic concentration for Parkinson's disease.

Lab on a body for biomedical electrochemical sensing applications: The next generation of microfluidic devices

This chapter highlights applications of microfluidic devices toward on-body biosensors. The emerging application of microfluidics to on-body bioanalysis is a new strategy to establish systems for the continuous, real-time, and on-site determination of informative markers present in biofluids, such as sweat, interstitial fluid, blood, saliva, and tear. Electrochemical sensors are attractive to integrate with such microfluidics due to the possibility to be miniaturized. Moreover, on-body microfluidics coupled with bioelectronics enable smart integration with modern information and communication technology. This chapter discusses requirements and several challenges when developing on-body microfluidics such as difficulties in manipulating small sample volumes while maintaining mechanical flexibility, power-consumption efficiency, and simplicity of total automated systems. We describe key components, e.g., microchannels, microvalves, and electrochemical detectors, used in microfluidics. We also introduce representatives of advanced lab-on-a-body microfluidics combined with electrochemical sensors for biomedical applications. The chapter ends with a discussion of the potential trends of research in this field and opportunities. On-body microfluidics as modern total analysis devices will continue to bring several fascinating opportunities to the field of biomedical and translational research applications.

Recent advancement in noninvasive glucose monitoring and closed-loop management system for diabetes

Diabetes can cause many complications, which has become one of the most common diseases that may lead to death. Currently, the number of diabetics continues increasing year by year. Thus,...

Integrated Wearable Sensors for Sensing Physiological Pressure Signals and β-Hydroxybutyrate in Physiological Fluids

Flexible and wearable sensors have attracted much attention for their applications in health monitoring and the human-machine interaction. The most studied wearable sensors have been demonstrated for sensing a limited range of metabolites such as ions, glucose, uric acid, lactate, etc. Both sweat and urine contain numerous other physiologically relevant metabolites indicative of health and wellness. This work demonstrates the use of the wearable sensor for the detection of β-hydroxybutyrate (HB) in sweat. HB is an important biomarker for diabetic ketoacidosis, a condition caused by the accumulation of ketone bodies in hyperglycemia or metabolic acidosis patients. Herein, we fabricated an integrated sensing system coupling an HB detection chamber with a serpentine electrode for sensing physiological signals such as pulse beat, vocal cord vibration, etc. The real-time HB detection was based on a β-hydroxybutyrate dehydrogenase enzymatic reaction. The stability of the enzyme and the cofactor couple was achieved by cross-linking networks and a redox mediator, thereby achieving high selectivity and low detection limits to HB in urine and sweat. The dual-functional sensor was integrated with a signal processing circuitry for signal transduction, conditioning, processing, wireless transmission, and real-time convenient health monitoring display to a smartphone via home-developed software.

Anisotropic Janus materials: from micro-/nanostructures to applications

Janus materials have led to great achievements in recent years owing to their unique asymmetric structures and properties. In this review, recent advances of Janus materials including Janus particles and Janus membranes are summarized, and then the microstructures and applications of Janus materials are emphasized. The asymmetric wettability of Janus materials is related to their microstructures; hence, the microstructures of Janus materials were analyzed, compared and summarized. Also presented are current and potential applications in sensing, drug delivery, oil-water separation and so on. Finally, a perspective on the research prospects and development of Janus materials in more fields is given.

Biospired Janus Silk E-Textiles with Wet-Thermal Comfort for Highly Efficient Biofluid Monitoring

Functionalized textiles capable of biofluid administration are favorable for enhancing the wet-thermal comfort of the wearer and healthcare performance. Herein, inspired by the Janus wettability of lotus leaf, we propose a skin-comfortable Janus electronic textile (e-textile) based on natural silk materials for managing and analysis of biofluid. Silk materials are chosen and modified as both a textile substrate and a sensing electrode due to its natural biocompatibility. The unidirectional biofluid behavior of such Janus silk substrate facilitates a comfortable skin microenvironment, including weakening the undesired wet adhesion (∼0 mN cm^-2) and avoiding excessive heat or cold on the epidermis. We noninvasively analyze multiple targets of human sweat with less required liquid volume (∼5 μL) and a faster (2-3 min) response time based on the silk-based yarn electrode woven into the hydrophilic side of Janus silk. This work bridges the gap between physiological comfort and sensing technology using biomass-derived elements, presenting a new type of smart textiles for wet-thermal management and health monitoring.

Cactus-Spine-Inspired Sweat-Collecting Patch for Fast and Continuous Monitoring of Sweat

A sweat sensor is expected to be the most appropriate wearable device for noninvasive healthcare monitoring. However, the practical use of sweat sensors is impeded by irregular and low sweat secretion rates. Here, a sweat-collecting patch that can collect sweat efficiently for fast and continuous healthcare monitoring is demonstrated. The patch uses cactus-spine-inspired wedge-shaped wettability-patterned channels on a hierarchical microstructured/nanostructured surface. The channel shape, in combination with the superhydrophobic/superhydrophilic surface materials, induces a unidirectional Laplace pressure that transports the sweat to the sensing area spontaneously even when the patch is aligned vertically. The patch demonstrates superior sweat-collecting efficiency and reduces the time required to fill the sensing area by transporting sweat almost without leaving it inside the channel. Therefore, a sensor based on the patch responds quickly to biochemicals in sweat, and the patch enables the continuous monitoring of changes in sweat biochemicals according to their changes in the wearer's blood.

Trending Technology of Glucose Monitoring during COVID-19 Pandemic: Challenges in Personalized Healthcare

The COVID-19 pandemic has continued to spread rapidly, and patients with diabetes are at risk of experiencing rapid progression and poor prognosis for appropriate treatment. Continuous glucose monitoring (CGM), which includes accurately tracking fluctuations in glucose levels without raising the risk of coronavirus exposure, becomes an important strategy for the self-management of diabetes during this pandemic, efficiently contributing to the diabetes care and the fight against COVID-19. Despite being less accurate than direct blood glucose monitoring, wearable noninvasive systems can encourage patient adherence by guaranteeing reliable results through high correlation between blood glucose levels and glucose concentrations in various other biofluids. This review highlights the trending technologies of glucose sensors during the ongoing COVID-19 pandemic (2019-2020) that have been developed to make a significant contribution to effective management of diabetes and prevention of coronavirus spread, from off-body systems to wearable on-body CGM devices, including nanostructure and sensor performance in various biofluids. The advantages and disadvantages of various human biofluids for use in glucose sensors are also discussed. Furthermore, the challenges faced by wearable CGM sensors with respect to personalized healthcare during and after the pandemic are deliberated to emphasize the potential future directions of CGM devices for diabetes management.

State of Sweat: Emerging Wearable Systems for Real-Time, Noninvasive Sweat Sensing and Analytics

Skin-interfaced wearable systems with integrated colorimetric assays, microfluidic channels, and electrochemical sensors offer powerful capabilities for noninvasive, real-time sweat analysis. This Perspective details recent progress in the development and translation of novel wearable sensors for personalized assessment of sweat dynamics and biomarkers, with precise sampling and real-time analysis. Sensor accuracy, system ruggedness, and large-scale deployment in remote environments represent key opportunity areas, enabling broad deployment in the context of field studies, clinical trials, and recent commercialization. On-body measurements in these contexts show good agreement compared to conventional laboratory-based sweat analysis approaches. These device demonstrations highlight the utility of biochemical sensing platforms for personalized assessment of performance, wellness, and health across a broad range of applications.

Epidermal Sensor for Potentiometric Analysis of Metabolite and Electrolyte

Wearable epidermal sensors that can provide noninvasive and continuous analysis of metabolites and electrolytes in sweat have great significance for healthcare monitoring. This study reports an epidermal sensor that can wirelessly, noninvasively, and potentiometrically analyze metabolites and electrolytes. Potentiometry-based ion-selective electrodes (ISE) are most widely used for detecting electrolytes, such as Na⁺ and K⁺. We develop an enzyme-based glucose ISE for potentiometric analysis of sweat glucose. The glucose ISE sensor is obtained by modifying a glucose oxidase layer (GOD) on an H⁺ ISE sensor. GOD catalyzes glucose to generate H⁺. The generated H⁺ passes through the H⁺ selective membrane to change the potential of the electrode. We have fully examined the limit of detection, detecting range, and stability of our epidermal sensor. Meanwhile, using this epidermal sensor, we can easily analyze the relationship between blood glucose and sweat glucose. The concentration curve of sweat glucose can represent blood glucose concentration, significantly contributing to sports and chronic disease monitoring.

Lab-on-Eyeglasses to Monitor Kidneys and Strengthen Vulnerable Populations in Pandemics: Machine Learning in Predicting Serum Creatinine Using Tear Creatinine

The serum creatinine level is commonly recognized as a measure of glomerular filtration rate (GFR) and is defined as an indicator of overall renal health. A typical procedure in determining kidney performance is venipuncture to obtain serum creatinine in the blood, which requires a skilled technician to perform on a laboratory basis and multiple clinical steps to acquire a meaningful result. Recently, wearable sensors have undergone immense development, especially for noninvasive health monitoring without a need for a blood sample. This article addresses a fiber-based sensing device selective for tear creatinine, which was fabricated using a copper-containing benzenedicarboxylate (BDC) metal-organic framework (MOF) bound with graphene oxide-Cu(II) and hybridized with Cu₂O nanoparticles (NPs). Density functional theory (DFT) was employed to study the binding energies of creatinine toward the ternary hybrid materials that irreversibly occurred at pendant copper ions attached with the BDC segments. Electrochemical impedance spectroscopy (EIS) was utilized to probe the unique charge-transfer resistances of the derived sensing materials. The single-use modified sensor achieved 95.1% selectivity efficiency toward the determination of tear creatinine contents from 1.6 to 2400 μM of 10 repeated measurements in the presence of interfering species of dopamine, urea, and uric acid. The machine learning with the supervised training estimated 83.3% algorithm accuracy to distinguish among low, moderate, and high normal serum creatinine by evaluating tear creatinine. With only one step of collecting tears, this lab-on-eyeglasses with disposable hybrid textile electrodes selective for tear creatinine may be greatly beneficial for point-of-care (POC) kidney monitoring for vulnerable populations remotely, especially during pandemics.

Bio-inspired fractal textile device for rapid sweat collection and monitoring

In this study, a new design concept in sweat collection was developed to achieve rapid and intact sweat sampling for analytical purposes. Textiles with fast water wicking properties were first selected and laser engraved into tree-like bifurcating channels for sweat collection. The fractal framework of the bifurcating textile channels was theoretically derived to minimize the flow resistance for fast sweat absorption. The optimized collector with designed fractal geometry exhibited thorough coverage of emerging droplets without overflow. Great collection efficiency was achieved with a short induction time (<1 minute after perspiration begins) and a maximum sweat collection flux up to 4.0 μL cm-2 min-1 without leakage. After being combined with printed sensors and microchips, the assembled sweat collection/sensing device can simultaneously provide measurements of salt concentration and sweat rate for wireless hydration state monitoring. The collection/sensing system also exhibited fast response times to abrupt changes in sweat rates or concentrations and thus can be used to detect instant physical conditions in exercise. Finally, field tests were performed to demonstrate the reliability and practicality of the device in real-time sweat monitoring under vigorous activities.

Stretchable and Superwettable Colorimetric Sensing Patch for Epidermal Collection and Analysis of Sweat

Stretchable and wearable sensors allow intimate integration with the human body for health and fitness monitoring. In addition to the acquisition of various physical parameters, quantitative analysis of chemical biomarkers present in sweat may provide vital insights into the physiological state of an individual. A widely investigated system utilizes electrochemical techniques for continuous monitoring of these biomarkers. The required supporting electronics and batteries are often challenging to form a deformable system. In this study, an intrinsically stretchable sensing patch is developed with compliant mechanical properties for conformal attachment to the skin and reliable collection of sweat. In these patches, superhydrophilic colorimetric assays consisting of thermoplastic polyurethane nanofiber textiles decorated with silica nanoparticles are assembled over a styrene-ethylene-butylene-styrene-based superhydrophobic substrate, thereby generating a large wettability contrast to efficiently concentrate the sweat. The system supports multiplexed colorimetric analysis of sweat to quantify pH and ion concentrations with images acquired using smartphones, in which the influence of ambient lighting conditions is largely compensated with a set of reference color markers. Successful demonstrations of in situ analysis of sweat after physical exercises effectively illustrate the practical suitability of the sensing patch, which is attractive for advanced health monitoring, clinical diagnostics, and competitive sports.

Recent progress, challenges, and opportunities for wearable biochemical sensors for sweat analysis

Sweat is a promising, yet relatively unexplored biofluid containing biochemical information that offers broad insights into the underlying dynamic metabolic activity of the human body. The rich composition of electrolytes, metabolites, hormones, proteins, nucleic acids, micronutrients, and exogenous agents found in sweat dynamically vary in response to the state of health, stress, and diet. Emerging classes of skin-interfaced wearable sensors offer powerful capabilities for the real-time, continuous analysis of sweat produced by the eccrine glands in a manner suitable for use in athletics, consumer wellness, military, and healthcare industries. This perspective examines the rapid and continuous progress of wearable sweat sensors through the most advanced embodiments that address the fundamental challenges currently restricting widespread deployment. It concludes with a discussion of efforts to expand the overall utility of wearable sweat sensors and opportunities for commercialization, in which advances in biochemical sensor technologies will be critically important.

Textile Chemical Sensors Based on Conductive Polymers for the Analysis of Sweat

Wearable textile chemical sensors are promising devices due to the potential applications in medicine, sports activities and occupational safety and health. Reaching the maturity required for commercialization is a technology challenge that mainly involves material science because these sensors should be adapted to flexible and light-weight substrates to preserve the comfort of the wearer. Conductive polymers (CPs) are a fascinating solution to meet this demand, as they exhibit the mechanical properties of polymers, with an electrical conductivity typical of semiconductors. Moreover, their biocompatibility makes them promising candidates for effectively interfacing the human body. In particular, sweat analysis is very attractive to wearable technologies as perspiration is a naturally occurring process and sweat can be sampled non-invasively and continuously over time. This review discusses the role of CPs in the development of textile electrochemical sensors specifically designed for real-time sweat monitoring and the main challenges related to this topic.

Use of Surface Penetration Technology to Fabricate Superhydrophobic Multifunctional Strain Sensors with an Ultrawide Sensing Range

Flexible sensors with wide sensing ranges require responsiveness under tiny and large strains. However, the development of strain sensors with wide detection ranges is still a great challenge due to the conflict between the tiny strain requirements of sparse conductive networks and the large strain requirement of dense conductive networks. Herein, we present a facile method for fabricating a gradient conductive network composed of sparse and dense conductive networks. The surface penetration technology in which carbon black (CB) penetrated from the natural rubber latex (NRL) glove surface to the interior was used to fabricate a gradient conductive network. The prolonged immersion time from 1 to 30 min caused the penetration depth of CB to increase from 2 to 80 μm. Moreover, CB formed hierarchical rough micro- and nanoscale structures, creating a superhydrophobic surface. The gradient conductive network of sensors produced an ultrawide detection range of strain (0.05-300%) and excellent reliability and reproducibility. The sensors can detect a wide range of human motions, from tiny (wrist pulse) to large (joint movements) motion monitoring. The flexible sensors attached to a flexible basement can be used to detect pressure in a wide detection range (1.7-2900 kPa). Pressure responsiveness was used to detect the weight, sound pressure, and dripping of tiny droplets. The sensor showed an excellent response to organic solvents, and the response intensity increased with the increasing swelling degree of the solvent for NRL.

Fiber-crafted biofuel cell bracelet for wearable electronics

Wearable devices that generate power using sweat have garnered much attention in the field of skin electronics. These devices require high performance with a small volume and low production rate of sweat by living organisms. Here we demonstrate a high-power biofuel cell bracelet based on the lactate in human sweat. The biofuel cell was developed by using a lactate oxidase/osmium-based mediator/carbon nanotube fiber for lactate oxidation and a bilirubin oxidase/carbon nanotube fiber for oxygen reduction; the fibers were woven into a hydrophilic supportive textile for sweat storage. The storage textile was sandwiched between a hydrophobic textile for sweat absorption from the skin and a hydrophilic textile for water evaporation to improve sweat collection. The performance of the layered cell was 74 μW at 0.39 V in 20 mM artificial sweat lactate, and its performance was maintained at over 80% for 12 h. Furthermore, we demonstrated a series-connection between anode/cathode fibers by tying them up to wrap the bracelet-type biofuel cell on the wrist. The booster six-cell bracelet generated power at 2.0 V that is sufficient for operating digital wrist watches.

Narrower Nanoribbon Biosensors Fabricated by Chemical Lift-off Lithography Show Higher Sensitivity

Wafer-scale nanoribbon field-effect transistor (FET) biosensors fabricated by straightforward top-down processes are demonstrated as sensing platforms with high sensitivity to a broad range of biological targets. Nanoribbons with 350 nm widths (700 nm pitch) were patterned by chemical lift-off lithography using high-throughput, low-cost commercial digital versatile disks (DVDs) as masters. Lift-off lithography was also used to pattern ribbons with 2 μm or 20 μm widths (4 or 40 μm pitches, respectively) using masters fabricated by photolithography. For all widths, highly aligned, quasi-one-dimensional (1D) ribbon arrays were produced over centimeter length scales by sputtering to deposit 20 nm thin-film In₂O₃ as the semiconductor. Compared to 20 μm wide microribbons, FET sensors with 350 nm wide nanoribbons showed higher sensitivity to pH over a broad range (pH 5 to 10). Nanoribbon FETs functionalized with a serotonin-specific aptamer demonstrated larger responses to equimolar serotonin in high ionic strength buffer than those of microribbon FETs. Field-effect transistors with 350 nm wide nanoribbons functionalized with single-stranded DNA showed greater sensitivity to detecting complementary DNA hybridization vs 20 μm microribbon FETs. In all, we illustrate facile fabrication and use of large-area, uniform In₂O₃ nanoribbon FETs for ion, small-molecule, and oligonucleotide detection where higher surface-to-volume ratios translate to better detection sensitivities.

Wearable Analytical Platform with Enzyme-Modulated Dynamic Range for the Simultaneous Colorimetric Detection of Sweat Volume and Sweat Biomarkers

In this manuscript, we introduce a wearable analytical platform that simultaneously measures the concentration of sweat lactate and sample volume. It contains two sensors entirely made of filter paper that can be easily affixed on the skin with medical-grade tape. The lactate biosensor features a unique signal modulation mechanism that enables fine-tuning the dynamic range. It consists of adding a competitive enzyme inhibitor in different reservoirs. Thanks to this, it is possible to choose between a very low limit of detection (0.06 mM) and a linear response in the physiological concentration range (10-30 mM). The sweat volume sensor was obtained by adding a reservoir containing gold nanoparticles. As the wearer sweats, the nanoparticles are carried through a paper channel. This is used to gauge the volume of sample by measuring the distance traveled by the nanoprobes. Using fine-tuned lactate biosensors and combining them with the volume sensors allowed us to quantify variations in the levels of sweat lactate independently of the wearer's sweat rate during an exercise routine. The platform design can be customized to meet the end user's needs, which makes it ideal for developing a wide array of disposable wearable biosensors.

Wearable strain sensor for real-time sweat volume monitoring

Reliably monitoring sweat volume has attracted much attention due to its important role in the assessment of physiological health conditions and the prevention of dehydration. Here, we present the first example of wearable strain sensor for real-time sweat volume monitoring. Such sweat volume monitoring sensor is simply fabricated via embedding strain sensing fabric in super-absorbent hydrogels, the hydrogels can wick sweat up off the skin surface to swell and then trigger the strain sensing fabrics response. This sensor can realize real-time detection of sweat volume (0.15-700 μL), shows excellent repeatability and stability against movement or light interference, reliability in the non-pathological range (pH: 4-9 and salinity: 0-100 mM NaCl) in addition. Such sensor combing swellable hydrogels with strain sensing fabrics provides a novel measurement method of wearable devices for sweat volume monitoring.

A Noninvasive Wearable Device for Real-Time Monitoring of Secretion Sweat Pressure by Digital Display

Sweat-based wearable devices have attracted increasing attention by providing abundant physiological information and continuous measurement through noninvasive healthcare monitoring. Sweat pressure generated via sweat glands to the skin surface associated with osmotic effects may help to elucidate such parameters as physiological conditions and psychological factors. This study introduces a wearable device for measuring secretion sweat pressure through noninvasive, continuous monitoring. Secretion pressure is detected by a microfluidic chip that shows the resistance variance from a paired electrode pattern and transfers digital signals to a smartphone for real-time display. A human study demonstrates this measurement with different exercise activities, showing the pressure ranges from 1.3 to 2.5 kPa. This device is user-friendly and applicable to exercise training and personal health care. The convenience and easy-to-wear characteristics of this device may establish a foundation for future research investigating sweat physiology and personal health care.

Recent Advances in Noninvasive Biosensors for Forensics, Biometrics, and Cybersecurity

Recently, biosensors have been used in an increasing number of different fields and disciplines due to their wide applicability, reproducibility, and selectivity. Three large disciplines in which this has become relevant has been the forensic, biometric, and cybersecurity fields. The call for novel noninvasive biosensors for these three applications has been a focus of research in these fields. Recent advances in these three areas has relied on the use of biosensors based on primarily colorimetric assays based on bioaffinity interactions utilizing enzymatic assays. In forensics, the use of different bodily fluids for metabolite analysis provides an alternative to the use of DNA to avoid the backlog that is currently the main issue with DNA analysis by providing worthwhile information about the originator. In biometrics, the use of sweat-based systems for user authentication has been developed as a proof-of-concept design utilizing the levels of different metabolites found in sweat. Lastly, biosensor assays have been developed as a proof-of-concept for combination with cybersecurity, primarily cryptography, for the encryption and protection of data and messages.

Flexible Multiplexed In2O3 Nanoribbon Aptamer-Field-Effect Transistors for Biosensing

Flexible sensors are essential for advancing implantable and wearable bioelectronics toward monitoring chemical signals within and on the body. Developing biosensors for monitoring multiple neurotransmitters in real time represents a key in vivo application that will increase understanding of information encoded in brain neurochemical fluxes. Here, arrays of devices having multiple In₂O₃ nanoribbon field-effect transistors (FETs) were fabricated on 1.4-μm-thick polyethylene terephthalate (PET) substrates using shadow mask patterning techniques. Thin PET-FET devices withstood crumpling and bending such that stable transistor performance with high mobility was maintained over >100 bending cycles. Real-time detection of the small-molecule neurotransmitters serotonin and dopamine was achieved by immobilizing recently identified high-affinity nucleic-acid aptamers on individual In₂O₃ nanoribbon devices. Limits of detection were 10 fM for serotonin and dopamine with detection ranges spanning eight orders of magnitude. Simultaneous sensing of temperature, pH, serotonin, and dopamine enabled integration of physiological and neurochemical data from individual bioelectronic devices.

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We fabricated flexible In₂O₃ nanoribbon transistors using cleanroom-free processes

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Flexible In₂O₃ transistors withstood crumpling and bending with stable performance

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Flexible aptamer biosensors detect neurotransmitters in real time

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Multiplexed sensors monitor temperature, pH, serotonin, and dopamine simultaneously