Non-invasive wearable electrochemical sensors: a review

Role of Wearable Sensing Technology to Manage Long COVID

Long COVID consequences have changed the perception towards disease management, and it is moving towards personal healthcare monitoring. In this regard, wearable devices have revolutionized the personal healthcare sector to track and monitor physiological parameters of the human body continuously. This would be largely beneficial for early detection (asymptomatic and pre-symptomatic cases of COVID-19), live patient conditions, and long COVID monitoring (COVID recovered patients and healthy individuals) for better COVID-19 management. There are multitude of wearable devices that can observe various human body parameters for remotely monitoring patients and self-monitoring mode for individuals. Smart watches, smart tattoos, rings, smart facemasks, nano-patches, etc., have emerged as the monitoring devices for key physiological parameters, such as body temperature, respiration rate, heart rate, oxygen level, etc. This review includes long COVID challenges for frequent monitoring of biometrics and its possible solution with wearable device technologies for diagnosis and post-therapy of diseases.

Applications of Smart Material Sensors and Soft Electronics in Healthcare Wearables for Better User Compliance

The need for innovation in the healthcare sector is essential to meet the demand of a rapidly growing population and the advent of progressive chronic ailments. Over the last decade, real-time monitoring of health conditions has been prioritized for accurate clinical diagnosis and access to accelerated treatment options. Therefore, the demand for wearable biosensing modules for preventive and monitoring purposes has been increasing over the last decade. Application of machine learning, big data analysis, neural networks, and artificial intelligence for precision and various power-saving approaches are used to increase the reliability and acceptance of smart wearables. However, user compliance and ergonomics are key areas that need focus to make the wearables mainstream. Much can be achieved through the incorporation of smart materials and soft electronics. Though skin-friendly wearable devices have been highlighted recently for their multifunctional abilities, a detailed discussion on the integration of smart materials for higher user compliance is still missing. In this review, we have discussed the principles and applications of sustainable smart material sensors and soft electronics for better ergonomics and increased user compliance in various healthcare devices. Moreover, the importance of nanomaterials and nanotechnology is discussed in the development of smart wearables.

A Step Forward for Smart Clothes─Fabric-Based Microfluidic Sensors for Wearable Health Monitoring

We report the first demonstration of fabric-based microfluidics for wearable sensing. A new technology to develop microfluidics on fabrics, as a part of an undergarment, is described here. Compared to conventional microfluidics from polydimethylsiloxane, fabric-based microfluidics are simple to make, robust, and suitable for efficient sweat delivery. Specifically, acrylonitrile butadiene styrene (ABS) films with precut microfluidic patterns were infused through fabrics to form hydrophobic areas in a specially controlled sandwich structure. Experimental tests and simulations confirmed the sweat delivery efficiency of the microfluidics. Electrodes were screen-printed onto the fabric-based microfluidic. A novel wearable potentiometer based on Arduino was also developed as the transducer and signal readouts, which was low-cost, standardized, open-source, and capable of wireless data transfer. We applied the sensor system as a standalone or as a module of a T-shirt to quantify [Ca²⁺] in a wearer's sweat, with physiological and accurate results generated. Overall, this work represents a critical step in turning regular undergarments into biochemically smart platforms for health monitoring, which will broadly benefit human healthcare.

Self-Testing of Ketone Bodies, along with Glucose, Using Touch-Based Sweat Analysis

β-Hydroxybutyrate (HB) is one of the main physiological ketone bodies that play key roles in human health and wellness. Besides their important role in diabetes ketoacidosis, ketone bodies are currently receiving tremendous attention for personal nutrition in connection to the growing popularity of oral ketone supplements. Accordingly, there are urgent needs for developing a rapid, simple, and low-cost device for frequent onsite measurements of β-hydroxybutyrate (HB), one of the main physiological ketone bodies. However, real-time profiling of dynamically changing HB concentrations is challenging and still limited to laboratory settings or to painful and invasive measurements (e.g., a commercial blood ketone meter). Herein, we address the critical need for pain-free frequent HB measurements in decentralized settings and report on a reliable noninvasive, simple, and rapid touch-based sweat HB testing and on its ability to track dynamic HB changes in secreted fingertip sweat, following the intake of commercial ketone supplements. The new touch-based HB detection method relies on an instantaneous collection of the fingertip sweat at rest on a porous poly(vinyl alcohol) (PVA) hydrogel that transports the sweat to a biocatalytic layer, composed of the β-hydroxybutyrate dehydrogenase (HBD) enzyme and its nicotinamide adenine dinucleotide (NAD⁺) cofactor, covering the modified screen-printed carbon working electrode. As a result, the sweat HB can be measured rapidly by the mediated oxidation reaction of the nicotinamide adenine dinucleotide (NADH) product. A personalized HB dose-response relationship is demonstrated within a group of healthy human subjects taking commercial ketone supplements, along with a correlation between the sweat and capillary blood HB levels. Furthermore, a dual disposable biosensing device, consisting of neighboring ketone and glucose enzyme electrodes on a single-strip substrate, has been developed toward the simultaneous touch-based detection of dynamically changing sweat HB and glucose levels, following the intake of ketone and glucose drinks.

Robust cholesteric liquid crystal elastomer fibres for mechanochromic textiles

Mechanically responsive textiles have transformative potential in many areas from fashion to healthcare. Cholesteric liquid crystal elastomers have strong mechanochromic responses that offer attractive opportunities for such applications. Nonetheless, making liquid crystalline elastomer fibres suitable for textiles is challenging since the Plateau-Rayleigh instability tends to break up precursor solutions into droplets. Here, we report a simple approach that balances the viscoelastic properties of the precursor solution to avoid this outcome and achieve long and mechanically robust cholesteric liquid crystal elastomer filaments. These filaments have fast, progressive and reversible mechanochromic responses, from red to blue (wavelength shift of 155 nm), when stretched up to 200%. Moreover, the fibres can be sewed into garments and withstand repeated stretching and regular machine washing. This approach and resulting fibres may be useful for applications in wearable technology and other areas benefiting from autonomous strain sensing or detection of critically strong deformations.

Synthesis of Aza-BODIPYs, Their Differential Binding for Cu(II), and Results of Bioimaging as Fluorescent Dyes of Langerhans β-Cells

Cellular labeling through the use of dyes is of great interest to the biomedical sciences for the characterization of the location and distribution of biomolecules and also for the tracking of the course of biological processes in both health and illness. This paper reports the synthesis, characterization, and subsequent evaluation as metal sensors and cell staining probes of four aza-BODIPY compounds [herein referred to as 7(a-d)]. Compounds 7(b-d) were found to display an outstanding selectivity for Cu(II) because their emission band at 720 nm was progressively quenched by this metal, presenting fluorescence quenching between 75 and 95%. On the other hand, cell imaging studies with pancreatic β-cells proved that aza-BODIPYs 7a and 7b showed selectivity for the cytoplasm, while 7c and 7d were selective for the cell membrane. Moreover, aza-BODIPY 7b allowed to characterize in a clear way a lipotoxic condition mediated by saturated fatty acids, a critical phenomenon on β-cell damage associated with diabetes mellitus type II. Taken together, the presented results highlight the obtained aza-BODIPY compounds as selective sensing/staining probes with the potential to be used in the biomedical field.

Flexible Wearable Sensors in Medical Monitoring

The popularity of health concepts and the wave of digitalization have driven the innovation of sensors in the medical field. Such continual development has made sensors progress in the direction of safety, flexibility, and intelligence for continuous monitoring of vital signs, which holds considerable promise for changing the way humans live and even treat diseases. To this end, flexible wearable devices with high performance, such as high sensitivity, high stability, and excellent biodegradability, have attracted strong interest from scientists. Herein, a review of flexible wearable sensors for temperature, heart rate, human motion, respiratory rate, glucose, and pH is highlighted. In addition, engineering issues are also presented, focusing on material selection, sensor fabrication, and power supply. Finally, potential challenges facing current technology and future directions of wearable sensors are also discussed.

Wearable chemical sensors for biomarker discovery in the omics era

Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.

A Conductive Hydrogel-Based Microneedle Platform for Real-Time pH Measurement in Live Animals

Conventional microneedles (MNs) have been extensively reported and applied toward a variety of biosensing and drug delivery applications. Hydrogel forming MNs with the added ability to electrically track health conditions in real-time is an area yet to be explored. The first conductive hydrogel microneedle (HMN) electrode that is capable of on-needle pH detection with no postprocessing required is presented here. The HMN array is fabricated using a swellable dopamine (DA) conjugated hyaluronic acid (HA) hydrogel, and is embedded with poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) to increase conductivity. The catechol-quinone chemistry intrinsic to DA is used to measure pH in interstitial fluid (ISF). The effect of PEDOT:PSS on the characteristics of the HMN array such as swelling capability and mechanical strength is fully studied. The HMN's capability for pH measurement is first demonstrated using porcine skin equilibrated with different pH solutions ranging from 3.5 to 9. Furthermore, the HMN-pH meter is capable of in vivo measurements with a 93% accuracy compared to a conventional pH probe meter. This HMN technology bridges the gap between traditional metallic electrochemical biosensors and the direct extraction of ISF, and introduces a platform for the development of polymeric wearable sensors capable of on-needle detection.

Ultra-Small Wearable Flexible Biosensor for Continuous Sweat Analysis

In the field of wearable sensing, small and precise sensors can greatly reduce the burden on the wearer and improve the sense of experience, which is the future direction of sensing development. Herein, we introduce an ultra-small wearable biosensor system that integrates an MS02 chip for real-time and highly accurate sweat detection. The whole system mainly includes flexible electrodes and a printed circle board (PCB). The size of the PCB is only 1.5 cm × 0.8 cm, which greatly minimizes the size of the sweat system and improves wearing comfort. Notably, this miniaturized system is comparable to a commercial electrochemical workstation, ensuring the reliability and accuracy of real-time analysis. The core processing MS02 chip, with a dimension of 1.2 mm × 1.1 mm, is used to perform electrochemical signal processing. By performing electrochemical characterization and measurements of the ultra-small wearable biosensor system, on-body monitoring of four biomarkers (glucose, lactate, Na⁺, and K⁺) in sweat of human volunteers has been successfully achieved. With the help of this electrochemical sensor system, mass of biochemical data from perspiration can be acquired to better understand the body's response to daily activities, which will facilitate the early prediction of abnormal physiological changes in the future.

Graphene-Based Sensor for the Detection of Cortisol for Stress Level Monitoring and Diagnostics

In this work, we study the sensing properties of multi-layer graphene combined with pyrrole in order to elaborate low-cost, high-sensitive material for cortisol detection. Graphene nanoplatelets and pyrrole were dispersed in a solution containing 1M HNO3 by using a powerful ultrasound probe for 10 min, then centrifuged for 30 min at 4000 rpm; polymerization was performed by cyclic voltammetry. The graphene-pyrrole composite was tested to ultra-low levels of cortisol in artificial saliva, consistent to the levels excreted in human salivary samples. The composite was further investigated by Raman spectroscopy and we modeled the interaction between the sensitive layer and cortisol using MarvinBeans software. It shows a good sensitivity for salivary values of cortisol cyclic voltammetry being able to detect a level down to 0.5 ng/mL cortisol.

Optical Measurement of Molar Absorption Coefficient of HbA1c: Comparison of Theoretical and Experimental Results

Diabetes can cause dangerous complications if not diagnosed in a timely manner. The World Health Organization accepts glycated hemoglobin (HbA1c) as a measure of diagnosing diabetes as it provides significantly more information on the glycemic behavior from a single blood sample than the fasting blood sugar reading. The molar absorption coefficient of HbA1c is needed to quantify the amount of HbA1c present in a blood sample. In this study, we measured the molar absorption coefficient of HbA1c in the range of 450 nm to 700 nm using optical methods experimentally. We observed that the characteristic peaks of the molar absorption coefficient of HbA1c (at 545 nm and 579 nm for level 1, at 544 nm and 577 nm for level 2) are in close agreement with those reported in previous studies. The molar absorption coefficient values were also found to be close to those of earlier reports. The average molar absorption coefficient values of HbA1c were found to be 804,403.5 M−1cm−1 at 545 nm and 703,704.5 M−1cm−1 at 579 nm for level 1 as well as 503,352.4 M−1cm−1 at 544 nm and 476,344.6 M−1cm−1 at 577 nm for level 2. Our experiments focused on calculating the molar absorption coefficients of HbA1c in the visible wavelength region, and the proposed experimental method has an advantage of being able to easily obtain the molar absorption coefficient at any wavelength in the visible wavelength region. The results of this study are expected to help future investigations on noninvasive methods of estimating HbA1c levels.

Graphene and Its Derivatives: Synthesis and Application in the Electrochemical Detection of Analytes in Sweat

Wearable sensors and invasive devices have been studied extensively in recent years as the demand for real-time human healthcare applications and seamless human-machine interaction has risen exponentially. An explosion in sensor research throughout the globe has been ignited by the unique features such as thermal, electrical, and mechanical properties of graphene. This includes wearable sensors and implants, which can detect a wide range of data, including body temperature, pulse oxygenation, blood pressure, glucose, and the other analytes present in sweat. Graphene-based sensors for real-time human health monitoring are also being developed. This review is a comprehensive discussion about the properties of graphene, routes to its synthesis, derivatives of graphene, etc. Moreover, the basic features of a biosensor along with the chemistry of sweat are also discussed in detail. The review mainly focusses on the graphene and its derivative-based wearable sensors for the detection of analytes in sweat. Graphene-based sensors for health monitoring will be examined and explained in this study as an overview of the most current innovations in sensor designs, sensing processes, technological advancements, sensor system components, and potential hurdles. The future holds great opportunities for the development of efficient and advanced graphene-based sensors for the detection of analytes in sweat.

A Wearable, Textile-Based Polyacrylate Imprinted Electrochemical Sensor for Cortisol Detection in Sweat

A wearable, textile-based molecularly imprinted polymer (MIP) electrochemical sensor for cortisol detection in human sweat has been demonstrated. The wearable cortisol sensor was fabricated via layer-by-layer assembly (LbL) on a flexible cotton textile substrate coated with a conductive nanoporous carbon nanotube/cellulose nanocrystal (CNT/CNC) composite suspension, conductive polyaniline (PANI), and a selective cortisol-imprinted poly(glycidylmethacrylate-co-ethylene glycol dimethacrylate) (poly(GMA-co-EGDMA)) decorated with gold nanoparticles (AuNPs), or plated with gold. The cortisol sensor rapidly (<2 min) responded to 9.8−49.5 ng/mL of cortisol, with an average relative standard deviation (%RSD) of 6.4% across the dynamic range, indicating excellent precision. The cortisol sensor yielded an excellent limit of detection (LOD) of 8.00 ng/mL, which is within the typical physiological levels in human sweat. A single cortisol sensor patch could be reused 15 times over a 30-day period with no loss in performance, attesting to excellent reusability. The cortisol sensor patch was successfully verified for use in quantification of cortisol levels in human sweat.

Nanomaterials-based portable electrochemical sensing and biosensing systems for clinical and biomedical applications

Miniaturized electrochemical sensing systems are employed in day-to-day uses in the several area from public health to scientific applications. A variety of electrochemical sensor and biosensor systems may not be effectively employed in real-world diagnostic laboratories and biomedical industries due to their limitation of portability, cost, analytical period, and need of skilled trainer for operating devices. The design of smart and portable sensors with high sensitivity, good selectivity, rapid measurement, and reusable platforms is the driving strength for sensing glucose, lactate, hydrogen peroxide, nitric oxide, mRNA, etc. The enhancement of sensing abilities of such sensor devices through the incorporation of both novel sensitive nanomaterials and design of sensor strategies are evidenced. Miniaturization, cost and energy efficient, online and quantitative detection and multiple sensing ability are the beneficial of the nanostructured-material-based electrochemical sensor and biosensor systems. Owing to the discriminating catalytic action, solidity and biocompatibility for designing sensing system, nanoscale materials empowered electrochemical detection systems are accomplished of being entrenched into/combined with portable or miniaturized devices for specific applications. In this review, the advance development of portable and smart sensing/biosensing systems derived from nanoscale materials for clinical and biomedical applications is described.

Graphical Abstract

Emerging Applications of Electrochemical Impedance Spectroscopy in Tear Film Analysis

Human tear film, with a flow rate of 1-3 µL/min, is a rich bodily fluid that transmits a variety of metabolites and hormones containing proteins, lipids and electrolytes that provide clues about ocular and systemic diseases. Analysis of disease biomarkers such as proteins, mRNA, enzymes and cytokines in the tear film, collected by noninvasive methods, can provide significant results for sustaining a predictive, preventive and personalized medicine regarding various diseases such as glaucoma, diabetic retinopathy, keratoconus, dry eye, cancer, Alzheimer's disease, Parkinson's disease and COVID-19. Electrochemical impedance spectroscopy (EIS) offers a powerful technique for analyzing these biomarkers. EIS detects electrical equivalent circuit parameters related to biorecognition of receptor-analyte interactions on the electrode surface. This method is advantageous as it performs a label-free detection and allows the detection of non-electroactive compounds that cannot be detected by direct electron transfer, such as hormones and some proteins. Here, we review the opportunities regarding the integration of EIS into tear fluid sampling approaches.

Non-Invasive Data Acquisition and IoT Solution for Human Vital Signs Monitoring: Applications, Limitations and Future Prospects

The rapid development of technology has brought about a revolution in healthcare stimulating a wide range of smart and autonomous applications in homes, clinics, surgeries and hospitals. Smart healthcare opens the opportunity for a qualitative advance in the relations between healthcare providers and end-users for the provision of healthcare such as enabling doctors to diagnose remotely while optimizing the accuracy of the diagnosis and maximizing the benefits of treatment by enabling close patient monitoring. This paper presents a comprehensive review of non-invasive vital data acquisition and the Internet of Things in healthcare informatics and thus reports the challenges in healthcare informatics and suggests future work that would lead to solutions to address the open challenges in IoT and non-invasive vital data acquisition. In particular, the conducted review has revealed that there has been a daunting challenge in the development of multi-frequency vital IoT systems, and addressing this issue will help enable the vital IoT node to be reachable by the broker in multiple area ranges. Furthermore, the utilization of multi-camera systems has proven its high potential to increase the accuracy of vital data acquisition, but the implementation of such systems has not been fully developed with unfilled gaps to be bridged. Moreover, the application of deep learning to the real-time analysis of vital data on the node/edge side will enable optimal, instant offline decision making. Finally, the synergistic integration of reliable power management and energy harvesting systems into non-invasive data acquisition has been omitted so far, and the successful implementation of such systems will lead to a smart, robust, sustainable and self-powered healthcare system.

Phytochemicals of mustard (Brassica Campestris) leaves tuned the nickel‐cobalt bimetallic oxide properties for enzyme‐free sensing of glucose

The fabrication of enzyme‐free glucose sensors is highly demanded for the biological, clinical, and food applications. In this study, we have developed a green method for tuning the surface properties of nickel‐cobalt bimetallic oxide (NiCo2O4) by adding mustard (Brassica Campestris) leaves extract during hydrothermal growth. The mustard (Brassica Campestris) leaves extract is rich with a variety of phytochemicals, which can easily tune the surface properties of NiCo2O4 nanostructures, thereby paving the way toward the development of sensitive and selective non‐enzymatic glucose sensors. The effect of various amounts of mustard (Brassica Campestris) leaves extract (0–20 ml) was also studied to find out the optimal conditions for growing surface‐modified NiCo2O4 nanostructures. The morphology and crystalline structure of the nanomaterials were studied by scanning electron microscopy (SEM) and powder X‐ray diffraction (XRD) techniques, respectively. The presence of an increasing quantity of mustard (Brassica Campestris) extract keeps the crystalline structure and the morphology of the NiCo2O4 nanostructures unaltered but changes their dimensions. All nanostructures show the same cubic spinel structure of NiCo2O4 and a morphology of spherical urchins composed of nanorods, but the diameter of the urchins decreases from ~10 μm to several nanometers, thus increasing the surface area of the nanomaterial. Furthermore, NiCo2O4 nanostructures were deposited onto glassy carbon electrodes (CGE), showing excellent catalytic properties toward the enzyme‐free detection of glucose using cyclic voltammetry. Importantly, the intensity of the oxidation current peak was linear over a wide range of glucose concentrations (from 0.1 to 10 mM) and the limit of detection (LOD) was estimated around 0.001 mM. Additionally, NiCo2O4 nanostructures grown in the presence of 20 ml of mustard leaf extract demonstrated good repeatability and excellent selectivity for glucose, without interference by other components such as urea, lactic acid, uric acid, ascorbic acid, as well as potassium and sodium ions. The combined results attest that mustard leaf extract has high potential as a green approach to improve the electrochemical properties of nanostructured materials, and could be useful for a wide range of materials for future electrochemical applications.

Microfluidic wearable electrochemical sweat sensors for health monitoring

Research on remote health monitoring through wearable sensors has attained popularity in recent decades mainly due to aging population and expensive health care services. Microfluidic wearable sweat sensors provide economical, non-invasive mode of sample collection, important physiological information, and continuous tracking of human health. Recent advances in wearable sensors focus on electrochemical monitoring of biomarkers in sweat and can be applicable in various fields like fitness monitoring, nutrition, and medical diagnosis. This review focuses on the evolution of wearable devices from benchtop electrochemical systems to microfluidic-based wearable sensors. Major classification of wearable sensors like skin contact-based and biofluidic-based sensors are discussed. Furthermore, sweat chemistry and related biomarkers are explained in addition to integration of microfluidic systems in wearable sweat sensors. At last, recent advances in wearable electrochemical sweat sensors are discussed, which includes tattoo-based, paper microfluidics, patches, wrist band, and belt-based wearable sensors.

A Smart Wristband Integrated with an IoT-Based Alarming System for Real-Time Sweat Alcohol Monitoring

Breathalyzer is a common approach to measuring blood alcohol concentration (BAC) levels of individuals suspected of drunk driving. Nevertheless, this device is relatively high-cost, inconvenient for people with limited breathing capacity, and risky for COVID-19 exposure. Here, we designed and developed a smart wristband integrating a real-time noninvasive sweat alcohol metal oxide (MOX) gas sensor with a Drunk Mate, an Internet of Thing (IoT)-based alarming system. A MOX sensor acquired transdermal alcohol concentration (TAC) which was converted to BAC and sent via the IoT network to the Blynk application platform on a smartphone, triggering alarming messages on LINE Notify. A user would receive an immediate alarming message when his BAC level reached an illegal alcohol concentration limit (BAC 50 mg%; TAC 0.70 mg/mL). The sensor readings showed a high linear correlation with TAC (R2 = 0.9815; limit of detection = 0.045 mg/mL) in the range of 0.10−1.05 mg/mL alcohol concentration in artificial sweat, achieving an accuracy of 94.66%. The sensor readings of ethanol in water were not statistically significantly different (p > 0.05) from the measurements in artificial sweat and other sweat-related solutions, suggesting that the device responded specifically to ethanol and was not affected by other electrolytes in the artificial sweat. Moreover, the device could continuously monitor TAC levels simulated in real-time in an artificial sweat testing system. With the integration of an IoT-based alarming system, the smart wristband developed from a commercial gas sensor presented here offers a promising low-cost MOX gas sensor monitoring technology for noninvasive and real-time sweat alcohol measurement and monitoring.

Gas Sensors Based on Single-Wall Carbon Nanotubes

Single-wall carbon nanotubes (SWCNTs) have a high aspect ratio, large surface area, good stability and unique metallic or semiconducting electrical conductivity, they are therefore considered a promising candidate for the fabrication of flexible gas sensors that are expected to be used in the Internet of Things and various portable and wearable electronics. In this review, we first introduce the sensing mechanism of SWCNTs and the typical structure and key parameters of SWCNT-based gas sensors. We then summarize research progress on the design, fabrication, and performance of SWCNT-based gas sensors. Finally, the principles and possible approaches to further improving the performance of SWCNT-based gas sensors are discussed.

Terahertz Asymmetric S-Shaped Complementary Metasurface Biosensor for Glucose Concentration

In this article, we present a free-standing terahertz metasurface based on asymmetric S-shaped complementary resonators under normal incidence in transmission mode configuration. Each unit cell of the metasurface consists of two arms of mirrored S-shaped slots. We investigate the frequency response at different geometrical asymmetry via modifying the dimensions of one arm of the resonator. This configuration enables the excitation of asymmetric quasi-bound states in the continuum resonance and, hence, features very good field confinement that is very important for biosensing applications. Moreover, the performance of this configuration as a biosensor was examined for glucose concentration levels from 54 mg/dL to 342 mg/dL. This range covers hypoglycemia, normal, and hyperglycemia diabetes mellitus conditions. Two sample coating scenarios were considered, namely the top layer when the sample covers the metasurface and the top and bottom layers when the metasurface is sandwiched between the two layers. This strategy enabled very large resonance frequency redshifts of 236.1 and 286.6 GHz that were observed for the two scenarios for a 342 mg/dL concentration level and a layer thickness of 20 μm. Furthermore, for the second scenario and the same thickness, a wavelength sensitivity of 322,749 nm/RIU was found, which represents a factor of 2.3 enhancement compared to previous studies. The suggested terahertz metasurface biosensor in this paper could be used in the future for identifying hypoglycaemia and hyperglycemia conditions.

Recent trends in layered double hydroxides based electrochemical and optical (bio)sensors for screening of emerging pharmaceutical compounds

The rapid expansion of the human population has given rise to new environmental and biomedical concerns, contributing to different advancements in the pharmaceutical industry. In the field of analytical chemistry over the last few years, layered double hydroxides (LDHs) have drawn significant attention, owing to their extraordinary properties. Furthermore, the novel advancement of LDH-based optical and electrochemical platforms to detect different pharmaceutical materials has acquired substantial attention because of their outstanding specificity, actual-time controlling, and user-friendliness. This review aims to recapitulate advanced LDHs-based optical and electrochemical sensors and biosensors to identify and measure important pharmaceutical compounds, such as anti-depressant, anti-inflammatory, anti-viral, anti-bacterial, anti-cancer, and anti-fungal drugs. Additionally, fundamental parameters, namely interactions between sensor and analyte, design rationale, classification, selectivity, and specificity are considered. Finally, the development of high-efficiency techniques for optical and electrochemical sensors and biosensors is featured to deliver scientists and readers a complete toolbox to identify a broad scope of pharmaceutical substances. Our goals are: (i) to elucidate the characteristics and capabilities of available LDHs for the identification of pharmaceutical compounds; and (ii) to deliver instances of the feasible opportunities that the existing devices have for the developed sensing of pharmaceuticals regarding the protection of ecosystems and human health at the global level.

Battery-free, tuning circuit-inspired wireless sensor systems for detection of multiple biomarkers in bodily fluids

Tracking the concentration of biomarkers in biofluids can provide crucial information about health status. However, the complexity and nonideal form factors of conventional digital wireless schemes impose challenges in realizing biointegrated, lightweight, and miniaturized sensors. Inspired by the working principle of tuning circuits in radio frequency electronics, this study reports a class of battery-free wireless biochemical sensors: In a resonance circuit, the coupling between a sensing interface and an inductor-capacitor oscillator through a pair of varactor diodes converts a change in electric potential into a modulation in capacitance, resulting in a quantifiable shift of the resonance circuit. Proper design of sensing interfaces with biorecognition elements enables the detection of various biomarkers, including ions, neurotransmitters, and metabolites. Demonstrations of "smart accessories" and miniaturized probes suggest the broad utility of this circuit model. The design concepts and sensing strategies provide a realistic pathway to building biointegrated electronics for wireless biochemical sensing.

Emerging Biosensors for Oral Cancer Detection and Diagnosis—A Review Unravelling Their Role in Past and Present Advancements in the Field of Early Diagnosis

Oral cancer is a serious concern to people all over the world because of its high mortality rate and metastatic spread to other areas of the body. Despite recent advancements in biomedical research, OC detection at an early stage remains a challenge and is complex and inaccurate with conventional diagnostics procedures. It is critical to study innovative approaches that can enable a faster, easier, non-invasive, and more precise diagnosis of OC in order to increase the survival rate of patients. In this paper, we conducted a review on how biosensors might be an excellent tool for detecting OC. This review covers the strategies that use different biosensors to target various types of biomarkers and focuses on biosensors that function at the molecular level viz. DNA biosensors, RNA biosensors, and protein biosensors. In addition, we reviewed non-invasive electrochemical methods, optical methods, and nano biosensors to analyze the OC biomarkers present in body fluids such as saliva and serum. As a result, this review sheds light on the development of ground-breaking biosensors for the early detection and diagnosis of OC.

Study of surface modification strategies to create glassy carbon-supported, aptamer-based sensors for continuous molecular monitoring

Electrochemical, aptamer-based (E-AB) sensors uniquely enable reagentless, reversible, and continuous molecular monitoring in biological fluids. Because of this ability, E-AB sensors have been proposed for therapeutic drug monitoring. However, to achieve translation from the bench to the clinic, E-AB sensors should ideally operate reliably and continuously for periods of days. Instead, because these sensors are typically fabricated on gold surfaces via self-assembly of alkanethiols that are prone to desorption from electrode surfaces, they undergo significant signal losses in just hours. To overcome this problem, our group is attempting to migrate E-AB sensor interfaces away from thiol-on-gold assembly towards stronger covalent bonds. Here, we explore the modification of carbon electrodes as an alternative substrate for E-AB sensors. We investigated three strategies to functionalize carbon surfaces: (I) anodization to generate surface carboxylic groups, (II) electrografting of arenediazonium ions, and (III) electrografting of primary aliphatic amines. Our results indicate that electrografting of primary aliphatic amines is the only strategy achieving monolayer organization and packing densities closely comparable to those obtained by alkanethiols on gold. In addition, the resulting monolayers enable covalent tethering of DNA aptamers and support electrochemical sensing of small molecule targets or complimentary DNA strands. These monolayers also achieve superior stability under continuous voltammetric interrogation in biological fluids relative to benchmark thiol-on-gold monolayers when a positive voltage scan window is used. Based on these results, we postulate the electrografting of primary aliphatic amines as a path forward to develop carbon-supported E-AB sensors with increased operational stability.

Wearable microfluidic patch with integrated capillary valves and pumps for sweat management and multiple biomarker analysis

Wearable sweat sensors are essential for providing insight into human physiological health. The currently developed microfluidic sweat sensors have demonstrated the function of collecting and storing sweat. However, they detect more average concentrations of substances based on time periods, which leads to the fact that in situ real-time measurement for multiple biomarkers remains a grand challenge. Here, we propose a wearable epidermal microfluidic patch with integrated microfluidic pumps and micro-valves for accelerated and continuous collection of the sweat, where the micro-pumps ensure the complete separation of old and new sweat for real-time detection of real concentration of biomarkers in sweat. The biomarker concentration at different time periods is detected by introducing a burst valve, which is used to assist in the analysis of the real-time detection. A quantitative relationship between the minimum burst pressure difference required for sequential collection and the size of the microchannel structure is established to overcome the effects of additional resistance at the gas-liquid interface. Additionally, the sensing modules, including sodium ion, chlorine ion, glucose, and pH level in sweat, are integrated into the patch to realize in situ, real-time detection of multiple biomarkers in the human sweat, decoding the correlation between changes in substance concentrations and physiological conditions. This work provides a unique and simplifying strategy for developing wearable sweat sensors for potential applications in health monitoring and disease diagnostics.

Fluorescence Sensing Technologies for Ophthalmic Diagnosis

Personalized and point-of-care (POC) diagnoses are critical for ocular physiology and disease diagnosis. Real-time monitoring and continuous sampling abilities of tear fluid and user-friendliness have become the key characteristics for the applied ophthalmic techniques. Fluorescence technologies, as one of the most popular methods that can fulfill the requirements of clinical ophthalmic applications for optical sensing, have been raised and applied for tear sensing and diagnostic platforms in recent decades. Wearable sensors in this case have been increasingly developed for ocular diagnosis. Contact lenses, as one of the commercialized and popular tools for ocular dysfunction, have been developed as a platform for fluorescence sensing in tears diagnostics and real-time monitoring. Numbers of biochemical analytes have been examined through developed fluorescent contact lens sensors, including pH values, electrolytes, glucose, and enzymes. These sensors have been proven for monitoring ocular conditions, enhancing and detecting medical treatments, and tracking efficiency of related ophthalmic surgeries at POC settings. This review summarizes the applied ophthalmic fluorescence sensing technologies in tears for ocular diagnosis and monitoring. In addition, the cooperation of fabricated fluorescent sensor with mobile phone readout devices for diagnosing ocular diseases with specific biomarkers continuously is also discussed. Further perspectives for the developments and applications of fluorescent ocular sensing and diagnosing technologies are also provided.

Closing the loop for patients with Parkinson disease: where are we?

Although levodopa remains the most efficacious symptomatic therapy for Parkinson disease (PD), management of levodopa treatment during the advanced stages of the disease is extremely challenging. This difficulty is a result of levodopa's short half-life, a progressive narrowing of the therapeutic window, and major inter-patient and intra-patient variations in the dose-response relationship. Therefore, a suitable alternative to repeated oral administration of levodopa is being sought. Recent research efforts have focused on the development of novel levodopa delivery strategies and wearable physical sensors that track symptoms and disease progression. However, the need for methods to monitor the levels of levodopa present in the body in real time has been overlooked. Advances in chemical sensor technology mean that the development of wearable and mobile biosensors for continuous or frequent levodopa measurements is now possible. Such levodopa monitoring could help to deliver personalized and timely medication dosing to alleviate treatment-related fluctuations in the symptoms of PD. Therefore, with the aim of optimizing therapeutic management of PD and improving the quality of life of patients, we share our vision of a future closed-loop autonomous wearable 'sense-and-act' system. This system consists of a network of physical and chemical sensors coupled with a levodopa delivery device and is guided by effective big data fusion algorithms and machine learning methods.

State of the Art in Smart Portable, Wearable, Ingestible and Implantable Devices for Health Status Monitoring and Disease Management

Several illnesses that are chronic and acute are becoming more relevant as the world's aging population expands, and the medical sector is transforming rapidly, as a consequence of which the need for "point-of-care" (POC), identification/detection, and real time management of health issues that have been required for a long time are increasing. Biomarkers are biological markers that help to detect status of health or disease. Biosensors' applications are for screening for early detection, chronic disease treatment, health management, and well-being surveillance. Smart devices that allow continual monitoring of vital biomarkers for physiological health monitoring, medical diagnosis, and assessment are becoming increasingly widespread in a variety of applications, ranging from biomedical to healthcare systems of surveillance and monitoring. The term "smart" is used due to the ability of these devices to extract data with intelligence and in real time. Wearable, implantable, ingestible, and portable devices can all be considered smart devices; this is due to their ability of smart interpretation of data, through their smart sensors or biosensors and indicators. Wearable and portable devices have progressed more and more in the shape of various accessories, integrated clothes, and body attachments and inserts. Moreover, implantable and ingestible devices allow for the medical diagnosis and treatment of patients using tiny sensors and biomedical gadgets or devices have become available, thus increasing the quality and efficacy of medical treatments by a significant margin. This article summarizes the state of the art in portable, wearable, ingestible, and implantable devices for health status monitoring and disease management and their possible applications. It also identifies some new technologies that have the potential to contribute to the development of personalized care. Further, these devices are non-invasive in nature, providing information with accuracy and in given time, thus making these devices important for the future use of humanity.

Advanced materials used in wearable health care devices and medical textiles in the battle against coronavirus (COVID-19): A review

The novel coronavirus disease (COVID-19) has generated great confusion around the world, affecting people's lives and producing a large number of deaths. The development of portable and wearable devices is of great importance in several fields such as point-of-care medical applications and environmental monitoring. Wearable devices with an ability to collect various types of physiological records are progressively becoming incorporated into everyday life of people. Physiological indicators are essential health indicators and their monitoring could efficiently enable early discovery of disease. This would also help decrease the number of extra severe health problems, in disease avoidance, and lower the overall public sector health cost. Protective clothing is nowadays a main part of textiles classified as technical or industrial textiles. Protective clothing aims to protect its wearer from the harsh environmental impacts that may result in injury or death. Providing protection for the common population has also been taken seriously considering the anticipated disaster due to virus attacks. This review highlights the properties of the materials that are used in wearable health care device and medical textiles.

Mental Stress and Its Effects on Vascular Health

Coronary artery disease continues to be a major cause of morbidity and mortality despite significant advances in risk stratification and management. This has prompted the search for alternative nonconventional risk factors that may provide novel therapeutic targets. Psychosocial stress, or mental stress, has emerged as an important risk factor implicated in a higher incidence of cardiovascular events, and although our understanding of this far ranging and interesting phenomenon has developed greatly over recent times, there is still much to be learned regarding how to measure mental stress and how it may impact physical health. With the current coronavirus disease 2019 global pandemic and its incumbent lockdowns and social distancing, understanding the potentially harmful biological effects of stress related to life-changing events and social isolation has become even more important. In the current review our multidisciplinary team discusses stress from a psychosocial perspective and aims to define psychological stress as rigorously as possible; discuss the pathophysiologic mechanisms by which stress may mediate cardiovascular disease, with a particular focus to its effects on vascular health; outline existing methods and approaches to quantify stress by means of a vascular biomarker; outline the mechanisms whereby psychosocial stressors may have their pathologic effects ultimately transduced to the vasculature through the neuroendocrine immunologic axis; highlight areas for improvement to refine existing approaches in clinical research when studying the consequences of psychological stress on cardiovascular health; and discuss evidence-based therapies directed at reducing the deleterious effects of mental stress including those that target endothelial dysfunction. To this end we searched PubMed and Google Scholar to identify studies evaluating the relationship between mental or psychosocial stress and cardiovascular disease with a particular focus on vascular health. Search terms included "myocardial ischemia," "coronary artery disease," "mental stress," "psychological stress," "mental∗ stress∗," "psychologic∗ stress∗," and "cardiovascular disease∗." The search was limited to studies published in English in peer-reviewed journals between 1990 and the present day. To identify potential studies not captured by our database search strategy, we also searched studies listed in the bibliography of relevant publications and reviews.

Towards skin-acetone monitors with selective sensitivity: Dynamics of PANI-CA films

Most research aimed at measuring biomarkers on the skin is only concerned with sensing chemicals in sweat using electrical signals, but these methods are not truly non-invasive nor non-intrusive because they require substantial amounts of sweat to get a reading. This project aims to create a truly non-invasive wearable sensor that continuously detects the gaseous acetone (a biomarker related to metabolic disorders) that ambiently comes out of the skin. Composite films of polyaniline and cellulose acetate, exhibiting chemo-mechanical actuation upon exposure to gaseous acetone, were tested in the headspaces above multiple solutions containing acetone, ethanol, and water to gauge response sensitivity, selectivity, and repeatability. The bending of the films in response to exposures to these environments was tracked by an automatic video processing code, which was found to out-perform an off-the-shelf deep neural network-based tracker. Using principal component analysis, we showed that the film bending is low dimensional with over 90% of the shape changes being captured with just two parameters. We constructed forward models to predict shape changes from the known exposure history and found that a linear model can explain 40% of the observed variance in film tip angle changes. We constructed inverse models, going from third order fits of shape changes to acetone concentrations where about 45% of the acetone variation and about 30% of ethanol variation are captured by linear models, and non-linear models did not perform substantially better. This suggests there is sufficient sensitivity and inherent selectivity of the films. These models, however, provide evidence for substantial hysteretic or long-time-scale responses of the PANI films, seemingly due to the presence of water. Further experiments will allow more accurate discrimination of unknown exposure environments. Nevertheless, the sensor will operate with high selectivity in low sweat body locations, like behind the ear or on the nails.

Glucose-to-Resistor Transduction Integrated into a Radio-Frequency Antenna for Chip-less and Battery-less Wireless Sensing

To maximize the potential of 5G infrastructure in healthcare, simple integration of biosensors with wireless tag antennas would be beneficial. This work introduces novel glucose-to-resistor transduction, which enables simple, wireless biosensor design. The biosensor was realized on a near-field communication tag antenna, where a sensing bioanode generated electrical current and electroreduced a nonconducting antenna material into an excellent conductor. For this, a part of the antenna was replaced by a Ag nanoparticle layer oxidized to high-resistance AgCl. The bioanode was based on Au nanoparticle-wired glucose dehydrogenase (GDH). The exposure of the cathode-bioanode to glucose solution resulted in GDH-catalyzed oxidation of glucose at the bioanode with a concomitant reduction of AgCl to highly conducting Ag on the cathode. The AgCl-to-Ag conversion strongly affected the impedance of the antenna circuit, allowing wireless detection of glucose. Mimicking the final application, the proposed wireless biosensor was ultimately evaluated through the measurement of glucose in whole blood, showing good agreement with the values obtained with a commercially available glucometer. This work, for the first time, demonstrates that making a part of the antenna from the AgCl layer allows achieving simple, chip-less, and battery-less wireless sensing of enzyme-catalyzed reduction reaction.

Machine-Learning-Based Noninvasive In Vivo Estimation of HbA1c Using Photoplethysmography Signals

Glycated hemoglobin (HbA1c) is an important factor in monitoring diabetes. Since the glycated hemoglobin value reflects the average blood glucose level over 3 months, it is not affected by exercise or food intake immediately prior to measurement. Thus, it is used as the most basic measure of evaluating blood-glucose control over a certain period and predicting the occurrence of long-term complications due to diabetes. However, as the existing measurement methods are invasive, there is a burden on the measurement subject who has to endure increased blood gathering and exposure to the risk of secondary infections. To overcome this problem, we propose a machine-learning-based noninvasive estimation method in this study using photoplethysmography (PPG) signals. First, the development of the device used to acquire the PPG signals is described in detail. Thereafter, discriminative and effective features are extracted from the acquired PPG signals using the device, and a machine-learning algorithm is used to estimate the glycated hemoglobin value from the extracted features. Finally, the performance of the proposed method is evaluated by comparison with existing model-based methods.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

Human sweat-based wearable glucose sensor on cotton fabric for real-time monitoring

In this work, a human sweat-based wearable sensor for real-time glucose monitoring has been fabricated on a cotton substrate after treating it with a two-step polymerization of pyrrole. The pyrrole-treated fabric was coated with solution of copper sulphate pentahydrate to grow Cu layer. The cotton/pyrrole/Cu fabric was treated with the solutions of copper acetate and manganese acetate to form Cu–Mn transition-metal alloy via electrochemical deposition technique. Results indicate that the developed sensor is reliable with glucose detection limit of 125 µM and 378 µM. In addition, the sensor output ranged between 50 and 400 µM glucose with coefficient of correlation, R2 = 0.983, indicating a linear range of output current. The sensor's response is not significantly affected by interferents. The developed sensor is also validated on human sweat with satisfactory results.

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

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

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.

Detection of the level of attention in children with ADHD through brain waves and corporal posture1

In the current world, the need to know instantaneous information that helps people to know their current physical and intellectual conditions has become paramount, each time new systems that provide information to the user in real time are incorporated in portable devices. This information indicates different health parameters of the user, it can be obtained through their physiological variables such as: number of steps, heart rate, oxygenation level in the blood and other ones. One of the most requested intellectual conditions to be known by the user is: the level of attention reached when the user executes a task. This work describes a methodology and the experimentation to know the level of attention of people through a test to identify colors also are shown the development and the application of a system (hardware and software) to measure the level of attention of people using two input signals: corporal posture and brain waves. The mathematical analysis to find the correlation between the corporal posture and the level of attention is shown in this paper. The results obtained indicate that the corporal posture influences on the level of attention of people directly.