Non-invasive wearable electrochemical sensors: a review

Battery-free, skin-interfaced microfluidic/electronic systems for simultaneous electrochemical, colorimetric, and volumetric analysis of sweat

Wearable sweat sensors rely either on electronics for electrochemical detection or on colorimetry for visual readout. Non-ideal form factors represent disadvantages of the former, while semiquantitative operation and narrow scope of measurable biomarkers characterize the latter. Here, we introduce a battery-free, wireless electronic sensing platform inspired by biofuel cells that integrates chronometric microfluidic platforms with embedded colorimetric assays. The resulting sensors combine advantages of electronic and microfluidic functionality in a platform that is significantly lighter, cheaper, and smaller than alternatives. A demonstration device simultaneously monitors sweat rate/loss, pH, lactate, glucose, and chloride. Systematic studies of the electronics, microfluidics, and integration schemes establish the key design considerations and performance attributes. Two-day human trials that compare concentrations of glucose and lactate in sweat and blood suggest a potential basis for noninvasive, semi-quantitative tracking of physiological status.

Three-Dimensional Integrated Ultra-Low-Volume Passive Microfluidics with Ion-Sensitive Field-Effect Transistors for Multiparameter Wearable Sweat Analyzers

Wearable systems could offer noninvasive and real-time solutions for monitoring of biomarkers in human sweat as an alternative to blood testing. Recent studies have demonstrated that the concentration of certain biomarkers in sweat can be directly correlated to their concentrations in blood, making sweat a trusted biofluid candidate for noninvasive diagnostics. We introduce a fully on-chip integrated wearable sweat sensing system to track biochemical information at the surface of the skin in real time. This system heterogeneously integrates, on a single silicon chip, state-of-the-art ultrathin body (UTB) fully depleted silicon-on-insulator (FD-SOI) ISFET sensors with a biocompatible microfluidic interface, to deliver a "lab-on-skin" sensing platform. A full process for the fabrication of this system is proposed in this work and is demonstrated by standard semiconductor fabrication procedures. The system is capable of collecting small volumes of sweat from the skin of a human and posteriorly passively driving the biofluid, by capillary action, to a set of functionalized ISFETs for analysis of pH level and Na⁺ and K⁺ concentrations. Drop-casted ion-sensing membranes on different sets of sensors on the same substrate enable multiparameter analysis on the same chip, with small and controlled cross-sensitivities, whereas a miniaturized quasireference electrodes set a stable analyte potential, avoiding the use of a cumbersome external reference electrode. The progress of lab-on-skin technology reported here can lead to autonomous wearable systems enabling real-time continuous monitoring of sweat composition, with applications ranging from medicine to lifestyle behavioral engineering and sports.

Real-time intradermal continuous glucose monitoring using a minimally invasive microneedle-based system

Continuous glucose monitoring (CGM) has the potential to greatly improve diabetes management. The aim of this work is to show a proof-of-concept CGM device which performs minimally invasive and minimally delayed in-situ glucose sensing in the dermal interstitial fluid, combining the advantages of microneedle-based and commercially available CGM systems. The device is based on the integration of an ultra-miniaturized electrochemical sensing probe in the lumen of a single hollow microneedle, separately realized using standard silicon microfabrication methods. By placing the sensing electrodes inside the lumen facing an opening towards the dermal space, real-time measurement purely can be performed relying on molecular diffusion over a short distance. Furthermore, the device relies only on passive capillary lumen filling without the need for complex fluid extraction mechanisms. Importantly, the transdermal portion of the device is 50 times smaller than that of commercial products. This allows access to the dermis and simultaneously reduces tissue trauma, along with being virtually painless during insertion. The three-electrode enzymatic sensor alone was previously proven to have satisfactory sensitivity (1.5 nA/mM), linearity (up to 14 mM), selectivity, and long-term stability (up to 4 days) in-vitro. In this work we combine this sensor technology with microneedles for reliable insertion in forearm skin. In-vivo human tests showed the possibility to correctly and dynamically track glycaemia over time, with approximately 10 min delay with respect to capillary blood control values, in line with the expected physiological lag time. The proposed device can thus reduce discomfort and potentially enable less invasive real-time CGM in diabetic patients.

Development of a selective chloride sensing platform using a screen-printed platinum electrode

A new and selective voltammetric method for chloride determination is proposed, based on platinum and chloride interactions. A screen-printed platinum electrode (SPPtE) functions as a sensing platform, which promotes the formation of chloro-adsorbed species on the electrode surface, acting as an effective means of anion-determination in several matrices. The pretreatment of the SPPtE and careful control of the cathodic stripping voltammetric parameters yielded a well-defined electrochemical signal. This cathodic peak was due to the adsorption of chlorine, which had previously been oxidized from chloride anions in the initial anodic deposition step. It offers a simple, low-cost, fast, reproducible (RSD < 6%) and precise method for selective chloride determination, with limit of detection of 0.76 mM, and a sensitivity of - 24.147 µA mM ^-1 for a broad determination range of up to 150 mM. Chloride determination was correctly performed with single drops of environmental, pharmaceutical and food samples. In addition, the sensor was successfully adapted as a flexible screen-printed platinum electrode sensor using Gore-Tex^® as support for printing.

Chemical Sensing at the Robot Fingertips: Toward Automated Taste Discrimination in Food Samples

The development of robotic sensors that mimic the human sensing capabilities is critical for the interaction and cognitive abilities of modern robots. Though robotic skin with embedded pressure or temperature sensors has received recent attention, robotic chemical sensors have long been unnoticed due to the challenges associated with realizing chemical sensing modalities on robotic platforms. For realizing such chemically sensitive robotic skin, we exploit here the recent advances in wearable chemical sensor technology and flexible electronics, and describe chemical sensing robotic fingers for rapid screening of food flavors and additives. The stretchable taste-sensing finger electrochemical devices are printed on the robotic glove, which simulates the soft skin, and are integrated with a wireless electronic board for real-time data transmission. The printed middle, index, and ring robotic fingers allow accurate discrimination between sweetness, sourness, and spiciness, via direct electrochemical detection of glucose, ascorbic acid, and capsaicin. The sweet-sensing ability has been coupled with a caffeine-sensing robotic finger for rapid screening of the presence of sugar and caffeine in common beverages. The "sense of taste" chemically sensitive robotic technology thus enables accurate discrimination between different flavors, as was illustrated in numerous tests involving a wide range of liquid and solid food samples. Such realization of advanced wearable taste-sensing systems at the robot fingertips should pave the way to automated chemical sensing machinery, facilitating robotic decision for practical food assistance applications, with broad implications to a wide range of robotic sensing applications.

Wearable Bioelectronics: Enzyme-Based Body-Worn Electronic Devices

In this Account, we detail recent progress in wearable bioelectronic devices and discuss the future challenges and prospects of on-body noninvasive bioelectronic systems. Bioelectronics is a fast-growing interdisciplinary research field that involves interfacing biomaterials with electronics, covering an array of biodevices, encompassing biofuel cells, biosensors, ingestibles, and implantables. In particular, enzyme-based bioelectronics, built on diverse biocatalytic reactions, offers distinct advantages and represents a centerpiece of wearable biodevices. Such wearable bioelectronic devices predominately rely on oxidoreductase enzymes and have already demonstrated considerable promise for on-body applications ranging from highly selective noninvasive biomarker monitoring to epidermal energy harvesting. These systems can thus greatly increase the analytical capability of wearable devices from the ubiquitous monitoring of mobility and vital signs, toward the noninvasive analysis of important chemical biomarkers. Wearable enzyme electrodes offer exciting opportunities to a variety of areas, spanning from healthcare, sport, to the environment or defense. These include real-time noninvasive detection of biomarkers in biofluids (such as sweat, saliva, interstitial fluid and tears), and the monitoring of environmental pollutants and security threats in the immediate surrounding of the wearer. Furthermore, the interface of enzymes with conducting flexible electrode materials can be exploited for developing biofuel cells, which rely on the bioelectrocatalytic oxidation of biological fuels, such as lactate or glucose, for energy harvesting applications. Crucial for such successful application of enzymatic bioelectronics is deep knowledge of enzyme electron-transfer kinetics, enzyme stability, and enzyme immobilization strategies. Such understanding is critical for establishing efficient electrical contacting between the redox enzymes and the conducting electrode supports, which is of fundamental interest for the development of robust and efficient bioelectronic platforms. Furthermore, stretchable and flexible bioelectronic platforms, with mechanical properties similar to those of biological tissues, are essential for handling the rigors of on-body operation. As such, special attention must be given to changes in the behavior of enzymes due to the uncontrolled conditions of on-body operation (including diverse outdoor activities and different biofluids), for maintaining the attractive performance that these bioelectronics devices display in controlled laboratory settings. Therefore, a focus of this Account is on interfacing biocatalytic layers onto wearable electronic devices for creating efficient and stable on-body electrochemical biosensors and biofuel cells. With proper attention to key challenges and by leveraging the advantages of biocatalysis, electrochemistry, and flexible electronics, wearable bioelectronic devices could have a tremendous impact on diverse biomedical, fitness, and defense fields.

A novel electrochemical sensor for non-invasive monitoring of lithium levels in mood disorders

Lithium is the main drug for the treatment of mood disorders. Due to its narrow therapeutic window, Therapeutic Drug Monitoring (TDM) is a norm during therapy in order to avoid adverse effects. Consequently, patients are obliged to frequent check-ups in hospitals to determine their serum concentration and optimize accordingly the drug dose. Wearable sensors have attracted a growing interest in the research community in recent years owing to their promising impact in personalized healthcare. In particular, sweat diagnosis has seen an enormous expansion and is currently entering the market thanks to the large availability and simple collection of this fluid. In this paper a novel approach for non-invasive decentralized monitoring of lithium drug concentration through sweat analysis is proposed for the first time. An all-solid-state Ion- Selective Electrode (ISE) with a nanostructured Solid-Contact (SC) is used to detect lithium ions in sweat. The sensor offers near-Nernstian behaviour (57:6±2:1 mV/decade) in the concentration range of interest. In addition, it shows fast response (15-30 s), good reversibility and small potential drift over time. A wide pH stability window (pH 4-12) is also proved.

Vertical Gold Nanowires Stretchable Electrochemical Electrodes

Conventional electrodes produced from gold or glassy carbon are outstanding electrochemical platforms for biosensing applications due to their chemical inertness and wide electrochemical window, but are intrinsically rigid and planar in nature. Hence, it is challenging to seamlessly integrate them with soft and curvilinear biological tissues for real-time wearable or implantable electronics. In this work, we demonstrate that vertically gold nanowires (v-AuNWs) possess an enokitake-like structure, with the nanoparticle (head) on one side and nanowires (tail) on the opposite side of the structure, and can serve as intrinsically stretchable, electrochemical electrodes due to the stronger nanowire-elastomer bonding forces preventing from interfacial delamination under strains. The exposed head side of the electrode comprising v-AuNWs can achieve a detection limit for H₂O₂ of 80 μM, with a linear range of 0.2-10.4 mM at 20% strain, with a reasonably high sensitivity using chronoamperometry. This excellent electrochemical performance in the elongated state, in conjunction with low-cost wet-chemistry fabrication, demonstrates that v-AuNWs electrodes may become a next-generation sensing platform for conformally integrated, in vivo biodiagnostics.

Wearable Sensor System for Detection of Lactate in Sweat

Increased development of wearable sensors for physiological monitoring has spurred complementary interest in the detection of biochemical indicators of health and performance. We report a wearable sensor system for non-invasive detection of excreted human biomarkers in sweat. The system consists of a thin, flexible, kapton patch (2.5 × 7.5 cm) that can be coated with adhesive and affixed to the skin. The system can be controlled by a cell phone via a near-field communications protocol, charged wirelessly, and the data can be downloaded and displayed in a smart phone app. The system is designed such that the sensing element plugs into a low-profile socket, and can easily be removed and replaced as needed due to saturation or aging effects. As a demonstration case, we examined using an organic electrochemical transistor (OECT) within this system to monitor lactate concentration. Several different methods for optimizing the sensor performance were compared, including altering electrode materials, employing various immobilization techniques, and tailoring operating voltages. Resulting functional response of the lactate oxidase enzyme was compared as a function of the sensor variables. The OECT sensor was shown to have high sensitivity to lactate, however the sensing range is limited to lactate concentrations below approximately 1 mM.

Hydrodynamic Layer-by-Layer Assembly of Transferable Enzymatic Conductive Nanonetworks for Enzyme-Sticker-Based Contact Printing of Electrochemical Biosensors

Realizing high-performance electrochemical biosensors in a simple contact-printing-based approach significantly increases the applicability of integrated flexible biosensors. Herein, an enzyme-sticker-based approach that enables flexible and multielectrochemical sensors via simple contact-transfer printing is reported. The enzyme sticker consists of an enzymatic conductive network film and a polymeric support. The enzyme-incorporated nanostructured conductive network showing an efficient electrical coupling was assembled via the hydrodynamic layer-by-layer assembly of redox enzymes, polyelectrolytes, single-walled carbon nanotubes, and a biological glue material, M13 phage. The enzymatic conductive network on a polymeric membrane support was facilely wet contact-transfer printed onto integrated electrode systems by exploiting varying degrees of hydrophilicity displayed by the enzymatic electronic film, polymeric support, and receiving electrodes of the sensor system. The glucose sensors fabricated using the enzyme sticker detected glucose at a concentration of as low as 35 μM and showed high selectivity and stability. Furthermore, a flexible dual-sensor array capable of detecting both glucose and lactate was demonstrated using the versatile enzyme sticker concept. This work presents a new route toward assembling and integrating hybrid nanomaterials with efficient electrochemical coupling for high-performance biosensors and health-monitoring devices as well as for emerging bioelectronics and electrochemical devices.

Accurate real time localization tracking in a clinical environment using Bluetooth Low Energy and deep learning

Deep learning has started to revolutionize several different industries, and the applications of these methods in medicine are now becoming more commonplace. This study focuses on investigating the feasibility of tracking patients and clinical staff wearing Bluetooth Low Energy (BLE) tags in a radiation oncology clinic using artificial neural networks (ANNs) and convolutional neural networks (CNNs). The performance of these networks was compared to relative received signal strength indicator (RSSI) thresholding and triangulation. By utilizing temporal information, a combined CNN+ANN network was capable of correctly identifying the location of the BLE tag with an accuracy of 99.9%. It outperformed a CNN model (accuracy = 94%), a thresholding model employing majority voting (accuracy = 95%), and a triangulation classifier utilizing majority voting (accuracy = 95%). Future studies will seek to deploy this affordable real time location system in hospitals to improve clinical workflow, efficiency, and patient safety.

Potentiometry as a Tool for Monitoring of Antioxidant Activity and Oxidative Stress Estimation in Medicine

The complexity of biological objects and the rapid change in their composition after sampling, the variety of compounds of different chemical nature, possessing oxidative and antioxidant properties, make the task of its estimating extremely nontrivial and important for food, nutrients and human health characterization. The paper discusses the use of potentiometry in determining integral antioxidant/oxidant activity mainly of biological fluids and human skin. The source of information is the electrode potential shift that occurs when the analyzed object is inserted in the solution of the mediator system or when the mediator system is exposed to human skin. The experimental approaches, protocols, calculations are described. A number of examples of antioxidant activity and oxidative stress estimation in medicine are presented. The works show lower levels of antioxidant activity (AOA) of plasma and blood serum in patients with cardiovascular diseases, obesity, and malignant neoplasms as compared with the healthy volunteers. It was found out that antioxidant activity of fertile men semen is higher than AOA of infertile patients. Using the method discussed have shown that in some infertile male patients antioxidant activity of semen has been accompanied by oxidant activity. It has been found, that antioxidant activity of skin increases after intake of ascorbic acid and vitamin-enriched juices. The described approach holds considerable promise for monitoring oxidative stress of the whole organism and its systems, and for selecting effective and safe therapy. Thus, it opens up new opportunities in expanding the use of analytical chemistry in such an important field as medicine.

Blending Electronics with the Human Body: A Pathway toward a Cybernetic Future

At the crossroads of chemistry, electronics, mechanical engineering, polymer science, biology, tissue engineering, computer science, and materials science, electrical devices are currently being engineered that blend directly within organs and tissues. These sophisticated devices are mediators, recorders, and stimulators of electricity with the capacity to monitor important electrophysiological events, replace disabled body parts, or even stimulate tissues to overcome their current limitations. They are therefore capable of leading humanity forward into the age of cyborgs, a time in which human biology can be hacked at will to yield beings with abilities beyond their natural capabilities. The resulting advances have been made possible by the emergence of conformal and soft electronic materials that can readily integrate with the curvilinear, dynamic, delicate, and flexible human body. This article discusses the recent rapid pace of development in the field of cybernetics with special emphasis on the important role that flexible and electrically active materials have played therein.

Simultaneous Monitoring of Sweat and Interstitial Fluid Using a Single Wearable Biosensor Platform

The development of wearable biosensors for continuous noninvasive monitoring of target biomarkers is limited to assays of a single sampled biofluid. An example of simultaneous noninvasive sampling and analysis of two different biofluids using a single wearable epidermal platform is demonstrated here. The concept is successfully realized through sweat stimulation (via transdermal pilocarpine delivery) at an anode, alongside extraction of interstitial fluid (ISF) at a cathode. The system thus allows on-demand, controlled sampling of the two epidermal biofluids at the same time, at two physically separate locations (on the same flexible platform) containing different electrochemical biosensors for monitoring the corresponding biomarkers. Such a dual biofluid sampling and analysis concept is implemented using a cost-effective screen-printing technique with body-compliant temporary tattoo materials and conformal wireless readout circuits to enable real-time measurement of biomarkers in the sampled epidermal biofluids. The performance of the developed wearable device is demonstrated by measuring sweat-alcohol and ISF-glucose in human subjects consuming food and alcoholic drinks. The different compositions of sweat and ISF with good correlations of their chemical constituents to their blood levels make the developed platform extremely attractive for enhancing the power and scope of next-generation noninvasive epidermal biosensing systems.

Fabrication and Optimization of Fiber-Based Lithium Sensor: A Step toward Wearable Sensors for Lithium Drug Monitoring in Interstitial Fluid

A miniaturized, flexible fiber-based lithium sensor was fabricated from low-cost cotton using a simple, repeatable dip-coating technique. This lithium sensor is highly suited for ready-to-use wearable applications and can be used directly without the preconditioning steps normally required with traditional ion-selective electrodes. The sensor has a stable, rapid, and accurate response over a wide Li⁺ concentration range that spans over the clinically effective and the toxic concentration limits for lithium in human serum. The sensor is selective to Li⁺ in human plasma even in the presence of a high concentration of Na⁺ ions. This novel sensor concept represents a significant advance in wearable sensor technology which will target lithium drug monitoring from under the skin.

Noninvasive Glucose Monitoring with a Contact Lens and Smartphone

Diabetes has become a chronic metabolic disorder, and the growing diabetes population makes medical care more important. We investigated using a portable and noninvasive contact lens as an ideal sensor for diabetes patients whose tear fluid contains glucose. The key feature is the reversible covalent interaction between boronic acid and glucose, which can provide a noninvasive glucose sensor for diabetes patients. We present a phenylboronic acid (PBA)-based HEMA contact lens that exhibits a reversible swelling/shrinking effect to change its thickness. The difference in thickness can be detected in a picture taken with a smartphone and analyzed using software. Our novel technique offers the following capabilities: (i) non-enzymatic and continuous glucose detection with the contact lens; (ii) no need for an embedded circuit and power source for the glucose sensor; and (iii) the use of a smartphone to detect the change in thickness of the contact lens with no need for additional photo-sensors. This technique is promising for a noninvasive measurement of the glucose level and simple implementation of glucose sensing with a smartphone.

A novel semiconductor based wireless electrochemical sensing platform for chronic disease management

Electrochemical sensors are very versatile and can be used for a diverse range of biomedical applications. In this paper, a novel fully-integrated wireless electrochemical sensing platform is presented. The platform uses standard semiconductor technology to create a miniaturized integrated bioelectronics system that consists of an electrochemical sensor, potentiostat, signal processing circuitry, wireless power harvesting circuitry, and wireless telemetry unit, all on a single microchip. The platform is orders of magnitude smaller than the state-of-the-art sensing systems and costs a fraction. At 1.4 mm × 1.4 mm size, the sensor costs less than $1 to manufacture. The presented design provides fundamental advantages in decreasing sensor noise and settling time, thus providing superior response compared to existing solutions. System design and implementation details are presented as well as examples for metabolic sensing (glucose, lactate, O₂) applications. The system can have widespread applications in biosensing applications.

Micro additive manufacturing of glucose biosensors: A feasibility study

Flexible electrochemical sensors for measurement and quantification of biomarkers are attracting a great deal of attention in non-invasive medical applications, due to their high mechanical compatibility and conformability with the human body. Realization of the full potential of such novel systems relies heavily on their effective manufacturing. Particularly, there is a need for manufacturing techniques that can realize complex designs, consisting of multiple functional materials which are required for sensor functionality. Among emerging additive manufacturing techniques, Direct-Ink-Writing (DIW), where polymer nanocomposite inks are dispensed through nozzles and deposited with high spatial control, carries a great potential to address this need. Here, we introduce a 3D printed flexible electrochemical biosensor for glucose detection. We show that our biosensor works linearly in glucose solution with a concentration range between 100 and 1000 μM. The sensitivity of glucose biosensor is estimated to be 17.5 nA μM^-1, and the calculated value of the detection limit (S/N = 3) is 6.9 μM. The demonstrated electrochemical performance and surface properties of the printed sensors show the promising advantages of using this technique over the conventional screen printing method. These advantages include higher sensitivity and specificity and, reduced material consumption.

Addressing Unmet Clinical Needs with 3D Printing Technologies

Recent advances in 3D printing have enabled the creation of novel 3D constructs and devices with an unprecedented level of complexity, properties, and functionalities. In contrast to manufacturing techniques developed for mass production, 3D printing encompasses a broad class of fabrication technologies that can enable 1) the creation of highly customized and optimized 3D physical architectures from digital designs; 2) the synergistic integration of properties and functionalities of distinct classes of materials to create novel hybrid devices; and 3) a biocompatible fabrication approach that facilitates the creation and cointegration of biological constructs and systems. This progress report describes how these capabilities can potentially address a myriad of unmet clinical needs. First, the creation of 3D-printed prosthetics to regain lost functionalities by providing structural support for skeletal and tubular organs is highlighted. Second, novel drug delivery strategies aided by 3D-printed devices are described. Third, the advancement of medical research heralded by 3D-printed tissue/organ-on-chips systems is discussed. Fourth, the developments of 3D-printed tissue and organ regeneration are explored. Finally, the potential for seamless integration of engineered organs with active devices by leveraging the versatility of multimaterial 3D printing is envisioned.

Contact-Lens Biosensors

Rapid diagnosis and screening of diseases have become increasingly important in predictive and preventive medicine as they improve patient treatment strategies and reduce cost as well as burden on our healthcare system. In this regard, wearable devices are emerging as effective and reliable point-of-care diagnostics that can allow users to monitor their health at home. These wrist-worn, head-mounted, smart-textile, or smart-patches devices can offer valuable information on the conditions of patients as a non-invasive form of monitoring. However, they are significantly limited in monitoring physiological signals and biomechanics, and, mostly, rely on the physical attributes. Recently, developed wearable devices utilize body fluids, such as sweat, saliva, or skin interstitial fluid, and electrochemical interactions to allow continuous physiological condition and disease monitoring for users. Among them, tear fluid has been widely utilized in the investigation of ocular diseases, diabetes, and even cancers, because of its easy accessibility, lower complexity, and minimal invasiveness. By determining the concentration change of analytes within the tear fluid, it would be possible to identify disease progression and allow patient-oriented therapies. Considering the emerging trend of tear-based biosensing technology, this review article aims to focus on an overview of the tear fluid as a detection medium for certain diseases, such as ocular disorders, diabetes, and cancer. In addition, the rise and application of minimally invasive detection and monitoring via integrated contact lens biosensors will also be addressed, in regards to their practicality and current developmental progress.

Enhanced enzymatic activity from phosphotriesterase trimer gold nanoparticle bioconjugates for pesticide detection

The rapid detection of organophosphates (OPs), a class of strong neurotoxins, is critically important for monitoring acute insecticide exposure and potential chemical warfare agent use. Herein, we improve the enzymatic activity of a phosphotriesterase trimer (PTE₃), an enzyme that selectively recognizes OPs directly, by conjugation with distinctly sized (i.e., 5, 10, and 20 nm diameter) gold nanoparticles (AuNPs). The number of enzymes immobilized on the AuNP was controlled by conjugating increasing molar ratios of PTE₃ onto the AuNP surface via metal affinity coordination. This occurs between the PTE₃-His₆ termini and the AuNP-displayed Ni²⁺-nitrilotriacetic acid end groups and was confirmed with gel electrophoresis. The enzymatic efficiency of the resultant PTE₃-AuNP bioconjugates was analyzed via enzyme progress curves acquired from two distinct assay formats that compared free unbound PTE₃ with the following PTE₃-AuNP bioconjugates: (1) fixed concentration of AuNPs while increasing the bioconjugate molar ratio of PTE₃ displayed around the AuNP and (2) fixed concentration of PTE₃ while increasing the bioconjugate molar ratio of PTE₃-AuNP by decreasing the AuNP concentration. Both assay formats monitored the absorbance of p-nitrophenol that was produced as PTE₃ hydrolyzed the substrate paraoxon, a commercial insecticide and OP nerve agent simulant. Results demonstrate a general equivalent trend between the two formats. For all experiments, a maximum enzymatic velocity (V_max) increased by 17-fold over free enzyme for the lowest PTE₃-AuNP ratio and the largest AuNP (i.e., ratio of 1 : 1, 20 nm dia. AuNP). This work provides a route to improve enzymatic OP detection strategies with enzyme-NP bioconjugates.

Smart Portable Devices Suitable for Cultural Heritage: A Review

This article reviews recent portable sensor technologies to apply in the Cultural Heritage (CH) fields. The review has been prepared in the form of a retrospective description of the sensor's history and technological evolution, having: new nanomaterials for transducers, miniaturized, portable and integrated sensors, the wireless transmission of the analytical signals, ICT_Information Communication Technology and IoT_Internet of Things to apply to the cultural heritage field. In addition, a new trend of movable tattoo sensors devices is discussed, referred to in situ analysis, which is especially important when scientists are in the presence of un-movable and un-tangible Cultural Heritage and Art Work objects. The new proposed portable contact sensors (directly applied to art work objects and surfaces) are non-invasive and non-destructive to the different materials and surfaces of which cultural heritage is composed.

Wearable Health Devices-Vital Sign Monitoring, Systems and Technologies

Wearable Health Devices (WHDs) are increasingly helping people to better monitor their health status both at an activity/fitness level for self-health tracking and at a medical level providing more data to clinicians with a potential for earlier diagnostic and guidance of treatment. The technology revolution in the miniaturization of electronic devices is enabling to design more reliable and adaptable wearables, contributing for a world-wide change in the health monitoring approach. In this paper we review important aspects in the WHDs area, listing the state-of-the-art of wearable vital signs sensing technologies plus their system architectures and specifications. A focus on vital signs acquired by WHDs is made: first a discussion about the most important vital signs for health assessment using WHDs is presented and then for each vital sign a description is made concerning its origin and effect on heath, monitoring needs, acquisition methods and WHDs and recent scientific developments on the area (electrocardiogram, heart rate, blood pressure, respiration rate, blood oxygen saturation, blood glucose, skin perspiration, capnography, body temperature, motion evaluation, cardiac implantable devices and ambient parameters). A general WHDs system architecture is presented based on the state-of-the-art. After a global review of WHDs, we zoom in into cardiovascular WHDs, analysing commercial devices and their applicability versus quality, extending this subject to smart t-shirts for medical purposes. Furthermore we present a resumed evolution of these devices based on the prototypes developed along the years. Finally we discuss likely market trends and future challenges for the emerging WHDs area.

Roll-to-Roll Gravure Printed Electrochemical Sensors for Wearable and Medical Devices

As recent developments in noninvasive biosensors spearhead the thrust toward personalized health and fitness monitoring, there is a need for high throughput, cost-effective fabrication of flexible sensing components. Toward this goal, we present roll-to-roll (R2R) gravure printed electrodes that are robust under a range of electrochemical sensing applications. We use inks and electrode morphologies designed for electrochemical and mechanical stability, achieving devices with uniform redox kinetics printed on 150 m flexible substrate rolls. We show that these electrodes can be functionalized into consistently high performing sensors for detecting ions, metabolites, heavy metals, and other small molecules in noninvasively accessed biofluids, including sensors for real-time, in situ perspiration monitoring during exercise. This development of robust and versatile R2R gravure printed electrodes represents a key translational step in enabling large-scale, low-cost fabrication of disposable wearable sensors for personalized health monitoring applications.

3D Carbon Microelectrodes with Bio-Functionalized Graphene for Electrochemical Biosensing

An enzyme-based electrochemical biosensor has been developed with 3D pyrolytic carbon microelectrodes that have been coated with bio-functionalized reduced graphene oxide (RGO). The 3D carbon working electrode was microfabricated using the pyrolysis of photoresist precursor structures, which were subsequently functionalized with graphene oxide and enzymes. Glucose detection was used to compare the sensor performance achieved with the 3D carbon microelectrodes (3DCMEs) to the 2D electrode configuration. The 3DCMEs provided an approximately two-fold higher sensitivity of 23.56 µA·mM⁻¹·cm⁻² compared to 10.19 µA mM⁻¹·cm⁻² for 2D carbon in glucose detection using cyclic voltammetry (CV). In amperometric measurements, the sensitivity was more than 4 times higher with 0.39 µA·mM⁻¹·cm⁻² for 3D electrodes and 0.09 µA·mM⁻¹·cm⁻² for the 2D configuration. The stability analysis of the enzymes on the 3D carbon showed reproducible results over 7 days. The selectivity of the electrode was evaluated with solutions of glucose, uric acid, cholesterol and ascorbic acid, which showed a significantly higher response for glucose.

Molecularly selective nanoporous membrane-based wearable organic electrochemical device for noninvasive cortisol sensing

Wearable biosensors have emerged as an alternative evolutionary development in the field of healthcare technology due to their potential to change conventional medical diagnostics and health monitoring. However, a number of critical technological challenges including selectivity, stability of (bio)recognition, efficient sample handling, invasiveness, and mechanical compliance to increase user comfort must still be overcome to successfully bring devices closer to commercial applications. We introduce the integration of an electrochemical transistor and a tailor-made synthetic and biomimetic polymeric membrane, which acts as a molecular memory layer facilitating the stable and selective molecular recognition of the human stress hormone cortisol. The sensor and a laser-patterned microcapillary channel array are integrated in a wearable sweat diagnostics platform, providing accurate sweat acquisition and precise sample delivery to the sensor interface. The integrated devices were successfully used with both ex situ methods using skin-like microfluidics and on human subjects with on-body real-sample analysis using a wearable sensor assembly.

Current and Emerging Trends in Point-of-Care Technology and Strategies for Clinical Validation and Implementation

BACKGROUND

Point-of-care technology (POCT) provides actionable information at the site of care to allow rapid clinical decision-making. With healthcare emphasis shifting toward precision medicine, population health, and chronic disease management, the potential impact of POCT continues to grow, and several prominent POCT trends have emerged or strengthened in the last decade.

CONTENT

This review summarizes current and emerging trends in POCT, including technologies approved or cleared by the Food and Drug Administration or in development. Technologies included have either impacted existing clinical diagnostics applications (e.g., continuous monitoring and targeted nucleic acid testing) or are likely to impact diagnostics delivery in the near future. The focus is limited to in vitro diagnostics applications, although in some sections, technologies beyond in vitro diagnostics are also included given the commonalities (e.g., ultrasound plug-ins for smart phones). For technologies in development (e.g., wearables, noninvasive testing, mass spectrometry and nuclear magnetic resonance, paper-based diagnostics, nanopore-based devices, and digital microfluidics), we also discuss their potential clinical applications and provide perspectives on strategies beyond technological and analytical proof of concept, with the end goal of clinical implementation and impact.

SUMMARY

The field of POCT has witnessed strong growth over the past decade, as evidenced by new clinical or consumer products or research and development directions. Combined with the appropriate strategies for clinical needs assessment, validation, and implementation, these and future POCTs may significantly impact care delivery and associated outcomes and costs.

Plasmonic molecular assays: Recent advances and applications for mobile health

Plasmonics-based biosensing assays have been extensively employed for biomedical applications. Significant advancements in use of plasmonic assays for the construction of point-of-care (POC) diagnostic methods have been made to provide effective and urgent health care of patients, especially in resourcelimited settings. This rapidly progressive research area, centered on the unique surface plasmon resonance (SPR) properties of metallic nanostructures with exceptional absorption and scattering abilities, has greatly facilitated the development of cost-effective, sensitive, and rapid strategies for disease diagnostics and improving patient healthcare in both developed and developing worlds. This review highlights the recent advances and applications of plasmonic technologies for highly sensitive protein and nucleic acid biomarker detection. In particular, we focus on the implementation and penetration of various plasmonic technologies in conventional molecular diagnostic assays, and discuss how such modification has resulted in simpler, faster, and more sensitive alternatives that are suited for point-of-use. Finally, integration of plasmonic molecular assays with various portable POC platforms for mobile health applications are highlighted.

Sensors and Functionalities of Non-Invasive Wrist-Wearable Devices: A Review

Wearable devices have recently received considerable interest due to their great promise for a plethora of applications. Increased research efforts are oriented towards a non-invasive monitoring of human health as well as activity parameters. A wide range of wearable sensors are being developed for real-time non-invasive monitoring. This paper provides a comprehensive review of sensors used in wrist-wearable devices, methods used for the visualization of parameters measured as well as methods used for intelligent analysis of data obtained from wrist-wearable devices. In line with this, the main features of commercial wrist-wearable devices are presented. As a result of this review, a taxonomy of sensors, functionalities, and methods used in non-invasive wrist-wearable devices was assembled.

Open-Source Potentiostat for Wireless Electrochemical Detection with Smartphones

This paper describes the design and characterization of an open-source "universal wireless electrochemical detector" (UWED). This detector interfaces with a smartphone (or a tablet) using "Bluetooth Low Energy" protocol; the smartphone provides (i) a user interface for receiving the experimental parameters from the user and visualizing the result in real time, and (ii) a proxy for storing, processing, and transmitting the data and experimental protocols. This approach simplifies the design, and decreases both the size and the cost of the hardware; it also makes the UWED adaptable to different types of analyses by simple modification of the software. The UWED can perform the most common electroanalytical techniques of potentiometry, chronoamperometry, cyclic voltammetry, and square wave voltammetry, with results closely comparable to benchtop commercial potentiostats. Although the operating ranges of electrical current and voltage of the UWED (±1.5 V, ±180 μA) are more limited than most benchtop commercial potentiostats, its functional range is sufficient for most electrochemical analyses in aqueous solutions. Because the UWED is simple, small in size, assembled from inexpensive components, and completely wireless, it offers new opportunities for the development of affordable diagnostics, sensors, and wearable devices.

Controlling Redox Enzyme Orientation at Planar Electrodes

Redox enzymes, which catalyze reactions involving electron transfers in living organisms, are very promising components of biotechnological devices, and can be envisioned for sensing applications as well as for energy conversion. In this context, one of the most significant challenges is to achieve efficient direct electron transfer by tunneling between enzymes and conductive surfaces. Based on various examples of bioelectrochemical studies described in the recent literature, this review discusses the issue of enzyme immobilization at planar electrode interfaces. The fundamental importance of controlling enzyme orientation, how to obtain such orientation, and how it can be verified experimentally or by modeling are the three main directions explored. Since redox enzymes are sizable proteins with anisotropic properties, achieving their functional immobilization requires a specific and controlled orientation on the electrode surface. All the factors influenced by this orientation are described, ranging from electronic conductivity to efficiency of substrate supply. The specificities of the enzymatic molecule, surface properties, and dipole moment, which in turn influence the orientation, are introduced. Various ways of ensuring functional immobilization through tuning of both the enzyme and the electrode surface are then described. Finally, the review deals with analytical techniques that have enabled characterization and quantification of successful achievement of the desired orientation. The rich contributions of electrochemistry, spectroscopy (especially infrared spectroscopy), modeling, and microscopy are featured, along with their limitations.

Recommendations for Assessment of the Reliability, Sensitivity, and Validity of Data Provided by Wearable Sensors Designed for Monitoring Physical Activity

Although it is becoming increasingly popular to monitor parameters related to training, recovery, and health with wearable sensor technology (wearables), scientific evaluation of the reliability, sensitivity, and validity of such data is limited and, where available, has involved a wide variety of approaches. To improve the trustworthiness of data collected by wearables and facilitate comparisons, we have outlined recommendations for standardized evaluation. We discuss the wearable devices themselves, as well as experimental and statistical considerations. Adherence to these recommendations should be beneficial not only for the individual, but also for regulatory organizations and insurance companies.

Skin-Attachable, Stretchable Electrochemical Sweat Sensor for Glucose and pH Detection

As part of increased efforts to develop wearable healthcare devices for monitoring and managing physiological and metabolic information, stretchable electrochemical sweat sensors have been investigated. In this study, we report on the fabrication of a stretchable and skin-attachable electrochemical sensor for detecting glucose and pH in sweat. A patterned stretchable electrode was fabricated via layer-by-layer deposition of carbon nanotubes (CNTs) on top of patterned Au nanosheets (AuNS) prepared by filtration onto stretchable substrate. For the detection of glucose and pH, CoWO₄/CNT and polyaniline/CNT nanocomposites were coated onto the CNT-AuNS electrodes, respectively. A reference electrode was prepared via chlorination of silver nanowires. Encapsulation of the stretchable sensor with sticky silbione led to a skin-attachable sweat sensor. Our sensor showed high performance with sensitivities of 10.89 μA mM^-1 cm^-2 and 71.44 mV pH^-1 for glucose and pH, respectively, with mechanical stability up to 30% stretching and air stability for 10 days. The sensor also showed good adhesion even to wet skin, allowing the detection of glucose and pH in sweat from running while being attached onto the skin. This work suggests the application of our stretchable and skin-attachable electrochemical sensor to health management as a high-performance healthcare wearable device.