A Wearable Paper-Based Sweat Sensor for Human Perspiration Monitoring

Bio-inspired hierarchical wearable patch for fast sweat collection

Sweat contains abundant physiological and metabolic data to evaluate an individual's physical health. Since the non-exercise sweat secretion rate is low, with an average value of 1-10 μl h-1 cm-2, sweat is generally collected during exercise for existing wearable sweat sensors. To expand their applications to include daily scenarios, these sensors developed for sports and fitness are challenged by the difficulty of collecting trace amounts of sweat. This study proposes a wearable patch inspired by the hierarchical structure of Sarracenia trichomes, allowing for the spontaneous and fast collection of a small amount of secreted sweat. The patch contains microfluidic channels featuring a 20 μm-wide rib structure, fully utilizing the capillary force, thereby eliminating the issue of sweat hysteresis. Furthermore, with only 0.5 μl of the sweat secreted at the collection site, it can converge on the detection medium located within the center reservoir. Volunteer verification demonstrated a twofold increase in sweat collection efficiency compared to traditional wearable patches. This patch serves as an efficient sweat-collection configuration, promising potential for diverse in situ sweat colorimetric analyses.

Multi-dimensional microfluidic paper-based analytical devices (μPADs) for noninvasive testing: A review of structural design and applications

The rapid emergence of microfluidic paper-based devices as point-of-care testing (POCT) tools for early disease diagnosis and health monitoring, particularly in resource-limited areas, holds immense potential for enhancing healthcare accessibility. Leveraging the numerous advantages of paper, such as capillary-driven flow, porous structure, hydrophilic functional groups, biodegradability, cost-effectiveness, and flexibility, it has become a pivotal choice for microfluidic substrates. The repertoire of microfluidic paper-based devices includes one-dimensional lateral flow assays (1D LFAs), two-dimensional microfluidic paper-based analytical devices (2D μPADs), and three-dimensional (3D) μPADs. In this comprehensive review, we provide and examine crucial information related to paper substrates, design strategies, and detection methods in multi-dimensional microfluidic paper-based devices. We also investigate potential applications of microfluidic paper-based devices for detecting viruses, metabolites and hormones in non-invasive samples such as human saliva, sweat and urine. Additionally, we delve into capillary-driven flow alternative theoretical models of fluids within the paper to provide guidance. Finally, we critically examine the potential for future developments and address challenges for multi-dimensional microfluidic paper-based devices in advancing noninvasive early diagnosis and health monitoring. This article showcases their transformative impact on healthcare, paving the way for enhanced medical services worldwide.

Calligraphic interdigitated capacitive sensors for green electronics

This study presents a novel approach to fabricating interdigitated capacitive (IDC) touch sensors using graphite-based pencils on a wood substrate. The sensors were designed to detect touches and pressure variations, offering a cost-effective and environmentally friendly solution for sensor fabrication. The fabrication process involved abrasion of graphite pencils on a wooden substrate to create conductive traces, followed by the integration of interdigitated electrode structures. Capacitance variations resulting from touch interactions were investigated to calibrate sensor responses for tailored tasks. The sensitivity of the sensor was found to be 1.2 pF/kPa, highlighting its responsiveness to pressure variations. Additionally, the sensors were interfaced with an Arduino Uno microcontroller board to demonstrate practical applications, such as replicating arrow key functionality. Additionally, the sensors exhibit sensitivity to environmental factors, with the relative change in capacitance increasing from 0.1 to 0.65 as relative humidity ranges from 30 to 90%. Furthermore, variations in temperature from 30 to 60ºC result in a relative change in capacitance increasing to approximately 0.5. The results indicate the feasibility and versatility of using wood-based substrates and graphite-based pencils for fabricating IDC touch sensors, offering promising prospects for sustainable and accessible sensor technology.

Wireless Technologies in Flexible and Wearable Sensing: From Materials Design, System Integration to Applications

Wireless and wearable sensors attract considerable interest in personalized healthcare by providing a unique approach for remote, noncontact, and continuous monitoring of various health-related signals without interference with daily life. Recent advances in wireless technologies and wearable sensors have promoted practical applications due to their significantly improved characteristics, such as reduction in size and thickness, enhancement in flexibility and stretchability, and improved conformability to the human body. Currently, most researches focus on active materials and structural designs for wearable sensors, with just a few exceptions reflecting on the technologies for wireless data transmission. This review provides a comprehensive overview of the state-of-the-art wireless technologies and related studies on empowering wearable sensors. The emerging functional nanomaterials utilized for designing unique wireless modules are highlighted, which include metals, carbons, and MXenes. Additionally, the review outlines the system-level integration of wireless modules with flexible sensors, spanning from novel design strategies for enhanced conformability to efficient transmitting data wirelessly. Furthermore, the review introduces representative applications for remote and noninvasive monitoring of physiological signals through on-skin and implantable wireless flexible sensing systems. Finally, the challenges, perspectives, and unprecedented opportunities for wireless and wearable sensors are discussed.

Skin-Attachable Ink-Dispenser-Printed Paper Fluidic Sensor Patch for Colorimetric Sweat Analysis

In situ analysis of sweat biomarkers potentially provides noninvasive lifestyle monitoring and early diagnosis. Quantitative detection of sweat rate is crucial for thermoregulation and preventing heat injuries. Here, a skin-attachable paper fluidic patch is reported for in situ colorimetric sensing of multiple sweat markers (pH, glucose, lactate, and uric acid) with concurrent sweat rate tracking. Two sets of fluidic patterns-multiplexed detection zones and a longitudinal sweat rate channel-are directly printed by an automated ink dispenser from a specially developed ceramic-based ink. The ceramic ink thermal-cures into an impervious barrier, confining sweat within the channels. The ceramic-ink-printed boundary achieves higher pattern resolution, prevents fluid leakage, attains pattern thermal stability, and resistant to organic solvents. The cellulose matrix of the detection zones is modified with nanoparticles to improve the color homogeneity and sweat sensor sensitivity. The sweat rate channel is made moisture sensitive by incorporating a metal-salt-based dye. The change in saturation/color of the detection zones and/or channels upon sweat addition can be visually detected or quantified by a smartphone camera. A cost-effective way is provided to fabricate paper fluidic sensor patches, successfully demonstrating on-body multiplexed evaluation of sweat analytes. Such skin wearables offer on-site analysis, meaningful to an increasingly health-conscious population.

Advances in Non-Electrochemical Sensing of Human Sweat Biomarkers: From Sweat Sampling to Signal Reading

Sweat, commonly referred to as the ultrafiltrate of blood plasma, is an essential physiological fluid in the human body. It contains a wide range of metabolites, electrolytes, and other biologically significant markers that are closely linked to human health. Compared to other bodily fluids, such as blood, sweat offers distinct advantages in terms of ease of collection and non-invasive detection. In recent years, considerable attention has been focused on wearable sweat sensors due to their potential for continuous monitoring of biomarkers. Electrochemical methods have been extensively used for in situ sweat biomarker analysis, as thoroughly reviewed by various researchers. This comprehensive review aims to provide an overview of recent advances in non-electrochemical methods for analyzing sweat, including colorimetric methods, fluorescence techniques, surface-enhanced Raman spectroscopy, and more. The review covers multiple aspects of non-electrochemical sweat analysis, encompassing sweat sampling methodologies, detection techniques, signal processing, and diverse applications. Furthermore, it highlights the current bottlenecks and challenges faced by non-electrochemical sensors, such as limitations and interference issues. Finally, the review concludes by offering insights into the prospects for non-electrochemical sensing technologies. By providing a valuable reference and inspiring researchers engaged in the field of sweat sensor development, this paper aspires to foster the creation of innovative and practical advancements in this domain.

A flexible and wearable three-electrode electrochemical sensing system consisting of a two-in-one enzyme-mimic working electrode

In this work, a wearable and flexible three-electrode electrochemical sensing system (TESS) by using a two-in-one enzyme-mimic working electrode (TIOWE) is reported. The integrated three-electrode, including working electrodes, reference electrodes, and counter electrodes are formed by transfer printing of Ni2P-based composite electrode ink (Ni2P/G ink), Ag/AgCl ink, and carbon ink onto PDMS substrate, respectively. The Ni2P/G ink-based working electrodes have both good conductivity and enzyme-mimic catalytic activity towards glucose. Under optimized conditions, the TIOWE-TESS has a low detection limit of 0.37 μM and wide linear ranges of 0.001 mM-0.1 mM and 0.1 mM-1.4 mM. Furthermore, the TIOWE-TESS has good applicability in serum samples and reveals remarkable electrochemical performance at fluctuant working temperatures. The proposed TIOWE-TESS can be integrated on a waterproof bandage to fabricate a skin-friendly patch device for sweet glucose monitoring, which highlights its potential applications in flexible and wearable commercial devices for health-monitoring.

Emerging Trends in Soft Electronics: Integrating Machine Intelligence with Soft Acoustic/Vibration Sensors

In the last decade, soft acoustic/vibration sensors have gained tremendous research interest due to their unique ability to detect broadband acoustic/vibration stimuli, potentializing futuristic applications including voice biometrics, voice-controlled human-machine-interfaces, electronic skin, and skin-mountable healthcare devices. Importantly, to benefit most from these sensors, it is inevitable to use machine learning (ML) to process their output signals; with ML, a more accurate and efficient interpretation of original data is possible. This paper is dedicated to offering an overview of recent advances empowering the development of soft acoustic/vibration sensors and their signal processing using ML. First, the key performance parameters of the sensors are discussed. Second, popular transduction mechanisms for the sensors are addressed, followed by an in-depth overview of each type, covering materials used, structural designs, and sensing performances. Third, potential applications of the sensors are elaborated and fourth, a thorough discussion on ML is conducted, exploring different types of ML, specific ML algorithms suitable for processing acoustic/vibration signals, and current trends in ML-assisted applications. Finally, the challenges and potential opportunities in soft acoustic/vibration sensor and ML research are revealed to offer new insights into future prospects in these fields.

Reconfigurable Electrical Networks within a Conductive Hydrogel Composite

Soft materials that exhibit compliance, programmability, and reconfigurability can have a transformative impact as electronic skin for applications in wearable electronics/soft robotics. There has been significant progress in soft conductive materials; however, achieving electrically controlled and reversible changes in conductivity and circuit connectivity remains challenging. To overcome this limitation, a soft material architecture with reconfigurable conductive networks of silver flakes embedded within a hydrogel matrix is presented. The conductive networks can be reversibly created/disconnected through various stimuli, including current, humidity, or temperature. Such stimuli affect electrical connectivity of the hydrogel by controlling its water content, which can be modulated by evaporation under ambient conditions (passive dehydration), evaporation through electrical Joule heating (active dehydration), or absorption of additional water (rehydration). The resulting change in electrical conductivity is reversible and repeatable, endowing the composite with on-demand reconfigurable conductivity. To highlight this material's unique properties, it is shown that conductive traces can be reconfigured after severe damage and revert to lower conductivity after rehydration. Additionally, a quadruped robot is demonstrated that can respond to stimuli by changing direction following exposure to excess water, thereby achieving reprogrammable locomotion behaviors.

Smart Janus fabrics for one-way sweat sampling and skin-friendly colorimetric detection

Functionalized textiles with biofluid management capability have attracted tremendous attention in recent years due to their significant roles in health monitoring and dehydration prevention. Here we propose a one-way colorimetric sweat sampling and sensing system based on a Janus fabric using interfacial modification techniques. The opposite wettability of Janus fabric enables sweat to be quickly moved from the skin surface to the hydrophilic side and colorimetric patches. The unidirectional sweat-wicking performance of Janus fabric not only facilitates adequate sweat sampling but also inhibits the backflow of hydrated colorimetric regent from the assay patch toward the skin, eliminating potential epidermal contaminations. On this basis, visual and portable detection of sweat biomarkers including chloride, pH, and urea is also achieved. The results show that the true concentrations of chloride, pH, and urea in sweat are ∼10 mM, ∼7.2, and ∼10 mM, respectively. The detection limits of chloride and urea are 1.06 mM and 3.05 mM. This work bridges the gap between sweat sampling and a friendly epidermal microenvironment, providing a promising way for multifunctional textiles.

Paper-Based Sandwich-Structured Wearable Sensor with Sebum Filtering for Continuous Detection of Sweat pH

Wearable sweat sensors, a product of the development of flexible electronics and microfluidic technologies, can continuously and noninvasively monitor abundant biomarkers in human sweat; however, sweat interferences, such as sebum, can reduce sensor reliability and accuracy. Herein, for the first time, the influence of sebum on the potentiometric response of an all-solid-state pH sensor was studied, and the obtained experimental results show that sebum mixed in sweat can decrease the potential response of the sensor and the slope of its calibration curve. A paper-based sandwich-structured pH sensor that can filter the sebum mixed in sweat was proposed based on commonly used oil-control sheets. Moreover, the hydrophilic properties, microstructure, and microfluidic performance of the sensor were investigated. The detection performance of the paper-based sandwich-structured pH sensor was comprehensively evaluated in terms of calibration in the presence of sebum and potentiometric response upon the addition of sebum. Furthermore, the anti-interference ability of the sensor was evaluated using different analytes under various deformation conditions. On-body trials were conducted to verify the performance, and their results showed that the proposed sensor can filter over 90% of the sebum in sweat, significantly enhancing sensor reliability and accuracy. Additionally, microfluidic channels could be simply fabricated using a scissor and paper, obviating the need for complex micromachining processes, such as photolithography and laser engraving. Overall, this work illustrates the influence of sebum on the detection performance of traditional potentiometric wearable sensors and paves the way for their development for real-world applications.

Antibody-Coated Wearable Organic Electrochemical Transistors for Cortisol Detection in Human Sweat

The dysregulation of the hormone cortisol is related to several pathological states, and its monitoring could help prevent severe stress, fatigue, and mental diseases. While wearable antibody-based biosensors could allow real-time and simple monitoring of antigens, an accurate and low-cost antibody-based cortisol detection through electrochemical methods is considerably challenging due to its low concentration and the high ionic strength of real biofluids. Here, a label-free and fast sensor for cortisol detection is proposed based on antibody-coated organic electrochemical transistors. The developed devices show unprecedented high sensitivities of 50 μA/dec for cortisol sensing in high-ionic-strength solutions with effective cortisol detection demonstrated with real human sweat. The sensing mechanism is analyzed through impedance spectroscopy and confirmed with electrical models. Compared to existing methods requiring bulky and expensive laboratory equipment, these wearable devices enable point-of-care cortisol detection in 5 min with direct sweat collection for personalized well-being monitoring.

A Focused Review on the Flexible Wearable Sensors for Sports: From Kinematics to Physiologies

As an important branch of wearable electronics, highly flexible and wearable sensors are gaining huge attention due to their emerging applications. In recent years, the participation of wearable devices in sports has revolutionized the way to capture the kinematical and physiological status of athletes. This review focuses on the rapid development of flexible and wearable sensor technologies for sports. We identify and discuss the indicators that reveal the performance and physical condition of players. The kinematical indicators are mentioned according to the relevant body parts, and the physiological indicators are classified into vital signs and metabolisms. Additionally, the available wearable devices and their significant applications in monitoring these kinematical and physiological parameters are described with emphasis. The potential challenges and prospects for the future developments of wearable sensors in sports are discussed comprehensively. This review paper will assist both athletic individuals and researchers to have a comprehensive glimpse of the wearable techniques applied in different sports.

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.

A paper-based optical sensor for the screening of viruses through the cysteine residues of their surface proteins: A proof of concept on the detection of coronavirus infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a serious threat to human health. Current methods such as reverse transcription polymerase chain reaction (qRT-PCR) are complex, expensive, and time-consuming. Rapid, and simple screening methods for the detection of SARS-CoV-2 are critically required to fight the current pandemic. In this work we present a proof of concept for, a simple optical sensing method for the screening of SARS-CoV-2 through its spike protein subunit S1. The method utilizes a target-specific extractor chip to bind the protein from the biological specimens. The disulfide bonds of the protein are then reduced into a biothiol with sulfhydryl (SH) groups that react with a blue-colored benzothiazole azo dye-Hg complex (BAN-Hg) and causes the spontaneous change of its blue color to pink which is observable by the naked eye. A linear relationship between the intensity of the pink color and the logarithm of reduced S1 protein concentration was found within the working range 130 ng.mL⁻¹-1.3 pg mL⁻¹. The lowest limit of detection (LOD) of the assay was 130 fg mL⁻¹. A paper based optical sensor was fabricated by loading the BAN-Hg sensor onto filter paper and used to screen the S1 protein in spiked saliva and patients’ nasopharyngeal swabs. The results obtained by the paper sensor corroborated with those obtained by qRT-PCR. The new paper-based sensing method can be extended to the screening of many viruses (e.g. the human immunodeficiency virus, the human polyomavirus, the human papilloma virus, the adeno associated viruses, the enteroviruses) through the cysteine residues of their capsid proteins. The new method has strong potential for screening viruses at pathology labs and in remote areas that lacks advanced scientific infrastructure. Further clinical studies are warranted to validate the new sensing method.

Paper-Based Bipolar Electrode Electrochemiluminescence Platform Combined with Pencil-Drawing Trace for the Detection of M.SssI Methyltransferase

Herein, a hand-drawing paper-based bipolar electrode (BPE) electrochemiluminescence (ECL) platform for M.SssI methyltransferase (M.SssI MTase) assay was proposed via employing high electrocatalytic Pt@CeO₂ as an ECL co-reaction accelerator and pencil-drawing graphite electric circuits as wires and electrodes. Notably, the introduction of pencil-drawing trace not only simplified the manufacturing process but also reduced the cost and saved fabricating time. Meanwhile, Pt@CeO₂ with good electrocatalytic activity and satisfactory chemical stability was used at the anode of the closed BPE-ECL device to accelerate the oxidation rate of uric acid. Due to the balanced charges of the bipolar electrode, the ECL response of the MnS: CdS@ZnS/S₂O₈^2- system emitted on the cathode was enhanced. In situ growth of gold nanoparticles in the two electrode areas was convenient for DNA immobilization. With the above points in mind, the specific DNA double strands functionalized via Pt@CeO₂ were employed to identify M.SssI MTase. The unmethylated DNA double strands were cut by HpaII endonuclease, resulting in the quenching of the ECL signal. Under the optimal conditions, sensitive detection of M.SssI MTase in a wide linear range of 0.01-100 U·mL^-1 with a satisfactory detection limit of 0.008 U·mL^-1 was realized. The reliable and versatile BPE-ECL tool for the determination of M.SssI MTase with easy-to-operate pencil-drawing traces and independent solution systems provides a new opportunity to develop paper-based devices applied in early disease diagnosis and pathogenesis research.

MXene-Based Textile Sensors for Wearable Applications

Textile-based sensors in the form of a wearable computing device that can be attached to or worn on the human body not only can transmit information but also can be used as a smart sensing device to access the mobile internet. These sensors represent a potential platform for the next generation of human-computer interfaces. The continuous emergence of new conductive materials is one of the driving forces for the development of textile sensors. Recently, a two-dimensional (2D) MXene material with excellent performance has received extensive attention due to its high conductivity, processability, and mechanical stability. In this paper, the synthesis of MXene materials, the fabrication of conductive textiles, the structural design of textile sensors, and the application of MXene-based textile sensors in the wearable field are reviewed. Furthermore, from the perspective of MXene preparation, wearability, stability, and evaluation standards, the difficulties and challenges of MXene-based textile sensors in the field of wearable applications are summarized and prospected. This review attempts to strengthen the connection between wearable smart textiles and MXene materials and promote the rapid development of wearable MXene-based textile sensors.

Recent Advances in Wearable Optical Sensor Automation Powered by Battery versus Skin-like Battery-Free Devices for Personal Healthcare-A Review

Currently, old-style personal Medicare techniques rely mostly on traditional methods, such as cumbersome tools and complicated processes, which can be time consuming and inconvenient in some circumstances. Furthermore, such old methods need the use of heavy equipment, blood draws, and traditional bench-top testing procedures. Invasive ways of acquiring test samples can potentially cause patient discomfort and anguish. Wearable sensors, on the other hand, may be attached to numerous body areas to capture diverse biochemical and physiological characteristics as a developing analytical tool. Physical, chemical, and biological data transferred via the skin are used to monitor health in various circumstances. Wearable sensors can assess the aberrant conditions of the physical or chemical components of the human body in real time, exposing the body state in time, thanks to unintrusive sampling and high accuracy. Most commercially available wearable gadgets are mechanically hard components attached to bands and worn on the wrist, with form factors ultimately constrained by the size and weight of the batteries required for the power supply. Basic physiological signals comprise a lot of health-related data. The estimation of critical physiological characteristics, such as pulse inconstancy or variability using photoplethysmography (PPG) and oxygen saturation in arterial blood using pulse oximetry, is possible by utilizing an analysis of the pulsatile component of the bloodstream. Wearable gadgets with “skin-like” qualities are a new type of automation that is only starting to make its way out of research labs and into pre-commercial prototypes. Flexible skin-like sensing devices have accomplished several functionalities previously inaccessible for typical sensing devices due to their deformability, lightness, portability, and flexibility. In this paper, we studied the recent advancement in battery-powered wearable sensors established on optical phenomena and skin-like battery-free sensors, which brings a breakthrough in wearable sensing automation.

Wearable Sweat Loss Measuring Devices: From the Role of Sweat Loss to Advanced Mechanisms and Designs

Wearable sweat sensors have received significant research interest and have become popular as sweat contains considerable health information about physiological and psychological states. However, measured biomarker concentrations vary with sweat rates, which has a significant effect on the accuracy and reliability of sweat biosensors. Wearable sweat loss measuring devices (SLMDs) have recently been proposed to overcome the limitations of biomarker tracking and reduce inter- and intraindividual variability. In addition, they offer substantial potential for monitoring human body homeostasis, because sweat loss plays an indispensable role in thermoregulation and skin hydration. Previous studies have not carried out a comprehensive and systematic review of the principles, importance, and development of wearable SLMDs. This paper reviews wearable SLMDs with a new health perspective from the role of sweat loss to advanced mechanisms and designs. Two types of sweat and their measurement significance for practical applications are highlighted. Then, a comprehensive review of advances in different wearable SLMDs based on hygrometers, absorbent materials, and microfluidics is presented by describing their respective device architectures, present situations, and future directions. Finally, concluding remarks on opportunities for future application fields and challenges for future sweat sensing are presented.

Wearables for Industrial Work Safety: A Survey

Today, ensuring work safety is considered to be one of the top priorities for various industries. Workplace injuries, illnesses, and deaths often entail substantial production and financial losses, governmental checks, series of dismissals, and loss of reputation. Wearable devices are one of the technologies that flourished with the fourth industrial revolution or Industry 4.0, allowing employers to monitor and maintain safety at workplaces. The purpose of this article is to systematize knowledge in the field of industrial wearables’ safety to assess the relevance of their use in enterprises as the technology maintaining occupational safety, to correlate the benefits and costs of their implementation, and, by identifying research gaps, to outline promising directions for future work in this area. We categorize industrial wearable functions into four classes (monitoring, supporting, training, and tracking) and provide a classification of the metrics collected by wearables to better understand the potential role of wearable technology in preserving workplace safety. Furthermore, we discuss key communication technologies and localization techniques utilized in wearable-based work safety solutions. Finally, we analyze the main challenges that need to be addressed to further enable and support the use of wearable devices for industrial work safety.

Integrated non-invasive biochemical and biophysical sensing systems for health and performance monitoring: A systems perspective

Advances in materials, bio-recognition elements, transducers, and microfabrication techniques, as well as progress in electronics, signal processing, and wireless communication have generated a new class of skin-interfaced wearable health monitoring systems for applications in personalized medicine and digital health. In comparison to conventional medical devices, these wearable systems are at the cusp of initiating a new era of longitudinal and noninvasive sensing for the prevention, detection, diagnosis, and treatment of diseases at the molecular level. Herein, we provide a review of recent developments in wearable biochemical and biophysical systems. We survey the sweat sampling and collection methods for biochemical systems, followed by an assessment of biochemical and biophysical sensors deployed in current wearable systems with an emphasis on their hardware specifications. Specifically, we address how sweat collection and sample handling platforms may be a rate limiting technology to realizing the clinical translation of wearable health monitoring systems; moreover, we highlight the importance of achieving both longitudinal sensing and assessment of intrapersonal variation in sweat-blood correlations to have the greatest clinical impact. Lastly, we assess a snapshot of integrated wireless wearable systems with multimodal sensing capabilities, and we conclude with our perspective on the state-of-the-art and the required developments to achieve the next-generation of integrated wearable health and performance monitoring systems.

Recent developments in flow modeling and fluid control for paper-based microfluidic biosensors

Over the last 10 years, researchers have shown that paper is a promising substrate for affordable biosensors. The field of paper-microfluidics has evolved rapidly in that time, with simple colorimetric assays giving way to more complex electrochemical devices that can handle multiple samples at a given time. As paper devices become more complex, the ability to precisely control different fluids simultaneously becomes a challenge. Specifically, automated flow control is a necessary attribute to make paper-based devices more useable in resource-limited settings. Flow control strategies on paper are typically developed experimentally through trial-and-error, with little focus on theory. This is because flow behavior in paper is not well understood and sometimes difficult to predict precisely. Additionally, popular theoretical models are too simplistic, making them unsuitable for complex device designs and application conditions. A better understanding of flow theory would allow devices conceived straight from theoretical models. This could save time and resources by reducing experimental work. In this review, we provide an overview of different theoretical models used to characterize imbibition in paper substrates and document the latest flow control strategies that have been applied to automated fluid control on paper. Additionally, we look at current efforts to commercialize paper-based devices along with challenges facing this industry.

Flexible capacitive sensor based on 2D-titanium dioxide nanosheets/bacterial cellulose composite film

In this paper, titanium dioxide nanosheets (Ti_0.91O₂ NSs) were incorporated into bacterial cellulose (BC) film for dielectric property tuning while maintaining the flexibility of the resulting composite paper. By taking advantage of the improved dielectric constant, the nanosheets/BC composites were employed as capacitive sensors. The fabricated devices showed the highest sensing performance of ∼2.44 × 10^-3 kPa^-1 from 0 to 30 N when incorporating as little as 3 vol% of Ti_0.91O₂ NSs (or ∼2 wt% Ti). Stable operation and high robustness of the sensor were demonstrated, where simple human motions could be efficiently monitored. This study provided a route for preparing flexible and low-cost BC composite paper for capacitive sensor. The strategy for enhancing the dielectric properties as well as sensing performances of the BC demonstrated herein will be essential for the future development of biocompatible, low-cost, and eco-friendly wearable electronics.

Electroanalytical Sensor Based on Gold-Nanoparticle-Decorated Paper for Sensitive Detection of Copper Ions in Sweat and Serum

The growth of (bio)sensors in analytical chemistry is mainly attributable to the development of affordable, effective, portable, and user-friendly analytical tools. In the field of sensors, paper-based devices are gaining a relevant position for their outstanding features including foldability, ease of use, and instrument-free microfluidics. Herein, a multifarious use of filter paper to detect copper ions in bodily fluids is reported by exploiting this eco-friendly material to (i) synthesize AuNPs without the use of reductants and/or external stimuli, (ii) print the electrodes, (iii) load the reagents for the assay, (iv) filter the gross impurities, and (v) preconcentrate the target analyte. Copper ions were detected down to 3 ppb with a linearity up to 400 ppb in standard solutions. The applicability in biological matrices, namely, sweat and serum, was demonstrated by recovery studies and by analyzing these biofluids with the paper-based platform and the reference method (atomic absorption spectroscopy), demonstrating satisfactory accuracy of the novel eco-designed analytical tool.

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

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

Biodegradable Materials for Sustainable Health Monitoring Devices

The recent advent of biodegradable materials has offered huge opportunity to transform healthcare technologies by enabling sensors that degrade naturally after use. The implantable electronic systems made from such materials eliminate the need for extraction or reoperation, minimize chronic inflammatory responses, and hence offer attractive propositions for future biomedical technology. The eco-friendly sensor systems developed from degradable materials could also help mitigate some of the major environmental issues by reducing the volume of electronic or medical waste produced and, in turn, the carbon footprint. With this background, herein we present a comprehensive overview of the structural and functional biodegradable materials that have been used for various biodegradable or bioresorbable electronic devices. The discussion focuses on the dissolution rates and degradation mechanisms of materials such as natural and synthetic polymers, organic or inorganic semiconductors, and hydrolyzable metals. The recent trend and examples of biodegradable or bioresorbable materials-based sensors for body monitoring, diagnostic, and medical therapeutic applications are also presented. Lastly, key technological challenges are discussed for clinical application of biodegradable sensors, particularly for implantable devices with wireless data and power transfer. Promising perspectives for the advancement of future generation of biodegradable sensor systems are also presented.

Fiber-Based Sensors and Energy Systems for Wearable Electronics

Wearable electronics have been receiving increasing attention for the past few decades. Particularly, fiber-based electronics are considered to be ideal for many applications for their flexibility, lightweight, breathability, and comfortability. Furthermore, fibers and fiber-based textiles can be 3D-molded with ease and potentially integrated with everyday clothes or accessories. These properties are especially desired in the fields of bio-related sensors and energy-storage systems. Wearable sensors utilize a tight interface with human skin and clothes for continuous environmental scanning and non-invasive health monitoring. At the same time, their flexible and lightweight properties allow more convenient and user-friendly experiences to the wearers. Similarly, for the wearable devices to be more accessible, it is crucial to incorporate energy harvesting and storage systems into the device themselves, removing the need to attach an external power source. This review summarizes the recent applications of fibers and fiber-based textiles in mechanical, photonic, and biomedical sensors. Pressure and strain sensors and their implementation as electronic skins will be explored, along with other various fiber sensors capable of imaging objects or monitoring safety and health markers. In addition, we attempt to elucidate recent studies in energy-storing fibers and their implication in self-powered and fully wireless wearable devices.

Wearable Sweat Biosensors Refresh Personalized Health/Medical Diagnostics

Sweat contains a broad range of critical biomarkers including ions, small molecules, and macromolecules that may indirectly or directly reflect the health status of the human body and thereby help track disease progression. Wearable sweat biosensors enable the collection and analysis of sweat in situ, achieving real-time, continuous, and noninvasive monitoring of human biochemical parameters at the molecular level. This review summarizes the physiological/pathological information of sweat and wearable sweat biosensors. First, the production of sweat pertaining to various electrolytes, metabolites, and proteins is described. Then, the compositions of the wearable sweat biosensors are summarized, and the design of each subsystem is introduced in detail. The latest applications of wearable sweat biosensors for outdoor, hospital, and family monitoring are highlighted. Finally, the review provides a summary and an outlook on the future developments and challenges of wearable sweat biosensors with the aim of advancing the field of wearable sweat monitoring technology.

Smart Ti3C2Tx MXene Fabric with Fast Humidity Response and Joule Heating for Healthcare and Medical Therapy Applications

An increasing utilization of flexible healthcare electronics and biomedicine-related therapeutic materials urges the development of multifunctional wearable/flexible smart fabrics for personal therapy and health management. However, it is currently a challenge to fabricate multifunctional and on-body healthcare electronic devices with reliable mechanical flexibility, excellent breathability, and self-controllable joule heating effects. Here, we fabricate a multifunctional MXene-based smart fabric by depositing 2D Ti₃C₂T_x nanosheets onto cellulose fiber nonwoven fabric via special MXene-cellulose fiber interactions. Such multifunctional fabrics exhibit sensitive and reversible humidity response upon H₂O-induced swelling/contraction of channels between the MXene interlayers, enabling wearable respiration monitoring application. Besides, it can also serve as a low-voltage thermotherapy platform due to its fast and stable electro-thermal response. Interestingly, water molecular extraction induces electrical response upon heating, i.e., functioning as a temperature alarm, which allows for real-time temperature monitoring for thermotherapy platform without low-temperature burn risk. Furthermore, metal-like conductivity of MXene renders the fabric an excellent Joule heating effect, which can moderately kill bacteria surrounding the wound in bacteria-infected wound healing therapy. This work introduces a multifunctional smart flexible fabric suitable for next-generation wearable electronic devices for mobile healthcare and personal medical therapy.

Sensors and Systems for Physical Rehabilitation and Health Monitoring-A Review

The use of wearable equipment and sensing devices to monitor physical activities, whether for well-being, sports monitoring, or medical rehabilitation, has expanded rapidly due to the evolution of sensing techniques, cheaper integrated circuits, and the development of connectivity technologies. In this scenario, this paper presents a state-of-the-art review of sensors and systems for rehabilitation and health monitoring. Although we know the increasing importance of data processing techniques, our focus was on analyzing the implementation of sensors and biomedical applications. Although many themes overlap, we organized this review based on three groups: Sensors in Healthcare, Home Medical Assistance, and Continuous Health Monitoring; Systems and Sensors in Physical Rehabilitation; and Assistive Systems.

Srivastava S. Wearable Skin Sensors and Their Challenges: A Review of Transdermal, Optical, and Mechanical Sensors

Wearable technology and mobile healthcare systems are both increasingly popular solutions to traditional healthcare due to their ease of implementation and cost-effectiveness for remote health monitoring. Recent advances in research, especially the miniaturization of sensors, have significantly contributed to commercializing the wearable technology. Most of the traditional commercially available sensors are either mechanical or optical, but nowadays transdermal microneedles are also being used for micro-sensing such as continuous glucose monitoring. However, there remain certain challenges that need to be addressed before the possibility of large-scale deployment. The biggest challenge faced by all these wearable sensors is our skin, which has an inherent property to resist and protect the body from the outside world. On the other hand, biosensing is not possible without overcoming this resistance. Consequently, understanding the skin structure and its response to different types of sensing is necessary to remove the scientific barriers that are hindering our ability to design more efficient and robust skin sensors. In this article, we review research reports related to three different biosensing modalities that are commonly used along with the challenges faced in their implementation for detection. We believe this review will be of significant use to researchers looking to solve existing problems within the ongoing research in wearable sensors.

Sweat monitoring beneath garments using passive, wireless resonant sensors interfaced with laser-ablated microfluidics

Sweat loss can help determine hydration status of individuals working in harsh conditions, which is especially relevant to those who wear thick personal protective equipment (PPE) such as firefighters. A wireless, passive, conformable sweat sensor sticker is described here that can be worn under and interrogated through thick clothing to simultaneously measure sweat loss volume and conductivity. The sticker consists of a laser-ablated, microfluidic channel and a resonant sensor transducer. The resonant sensor is wirelessly read with a handheld vector network analyzer coupled to two, co-planar, interrogation antennas that measure the transmission loss. A sweat proxy is used to fill the channels and it is determined that the sensor can orthogonally determine the sweat conductivity and volume filled in the channel via peak transmission loss magnitude and frequency respectively. A four-person study is then used to determine level of sensor variance caused by local tissue dielectric heterogeneity and sensor-reader orientation.

Long-Term Stability Monitoring of Printed Proteins on Paper-Based Membranes

Monitoring of long-term stability of proteins on paper-based membranes is important as it is directly related to paper-based sensor fabrication. By using a simple piezo printhead inkjet printer, recombinant proteins and antibodies were printed on paper-based membranes to test their stability and sensitivity under varying lengths of storage and temperature conditions. Our data show that a printed IgG-HRP antibody on simple printing paper maintains >50% functionality up to ∼2 months under 4 and -20 °C storage. Antibodies printed on polyvinylidene difluoride (PVDF) and nitrocellulose showed 5.3 and 9.7% decreases, respectively, in initial signal intensities compared to printing paper. Prostate-specific membrane antigen and tumor necrosis factor alpha recombinant proteins printed on paper-based membranes can be detected by antibodies, and antibody signal intensities can be detected up to 28 days after storage at 4 and -20 °C when printed on PVDF membrane or printing paper. These data suggest that printed proteins on simple printing paper and PVDF membrane can maintain their functionality up to few months when stored at 4 °C or lower and can be potentially applied in paper-based sensor development.