Wearable hydrogel patch with noninvasive, electrochemical glucose sensor for natural sweat detection

Innovative Material-Based Wearable Non-Invasive Electrochemical Sweat Sensors towards Biomedical Applications

Sweat is an accessible biofluid that provides useful physiological information about the body's biomolecular state and systemic health. Wearable sensors possess various advantageous features, such as lightweight design, wireless connectivity, and compatibility with human skin, that make them suitable for continuous monitoring. Wearable electrochemical sweat sensors can diagnose diseases and monitor health conditions by detecting biomedical signal changes in sweat. This paper discusses the state-of-the-art research in the field of wearable sweat sensors and the materials used in their construction. It covers biomarkers present in sweat, sensing modalities, techniques for sweat collection, and ways to power these sensors. Innovative materials are categorized into three subcategories: sweat collection, sweat detection, and self-powering. These include substrates for sensor fabrication, analyte detection electrodes, absorbent patches, microfluidic devices, and self-powered devices. This paper concludes by forecasting future research trends and prospects in material-based wearable non-invasive sweat sensors.

Wearable biosensors for human sweat glucose detection based on carbon black nanoparticles

Wearable glucose biosensors enable noninvasive glucose monitoring, thereby enhancing blood glucose management. In this work, we present a wearable biosensor based on carbon black nanoparticles (CBNPs) for glucose detection in human sweat. The biosensor consists of CBNPs, Prussian blue (PB), glucose oxidase, chitosan, and Nafion. The fabricated biosensor has a linear range of 5 µM to 1250 µM, sensitivity of 14.64 µA mM-1 cm-2, and a low detection potential (-0.05 V, vs. Ag/AgCl). The detection limit for glucose was calculated as 4.83 µM. This reusable biosensor has good selectivity and stability and exhibits a good response to glucose in real sweat. These results demonstrate the potential of our CBNP-based biosensor for monitoring blood glucose in human sweat.

A Bifunctional Wearable Sensor Based on a Nanoporous Membrane for Simultaneous Detection of Sweat Lactate and Temperature

Wearable sensors for non-invasive, real-time detection of sweat lactate have far-reaching implications in the fields of health care and exercise physiological responses. Here, we propose a wearable electrochemical sensor with gold nanoelectrode arrays fabricated on the nanoporous polycarbonate (PC) membrane by encapsulating lactate oxidase (LOx) in chitosan (CS) hydrogel for detecting body temperature and sweat lactate concurrently. Flexible gold nanoporous electrodes not only enhance electrode area but also offer a nanoconfined space to accelerate the catalytic reaction of LOx and control substrate concentration on the surface of LOx to decrease substrate inhibition. The proposed sensor has a long durability of 13 days and better selectivity for the detection of sweat lactate over a wide linear range (0.01-35 mM) with a low detection limit (0.144 μM). Furthermore, temperature-dependent transmembrane currents passing through the sensor are used to estimate body temperature. We then use multiple linear regression to adjust the effect of temperature on lactate detection and succeed in monitoring lactate molecules in sweat and body temperature during exercise.

Electrochemically Synthesized MIP Sensors: Applications in Healthcare Diagnostics

Early-stage detection and diagnosis of diseases is essential to the prompt commencement of treatment regimens, curbing the spread of the disease, and improving human health. Thus, the accurate detection of disease biomarkers through the development of robust, sensitive, and selective diagnostic tools has remained cutting-edge scientific research for decades. Due to their merits of being selective, stable, simple, and having a low preparation cost, molecularly imprinted polymers (MIPs) are increasingly becoming artificial substitutes for natural receptors in the design of state-of-the-art sensing devices. While there are different MIP preparation approaches, electrochemical synthesis presents a unique and outstanding method for chemical sensing applications, allowing the direct formation of the polymer on the transducer as well as simplicity in tuning the film properties, thus accelerating the trend in the design of commercial MIP-based sensors. This review evaluates recent achievements in the applications of electrosynthesized MIP sensors for clinical analysis of disease biomarkers, identifying major trends and highlighting interesting perspectives on the realization of commercial MIP-endowed testing devices for rapid determination of prevailing diseases.

Paper-based ratiometric fluorescent sensing platform based on mixed quantum dots for the detection of glucose in urine

A paper-based ratiometric fluorescent sensing platform has been developed for glucose detection based on a dual-emission fluorescent probe consisting of carbon quantum dots (C QDs) and CdTe QDs. When the two kinds of QDs are mixed, the fluorescence of C QDs is reversibly quenched by CdTe QDs. However, in the presence of glucose, the fluorescence of CdTe QDs is quenched by H2O2 catalyzed by glucose oxidase (GOx), which restores the fluorescence of C QDs. The proposed paper-based ratiometric fluorescent sensing platform exhibited good sensitivity and selectivity towards glucose. The working linear range was 0.1 mM to 50 mM with a limit of detection (LOD) of 0.026 mM. Additionally, the proposed paper-based sensor possesses viability for the determination of glucose in actual urine samples.

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 highly sensitive and long-term stable wearable patch for continuous analysis of biomarkers in sweat

Although increasing efforts have been devoted to the development of non-invasive wearable or stretchable electrochemical sweat sensors for monitoring physiological and metabolic information, most of them still suffer from poor stability and specificity over time and fluctuating temperatures. This study reports the design and fabrication of a long-term stable and highly sensitive flexible electrochemical sensor based on nanocomposite-modified porous graphene by simple and facile laser treatment for detecting biomarkers such as glucose in sweat. The laser-reduced and patterned stable conductive nanocomposite on the porous graphene electrode provides the resulting glucose sensor with an excellent sensitivity of 1317.69 μAmM-1cm-2 with an ultra-low limit of detection (LOD) of 0.079 μM. The sensor can also detect pH and exhibit extraordinary stability to maintain more than 91% sensitivity over 21 days in ambient conditions. Taken together with a temperature sensor based on the same material system, the dual glucose and pH sensor integrated with a flexible microfluidic sweat sampling network further results in accurate continuous on-body glucose detection calibrated by the simultaneously measured pH and temperature. The low-cost, highly sensitive, and long-term stable platform could facilitate and pave the way for the early identification and continuous monitoring of different biomarkers for non-invasive disease diagnosis and treatment evaluation.

Chromophoric cerium oxide nanoparticle-loaded sucking disk-type strip sensor for optical measurement of glucose in tear fluid

BACKGROUND

Noninvasive monitoring of tear glucose levels can be convenient for patients to manage their diabetes mellitus. However, there are issues with monitoring tear glucose levels, such as the invasiveness of some methods, the miniaturization, inaccuracy, or the high cost of wearable devices. To overcome the issues, we newly designed a sucking disk-type (SD) strip biosensor that can quickly suck tear fluid and contains cerium oxide nanoparticle (CNP) that causes a unique color change according to the glucose level of the tear without complicated electronic components.

METHODS

The SD strip biosensor composed of three distinct parts (tip, channel, and reaction chamber) was designed to contain the sensing paper, onto which tear fluid can be collected and delivered. The sensing paper treated with CNP/APTS (aminopropyltriethoxysilane) /GOx (glucose oxidase) was characterized. Then we carried out the reliability of the SD strip biosensor in the diabetic rabbit animals. We quantitatively analyzed the color values of the SD strip biosensor through the colorimetric analysis algorithm.

RESULTS

We contacted the inferior palpebral conjunctiva (IPC) of a diabetic rabbit eye using an SD strip biosensor to collect tears without eye irritation and successfully verified the performance and quantitative efficacy of the sensor. An image processing algorithm that can optimize measurement accuracy is developed for accurate color change measurement of SD strip biosensors. The validation tests show a good correlation between glucose concentrations measured in the tear and blood.

CONCLUSION

Our findings demonstrate that the CNP-embedded SD strip biosensor and the associated image processing can simply monitor tear glucose to manage diabetes mellitus.

Access and Management of Sweat for Non-Invasive Biomarker Monitoring: A Comprehensive Review

Sweat is an important biofluid presents in the body since it regulates the internal body temperature, and it is relatively easy to access on the skin unlike other biofluids and contains several biomarkers that are also present in the blood. Although sweat sensing devices have recently displayed tremendous progress, most of the emerging devices primarily focus on the sensor development, integration with electronics, wearability, and data from in vitro studies and short-term on-body trials during exercise. To further the advances in sweat sensing technology, this review aims to present a comprehensive report on the approaches to access and manage sweat from the skin toward improved sweat collection and sensing. It is begun by delineating the sweat secretion mechanism through the skin, and the historical perspective of sweat, followed by a detailed discussion on the mechanisms governing sweat generation and management on the skin. It is concluded by presenting the advanced applications of sweat sensing, supported by a discussion of robust, extended-operation epidermal wearable devices aiming to strengthen personalized healthcare monitoring systems.

Parallel Monitoring of Glucose, Free Amino Acids, and Vitamin C in Fruits Using a High-Throughput Paper-Based Sensor Modified with Poly(carboxybetaine acrylamide)

Herein, a cost-effective and portable microfluidic paper-based sensor is proposed for the simultaneous and rapid detection of glucose, free amino acids, and vitamin C in fruit. The device was constructed by embedding a poly(carboxybetaine acrylamide) (pCBAA)-modified cellulose paper chip within a hydrophobic acrylic plate. We successfully showcased the capabilities of a filter paper-based microfluidic sensor for the detection of fruit nutrients using three distinct colorimetric analyses. Within a single paper chip, we simultaneously detected glucose, free amino acids, and vitamin C in the vivid hues of cyan blue, purple, and Turnbull's blue, respectively, in three distinctive detection zones. Notably, we employed more stable silver nanoparticles for glucose detection, replacing the traditional peroxidase approach. The detection limits for glucose reached a low level of 0.049 mmol/L. Meanwhile, the detection limits for free amino acids and vitamin C were found to be 0.236 mmol/L and 0.125 mmol/L, respectively. The feasibility of the proposed sensor was validated in 13 different practical fruit samples using spectrophotometry. Cellulose paper utilizes capillary action to process trace fluids in tiny channels, and combined with pCBAA, which has superior hydrophilicity and anti-pollution properties, it greatly improves the sensitivity and practicality of paper-based sensors. Therefore, the paper-based colorimetric device is expected to provide technical support for the nutritional value assessment of fruits in the field of rapid detection.

Optimization of Electrolytes with Redox Reagents to Improve the Impedimetric Signal for Use with a Low-Cost Analyzer

The most well-known criterion for POC devices is ASSURED, and affordability, i.e., using low-cost instrumentation, is the most challenging one. This manuscript provides a pathway for transitioning ESSENCE, an impedance-based biosensor platform, from using an expensive benchtop analyzer-KeySight 4294A (~$50k)-to using a significantly portable and cheaper USB oscilloscope-Analog Discovery 2 (~$200) -with similar sensitivity (around 100 times price difference). To achieve this, we carried out a fundamental study of the interplay between an electrolyte like potassium chloride (KCl), and an electrolyte buffer like phosphate buffered saline (PBS) in the presence and absence of a redox buffer like ferro/ferricyanide system and ([Ru(bpy)3]2+). Redox molecules in the electrolyte caused a significant change in the Nyquist curve of the impedance depending on the redox molecule type. The redox species and the background electrolyte have their own RC semicircles in the Nyquist curve, whose overlap depends on the redox concentration and electrolyte ionic strength. We found that by increasing the electrolyte ionic strength or the redox concentration, the RC semicircle moves to higher frequencies and vice versa. Importantly, the use of the buffer electrolyte, instead of KCl, led to a lower standard deviation and overall signal (lesser sensitivity). However, to achieve the best results from the biorecognition signal, we chose a buffered electrolyte like PBS with high ionic strength and lowered the redox probe concentrations to minimize the standard deviation and reduce any noise from migrating to the low-cost analyzer. Comparing the two analyzers shows similar results, with a lowered detection limit from the low-cost analyzer.

Colorimetric sweat analysis using wearable hydrogel patch sensors for detection of chloride and glucose

Sweat is a promising non-invasive biofluid that can provide valuable insights into the physiological state of the human body. However, a major obstacle to analyzing sweat in real-time is the fabrication of simple, fast-acting, accurate, and low-cost sensing constructs. To address this challenge, we introduced easily-prepared wearable hydrogel sensors that can be placed on the skin and used colorimetric techniques to assess sweat analytes without invasive procedures. Two typical sweat sensors, chloride ion (Cl-) responsive patches for cystic fibrosis (CF) analysis and glucose response patches for diabetic monitoring, were demonstrated for real sample analysis. The Cl- colorimetric sensor, with a detection limit down to 100 μM, shows a good linear response from 1.56 mM to 200 mM Cl-, and the glucose colorimetric sensor, with a detection limit down to 1 μM, exhibits an adequate linear response from 10 μM to 1 mM glucose. These colorimetric hydrogel sensors are also incorporated into a medical dressing to create wearable sensor devices for real-time sweat analysis. The acquired readings closely match the results obtained from the benchmark analyzing instrument, with a small deviation of less than 10%. Therefore, our simple colorimetric hydrogel sensing patches hold great potential to advance real-time sweat testing and contribute to the transitional development of wearable medical devices.

Review of Noninvasive Continuous Glucose Monitoring in Diabetics

For diabetics, taking regular blood glucose measurements is crucial. However, traditional blood glucose monitoring methods are invasive and unfriendly to diabetics. Recent studies have proposed a biofluid-based glucose sensing technique that creatively combines wearable devices with noninvasive glucose monitoring technology to enhance diabetes management. This is a revolutionary advance in the diagnosis and management of diabetes, reflects the thoughtful modernization of medicine, and promotes the development of digital medicine. This paper reviews the research progress of noninvasive continuous blood glucose monitoring (CGM), with a focus on the biological liquids that replace blood in monitoring systems, the technical principles of continuous noninvasive glucose detection, and the output and calibration of sensor signals. In addition, the existing limits of noninvasive CGM systems and prospects for the future are discussed. This work serves as a resource for further promoting the development of noninvasive CGM systems.

Fe Single-Atom Nanozyme-Modified Wearable Hydrogel Patch for Precise Analysis of Uric Acid at Rest

Resting sweat analysis could provide unique insight into the metabolic levels of physiological and pathological states. However, the low secretion rate of resting sweat and the low concentration of metabolic molecules pose challenges for the development of noninvasive wearable sensors. Here, we demonstrated a wearable patch for the precise analysis of uric acid at rest. Fe single-atom nanozymes (FeSAs) with excellent electrocatalytic activity were used to develop a sensor for selective catalysis of uric acid (UA, 1-425 μM), and the catalytic mechanism of UA was later explored by density functional theory. In addition, polyaniline was integrated into the wearable patch for pH detection; thus, accurate analysis of sweat UA molecules can be achieved by pH calibration. Then, we explored the possibility of collecting resting sweat with different ratios of agarose hydrogels to reduce the sweat accumulation time. Finally, the possibility of a wearable patch for accurate UA detection in volunteer sweat samples was experimentally verified. We believe that our work provides novel insights and ideas for the analysis of resting sweat using wearable devices, further driving advancements in the field of personalized medicine.

Electrochemical Wearable Biosensors and Bioelectronic Devices Based on Hydrogels: Mechanical Properties and Electrochemical Behavior

Hydrogel-based wearable electrochemical biosensors (HWEBs) are emerging biomedical devices that have recently received immense interest. The exceptional properties of HWEBs include excellent biocompatibility with hydrophilic nature, high porosity, tailorable permeability, the capability of reliable and accurate detection of disease biomarkers, suitable device-human interface, facile adjustability, and stimuli responsive to the nanofiller materials. Although the biomimetic three-dimensional hydrogels can immobilize bioreceptors, such as enzymes and aptamers, without any loss in their activities. However, most HWEBs suffer from low mechanical strength and electrical conductivity. Many studies have been performed on emerging electroactive nanofillers, including biomacromolecules, carbon-based materials, and inorganic and organic nanomaterials, to tackle these issues. Non-conductive hydrogels and even conductive hydrogels may be modified by nanofillers, as well as redox species. All these modifications have led to the design and development of efficient nanocomposites as electrochemical biosensors. In this review, both conductive-based and non-conductive-based hydrogels derived from natural and synthetic polymers are systematically reviewed. The main synthesis methods and characterization techniques are addressed. The mechanical properties and electrochemical behavior of HWEBs are discussed in detail. Finally, the prospects and potential applications of HWEBs in biosensing, healthcare monitoring, and clinical diagnostics are highlighted.

Focus Review on Nanomaterial-Based Electrochemical Sensing of Glucose for Health Applications

Diabetes management can be considered the first paradigm of modern personalized medicine. An overview of the most relevant advancements in glucose sensing achieved in the last 5 years is presented. In particular, devices exploiting both consolidated and innovative electrochemical sensing strategies, based on nanomaterials, have been described, taking into account their performances, advantages and limitations, when applied for the glucose analysis in blood and serum samples, urine, as well as in less conventional biological fluids. The routine measurement is still largely based on the finger-pricking method, which is usually considered unpleasant. In alternative, glucose continuous monitoring relies on electrochemical sensing in the interstitial fluid, using implanted electrodes. Due to the invasive nature of such devices, further investigations have been carried out in order to develop less invasive sensors that can operate in sweat, tears or wound exudates. Thanks to their unique features, nanomaterials have been successfully applied for the development of both enzymatic and non-enzymatic glucose sensors, which are compliant with the specific needs of the most advanced applications, such as flexible and deformable systems capable of conforming to skin or eyes, in order to produce reliable medical devices operating at the point of care.

Multifunctional Biosensing Platform Based on Nickel-Modified Laser-Induced Graphene

Nickel plating electrolytes prepared by using a simple salt solution can achieve nickel plating on laser-induced graphene (LIG) electrodes, which greatly enhances the electrical conductivity, electrochemical properties, wear resistance, and corrosion resistance of LIG. This makes the LIG-Ni electrodes well suited for electrophysiological, strain, and electrochemical sensing applications. The investigation of the mechanical properties of the LIG-Ni sensor and the monitoring of pulse, respiration, and swallowing confirmed that the sensor can sense insignificant deformations to relatively large conformal strains of skin. Modulation of the nickel-plating process of LIG-Ni, followed by chemical modification, may allow for the introduction of glucose redox catalyst Ni₂Fe(CN)₆ with interestingly strong catalytic effects, which gives LIG-Ni impressive glucose-sensing properties. Additionally, the chemical modification of LIG-Ni for pH and Na⁺ monitoring also confirmed its strong electrochemical monitoring potential, which demonstrates application prospects in the development of multiple electrochemical sensors for sweat parameters. A more uniform LIG-Ni multi-physiological sensor preparation process provides a prerequisite for the construction of an integrated multi-physiological sensor system. The sensor was validated to have continuous monitoring performance, and its preparation process is expected to form a system for non-invasive physiological parameter signal monitoring, thus contributing to motion monitoring, disease prevention, and disease diagnosis.

A sensitive enzyme-free electrochemical sensor based on a rod-shaped bimetallic MOF anchored on graphene oxide nanosheets for determination of glucose in huangshui

In this work, we propose a bimetallic Ni-Co based MOF attached to graphene oxide (GO) by a one-step hydrothermal approach which may be employed as an electrochemical enzyme-free glucose sensor. Due to the obvious synergistic catalysis of Ni and Co, as well as the combination of NiCo-MOF and GO, NiCo-MOF/GO not only enhances energy transfer and electrocatalytic performance but also provides a larger surface area and more active sites. Electrochemical studies show that NiCo-MOF/GO exhibits outstanding electrochemical activity, with a sensitivity of 11 177 μA mM^-1 cm^-2 and 4492 μA mM^-1 cm^-2 in the linear ranges of 1-497 μM and 597-3997 μM, a detection limit of 0.23 μM, and a response time of 2 seconds. More importantly, the newly fabricated sensor is successfully applied for glucose determination in huangshui. This method provides a novel strategy for the controlled fermentation process and product quality of Chinese baijiu.

Stimuli-bioresponsive hydrogels as new generation materials for implantable, wearable, and disposable biosensors for medical diagnostics: Principles, opportunities, and challenges

Hydrogels are excellent water-swollen polymeric materials for use in wearable, implantable, and disposable biosensors. Hydrogels have unique properties such as low cost, ease of preparation, transparency, rapid response to external conditions, biocompatibility and self-adhesion to the skin, flexibility, and strain sensitivity, making them ideal for use in biosensor platforms. This review provides a detailed overview of advanced applications of stimuli-responsive hydrogels in biosensor platforms, from hydrogel synthesis and functionalization for bioreceptor immobilization to several important diagnostic applications. Emphasis is placed on recent advances in the fabrication of ultrasensitive fluorescent and electrically conductive hydrogels and their applications in wearable, implantable, and disposable biosensors for quantitative measurements. Design, modification, and assembly techniques of fluorescent, ionically conductive, and electrically conductive hydrogels to improve performance will be addressed. The advantages and performance improvements of immobilizing bioreceptors (e.g., antibodies, enzymes, and aptamers), and incorporating fluorescent and electrically conductive nanomaterials are described, as are their limitations. Potential applications of hydrogels in implantable, wearable, disposable portable biosensors for quantitative detection of the various bioanalytes (ions, molecules, drugs, proteins, and biomarkers) are discussed. Finally, the global market for hydrogel-based biosensors and future challenges and prospects are discussed in detail.

Evolution of nanostructured skin patches towards multifunctional wearable platforms for biomedical applications

Recent advances in the field of skin patches have promoted the development of wearable and implantable bioelectronics for long-term, continuous healthcare management and targeted therapy. However, the design of electronic skin (e-skin) patches with stretchable components is still challenging and requires an in-depth understanding of the skin-attachable substrate layer, functional biomaterials and advanced self-powered electronics. In this comprehensive review, we present the evolution of skin patches from functional nanostructured materials to multi-functional and stimuli-responsive patches towards flexible substrates and emerging biomaterials for e-skin patches, including the material selection, structure design and promising applications. Stretchable sensors and self-powered e-skin patches are also discussed, ranging from electrical stimulation for clinical procedures to continuous health monitoring and integrated systems for comprehensive healthcare management. Moreover, an integrated energy harvester with bioelectronics enables the fabrication of self-powered electronic skin patches, which can effectively solve the energy supply and overcome the drawbacks induced by bulky battery-driven devices. However, to realize the full potential offered by these advancements, several challenges must be addressed for next-generation e-skin patches. Finally, future opportunities and positive outlooks are presented on the future directions of bioelectronics. It is believed that innovative material design, structure engineering, and in-depth study of fundamental principles can foster the rapid evolution of electronic skin patches, and eventually enable self-powered close-looped bioelectronic systems to benefit mankind.

Catalytic Modification of Porous Two-Dimensional Ni-MOFs on Portable Electrochemical Paper-Based Sensors for Glucose and Hydrogen Peroxide Detection

Rapid and accurate detection of changes in glucose (Glu) and hydrogen peroxide (H₂O₂) concentrations is essential for the predictive diagnosis of diseases. Electrochemical biosensors exhibiting high sensitivity, reliable selectivity, and rapid response provide an advantageous and promising solution. A porous two-dimensional conductive metal-organic framework (cMOF), Ni-HHTP (HHTP = 2,3,6,7,10,11-hexahydroxytriphenylene), was prepared by using a one-pot method. Subsequently, it was employed to construct enzyme-free paper-based electrochemical sensors by applying mass-producing screen-printing and inkjet-printing techniques. These sensors effectively determined Glu and H₂O₂ concentrations, achieving low limits of detection of 1.30 μM and 2.13 μM, and high sensitivities of 5573.21 μA μM^-1 cm^-2 and 179.85 μA μM^-1 cm^-2, respectively. More importantly, the Ni-HHTP-based electrochemical sensors showed an ability to analyze real biological samples by successfully distinguishing human serum from artificial sweat samples. This work provides a new perspective for the use of cMOFs in the field of enzyme-free electrochemical sensing, highlighting their potential for future applications in the design and development of new multifunctional and high-performance flexible electronic sensors.

Skin-Interfaced Wearable Sweat Sensors for Precision Medicine

Wearable sensors hold great potential in empowering personalized health monitoring, predictive analytics, and timely intervention toward personalized healthcare. Advances in flexible electronics, materials science, and electrochemistry have spurred the development of wearable sweat sensors that enable the continuous and noninvasive screening of analytes indicative of health status. Existing major challenges in wearable sensors include: improving the sweat extraction and sweat sensing capabilities, improving the form factor of the wearable device for minimal discomfort and reliable measurements when worn, and understanding the clinical value of sweat analytes toward biomarker discovery. This review provides a comprehensive review of wearable sweat sensors and outlines state-of-the-art technologies and research that strive to bridge these gaps. The physiology of sweat, materials, biosensing mechanisms and advances, and approaches for sweat induction and sampling are introduced. Additionally, design considerations for the system-level development of wearable sweat sensing devices, spanning from strategies for prolonged sweat extraction to efficient powering of wearables, are discussed. Furthermore, the applications, data analytics, commercialization efforts, challenges, and prospects of wearable sweat sensors for precision medicine are discussed.

Research Progress on Biomimetic Nanomaterials for Electrochemical Glucose Sensors

Diabetes has become a chronic disease that necessitates timely and accurate detection. Among various detection methods, electrochemical glucose sensors have attracted much attention because of low cost, real-time detection, and simple and easy operation. Nonenzymatic biomimetic nanomaterials are the vital part in electrochemical glucose sensors. This review article summarizes the methods to enhance the glucose sensing performance of noble metal, transition metal oxides, and carbon-based materials and introduces biomimetic nanomaterials used in noninvasive glucose detection in sweat, tear, urine, and saliva. Based on these, this review provides the foundation for noninvasive determination of trace glucose for diabetic patients in the future.

Eco-friendly fabrication of nonenzymatic electrochemical sensor based on cobalt/polymelamine/nitrogen-doped graphitic-porous carbon nanohybrid material for glucose monitoring in human blood

The design and development of eco-friendly fabrication of cost-effective electrochemical nonenzymatic biosensors with enhanced sensitivity and selectivity are one of the emerging area in nanomaterial and analytical chemistry. In this aspect, we developed a facile fabrication of tertiary nanocomposite material based on cobalt and polymelamine/nitrogen-doped graphitic porous carbon nanohybrid composite (Co-PM-NDGPC/SPE) for the application as a nonenzymatic electrochemical sensor to quantify glucose in human blood samples. Co-PM-NDGPC/SPE nanocomposite electrode fabrication was achieved using a single-step electrodeposition method under cyclic voltammetry (CV) technique under 1 M NH₄Cl solution at 20 constitutive CV cycles (sweep rate 20 mV/s). Notably, the fabricated nonenzymatic electroactive nanocomposite material exhibited excellent electrocatalytic sensing towards the quantification of glucose in 0.1 M NaOH over a wide concentration range from 0.03 to 1.071 mM with a sensitive limit of detection 7.8 μM. Moreover, the Co-PM-NDGPC nanocomposite electrode with low charge transfer resistance (Rct∼81 Ω) and high ionic diffusion indicates excellent stability, reproducibility, and high sensitivity. The fabricated nanocomposite materials exhibit a commendable sensing response toward glucose molecules present in the blood serum samples recommends its usage in real-time applications.

Pt/MXene-Based Flexible Wearable Non-Enzymatic Electrochemical Sensor for Continuous Glucose Detection in Sweat

Wearable non-invasive sensors facilitate the continuous measurement of glucose in sweat for the treatment and management of diabetes. However, the catalysis of glucose and sweat sampling are challenges in the development of efficient wearable glucose sensors. Herein, we report a flexible wearable non-enzymatic electrochemical sensor for continuous glucose detection in sweat. We synthesized a catalyst (Pt/MXene) by the hybridization of Pt nanoparticles onto MXene (Ti₃C₂T_x) nanosheets with a broad linear range of glucose detection (0-8 mmol/L) under neutral conditions. Furthermore, we optimized the structure of the sensor by immobilizing Pt/MXene with a conductive hydrogel to enhance the stability of the sensor. Based on Pt/MXene and the optimized structure, we fabricated a flexible wearable glucose sensor by integrating a microfluidic patch for sweat collection onto a flexible sensor. We evaluated the utility of the sensor for the detection of glucose in sweat, and the sensor could detect the glucose change with the replenishment and consumption of energy by the body, and a similar trend was observed in the blood. An in vivo glucose test in sweat indicated that the fabricated sensor is promising for the continuous measurement of glucose, which is essential for the treatment and management of diabetes.

Conductive polymers and composites-based systems: An incipient stride in drug delivery and therapeutics realm

Novel therapies and drug delivery systems (DDS) emphasis on localized, personalized, triggered, and regulated drug administration have heavily implicated electrically responsive DDS. An ideal DDS must deliver drugs to the target region at therapeutically effective concentrations to elicit a pharmacological response, resulting in better prophylaxis of the disease and the treatment. Biodegradable polymers are frequently employed for in-vivo long-term release; however, dose dumping can be anticipated. As a result, current DDSs can be tagged as dubbed "Smart Biomaterials" since they only focus on an on-demand cargo release in response to a trigger or stimulation. These organic materials have been recognized for their metal-like conductivity, as well as their mechanical stability and ease of production. These biomaterials can be programmed to respond to both internal and external stimuli. External pulsed triggers are required for extrinsic stimuli-responsive materials, whereas intrinsic stimuli-responsive materials rely on localized changes in the tissue environment. Furthermore, these materials have the ability to deliver active pharmaceutical agents at a varied concentration levels and across a broad spectrum of action. Drug delivery, biomedical implant technology, biosensor technology, and tissue engineering can be listed as a few prominent applications that have sparked immense interest for conductive polymers-based research and advancements in academia as well as in industry. This review comprehensively covers a cutting-edge collection of electrically conductive polymers and composites, and provide detailed insights of recent trends and advancements allied to conductive polymers for their potential applicability in an array of diverse meadows primarily focusing on drug delivery, biosensing and therapeutics. Furthermore, progressions in their synthesis, structural and functional properties have been presented in conjunction with futuristic directions for the smooth clinical translations.

Multiplex Chroma Response Wearable Hydrogel Patch: Visual Monitoring of Urea in Body Fluids for Health Prognosis

Visual wearable devices can rapid intuitively monitor biomarkers in body fluids to indicate the human health status and provide valuable reference for further medical diagnosis. However, unavoidable interference factors such as skin color, natural light, and background luminescence can interfere with the visualization accuracy of flexible wearable devices, limiting their practical sensing application. Here, we designed a wearable sensing patch via an embedded upconversion optical probe in a 3D porous polyacrylamide hydrogel, exhibiting a multiplex chroma response to urea based on the inner filter effect, which overcomes the susceptibility to external conditions due to its near-infrared excited luminescence and improves the resolution and accuracy of visual sensing. Furthermore, a highly compatible portable sensing platform combined with a smartphone was designed to achieve in situ rapid quantitative analysis of urea. The limit of detection values of the upconversion optical probe and hydrogel sensor are as low as 1.4 and 30 μM respectively, exhibiting the practicality in different scenarios. The designed sensing patch provides a convenient and accurate sensing strategy for the detection of biomarkers in body fluids and has the potential to be developed into a point-of-care device to provide disease early warning and clinical diagnosis.

Advances in wearable electrochemical antibody-based sensors for cortisol sensing

Cortisol is a crucial hormone involving many physiological processes. Hence, cortisol detection is essential. This review highlights the key progress made on wearable electrochemical sensors using antibodies. It covers the design, principle, and electroanalytical methodology for detecting cortisol noninvasively. This article also analyzes and collects the analytical performances of electrochemical cortisol sensors. The development of these sensors continues to face challenges such as biofouling, sample management, sensitivity, flexibility, stability, and recognition layer performance. It is also necessary to develop a sensitive electrode and material. This article also presents potential strategies for designing antibody electrodes and provides examples of sensing systems. Additionally, it discusses the challenges in translating research into practical applications.

Hand-Powered Point-of-Care: Centrifugal Microfluidic Platform for Urine Routine Examination (μCUREX)

Urinalysis is one of the simplest and most common medical tests in modern cities. With the assistance of professional technicians and equipment, people in metropolitan areas can effortlessly acquire information about their physiological conditions from traditional clinical laboratories. However, the threshold, including precise benchtop equipment and well-trained personnel, still remains a considerable dilemma for residents in healthcare-poor areas. Hence, it is a crucial and urgent topic to develop a smart and affordable widget to address this challenge. To improve the healthcare rights of residents, we proposed a disposable centrifugal microfluidic urine routine examination platform (named μCUREX) actuated with a modified hand-powered fan. Two parts of urinalysis (sediment test and chemical strip test) were integrated into the μCUREX disc. The influence on sedimentation by variant hand-powered manipulation was simulated using COMSOL. As a result, more than 70% of the sediment can be collected. Moreover, the color change of chemical strip papers (indicators for glucose, pH, protein, and occult blood) was recorded with a 3D-printed studio and analyzed after reaction with chemical-spiked and pH-adjusted artificial and human urine specimens. The whole process can be completed within 10 min, with only 200 μL of urine needed. In conclusion, we successfully constructed an ultra-low-cost point-of-care platform for urinalysis in extremely resource-poor settings. The handy size, high affordability, and user-friendliness of the μCUREX disc provide strong potential and feasibility in solving problems in resource-poor settings. Furthermore, we highly expect the μCUREX platform to improve the level of healthcare in resource-limited areas.

Electrochemical Nanosensors for Sensitization of Sweat Metabolites: From Concept Mapping to Personalized Health Monitoring

Sweat contains a broad range of important biomarkers, which may be beneficial for acquiring non-invasive biochemical information on human health status. Therefore, highly selective and sensitive electrochemical nanosensors for the non-invasive detection of sweat metabolites have turned into a flourishing contender in the frontier of disease diagnosis. A large surface area, excellent electrocatalytic behavior and conductive properties make nanomaterials promising sensor materials for target-specific detection. Carbon-based nanomaterials (e.g., CNT, carbon quantum dots, and graphene), noble metals (e.g., Au and Pt), and metal oxide nanomaterials (e.g., ZnO, MnO2, and NiO) are widely used for modifying the working electrodes of electrochemical sensors, which may then be further functionalized with requisite enzymes for targeted detection. In the present review, recent developments (2018-2022) of electrochemical nanosensors by both enzymatic as well as non-enzymatic sensors for the effectual detection of sweat metabolites (e.g., glucose, ascorbic acid, lactate, urea/uric acid, ethanol and drug metabolites) have been comprehensively reviewed. Along with this, electrochemical sensing principles, including potentiometry, amperometry, CV, DPV, SWV and EIS have been briefly presented in the present review for a conceptual understanding of the sensing mechanisms. The detection thresholds (in the range of mM-nM), sensitivities, linear dynamic ranges and sensing modalities have also been properly addressed for a systematic understanding of the judicious design of more effective sensors. One step ahead, in the present review, current trends of flexible wearable electrochemical sensors in the form of eyeglasses, tattoos, gloves, patches, headbands, wrist bands, etc., have also been briefly summarized, which are beneficial for on-body in situ measurement of the targeted sweat metabolites. On-body monitoring of sweat metabolites via wireless data transmission has also been addressed. Finally, the gaps in the ongoing research endeavors, unmet challenges, outlooks and future prospects have also been discussed for the development of advanced non-invasive self-health-care-monitoring devices in the near future.

Advances in the Translation of Electrochemical Hydrogel-Based Sensors

Novel biomaterials for bio- and chemical sensing applications have gained considerable traction in the diagnostic community with rising trends of using biocompatible and lowly cytotoxic material. Hydrogel-based electrochemical sensors have become a promising candidate for their swellable, nano-/microporous, and aqueous 3D structures capable of immobilizing catalytic enzymes, electroactive species, whole cells, and complex tissue models, while maintaining tunable mechanical properties in wearable and implantable applications. With advances in highly controllable fabrication and processability of these novel biomaterials, the possibility of bio-nanocomposite hydrogel-based electrochemical sensing presents a paradigm shift in the development of biocompatible, "smart," and sensitive health monitoring point-of-care devices. Here, recent advances in electrochemical hydrogels for the detection of biomarkers in vitro, in situ, and in vivo are briefly reviewed to demonstrate their applicability in ideal conditions, in complex cellular environments, and in live animal models, respectively, to provide a comprehensive assessment of whether these biomaterials are ready for point-of-care translation and biointegration. Sensors based on conductive and nonconductive polymers are presented, with highlights of nano-/microstructured electrodes that provide enhanced sensitivity and selectivity in biocompatible matrices. An outlook on current challenges that shall be addressed for the realization of truly continuous real-time sensing platforms is also presented.

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

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

A Comprehensive Review of the Recent Developments in Wearable Sweat-Sensing Devices

Sweat analysis offers non-invasive real-time on-body measurement for wearable sensors. However, there are still gaps in current developed sweat-sensing devices (SSDs) regarding the concerns of mixing fresh and old sweat and real-time measurement, which are the requirements to ensure accurate the measurement of wearable devices. This review paper discusses these limitations by aiding model designs, features, performance, and the device operation for exploring the SSDs used in different sweat collection tools, focusing on continuous and non-continuous flow sweat analysis. In addition, the paper also comprehensively presents various sweat biomarkers that have been explored by earlier works in order to broaden the use of non-invasive sweat samples in healthcare and related applications. This work also discusses the target analyte's response mechanism for different sweat compositions, categories of sweat collection devices, and recent advances in SSDs regarding optimal design, functionality, and performance.

Continuous Glucose Monitoring in Preterm Infants: The Role of Nutritional Management in Minimizing Glycemic Variability

Glycemic variability (GV) is common in preterm infants. In the premature population, GV is a risk factor for morbidity and mortality. Both hypo- and hyperglycemia can impair neurodevelopment. We investigated the impact of continuous versus intermittent tube enteral feeding on GV. In our prospective observational study, 20 preterm infants with a gestational age ≤ 34 weeks at either continuous or intermittent bolus full enteral feeding. For five days, continuous glucose monitoring (CGM) was utilized, which was achieved through the subcutaneous insertion of a sensor. A total of 27,532 measurements of blood glucose were taken. The mean amplitude of glycemic excursions did not differ between the two cohorts statistically. Continuous feeding resulted in higher positive values, increasing the risk of hypo- and hyperglycemia. Subjects who were small for their gestational age had a higher standard deviation during continuous feeding (p = 0.001). Data suggest that intermittent bolus nutrition is better for glycemic control than continuous nutrition. Nutritional management optimization of preterm infants appears to be critical for long-term health. In the future, CGM may provide a better understanding of the optimal glucose targets for various clinical conditions, allowing for a more personalized approach to management.

Microfluidic wearable electrochemical sweat sensors for health monitoring

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

Hydrogel-extraction technique for non-invasive detection of blue fluorescent substances in plant leaves

This paper reports a new hydrogel extraction technique for detecting blue fluorescent substances in plant leaves. These blue fluorescent substances were extracted by placing a hydrogel film on the leaf of a cherry tomato plant infected with Ralstonia solanacearum; herein, chlorogenic acid was confirmed to be a blue fluorescent substance. The wavelength at the maximum fluorescence intensity of the film after the hydrogel extraction was similar to that of the methanolic extract obtained from the infected cherry tomato leaves. Chlorophyll was not extracted from the hydrogel film because no fluorescence peak was observed at 680 nm. Accordingly, the blue fluorescence of the substances extracted from the hydrogel film was not quenched by the strong absorption of chlorophyll in the blue light region. This hydrogel extraction technique can potentially detect small amounts of blue fluorescent substances and the changes in its amount within the leaves of infected plants. These changes in the amount of blue fluorescent substances in the early stages of infection can be used to detect presymptomatic infections. Therefore, hydrogel extraction is a promising technique for the noninvasive detection of infections before onset.

Wireless Wearable Electrochemical Sensing Platform with Zero-Power Osmotic Sweat Extraction for Continuous Lactate Monitoring

Wearable and wireless monitoring of biomarkers such as lactate in sweat can provide a deeper understanding of a subject's metabolic stressors, cardiovascular health, and physiological response to exercise. However, the state-of-the-art wearable and wireless electrochemical systems rely on active sweat released either via high-exertion exercise, electrical stimulation (such as iontophoresis requiring electrical power), or chemical stimulation (such as by delivering pilocarpine or carbachol inside skin), to extract sweat under low-perspiring conditions such as at rest. Here, we present a continuous sweat lactate monitoring platform combining a hydrogel for osmotic sweat extraction, with a paper microfluidic channel for facilitating sweat transport and management, a screen-printed electrochemical lactate sensor, and a custom-built wireless wearable potentiostat system. Osmosis enables zero-electrical power sweat extraction at rest, while continuous evaporation at the end of a paper channel allows long-term sensing from fresh sweat. The positioning of the lactate sensors provides near-instantaneous sensing at low sweat volume, and the custom-designed potentiostat supports continuous monitoring with ultra-low power consumption. For a proof of concept, the prototype system was evaluated for continuous measurement of sweat lactate across a range of physiological activities with changing lactate concentrations and sweat rates: for 2 h at the resting state, 1 h during medium-intensity exercise, and 30 min during high-intensity exercise. Overall, this wearable system holds the potential of providing comprehensive and long-term continuous analysis of sweat lactate trends in the human body during rest and under exercising conditions.

Colorimetric Nanoparticle-Embedded Hydrogels for a Biosensing Platform

Hydrogels containing colorimetric nanoparticles have been used for ion sensing, glucose detection, and microbial metabolite analyses. In particular, the rapid chemical reaction owing to both the hydrogel form of water retention and the sensitive color change of nanoparticles enables the rapid detection of target substances. Despite this advantage, the poor dispersibility of nanoparticles and the mechanical strength of nanoparticle-hydrogel complexes have limited their application. In this study, we demonstrate a milliliter agarose gel containing homogeneously synthesized polyaniline nanoparticles (PAni-NPs), referred to as PAni-NP-hydrogel complexes (PNHCs). To fabricate the optimal PNHC, we tested various pH solvents based on distilled water and phosphate-buffered saline and studied the colorimetric response of the PNHC with thickness. The colorimetric response of the prepared PNHC to the changes in the pH of the solution demonstrated excellent linearity, suggesting the possibility of using PNHC as a pH sensor. In addition, it was verified that the PNHC could detect minute pH changes caused by the cancer cell metabolites without cytotoxicity. Furthermore, the PNHC can be stably maintained outside water for approximately 12 h without deformation, indicating that it can be used as a disposable patch-type wearable biosensing platform.

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

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

Polymeric Nanostructures Containing Proteins and Peptides for Pharmaceutical Applications

Over the last three decades, proteins and peptides have attracted great interest as drugs of choice for combating a broad spectrum of diseases, including diabetes mellitus, cancer, and infectious and neurological diseases. However, the delivery of therapeutic proteins to target sites should take into account the obstacles and limitations related to their intrinsic sensitivity to different environmental conditions, fragile tertiary structures, and short half-life. Polymeric nanostructures have emerged as competent vehicles for protein delivery, as they are multifunctional and can be tailored according to their peculiarities. Thus, the enhanced bioavailability and biocompatibility, the adjustable control of physicochemical features, and the colloidal stability of polymer-based nanostructures further enable either the embedding or conjugation of hydrophobic or hydrophilic bioactive molecules, which are some of the features of paramount importance that they possess and which contribute to their selection as vehicles. The present review aims to discuss the prevalent nanostructures composed of block copolymers from the viewpoint of efficient protein hospitality and administration, as well as the up-to-date scientific publications and anticipated applications of polymeric nanovehicles containing proteins and peptides.