Enokitake Mushroom-like Standing Gold Nanowires toward Wearable Noninvasive Bimodal Glucose and Strain Sensing

Real-Time Quantification of Nanoplastics-Induced Oxidative Stress in Stretching Alveolar Cells

Nanoplastics from air pollutants can be directly inhaled into the alveoli in the lungs and further enter blood circulation, and numerous studies have revealed the close relation between internalized nanoplastics with many physiological disorders via intracellular oxidative stress. However, the dynamic process of nanoplastics-induced oxidative stress in lung cells under breath-mimicked conditions is still unclear, due to the lack of methods that can reproduce the mechanical stretching of the alveolar and simultaneously monitor the oxidative stress response. Here, we describe a biomimetic platform by culturing alveoli epithelial cells on a stretchable electrochemical sensor and integrating them into a microfluidic device. This allows reproducing the respiration of alveoli by cyclic stretching of the alveoli epithelial cells and monitoring the nanoplastics-induced oxidative stress by the built-in sensor. By this device, we prove that cyclic stretches can greatly enhance the cellular uptake of nanoplastics with the dependencies of strain amplitude. Importantly, oxidative stress evoked by internalized nanoplastics can be quantitatively monitored in real time. This work will promote the deep understanding about the cytotoxicity of inhaled nanoplastics in the pulmonary mechanical microenvironment.

Wearable electrochemical glucose sensor of high flexibility and sensitivity using novel mushroom-like gold nanowires decorated bendable stainless steel wire sieve

Long-term high blood glucose levels brings extremely detrimental effect on diabetic patients, such as blindness, renal failure, and cardiovascular diseases. Therefore, there is an urgent need to develop highly flexible and sensitive sensors for precisely non-invasive and continuous monitoring glucose levels. Herein, we present a highly flexible and sensitive wearable sensor for non-enzymatic electrochemical glucose analysis with vertically aligned mushroom-like gold nanowires (v-AuNWs) chemically grown on stainless steel wire sieve (SSWS) as integrated electrode. Owing to the unique nanostructures and excellent catalysis of the v-AuNWs, the as-fabricated glucose sensors exhibit superior flexibility and excellent electro-catalytic capability. In detail, these sensors display rapid response towards glucose within 5 s, and the sensor constructed with v-AuNWs for growth time of 15 min shows the highest sensitivity of 180.1 μA mM-1 cm-2 within a wide linear range of 6.5 × 10-4 mM-12.0 mM and the lowest detection limit of 0.65 μM (S/N = 3). It is noteworthy that due to the good ductility of the v-AuNWs and their strong contact with the SSWS substrate, these glucose sensors exhibit no obvious response variation after repeated bending for 100 times at bending angle of 180°. Additionally, the glucose sensors display superior anti-interfering capability as well as desirable repeatability. More importantly, these glucose sensors can be attached on human skin to determine sweat glucose reliably and analyze glucose concentration in human serum in vitro.

Materials-Driven Soft Wearable Bioelectronics for Connected Healthcare

In the era of Internet-of-things, many things can stay connected; however, biological systems, including those necessary for human health, remain unable to stay connected to the global Internet due to the lack of soft conformal biosensors. The fundamental challenge lies in the fact that electronics and biology are distinct and incompatible, as they are based on different materials via different functioning principles. In particular, the human body is soft and curvilinear, yet electronics are typically rigid and planar. Recent advances in materials and materials design have generated tremendous opportunities to design soft wearable bioelectronics, which may bridge the gap, enabling the ultimate dream of connected healthcare for anyone, anytime, and anywhere. We begin with a review of the historical development of healthcare, indicating the significant trend of connected healthcare. This is followed by the focal point of discussion about new materials and materials design, particularly low-dimensional nanomaterials. We summarize material types and their attributes for designing soft bioelectronic sensors; we also cover their synthesis and fabrication methods, including top-down, bottom-up, and their combined approaches. Next, we discuss the wearable energy challenges and progress made to date. In addition to front-end wearable devices, we also describe back-end machine learning algorithms, artificial intelligence, telecommunication, and software. Afterward, we describe the integration of soft wearable bioelectronic systems which have been applied in various testbeds in real-world settings, including laboratories that are preclinical and clinical environments. Finally, we narrate the remaining challenges and opportunities in conjunction with our perspectives.

Current advancements and prospects of enzymatic and non-enzymatic electrochemical glucose sensors

This review discusses the most current developments and future perspectives in enzymatic and non-enzymatic glucose sensors, which have notably evolved over the preceding quadrennial period. Furthermore, a thorough exploration encompassed the sensor's intricate fabrication processes, the diverse range of materials employed, the underlying principles of detection, and an in-depth assessment of the sensors' efficacy in detecting glucose levels within essential bodily fluids such as human blood serums, urine, saliva, and interstitial fluids. It is worth noting that the accurate quantification of glucose concentrations within human blood has been effectively achieved by utilizing classical enzymatic sensors harmoniously integrated with optical and electrochemical transduction mechanisms. Monitoring glucose levels in various mediums has attracted exceptional attention from industrial to academic researchers for diabetes management, food quality control, clinical medicine, and bioprocess inspection. There has been an enormous demand for the creation of novel glucose sensors over the past ten years. Research has primarily concentrated on succeeding biocompatible and enhanced sensing abilities related to the present technologies, offering innovative avenues for more effective glucose sensors. Recent developments in wearable optical and electrochemical sensors with low cost, high stability, point-of-care testing, and online tracking of glucose concentration levels in biological fluids can aid in managing and controlling diabetes globally. New nanomaterials and biomolecules that can be used in electrochemical sensor systems to identify glucose concentration levels are developed thanks to advances in nanoscience and nanotechnology. Both enzymatic and non-enzymatic glucose electrochemical sensors have garnered much interest recently and have made significant strides in detecting glucose levels. In this review, we summarise several categories of non-enzymatic glucose sensor materials, including composites, non-precious transition metals and their metal oxides, hydroxides, precious metals and their alloys, carbon-based materials, conducting polymers, metal-organic framework (MOF)-based electrocatalysts, and wearable device-based glucose sensors deeply.

Advances in Wireless, Batteryless, Implantable Electronics for Real-Time, Continuous Physiological Monitoring

This review summarizes recent progress in developing wireless, batteryless, fully implantable biomedical devices for real-time continuous physiological signal monitoring, focusing on advancing human health care. Design considerations, such as biological constraints, energy sourcing, and wireless communication, are discussed in achieving the desired performance of the devices and enhanced interface with human tissues. In addition, we review the recent achievements in materials used for developing implantable systems, emphasizing their importance in achieving multi-functionalities, biocompatibility, and hemocompatibility. The wireless, batteryless devices offer minimally invasive device insertion to the body, enabling portable health monitoring and advanced disease diagnosis. Lastly, we summarize the most recent practical applications of advanced implantable devices for human health care, highlighting their potential for immediate commercialization and clinical uses.

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.

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

BACKGROUND

Numerous laboratory tests are used in the diagnosis and management of diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially.

APPROACH

An expert committee compiled evidence-based recommendations for laboratory analysis in screening, diagnosis, or monitoring of diabetes. The overall quality of the evidence and the strength of the recommendations were evaluated. The draft consensus recommendations were evaluated by invited reviewers and presented for public comment. Suggestions were incorporated as deemed appropriate by the authors (see Acknowledgments). The guidelines were reviewed by the Evidence Based Laboratory Medicine Committee and the Board of Directors of the American Association for Clinical Chemistry and by the Professional Practice Committee of the American Diabetes Association.

CONTENT

Diabetes can be diagnosed by demonstrating increased concentrations of glucose in venous plasma or increased hemoglobin A1c (HbA1c) in the blood. Glycemic control is monitored by the people with diabetes measuring their own blood glucose with meters and/or with continuous interstitial glucose monitoring (CGM) devices and also by laboratory analysis of HbA1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of ketones, autoantibodies, urine albumin, insulin, proinsulin, and C-peptide are addressed.

SUMMARY

The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.

Manipulator Control System Based on Flexible Sensor Technology

The research on the remote control of manipulators based on flexible sensor technology is gradually extensive. In order to achieve stable, accurate, and efficient control of the manipulator, it is necessary to reasonably design the structure of the sensor with excellent tensile strength and flexibility. The acquisition of manual information by high-performance sensors is the basis of manipulator control. This paper starts with the manufacturing of materials of the flexible sensor for the manipulator, introduces the substrate, sensor, and flexible electrode materials, respectively, and summarizes the performance of different flexible sensors. From the perspective of manufacturing, it introduces their basic principles and compares their advantages and disadvantages. Then, according to the different ways of wearing, the two control methods of data glove control and surface EMG control are respectively introduced, the principle, control process, and detection accuracy are summarized, and the problems of material microstructure, reducing the cost, optimizing the circuit design and so on are emphasized in this field. Finally, the commercial application in this field is explained and the future research direction is proposed from two aspects: how to ensure real-time control and better receive the feedback signal from the manipulator.

Flexible and Stretchable Electrochemical Sensors for Biological Monitoring

The rise of flexible and stretchable electronics has revolutionized biosensor techniques for probing biological systems. Particularly, flexible and stretchable electrochemical sensors (FSECSs) enable the in situ quantification of numerous biochemical molecules in different biological entities owing to their exceptional sensitivity, fast response, and easy miniaturization. Over the past decade, the fabrication and application of FSECSs have significantly progressed. This review highlights key developments in electrode fabrication and FSECSs functionalization. It delves into the electrochemical sensing of various biomarkers, including metabolites, electrolytes, signaling molecules, and neurotransmitters from biological systems, encompassing the outer epidermis, tissues/organs in vitro and in vivo, and living cells. Finally, considering electrode preparation and biological applications, current challenges and future opportunities for FSECSs are discussed.

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

BACKGROUND

Numerous laboratory tests are used in the diagnosis and management of diabetes mellitus. The quality of the scientific evidence supporting the use of these assays varies substantially.

APPROACH

An expert committee compiled evidence-based recommendations for laboratory analysis in screening, diagnosis, or monitoring of diabetes. The overall quality of the evidence and the strength of the recommendations were evaluated. The draft consensus recommendations were evaluated by invited reviewers and presented for public comment. Suggestions were incorporated as deemed appropriate by the authors (see Acknowledgments). The guidelines were reviewed by the Evidence Based Laboratory Medicine Committee and the Board of Directors of the American Association of Clinical Chemistry and by the Professional Practice Committee of the American Diabetes Association.

CONTENT

Diabetes can be diagnosed by demonstrating increased concentrations of glucose in venous plasma or increased hemoglobin A1c (Hb A1c) in the blood. Glycemic control is monitored by the people with diabetes measuring their own blood glucose with meters and/or with continuous interstitial glucose monitoring (CGM) devices and also by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of ketones, autoantibodies, urine albumin, insulin, proinsulin, and C-peptide are addressed.

SUMMARY

The guidelines provide specific recommendations based on published data or derived from expert consensus. Several analytes are found to have minimal clinical value at the present time, and measurement of them is not recommended.

Wearable non-invasive glucose sensors based on metallic nanomaterials

The development of wearable non-invasive glucose sensors provides a convenient technical means to monitor the glucose concentration of diabetes patients without discomfortability and risk of infection. Apart from enzymes as typical catalytic materials, the active catalytic materials of the glucose sensor are mainly composed of polymers, metals, alloys, metal compounds, and various metals that can undergo catalytic oxidation with glucose. Among them, metallic nanomaterials are the optimal materials applied in the field of wearable non-invasive glucose sensing due to good biocompatibility, large specific surface area, high catalytic activity, and strong adsorption capacity. This review summarizes the metallic nanomaterials used in wearable non-invasive glucose sensors including zero-dimensional (0D), one-dimensional (1D), and two-dimensional (2D) monometallic nanomaterials, bimetallic nanomaterials, metal oxide nanomaterials, etc. Besides, the applications of wearable non-invasive biosensors based on these metallic nanomaterials towards glucose detection are summarized in detail and the development trend of the wearable non-invasive glucose sensors based on metallic nanomaterials is also outlook.

An Energy-Efficient Flexible Multi-Modal Wireless Sweat Sensing System Based on Laser Induced Graphene

Real-time sweat monitoring is vital for athletes in order to reflect their physical conditions, quantify their exercise loads, and evaluate their training results. Therefore, a multi-modal sweat sensing system with a patch-relay-host topology was developed, which consisted of a wireless sensor patch, a wireless data relay, and a host controller. The wireless sensor patch can monitor the lactate, glucose, K⁺, and Na⁺ concentrations in real-time. The data is forwarded via a wireless data relay through Near Field Communication (NFC) and Bluetooth Low Energy (BLE) technology and it is finally available on the host controller. Meanwhile, existing enzyme sensors in sweat-based wearable sports monitoring systems have limited sensitivities. To improve their sensitivities, this paper proposes a dual enzyme sensing optimization strategy and demonstrates Laser-Induced Graphene (LIG)-based sweat sensors decorated with Single-Walled Carbon Nanotubes (SWCNT). Manufacturing an entire LIG array takes less than one minute and costs about 0.11 yuan in materials, making it suitable for mass production. The in vitro test result showed sensitivities of 0.53 μA/mM and 3.9 μA/mM for lactate and glucose sensing, and 32.5 mV/decade and 33.2 mV/decade for K⁺ and Na⁺ sensing, respectively. To demonstrate the ability to characterize personal physical fitness, an ex vivo sweat analysis test was also performed. Overall, the high-sensitivity lactate enzyme sensor based on SWCNT/LIG can meet the requirements of sweat-based wearable sports monitoring systems.

Electrochemical-based remote biomarker monitoring: Toward Internet of Wearable Things in telemedicine

Internet of Wearable Things (IoWT) will be a major breakthrough for remote medical monitoring. In this scenario, wearable biomarker sensors have been developing not only to diagnose point-of-care (POC) of diseases, but also to continuously manage them. On-body tracking of biomarkers in biofluids is regarded as a proper substitution of conventional biomarker sensors for dynamic sampling and analyzing due to their high sensitivity, conformability, and affordability, creating ever-rising the market demand for them. In a wireless body area network (WBAN), data is captured from all sensors on the body to a smartphone/laptop, and sent the sensed data to a cloud for storing, processing, and retrieving, and ultimately displayed the data on custom applications (Apps). Wearable IoT biomarker sensors are used for early diseases diagnosis and continuous monitoring in developing countries in which people hardly access to healthcare systems. In this review, we aim to highlight a wide range of wearable electrochemical biomarker sensors, accompanied by microfluidics for continuous sampling, which will pave the way toward developing wearable IoT biomarker sensors to track health status. The current challenges and future perspective in skin-conformal biomarker sensors will be discussing their potential applicability for IoWT in cloud-based telemedicine.

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.

Plasmonic/magnetic nanoarchitectures: From controllable design to biosensing and bioelectronic interfaces

Controllable design of the nanocrystal-assembled plasmonic/magnetic nanoarchitectures (P/MNAs) inspires abundant methodologies to enhance light-matter interactions and control magnetic-induced effects by means of fine-tuning the morphology and ordered packing of noble metallic or magnetic building blocks. The burgeoning development of multifunctional nanoarchitectures has opened up broad range of interdisciplinary applications including biosensing, in vitro diagnostic devices, point-of-care (POC) platforms, and soft bioelectronics. By taking advantage of their customizability and efficient conjugation with capping biomolecules, various nanoarchitectures have been integrated into high-performance biosensors with remarkable sensitivity and versatility, enabling key features that combined multiplexed detection, ease-of-use and miniaturization. In this review, we provide an overview of the representative developments of nanoarchitectures that being built by plasmonic and magnetic nanoparticles over recent decades. The design principles and key mechanisms for signal amplification and quantitative sensitivity have been explored. We highlight the structure-function programmability and prospects of addressing the main limitations for conventional biosensing strategies in terms of accurate selectivity, sensitivity, throughput, and optoelectronic integration. State-of-the-art strategies to achieve affordable and field-deployable POC devices for early multiplexed detection of infectious diseases such as COVID-19 has been covered in this review. Finally, we discuss the urgent yet challenging issues in nanoarchitectures design and related biosensing application, such as large-scale fabrication and integration with portable devices, and provide perspectives and suggestions on developing smart biosensors that connecting the materials science and biomedical engineering for personal health monitoring.

Emerging biotransduction strategies on soft interfaces for biosensing

As a lab-on-soft biochip providing accurate and timely biomarker information, wearable biosensors can satisfy the increasing demand for intelligent e-health services, active disease diagnosis/therapy, and huge bioinformation data. As biomolecules generally could not directly produce detectable signals, biotransducers that specifically convert biomolecules to electrical or optical signals are involved, which determines the pivotal sensing performance including 3S (sensitivity, selectivity, and stability), reversibility, etc. The soft interface poses new requirements for biotransducers, especially equipment-free, facile operation, mechanical tolerance, and high sensing performance. In this review, we discussed the emerging electrochemical and optical biotransduction strategies on wearables from the aspects of the transduction mechanism, amplification strategies, biomaterial selection, and device fabrication procedures. Challenges and perspectives regarding future biotransducers for monitoring trace amounts of biomolecules with high fidelity, sensitivity, and multifunctionality are also discussed. It is expected that through fusion with functional electronics, wearable biosensors can provide possibilities to further decentralize the healthcare system and even build biomolecule-based intelligent cyber-physical systems and new modalities of cyborgs.

Flexible surface-enhanced Raman scatting substrates: recent advances in their principles, design strategies, diversified material selections and applications

Surface-enhanced Raman scattering (SERS) is widely used as a powerful analytical technology in cutting-edge areas such as food safety, biology, chemistry, and medical diagnosis, providing ultra-fast, ultra-sensitive, nondestructive characterization and achieving ultra-high detection sensitivity even down to the single-molecule level. Development of Raman spectroscopy is strongly dependent on high-performance SERS substrates, which have long evolved from the early days of rough metal electrodes to periodic nanopatterned arrays building on solid supporting substrates. For rigid SERS substrates, however, their applications are restricted by sophisticated pretreatments for detecting solid samples with non-planar surfaces. It is therefore essential to reassert the principles in constructing flexible SERS substrates. Herein, we comprehensively review the state-of-the-art in understanding, preparing and using flexible SERS. The basic mechanisms behind the flexible SERS are briefly outlined, typical design strategies are highlighted and diversified selection of materials in preparing flexible SERS substrates are reviewed. Then the recent achievements of various interdisciplinary applications based on flexible SERS substrates are summarized. Finally, the challenges and perspectives for future evolution of flexible SERS and their applications are demonstrated. We propose new research directions focused on stimulating the real potential of SERS as an advanced analytical technique for commercialization.

Redox Homeostasis Alteration in Endothelial Mechanotransduction Monitored by Dual Stretchable Electrochemical Sensors

In vivo, endothelial cells are permanently subjected to dynamic cyclic stretch and adapt to it through the release of vasoactive substances. Among them, reactive oxygen species (ROS) and nitric oxide (NO) are indispensable redox molecules, the contents of which and their ratio are closely implicated with endothelial redox homeostasis. However, simultaneous and quantitative monitoring of ROS and NO release in endothelial mechanotransduction remains a great challenge. Herein, a stretchable electrochemical device is developed with a dual electrode based on gold nanotubes decorated with uniform and tiny platinum nanoparticles. This hybrid nanostructure endows the sensor with high sensitivity toward both hydrogen peroxide (H₂O₂) (as the most stable ROS) and NO electrooxidation. Importantly, the two species can be well discriminated by applying different potentials, which allows simultaneous monitoring of H₂O₂ and NO release in stretch-induced endothelial mechanotransduction by the same device. The results of quantitative analysis suggest that endothelial redox homeostasis and its alteration are strongly related to vascular biomechanical and biochemical milieus. Further investigation reveals that the interplay of ROS and NO signaling has an important role in the regulation of endothelial redox state. This work will greatly facilitate the deep understanding of the molecular mechanism of endothelial dysfunction and vascular disorder.

MXene nanoflakes decorating ZnO tetrapods for enhanced performance of skin-attachable stretchable enzymatic electrochemical glucose sensor

Continuous painless glucose monitoring is the greatest desire of more than 422 million diabetics worldwide. Therefore, new non-invasive and convenient approaches to glucose monitoring are more in demand than other tests for microanalytical diagnostic tools. Besides, blood glucose detection can be replaced by continuous glucose monitoring of other human biological fluids (e.g. sweat) collected non-invasively. In this study, a skin-attachable and stretchable electrochemical enzymatic sensor based on ZnO tetrapods (TPs) and a new class of 2D materials - transition metal carbides, known as MXene, was developed and their electroanalytical behavior was tailored for continuous detection glucose in sweat. The high specific area of ZnO TPs and superior electrical conductivity of MXene (Ti₃C₂Tx) nanoflakes enabled to produce enzymatic electrochemical glucose biosensor with enhanced sensitivity in sweat sample (29 μA mM^-1 cm^-2), low limit of detection (LOD ≈ 17 μM), broad linear detection range (LDR = 0.05-0.7 mM) that satisfices glucose detection application in human sweat, and advanced mechanical stability (up to 30% stretching) of the template. The developed skin-attachable stretchable electrochemical electrodes allowed to monitor the level of glucose in sweat while sugar uptake and during physical activity. Continuous in vivo monitoring of glucose in sweat obtained during 60 min correlated well with data collected by a conventional amperometric blood glucometer in vitro mode. Our findings demonstrate the high potential of developed ZnO/MXene skin-attachable stretchable sensors for biomedical applications on a daily basis.

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

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

Network crack-based high performance stretchable strain sensors for human activity and healthcare monitoring

In this study, high performance wearable and stretchable strain sensors are developed for human activity and healthcare monitoring, and wearable electronics.

Wearable Sensors for Remote Health Monitoring: Potential Applications for Early Diagnosis of Covid-19

Wearable sensors are emerging as a new technology to detect physiological and biochemical markers for remote health monitoring. By measuring vital signs such as respiratory rate, body temperature, and blood oxygen level, wearable sensors offer tremendous potential for the noninvasive and early diagnosis of numerous diseases such as Covid-19. Over the past decade, significant progress has been made to develop wearable sensors with high sensitivity, accuracy, flexibility, and stretchability, bringing to reality a new paradigm of remote health monitoring. In this review paper, the latest advances in wearable sensor systems that can measure vital signs at an accuracy level matching those of point-of-care tests are presented. In particular, the focus of this review is placed on wearable sensors for measuring respiratory behavior, body temperature, and blood oxygen level, which are identified as the critical signals for diagnosing and monitoring Covid-19. Various designs based on different materials and working mechanisms are summarized. This review is concluded by identifying the remaining challenges and future opportunities for this emerging field.

Recent advances in catalytic hairpin assembly signal amplification-based sensing strategies for microRNA detection

Accumulative evidences have indicated that abnormal expression of microRNAs (miRNAs) is closely associated with many health disorders, making them be regarded as potentialbiomarkers for early clinical diagnosis. Therefore, it is extremely necessary to develop a highly sensitive, specific and reliable approach for miRNA analysis. Catalytic hairpin assembly (CHA) signal amplification is an enzyme-free toehold-mediated strand displacement method, exhibiting significant potential in improving the sensitivity of miRNA detection strategies. In this review, we first describe the potential of miRNAs as disease biomarkers and therapeutics, and summarize the latest advances in CHA signal amplification-based sensing strategies for miRNA monitoring. We describe the characteristics and mechanism of CHA signal amplification and classify the CHA-based miRNA sensing strategies into several categories based on the "signal conversion substance", including fluorophores, enzymes, nanomaterials, and nucleotide sequences. Sensing performance, limit of detection, merits and disadvantages of these miRNA sensing strategies are discussed. Moreover, the current challenges and prospects are also presented.

Mechanically-gated electrochemical ionic channels with chemically modified vertically aligned gold nanowires

Mechanically-gated ion channels play an important role in the human body, whereas it is challenging to design artificial mechanically-controlled ionic transport devices as the intrinsically rigidity of traditional electrodes. Here, we report on a mechanically-gated electrochemical channel by virtue of vertically aligned gold nanowires (v-AuNWs) as 3D stretchable electrodes. By surface modification with a self-assembled 1-Dodecanethiol monolayer, the v-AuNWs become hydrophobic and inaccessible to hydrated redox species (e.g., Fe ( CN ) 6 3 - / 4 - and Ru ( bpy ) 3 2 + ). Under mechanical strains, the closely-packed v-AuNWs unzip/crack to generate ionic channels to enable redox reactions, giving rise to increases in Faradaic currents. The redox current increases with the strain level until it reaches a certain threshold value, and then decreases as the strain-induced conductivity decreases. The good reversible "on-off" behaviors for multiple cycles were also demonstrated. The results presented demonstrate a new strategy to control redox reactions simply by tensile strain, indicating the potential applications in future soft smart mechanotransduction devices.

Soft Wearable Healthcare Materials and Devices

In spite of advances in electronics and internet technologies, current healthcare remains hospital-centred. Disruptive technologies are required to translate state-of-art wearable devices into next-generation patient-centered diagnosis and therapy. In this review, recent advances in the emerging field of soft wearable materials and devices are summarized. A prerequisite for such future healthcare devices is the need of novel materials to be mechanically compliant, electrically conductive, and biologically compatible. It is begun with an overview of the two viable design strategies reported in the literatures, which is followed by description of state-of-the-art wearable healthcare devices for monitoring physical, electrophysiological, chemical, and biological signals. Self-powered wearable bioenergy devices are also covered and sensing systems, as well as feedback-controlled wearable closed-loop biodiagnostic and therapy systems. Finally, it is concluded with an overall summary and future perspective.

Low dimensional materials for glucose sensing

Biosensors are essential components for effective healthcare management. Since biological processes occur on molecular scales, nanomaterials and nanosensors intrinsically provide the most appropriate landscapes for developing biosensors. Low-dimensional materials have the advantage of offering high surface areas, increased reactivity and unique physicochemical properties for efficient and selective biosensing. So far, nanomaterials and nanodevices have offered significant prospects for glucose sensing. Targeted glucose biosensing using such low-dimensional materials enables much more effective monitoring of blood glucose levels, thus providing significantly better predictive diabetes diagnostics and management. In this review, recent advances in using low dimensional materials for sensing glucose are summarized. Sensing fundamentals are discussed, as well as invasive, minimally-invasive and non-invasive sensing methods. The effects of morphological characteristics and size-dependent properties of low dimensional materials are explored for glucose sensing, and the key performance parameters such as selectivity, stability and sensitivity are also discussed. Finally, the challenges and future opportunities that low dimensional materials can offer for glucose sensing are outlined.

Interface Design for Stretchable Electronic Devices

Stretchable electronics has emerged over the past decade and is now expected to bring form factor-free innovation in the next-generation electronic devices. Stretchable devices have evolved with the synthesis of new soft materials and new device architectures that require significant deformability while maintaining the high device performance of the conventional rigid devices. As the mismatch in the mechanical stiffness between materials, layers, and device units is the major challenge for stretchable electronics, interface control in varying scales determines the device characteristics and the level of stretchability. This article reviews the recent advances in interface control for stretchable electronic devices. It summarizes the design principles and covers the representative approaches for solving the technological issues related to interfaces at different scales: i) nano- and microscale interfaces between materials, ii) mesoscale interfaces between layers or microstructures, and iii) macroscale interfaces between unit devices, substrates, or electrical connections. The last section discusses the current issues and future challenges of the interfaces for stretchable devices.

Wearable biochemical sensors for human health monitoring: sensing materials and manufacturing technologies

Wearable biochemical sensors are of great interest nowadays due to their powerful potential in personalized medicine and continuous monitoring of human health. Thus, a great deal of effort has been put into the development of such sensors to enable real-time and non-invasive quantification of various chemical constituents in the human body such as sweat, saliva, and tears. Owing to the advances in materials science and mechanical engineering, wearable biochemical sensors have been developed to probe various biomarkers and have been subsequently considered as wearable electronic devices for practical applications. In this review, we present a broad overview on the recent advances in electrochemical wearable sensors towards various organic components and ions closely linked to human health. With an emphasis on materials and manufacturing technologies of the sensing electrodes, the research status is summarized, and the challenges and opportunities in this growing field are prospected.

Integration of interstitial fluid extraction and glucose detection in one device for wearable non-invasive blood glucose sensors

Wearable non-invasive glucose sensors that can provide human a painless and portable means to monitor their blood glucose and manage their health condition draw great attentions, recently. Non-invasive human glucose sensors by detecting glucose in interstitial fluid (ISF) extracted through a reverse iontophoresis (RI) approach have been widely investigated, but the current challenges are their complex structure and instability for continuous monitor. Herein, we demonstrate a simple two-electrode non-invasive blood glucose sensor, which is fabricated by using graphene/carbon nanotubes/glucose oxidase composite textile and graphene/carbon nanotube/silver/silver chloride composite textile as the working electrode and counter electrode, respectively. By using one single device, extraction of ISF through RI process is firstly conducted by loading a certain electric current between two electrodes, then the glucose concentration in the ISF is detected through an amperometric approach by using the same two electrodes. The feasibility of these non-invasive glucose sensors is validated on porcine skin, nude mice and human. The blood glucose concentration calculated according to the response currents of the two-electrode sensors is highly consistent with that measured by commercial glucose meter. Furthermore, the used textile-like electrodes provide the non-invasive blood glucose sensors with excellent flexible and wearable properties, which make them promising to be integrated with other electronic units for monitor and management of human health.

Non-Invasive Blood Glucose Monitoring Technology: A Review

In recent years, with the rise of global diabetes, a growing number of subjects are suffering from pain and infections caused by the invasive nature of mainstream commercial glucose meters. Non-invasive blood glucose monitoring technology has become an international research topic and a new method which could bring relief to a vast number of patients. This paper reviews the research progress and major challenges of non-invasive blood glucose detection technology in recent years, and divides it into three categories: optics, microwave and electrochemistry, based on the detection principle. The technology covers medical, materials, optics, electromagnetic wave, chemistry, biology, computational science and other related fields. The advantages and limitations of non-invasive and invasive technologies as well as electrochemistry and optics in non-invasives are compared horizontally in this paper. In addition, the current research achievements and limitations of non-invasive electrochemical glucose sensing systems in continuous monitoring, point-of-care and clinical settings are highlighted, so as to discuss the development tendency in future research. With the rapid development of wearable technology and transdermal biosensors, non-invasive blood glucose monitoring will become more efficient, affordable, robust, and more competitive on the market.

Stretchable Electrode Based on Au@Pt Nanotube Networks for Real-Time Monitoring of ROS Signaling in Endothelial Mechanotransduction

Vascular endothelial cells (ECs) are natively exposed to dynamic cyclic stretch and respond to it by the production of vasoactive molecules. Among them, reactive oxygen species (ROS) are closely implicated to the endothelial function and vascular homeostasis. However, the dynamic monitoring of ROS release during endothelial mechanotransduction remains a steep challenge. Herein, we developed a stretchable electrochemical sensor by decoration of uniform and ultrasmall platinum nanoparticles (Pt NPs) on gold nanotube (Au NT) networks (denoted as Au@Pt NTs). The orchestrated structure exhibited prominent electrocatalytic property toward the oxidation of hydrogen peroxide (H₂O₂) (as the most stable ROS) while maintaining excellent mechanical compliance of Au NT networks. Moreover, the favorable biocompatibility of Au NTs and Pt NPs promoted the adhesion and proliferation of ECs cultured thereon. These allowed in situ inducing ECs mechanotransduction and synchronously real-time monitoring of H₂O₂ release. Further investigation revealed that the production of H₂O₂ was positively correlated with the applied mechanical strains and could be boosted by other coexisting pathogenic factors. This indicates the great prospect of our proposed sensor in exploring ROS-related signaling for the deep understanding of cell mechanotransduction and vascular disorder.

Non-invasive detection of glucose via a solution-gated graphene transistor

Owing to its high sensitivity, a solution-gated graphene transistor has rapidly emerged as a cutting edge technology in electrochemical sensing. In this work, composites of gold nanoparticles and reduced graphene oxide were synthesized on a glassy carbon electrode by using the electrodeposition method. A modified glassy carbon electrode was used as the gate electrode and assembled into the solution-gated graphene transistor device along with the graphene channel for a non-invasive glucose detection. The sensing mechanism was based on the change in current in the channel of the device caused by the addition of glucose, of which electro-oxidation on the surface of the gold nanoparticles and reduced graphene oxide led to a change in equivalent gate voltage, and consequently, affected the channel carrier concentration. The self-amplification effect of transistors was utilized in our sensors, which resulted in a detection limit that was 10 times lower than those of conventional electrochemical sensors. Compared to traditional enzymatic transistor sensors, the novel solution-gated graphene transistor nonenzymatic sensors based on gold nanoparticles and reduced graphene oxide demonstrated significant sensing advantages, such as a simple structure, wide linear range from 10 μM to 400 μM and 400 μM to 31 mM, and low detection limit down to 4 μM. The chemicals coexisting in human sweat e.g. sodium chloride, urea, and lactic acid imposed no distinct interference for the glucose detection. Therefore, we achieved a non-invasive detection of glucose in the artificial sweat samples with satisfactory sensing results. This work demonstrates an effective route for non-invasive glucose testing in practical clinical diagnosis by using nonenzymatic, solution-gated graphene transistor devices.

Stretchable gold fiber-based wearable textile electrochemical biosensor for lactate monitoring in sweat

Past several years have witnessed growing interest in developing wearable biosensors for non-invasive monitoring vital signs of chemical/biological markers such as lactate. In this context, textiles can be seen as a promising platform for the integration of wearable chemical sensors due to their inherent breathability, flexibility, softness and comfortableness. Gold is regarded as a preferred active sensing material due to its excellent biocompatibility, chemical inertness and wide electrochemical window. Here, a dry-spinning method was used to fabricate stretchable, strain-insensitive and highly conductive gold fibers. Such gold fibers could be used to fabricate lactate-sensing working electrodes, reference electrode, counter electrodes and further weaved into textiles in a standard three-electrode system with a planar layout. The textile lactate biosensors showed a high sensitivity of 19.13 μA/mM cm² in phosphate-buffered solution (PBS) and 14.6 μA/mM cm² in artificial sweat. This sensitivity could be maintained under high tensile strain up to 100% without external structural design. The results presented here indicate the potential application of wearable smart textile towards non-invasive lactate monitoring.

Advances in Sweat Wearables: Sample Extraction, Real-Time Biosensing, and Flexible Platforms

Wearable biosensors for sweat-based analysis are gaining wide attention due to their potential use in personal health monitoring. Flexible wearable devices enable sweat analysis at the molecular level, facilitating noninvasive monitoring of physiological states via real-time monitoring of chemical biomarkers. Advances in sweat extraction technology, real-time biosensors, stretchable materials, device integration, and wireless digital technologies have led to the development of wearable sweat-biosensing devices that are light, flexible, comfortable, aesthetic, affordable, and informative. Herein, we summarize recent advances of sweat wearables from the aspects of sweat extraction, fabrication of stretchable biomaterials, and design of biosensing modules to enable continuous biochemical monitoring, which are essential for a biosensing device. Key chemical components of sweat, sweat capture methodologies, and considerations of flexible substrates for integrating real-time biosensors with electronics to bring innovations in the art of wearables are elaborated. The strategies and challenges involved in improving the wearable biosensing performance and the perspectives for designing sweat-based wearable biosensing devices are discussed.

Mechanical Tolerance of Cascade Bioreactions via Adaptive Curvature Engineering for Epidermal Bioelectronics

Epidermal bioelectronics that can monitor human health status non-invasively and in real time are core to wearable healthcare equipment. Achieving mechanically tolerant surface bioreactions that convert biochemical information to detectable signals is crucial for obtaining high sensing fidelity. In this work, by combining simulations and experiments, a typical epidermal biosensor system is investigated based on a redox enzyme cascade reaction (RECR) comprising glucose oxidase/lactate oxidase enzymes and Prussian blue nanoparticles. Simulations reveal that strain-induced change in surface reactant flux is the key to the performance drop in traditional flat bioelectrodes. In contrast, wavy bioelectrodes capable of curvature adaptation maintain the reactant flux under strain, which preserves sensing fidelity. This rationale is experimentally proven by bioelectrodes with flat/wavy geometry under both static strain and dynamic stretching. When exposed to 50% strain, the signal fluctuations for wavy bioelectrodes are only 7.0% (4.9%) in detecting glucose (lactate), which are significantly lower than the 40.3% (51.8%) in flat bioelectrodes. Based on this wavy bioelectrode, a stable human epidermal metabolite biosensor insensitive to human gestures is further demonstrated. This mechanically tolerant biosensor based on adaptive curvature engineering provides a reliable bio/chemical-information monitoring platform for soft healthcare bioelectronics.

Disruptive, Soft, Wearable Sensors

The wearable industry is on the rise, with a myriad of technical applications ranging from real-time health monitoring, the Internet of Things, and robotics, to name but a few. However, there is a saying "wearable is not wearable" because the current market-available wearable sensors are largely bulky and rigid, leading to uncomfortable wearing experience, motion artefacts, and poor data accuracy. This has aroused a world-wide intensive research quest for novel materials, with the aim of fabricating next-generation ultra-lightweight and soft wearable devices. Such disruptive second-skin-like biosensing technologies may enable a paradigm shift from current wearable 1.0 to future wearable 2.0 products. Here, the state-of-the-art progress made in the key phases for future wearable technology, namely, wear → sense → communicate → analyze → interpret → decide, is summarized. Without a doubt, materials innovation is the key, which is the main focus of the discussion. In addition, emphasis is also given to wearable energy, multicomponent integration, and wireless communication.

Application of Zero-Dimensional Nanomaterials in Biosensing

Zero-dimensional (0D) nanomaterials, including graphene quantum dots (GQDs), carbon quantum dots (CQDs), fullerenes, inorganic quantum dots (QDs), magnetic nanoparticles (MNPs), noble metal nanoparticles, upconversion nanoparticles (UCNPs) and polymer dots (Pdots), have attracted extensive research interest in the field of biosensing in recent years. Benefiting from the ultra-small size, quantum confinement effect, excellent physical and chemical properties and good biocompatibility, 0D nanomaterials have shown great potential in ion detection, biomolecular recognition, disease diagnosis and pathogen detection. Here we first introduce the structures and properties of different 0D nanomaterials. On this basis, recent progress and application examples of 0D nanomaterials in the field of biosensing are discussed. In the last part, we summarize the research status of 0D nanomaterials in the field of biosensing and anticipate the development prospects and future challenges in this field.

Multiscale Soft-Hard Interface Design for Flexible Hybrid Electronics

Emerging next-generation soft electronics will require versatile properties functioning under mechanical compliance, which will involve the use of different types of materials. As a result, control over material interfaces (particularly soft/hard interfaces) has become crucial and is now attracting intensive worldwide research efforts. A series of material and structural interface designs has been devised to improve interfacial adhesion, preventing failure of electromechanical properties under mechanical deformation. Herein, different soft/hard interface design strategies at multiple length scales in the context of flexible hybrid electronics are reviewed. The crucial role of soft ligands and/or polymers in controlling the morphologies of active nanomaterials and stabilizing them is discussed, with a focus on understanding the soft/hard interface at the atomic/molecular scale. Larger nanoscopic and microscopic levels are also discussed, to scrutinize viable intrinsic and extrinsic interfacial designs with the purpose of promoting adhesion, stretchability, and durability. Furthermore, the macroscopic device/human interface as it relates to real-world applications is analyzed. Finally, a perspective on the current challenges and future opportunities in the development of truly seamlessly integrated soft wearable electronic systems is presented.

Effect of thiolate-ligand passivation on the electronic structure and optical absorption properties of ultrathin one and two-dimensional gold nanocrystals

Gold nanomaterials, including one-dimensional (1D) gold nanorods (AuNRs) and nanowires (AuNWs) and two-dimensional (2D) gold nanoprisms with a large surface area and stability, have attracted widespread research interest. A large number of experimental and theoretical studies have shown that the properties of low dimensional gold nanomaterials depend on their anisotropic shape. In this work, we theoretically conceived a new type of gold nanomaterial, namely, thiolate (SR) monolayer passivated quasi-1D and quasi-2D gold nanocrystals and infinite superstructures, which were formed by the fusion of seed clusters Au₂₈(SR)₂₀, Au₃₆(SR)₂₄, Au₄₄(SR)₂₈ and Au₅₂(SR)₃₂ or the layer by layer growth of gold atoms along the [100] and/or [010] directions. By means of DFT and TD-DFT calculations, the structure and properties of these model gold nanocrystals and superstructures are studied in depth. It is found that the passivation of the monolayer of thiolate leads to significantly improved near-infrared absorption properties in comparison with the ligand free gold nanocrystals. Upon passivating the thiolate-monolayer, the ultrathin 1D gold nanowire and 2D gold nanosheet demonstrate a metal to semiconductor transition. The novel electronic structures, optical absorption and semiconductor-to-metal transition found in these thiolate-protected low-dimensional gold nanocrystals suggest that the passivation of the SR ligand is a promising way to tailor the properties of gold nanomaterials.

Cyber-Physiochemical Interfaces

Living things rely on various physical, chemical, and biological interfaces, e.g., somatosensation, olfactory/gustatory perception, and nervous system response. They help organisms to perceive the world, adapt to their surroundings, and maintain internal and external balance. Interfacial information exchanges are complicated but efficient, delicate but precise, and multimodal but unisonous, which has driven researchers to study the science of such interfaces and develop techniques with potential applications in health monitoring, smart robotics, future wearable devices, and cyber physical/human systems. To understand better the issues in these interfaces, a cyber-physiochemical interface (CPI) that is capable of extracting biophysical and biochemical signals, and closely relating them to electronic, communication, and computing technology, to provide the core for aforementioned applications, is proposed. The scientific and technical progress in CPI is summarized, and the challenges to and strategies for building stable interfaces, including materials, sensor development, system integration, and data processing techniques are discussed. It is hoped that this will result in an unprecedented multi-disciplinary network of scientific collaboration in CPI to explore much uncharted territory for progress, providing technical inspiration-to the development of the next-generation personal healthcare technology, smart sports-technology, adaptive prosthetics and augmentation of human capability, etc.