Touch-Based Fingertip Blood-Free Reliable Glucose Monitoring: Personalized Data Processing for Predicting Blood Glucose Concentrations

A personalized model and optimization strategy for estimating blood glucose concentrations from sweat measurements

BACKGROUND AND OBJECTIVE

Diabetes is one of the four leading causes of death worldwide, necessitating daily blood glucose monitoring. While sweat offers a promising non-invasive alternative for glucose monitoring, its application remains limited due to the low to moderate correlation between sweat and blood glucose concentrations, which has been obtained until now by assuming a linear relationship. This study proposes a novel model-based strategy to estimate blood glucose concentrations from sweat samples, setting the stage for non-invasive glucose monitoring through sweat-sensing technology.

METHODS

We first developed a pharmacokinetic glucose transport model that describes the glucose transport from blood to sweat. Secondly, we designed a novel optimization strategy leveraging the proposed model to solve the inverse problem and infer blood glucose levels from measured glucose concentrations in sweat. To this end, the pharmacokinetic model parameters with the highest sensitivity were also optimized so as to achieve a personalized estimation. Our strategy was tested on a dataset composed of 108 samples from healthy volunteers and diabetic patients.

RESULTS

Our glucose transport model improves over the state-of-the-art in estimating sweat glucose concentrations from blood levels (higher accuracy, p<0.001). Additionally, our optimization strategy effectively solved the inverse problem, yielding a Pearson correlation coefficient of 0.98 across all 108 data points, with an average root-mean-square-percent-error of 12%±8%. This significantly outperforms the best sweat-blood glucose correlation reported in the existing literature (0.75).

CONCLUSION

Our innovative optimization strategy, also leveraging more accurate modeling, shows promising results, paving the way for non-invasive blood glucose monitoring and, possibly, improved diabetes management.

Uniformity and stability of saliva composition based on glucose concentration analysis

Saliva holds promise as a biomarker for glucose monitoring due to its non-invasive and self-collection characteristics. However, its viscosity may lead to uneven glucose distribution, reflecting the uniformity of saliva, and individual glycemic control factors such as diet may affect salivary glucose concentration, reflecting the stability of saliva. To address these concerns, this study aims to evaluate the uniformity and stability of salivary glucose concentrations. Macro-rheological properties (shear viscosity, elastic modulus, and viscous modulus) and micro-morphological characteristics of saliva were analyzed using a rheometer and Scanning Electron Microscopy and Energy-Dispersive X-ray Spectroscopy (SEM-EDS) techniques. Salivary glucose uniformity and stability were assessed under room-temperature static conditions, fasting saliva over a one-month period, and in postprandial states. Results showed that saliva exhibits shear-thinning behavior, with shear viscosity decreasing from 0.1 Pa∙s to 0.001 Pa∙s as shear rate increases from 0.1 to 150 s-1. This shear-thinning property, linked to the porous glycoprotein network observed through micro-morphological analysis, may influence analyte distribution. Despite the inherent viscosity, salivary glucose concentrations demonstrated high uniformity: 89 % of fasting samples and 92 % of postprandial samples showed less than 10 % variation when divided into three portions. Regarding stability, salivary glucose levels in healthy individuals remained consistently more stable than those in diabetic patients across various conditions, including static room-temperature storage of fasting saliva, fasting saliva over one month, and postprandial saliva. For example, fasting glucose levels over one month in diabetic patients (7.38 ± 6.3 mg/dL) were higher and less stable than those observed in healthy individuals (1.674 ± 0.72 mg/dL). This study confirms that fasting salivary glucose is both homogeneous and sufficiently stable, supporting its potential as a viable biomarker for blood glucose monitoring.

Touch-based uric acid sweat biosensor towards personal health and nutrition

Monitoring uric acid (UA) levels is critical since elevated UA levels are associated with diverse conditions, such as gout, kidney disorders, kidney stones, hypertension, cardiovascular diseases, and metabolic syndrome. Maintaining balanced UA levels demands reliable and regular monitoring. Traditionally, such frequent UA measurements rely on blood-based UA self-testing strips. Developing sensitive and reliable noninvasive sweat-based UA sensors presents challenges, including the low UA sweat concentrations and interpersonal variations. We present here an attractive on-site UA self-testing approach utilizing a touch-enabled fingertip sweat UA electrochemical biosensor based on a uricase-enzyme electrode and sweat wicking hydrogel. This noninvasive method is rapid, simple, convenient, and painless, leveraging the high sweat rate on the fingertip at rest without any sweat stimulation. The touch-based protocol exhibits a wide linear range of UA concentrations from 10 to 1000 μM, covering normal and elevated UA sweat levels with high selectivity, reproducibility (RSD = 4.94%), good storage stability (1 week), and significant tolerance to temperature and humidity variations. The performance of the UA-touch sweat biosensor was evaluated and validated by parallel blood meter measurements by monitoring dynamically-changing sweat UA levels in healthy subjects after consuming purine-rich meals. The distinct sweat UA temporal profiles among individuals highlight the potential of the touch-based UA biosensor for personal health and nutrition. The speed and simplicity of this sweat UA assay thus encourage frequent self-testing and enhance user's compliance towards dietary interventions and lifestyle changes in connection to diverse healthcare and nutrition applications.

Wearable epidermal sensor patch with biomimetic microfluidic channels for fast and time-sequence monitoring of sweat glucose and lactate

Wearable sweat sensors enable non-invasive tracking and monitoring of human physiological information, which is expected to attract wide interest and rapid development in dietary health management and disease prevention. Unfortunately, sweat sensors are limited by rapid evaporation and low secretion rates of sweat. Herein, a sweat detection patch is proposed, which integrates bionic microchannels and multiparameter electrochemical sensors. The microfluidic channel (5°), which mimics ginkgo biloba veins, provided a 40 % higher flow rate compared to the normal channel (0°). Combined with burst pressure, the bionic channel enabled unidirectional transport of 6 μL sweat, effectively avoiding the mixing of old and new sweat. The electrochemical sensors possessed excellent specificity recognition, stability and durability, and have been used to detect substances in sweat, in particular to analyze changes in glucose concentration at different dietary intakes and changes in lactate metabolism after exercise. The rapid collection effect of the microchannels on trace sweat and the fast response of sensors have broad application prospects in real-time human health monitoring.

Wearable MXene-enhanced organic Bio-FET paper patch for glucose detection in sweat with pH and temperature calibration

This paper proposes the design of organic Bio-FET sensors using paper as a substrate. Three different wearable biosensors have been engineered for the non-invasive monitoring of sweat biomarkers. The proposed sensors, which have a field-effect transistor (FET) structure, contribute to an array that is flexible, bendable, affordable, disposable, and biocompatible. The approach of drawing Organic FETs (OFETs) on paper using a paintbrush could successfully make cost-effective sweat biochemical sensors (glucose and pH Sensors) and biophysical sensors (temperature-sensor) which are versatile and sensors for real-time health monitoring. PDMS, PEDOT: PSS, and sensitive materials have been used as the oxide layer, source/drain electrodes, and the FET channel, respectively. The wearable glucose sensor utilizes a composite of copper oxide (CuO), carboxyl-functionalized multiwall carbon nanotubes (MWCNT-COOH), and Ti₃C₂ MXene (Ti₃C₂ MXene/CuO/MWCNT) as the channel material in its FET structure, enhancing its sensitivity and performance. Additionally, Ti3C2 MXene/MWCNT and Ti₃C₂ MXene/rGO/MWCNT composites were employed in the pH and temperature sensors, respectively, to enhance their functionality and performance. The proposed Bio-FETs are fabricated in three different designs: resistive, side-gated and back-gated structures, and their responses are compared and discussed. Continuous health monitoring is achieved through a fully integrated, disposable wireless device that combines glucose, pH, and temperature sensing. The fabricated Bio-FET exhibits high sensitivity and promising reproducibility, stability, and repeatability. To enhance precision, the proposed glucose sensor has been calibrated using real-time temperature and pH measurements.

Temperature-dependent microfluidic impedance spectroscopy for non-invasive biofluid characterization

Remote health monitoring has the potential to enable individuals to take control of their own health and well-being and to facilitate a transition toward preventative and personalized healthcare. Sweat can be sampled non-invasively and contains a wealth of information about the metabolic state of an individual, making it an excellent candidate for remote health monitoring. An accurate, rapid, and low-cost biofluid characterization technique is required to enable the widespread use of remote health monitoring. We previously introduced microfluidic impedance spectroscopy for the detection of electrolyte concentration in fluids, whereby a novel device architecture, measurement method, and analysis technique were presented for the characterization of cationic species. The purely electrical nature of this measurement technique removes the intermediate steps inherent in common rival technologies such as optical and electrochemical sensing, offering a range of advantages. In this work, we investigate the effect of temperature on microfluidic impedance spectroscopy of ionic species commonly present in biofluids. We find that the impedance spectra and concentration determination are temperature-dependent; remote health monitoring devices must be calibrated appropriately as they are likely to experience temperature fluctuations. Importantly, we demonstrate the ability of the method to measure the concentration of anionic species alongside that of cationic species, enabling the detection of chloride and lactate, which are useful biomarkers for hydration, cystic fibrosis, fatigue, sepsis, and hypoperfusion. We show that the presence of neutral species does not impair accurate determination of ionic concentration, thus, demonstrating the suitability of microfluidic impedance spectroscopy for non-invasive biofluid characterization.

A Touch Enabled Hemodynamic and Metabolic Monitor

Accurate health analysis demands real-time tracking of multiple biomarkers and vital signs under dynamic physiological conditions. Current multimodal hybrid platforms provide biochemical and biophysical data but are limited by active sweat collection for biochemical sensing and bulky designs for biophysical sensing. Here a touch-enabled platform is presented that simultaneously monitors vitals and metabolic markers. With a simple tri-finger touch, the platform measures mean arterial pressure and heart rate using photoplethysmography, and glucose, uric acid, and cortisol at rest by leveraging the natural perspiration at the fingertip. Extended studies involving diverse activities reveal strong dynamic interplay among the metabolic and vital profiles, with mean arterial pressure showing the highest sensitivity to cortisol fluctuations. The platform delivers comprehensive health information linking diet, lifestyle, metabolism, and serves as an early metabolic or hormonal stress indicator. Valuable insights gained through the platform position it as a promising tool for personalized health and wellness management.

Wearable Electrochemical Biosensors for Advanced Healthcare Monitoring

Recent advancements in wearable electrochemical biosensors have opened new avenues for on-body and continuous detection of biomarkers, enabling personalized, real-time, and preventive healthcare. While glucose monitoring has set a precedent for wearable biosensors, the field is rapidly expanding to include a wider range of analytes crucial for disease diagnosis, treatment, and management. In this review, recent key innovations are examined in the design and manufacturing underpinning these biosensing platforms including biorecognition elements, signal transduction methods, electrode and substrate materials, and fabrication techniques. The applications of these biosensors are then highlighted in detecting a variety of biochemical markers, such as small molecules, hormones, drugs, and macromolecules, in biofluids including interstitial fluid, sweat, wound exudate, saliva, and tears. Additionally, the review also covers recent advances in wearable electrochemical biosensing platforms, such as multi-sensory integration, closed-loop control, and power supply. Furthermore, the challenges associated with critical issues are discussed, such as biocompatibility, biofouling, and sensor degradation, and the opportunities in materials science, nanotechnology, and artificial intelligence to overcome these limitations.

Pumpless microfluidic sweat sensing yarn

Textile sweat sensors possess immense potential for non-invasive health monitoring. Rapid in-situ sweat capture and prevention of its evaporation are crucial for accurate and stable real-time monitoring. Herein, we introduce a unidirectional, pump-free microfluidic sweat management system to tackle this challenge. A nanofiber sheath layer on micrometer-scale sensing filaments enables this pumpless microfluidic design. Utilizing the capillary effect of the nanofibers allows for the swift capture of sweat, while the differential configuration of the hydrophilic and hydrophobic properties of the sheath and core yarns prevents sweat evaporation. The Laplace pressure difference between the cross-scale fibers facilitates the management system to ultimately expulse sweat. This results in microfluidic control of sweat without the need for external forces, resulting in rapid (<5 s), sensitive (19.8 nA μM-1), and stable (with signal noise and drift suppression) sweat detection. This yarn sensor can be easily integrated into various fabrics, enabling the creation of health monitoring smart garments. The garments maintain good monitoring performance even after 20 washes. This work provides a solution for designing smart yarns for high-precision, stable, and non-invasive health monitoring.

Earable Multimodal Sensing and Stimulation: A Prospective Towards Unobtrusive Closed-Loop Biofeedback

The human ear has emerged as a bidirectional gateway to the brain's and body's signals. Recent advances in around-the-ear and in-ear sensors have enabled the assessment of biomarkers and physiomarkers derived from brain and cardiac activity using ear-electroencephalography (ear-EEG), photoplethysmography (ear-PPG), and chemical sensing of analytes from the ear, with ear-EEG having been taken beyond-the-lab to outer space. Parallel advances in non-invasive and minimally invasive brain stimulation techniques have leveraged the ear's access to two cranial nerves to modulate brain and body activity. The vestibulocochlear nerve stimulates the auditory cortex and limbic system with sound, while the auricular branch of the vagus nerve indirectly but significantly couples to the autonomic nervous system and cardiac output. Acoustic and current mode stimuli delivered using discreet and unobtrusive earables are an active area of research, aiming to make biofeedback and bioelectronic medicine deliverable outside of the clinic, with remote and continuous monitoring of therapeutic responsivity and long-term adaptation. Leveraging recent advances in ear-EEG, transcutaneous auricular vagus nerve stimulation (taVNS), and unobtrusive acoustic stimulation, we review accumulating evidence that combines their potential into an integrated earable platform for closed-loop multimodal sensing and neuromodulation, towards personalized and holistic therapies that are near, in- and around-the-ear.

A Passive Perspiration Inspired Wearable Platform for Continuous Glucose Monitoring

The demand for glucose monitoring devices has witnessed continuous growth from the rising diabetic population. The traditional approach of blood glucose (BG) sensor strip testing generates only intermittent glucose readings. Interstitial fluid-based devices measure glucose dynamically, but their sensing approaches remain either minimally invasive or prone to skin irritation. Here, a sweat glucose monitoring system is presented, which completely operates under rest with no sweat stimulation and can generate real-time BG dynamics. Osmotically driven hydrogels, capillary action with paper microfluidics, and self-powered enzymatic biochemical sensor are used for simultaneous sweat extraction, transport, and glucose monitoring, respectively. The osmotic forces facilitate greater flux inflow and minimize sweat rate fluctuations compared to natural perspiration-based sampling. The epidermal platform is tested on fingertip and forearm under varying physiological conditions. Personalized calibration models are developed and validated to obtain real-time BG information from sweat. The estimated BG concentration showed a good correlation with measured BG concentration, with all values lying in the A+B region of consensus error grid (MARD = 10.56% (fingertip) and 13.17% (forearm)). Overall, the successful execution of such osmotically driven continuous BG monitoring system from passive sweat can be a useful addition to the next-generation continuous sweat glucose monitors.

Review of Liquid Metal Fiber Based Biosensors and Bioelectronics

Liquid metal, as a novel material, has become ideal for the fabrication of flexible conductive fibers and has shown great potential in the field of biomedical sensing. This paper presents a comprehensive review of the unique properties of liquid metals such as gallium-based alloys, including their excellent electrical conductivity, mobility, and biocompatibility. These properties make liquid metals ideal for the fabrication of flexible and malleable biosensors. The article explores common preparation methods for liquid metal conductive fibers, such as internal liquid metal filling, surface printing with liquid metal, and liquid metal coating techniques, and their applications in health monitoring, neural interfaces, and wearable devices. By summarizing and analyzing the current research, this paper aims to reveal the current status and challenges of liquid metal conductive fibers in the field of biosensors and to look forward to their development in the future, which will provide valuable references and insights for researchers in the field of biomedical engineering.

Noninvasive Monitoring of Glycemia Level in Diabetic Patients by Wearable Advanced Biosensors

We report on the possibility of noninvasive diabetes monitoring through continuous analysis of sweat. The prediction of the blood glucose level in diabetic patients is possible on the basis of their sweat glucose content due to the positive correlation discovered. The ratio between the blood glucose and sweat glucose concentrations for a certain diabetic subject is stable within weeks, excluding requirements for frequent blood probing. The glucose variations in sweat display allometric (non-linear) dependence on those in blood, allowing more precise blood glucose estimation. Selective (avoiding false-positive responses) and sensitive (sweat glucose is on average 30-50 times lower) detection is possible with biosensors based on the glucose oxidase enzyme coupled with a Prussian Blue transducer. Reliable glucose detection in just secreted sweat would allow noninvasive monitoring of the glycemia level in diabetic patients.

Multifunctional nanomaterials for smart wearable diabetic healthcare devices

Wearable diabetic healthcare devices have attracted great attention for real-time continuous glucose monitoring (CGM) using biofluids such as tears, sweat, saliva, and interstitial fluid via noninvasive ways. In response to the escalating global demand for CGM, these devices enable proactive management and intervention of diabetic patients with incorporated drug delivery systems (DDSs). In this context, multifunctional nanomaterials can trigger the development of innovative sensing and management platforms to facilitate real-time selective glucose monitoring with remarkable sensitivity, on-demand drug delivery, and wireless power and data transmission. The seamless integration into wearable devices ensures patient's compliance. This comprehensive review evaluates the multifaceted roles of these materials in wearable diabetic healthcare devices, comparing their glucose sensing capabilities with conventionally available glucometers and CGM devices, and finally outlines the merits, limitations, and prospects of these devices. This review would serve as a valuable resource, elucidating the intricate functions of nanomaterials for the successful development of advanced wearable devices in diabetes management.

Diving into Sweat: Advances, Challenges, and Future Directions in Wearable Sweat Sensing

Sweat analysis has advanced from diagnosing cystic fibrosis and testing for illicit drugs to noninvasive monitoring of health biomarkers. This article introduces the rapid development of wearable and flexible sweat sensors, highlighting key milestones and various sensing strategies for real-time monitoring of analytes. We discuss challenges such as developing high-performance nanomaterial-based biosensors, ensuring continuous sweat production and sampling, achieving high sweat/blood correlation, and biocompatibility. The potential of machine learning to enhance these sensors for personalized healthcare is presented, enabling real-time tracking and prediction of physiological changes and disease onset. Leveraging advancements in flexible electronics, nanomaterials, biosensing, and data analytics, wearable sweat biosensors promise to revolutionize disease management, prevention, and prediction, promoting healthier lifestyles and transforming medical practices globally.

Magnetic Porous Hydrogel-Enhanced Wearable Patch Sensor for Sweat Zinc Ion Monitoring

Wearable sensors for sweat trace metal monitoring have the challenges of effective sweat collection and the real-time recording of detection signals. The existing detection technologies are implemented by generating enough sweat through exercise, which makes detecting trace metals in sweat cumbersome. Generally, it takes around 20 min to obtain enough sweat, resulting in dallied and prolonged detection signals that cannot reflect the endogenous fluctuations of the body. To solve these problems, we prepared a multifunctional hydrogel as an electrolyte and combined it with a flexible patch electrode to realize real-time monitoring of sweat Zn2+. Such hydrogel has magnetic and porous properties, and the porous structure of hydrogel enables a fast absorption of sweat, and the magnetic property of the addition of fabricated Fe3O4 NPs not only improves the conductivity but also ensures the adjustable internal structures of the hydrogel. Such a sensing platform for sweat Zn2+ monitoring shows a satisfied linear relationship in the concentration range of 0.16-16 µg/mL via differential pulsed anodic striping voltammetry (DPASV) and successfully detects the sweat Zn2+ of four volunteers during exercise and resting, displaying a promising path for commercial application.

Synergistic enhancement of wearable biosensor through Pt single-atom catalyst for sweat analysis

Real-time monitoring of biological markers in sweat is a valuable tool for health assessment. In this study, we have developed an innovative wearable biosensor for precise analysis of glucose in sweat during physical activities. The sensor is based on a single-atom catalyst of platinum (Pt) uniformly dispersed on tricobalt tetroxide (Co3O4) nanorods and reduced graphene oxide (rGO), featuring a unique three-dimensional nanostructure and excellent glucose electrocatalytic performance with a wide detection range of 1-800 μM. Additionally, density functional theory calculations have revealed the synergetic role of Pt active sites in the Pt single-atom catalyst (Co3O4/rGO/Pt) in glucose adsorption and electron transfer, thereby enhancing sensor performance. To enable application in wearable devices, we designed an S-shaped microfluidic chip and a point-of-care testing (POCT) device, both of which were validated for effectiveness through actual use by volunteers. This research provides valuable insights and innovative approaches for analyzing sweat glucose using wearable devices, contributing to the advancement of personalized healthcare.

Sweat gland morphology and physiology in diabetes, neuropathy, and nephropathy: a review

Context: Sweat glands (SGs) play a vital role in thermal regulation. The function and structure are altered during the different pathological conditions.Objective: These alterations are studied through three techniques: biopsy, sweat analytes and electrical activity of SG.Methods: The morphological study of SG through biopsy and various techniques involved in quantifying sweat analytes is focussed on here. Electrical activities of SG in diabetes, neuropathy and nephropathy cases are also discussed, highlighting their limitations and future scope.Results and Conclusion: The result of this review identified three areas of the knowledge gap. The first is wearable sensors to correlate pathological conditions. Secondly, there is no device to look for its structure and quantify its associated function. Finally, therapeutic applications of SG are explored, especially for renal failure. With these aspects, this paper provides information collection and correlates SG with pathologies related to diabetes. Hence this could help researchers develop suitable technologies for the gaps identified.

Wearable Electrochemical Sensor for Sweat-Based Potassium Ion and Glucose Detection in Exercise Health Monitoring

The increasing prevalence of wearable devices has sparked a growing interest in real-time health monitoring and physiological parameter tracking. This study focuses on the development of a cost-effective sweat analysis device, utilizing microfluidic technology and selective electrochemical electrodes for non-invasive monitoring of glucose and potassium ions. The device, through real-time monitoring of glucose and potassium ion levels in sweat during physical activity, issues a warning signal when reaching experimentally set thresholds (K+ concentration at 7.5 mM, glucose concentrations at 60 μM and 120 μM). This alerts users to potential dehydration and hypoglycemic conditions. Through the integration of microfluidic devices and precise electrochemical analysis techniques, the device enables accurate and real-time monitoring of glucose and potassium ions in sweat. This advancement in wearable technology holds significant potential for personalized health management and preventive care, promoting overall well-being, and optimizing performance during physical activities.

Blood Micro-sampling: An alternative blood collection method for radioiodine therapy dosimetry

PURPOSE

Collecting venous blood samples from patients post administration of high therapeutic activities results in radiation exposure to staff collecting the blood. This study investigated the use of finger-tip capillary-blood collection as an alternative to the venous-blood collection method recommended by the European Association of Nuclear Medicine (EANM) dosimetry protocol for quantifying 131I concentration in the critical organ after therapeutic dose of 131I.

METHODS

The study included differentiated thyroid cancer patients referred to a thyroid cancer centre at St James's Hospital, Ireland, for therapeutic and diagnostic oral administration of 131I. The 15 patients recruited for this study provided 30 venous and capillary paired-blood samples. The activity concentration of the blood samples was compared between the type of blood (venous vs capillary) and the geometry/volume of the blood (1.0 ml versus 0.03 ml). Other variables were also investigated including administered activities, dose to staff performing the sampling, duration of sampling and time since administration.

RESULTS

Blood samples were taken at 2.0-91.9 h post administration using 0.2 ± 0.0 GBq (n = 2) or 4.0 ± 0.1 GBq (n = 28) 131I activities. There was no significant difference found between different blood sampling types (-1.0 ± 4.3 %, p = 0.223), different blood volumes (-3.2 ± 10.0 %, p = 0.070), or between their combination. No significant correlation was found between the percentage differences and investigated parameters.

CONCLUSION

A high degree of accuracy was achieved with blood radioactivity quantified using capillary blood collection using the finger-prick method. Further validation of the method would be required prior to implementation, to investigate patient specific factors which may affect accuracy.

Approaches of wearable and implantable biosensor towards of developing in precision medicine

In the relentless pursuit of precision medicine, the intersection of cutting-edge technology and healthcare has given rise to a transformative era. At the forefront of this revolution stands the burgeoning field of wearable and implantable biosensors, promising a paradigm shift in how we monitor, analyze, and tailor medical interventions. As these miniature marvels seamlessly integrate with the human body, they weave a tapestry of real-time health data, offering unprecedented insights into individual physiological landscapes. This log embarks on a journey into the realm of wearable and implantable biosensors, where the convergence of biology and technology heralds a new dawn in personalized healthcare. Here, we explore the intricate web of innovations, challenges, and the immense potential these bioelectronics sentinels hold in sculpting the future of precision medicine.

Smartphone based wearable sweat glucose sensing device correlated with machine learning for real-time diabetes screening

BACKGROUND

Diabetes is a significant health threat, with its prevalence and burden increasing worldwide indicating its challenge for global healthcare management. To decrease the disease severity, the diabetic patients are recommended to regularly check their blood glucose levels. The conventional finger-pricking test possesses some drawbacks, including painfulness and infection risk. Nowadays, smartphone has become a part of our lives offering an important benefit in self-health monitoring. Thus, non-invasive wearable sweat glucose sensor connected with a smartphone readout is of interest for real-time glucose detection.

RESULTS

Wearable sweat glucose sensing device is fabricated for self-monitoring of diabetes. This device is designed as a body strap consisting of a sensing strip and a portable potentiostat connected with a smartphone readout via Bluetooth. The sensing strip is modified by carbon nanotubes (CNTs)-cellulose nanofibers (CNFs), followed by electrodeposition of Prussian blue. To preserve the activity of glucose oxidase (GOx) immobilized on the modified sensing strip, chitosan is coated on the top layer of the electrode strip. Herein, machine learning is implemented to correlate between the electrochemical results and the nanomaterial content along with deposition cycle of prussian blue, which provide the highest current response signal. The optimized regression models provide an insight, establishing a robust framework for design of high-performance glucose sensor.

SIGNIFICANCE

This wearable glucose sensing device connected with a smartphone readout offers a user-friendly platform for real-time sweat glucose monitoring. This device provides a linear range of 0.1-1.5 mM with a detection limit of 0.1 mM that is sufficient enough for distinguishing between normal and diabetes patient with a cut-off level of 0.3 mM. This platform might be an alternative tool for improving health management for diabetes patients.

Long-Term Detection of Glycemic Glucose/Hypoglycemia by Microfluidic Sweat Monitoring Patch

A microfluidic sweat monitoring patch that collects human sweat for a long time is designed to achieve the effect of detecting the rise and fall of human sweat glucose over a long period of time by increasing the use time of a single patch. Five collection pools, four serpentine channels, and two different valves are provided. Among them, the three-dimensional valve has a large burst pressure as a balance between the internal and external air pressures of the patch. The bursting pressure of the two-dimensional diverter valve is smaller than that of the three-dimensional gas valve, and its role is to control the flow direction of the liquid. Through plasma hydrophilic treatment of different durations, the optimal hydrophilic duration is obtained. The embedded chromogenic disc detects the sweat glucose value at two adjacent time intervals and compares the information of the human body to increase or reduce glucose. The patch has good flexibility and can fit well with human skin, and because polydimethylsiloxane (PDMS) has good light transmission, it reduces the measurement error caused by the color-taking process and makes the detection results more accurate.

The challenges and promise of sweat sensing

The potential of monitoring biomarkers in sweat for health-related applications has spurred rapid growth in the field of wearable sweat sensors over the past decade. Some of the key challenges have been addressed, including measuring sweat-secretion rate and collecting sufficient sample volumes for real-time, continuous molecular analysis without intense exercise. However, except for assessment of cystic fibrosis and regional nerve function, the ability to accurately measure analytes of interest and their physiological relevance to health metrics remain to be determined. Although sweat is not a crystal ball into every aspect of human health, we expect sweat measurements to continue making inroads into niche applications involving active sweating, such as hydration monitoring for athletes and physical laborers and later for medical and casual health monitoring of relevant drugs and hormones.

Triple-Responsive, Multimodal, Visual Electronic Skin toward All-in-One Health Management for Gestational Diabetes Mellitus

Gestational diabetes mellitus (GDM) is one of the most common metabolic disorders during pregnancy, leading to serious complications for pregnant women and a threat to life safety of infants. Therefore, it is particularly important to establish a multipurpose monitoring pathway to important physiological indicators of pregnant women. In this work, three kinds of double network hydrogels are prepared with poly(vinyl alcohol) (PVA), borax, and cellulose ethers with varying substituents of methyl (methyl cellulose, MC), hydroxypropyl (hydroxypropyl cellulose, HPC), or both (hydroxypropyl methyl cellulose, HPMC), respectively. The corresponding toughness (143.9, 102.3, and 135.9 kJ cm-3) and conductivity (0.69, 0.45, and 0.51 S m-1) of the hydrogels demonstrate that PB-MC was endowed with the prominent performance. Molecular dynamics simulations further revealed the essence that hydrogen bond interactions between PVA and cellulose ethers play a critical role in regulating the structure and properties of hydrogels. Thermochromic capsule powders (TCPs) were subsequently doped in to achieve a composite hydrogel (TCPs@PB-MC) to indicate the change in human body temperature. Furthermore, the process of the TCPs@PB-MC response to glucose, pH, and temperature was tracked in-depth through the electrochemical window. This work provides a novel strategy for all-in-one health management of GDM.

Wireless electrochemiluminescent biosensors: Powering innovation with smartphone technology

Energy supply and sensor response acquisition can be performed wirelessly, enabling biosensors as Internet of Thing (IoT) tools by linking wireless power supply and electrochemical sensors. Here, we used the electromagnetic induction method to clarify the conditions under which electrochemiluminescence is induced by a simple potential modulation circuit without an integrated circuit on the electrode chip that receives the power. Initially, the potential waveform obtained in a circuit with inductance and capacitance components that resonate with the transmission frequency and a diode for rectification was investigated to clarify the conditions inducing an electrochemiluminescence reaction at the printed electrode. A high-sensitivity complementary metal-oxide semiconductor camera built into the smartphone wirelessly detected the luminescence generated on the electrode chip. The images were quantitatively evaluated using open-source image analysis software which determine the sensitivity of detecting hydrogen peroxide. Glucose oxidase (GOD) encapsulated in a matrix of chitosan polymers and photocrosslinkable polymers was immobilized on a mass-producible and inexpensive printed electrode to maintain high activity. The immobilized membrane suppressed luminescence when immobilized on the working electrode; therefore, the enzyme was immobilized on the counter electrode for glucose measurement over a wide concentration. Thus, luminol electrochemiluminescence was induced on the electrode chip by wireless power supply from a smartphone. Human serum and artificial sweat samples were tested and indicated possibility for actual applications. In this way a fully wireless biosensor was developed with potential as an IoT biosensor.

Pursuing precision in medicine and nutrition: the rise of electrochemical biosensing at the molecular level

In the era that we seek personalization in material things, it is becoming increasingly clear that the individualized management of medicine and nutrition plays a key role in life expectancy and quality of life, allowing participation to some extent in our welfare and the use of societal resources in a rationale and equitable way. The implementation of precision medicine and nutrition are highly complex challenges which depend on the development of new technologies able to meet important requirements in terms of cost, simplicity, and versatility, and to determine both individually and simultaneously, almost in real time and with the required sensitivity and reliability, molecular markers of different omics levels in biofluids extracted, secreted (either naturally or stimulated), or circulating in the body. Relying on representative and pioneering examples, this review article critically discusses recent advances driving the position of electrochemical bioplatforms as one of the winning horses for the implementation of suitable tools for advanced diagnostics, therapy, and precision nutrition. In addition to a critical overview of the state of the art, including groundbreaking applications and challenges ahead, the article concludes with a personal vision of the imminent roadmap.

A Review of Recent Advances in Microneedle-Based Sensing within the Dermal ISF That Could Transform Medical Testing

Interstitial fluid (ISF) has attracted extensive attention in an extremely wide range of areas due to its unique advantages, such as portability, high precision, comfortable operation, and superior stability. In recent years, the microneedle (MN) technique has been considered to be an excellent tool for extracting ISF because it is painless and noninvasive. Recent reports have shown that MN has good application prospects in ISF extraction. In this review, we provide comprehensive and in-depth insight into integrated MN devices for ISF detection, covering the basic structure as well as the fabrication of integrated MN devices and various applications in ISF extraction. Challenges and prospects are highlighted, with a discussion on how to transition such MN-integrated devices toward personalized healthcare monitoring systems.

Technological Advances of Wearable Device for Continuous Monitoring of In Vivo Glucose

Managing diabetes is a chronic challenge today, requiring monitoring and timely insulin injections to maintain stable blood glucose levels. Traditional clinical testing relies on fingertip or venous blood collection, which has facilitated the emergence of continuous glucose monitoring (CGM) technology to address data limitations. Continuous glucose monitoring technology is recognized for tracking long-term blood glucose fluctuations, and its development, particularly in wearable devices, has given rise to compact and portable continuous glucose monitoring devices, which facilitates the measurement of blood glucose and adjustment of medication. This review introduces the development of wearable CGM-based technologies, including noninvasive methods using body fluids and invasive methods using implantable electrodes. The advantages and disadvantages of these approaches are discussed as well as the use of microneedle arrays in minimally invasive CGM. Microneedle arrays allow for painless transdermal puncture and are expected to facilitate the development of wearable CGM devices. Finally, we discuss the challenges and opportunities and look forward to the biomedical applications and future directions of wearable CGM-based technologies in biological research.

Liquid Metal-Polymer Conductor-Based Conformal Cyborg Devices

Gallium-based liquid metal (LM) exhibits exceptional properties such as high conductivity and biocompatibility, rendering it highly valuable for the development of conformal bioelectronics. When combined with polymers, liquid metal-polymer conductors (MPC) offer a versatile platform for fabricating conformal cyborg devices, enabling functions such as sensing, restoration, and augmentation within the human body. This review focuses on the synthesis, fabrication, and application of MPC-based cyborg devices. The synthesis of functional materials based on LM and the fabrication techniques for MPC-based devices are elucidated. The review provides a comprehensive overview of MPC-based cyborg devices, encompassing their applications in sensing diverse signals, therapeutic interventions, and augmentation. The objective of this review is to serve as a valuable resource that bridges the gap between the fabrication of MPC-based conformal devices and their potential biomedical applications.

Skin-Interfaced Bifluidic Paper-Based Device for Quantitative Sweat Analysis

The erratic, intermittent, and unpredictable nature of sweat production, resulting from physiological or psychological fluctuations, poses intricacies to consistently and accurately sample and evaluate sweat biomarkers. Skin-interfaced microfluidic devices that rely on colorimetric mechanisms for semi-quantitative detection are particularly susceptible to these inaccuracies due to variations in sweat secretion rate or instantaneous volume. This work introduces a skin-interfaced colorimetric bifluidic sweat device with two synchronous channels to quantify sweat rate and biomarkers in real-time, even during uncertain sweat activities. In the proposed bifluidic-distance metric approach, with one channel to measure sweat rate and quantify collected sweat volume, the other channel can provide an accurate analysis of the biomarkers based on the collected sweat volume. The closed channel design also reduces evaporation and resists contamination from the external environment. The feasibility of the device is highlighted in a proof-of-the-concept demonstration to analyze sweat chloride for evaluating hydration status and sweat glucose for assessing glucose levels. The low-cost yet highly accurate device provides opportunities for clinical sweat analysis and disease screening in remote and low-resource settings. The developed device platform can be facilely adapted for the other biomarkers when corresponding colorimetric reagents are exploited.

Harvesting and manipulating sweat and interstitial fluid in microfluidic devices

Microfluidic devices began to be used to facilitate sweat and interstitial fluid (ISF) sensing in the mid-2010s. Since then, numerous prototypes involving microfluidics have been developed in different form factors for sensing biomarkers found in these fluids under in vitro, ex vivo, and in vivo (on-body) settings. These devices transport and manipulate biofluids using microfluidic channels composed of silicone, polymer, paper, or fiber. Fluid flow transport and sample management can be achieved by controlling the flow rate, surface morphology of the channel, and rate of fluid evaporation. Although many devices have been developed for estimating sweat rate, electrolyte, and metabolite levels, only a handful have been able to proceed beyond laboratory testing and reach the stage of clinical trials and commercialization. To further this technology, this review reports on the utilization of microfluidics towards sweat and ISF management and transport. The review is distinguished from other recent reviews by focusing on microfluidic principles of sweat and ISF generation, transport, extraction, and management. Challenges and prospects are highlighted, with a discussion on how to transition such prototypes towards personalized healthcare monitoring systems.

Interindividual- and blood-correlated sweat phenylalanine multimodal analytical biochips for tracking exercise metabolism

In situ monitoring of endogenous amino acid loss through sweat can provide physiological insights into health and metabolism. However, existing amino acid biosensors are unable to quantitatively assess metabolic status during exercise and are rarely used to establish blood-sweat correlations because they only detect a single concentration indicator and disregard sweat rate. Here, we present a wearable multimodal biochip integrated with advanced electrochemical electrodes and multipurpose microfluidic channels that enables simultaneous quantification of multiple sweat indicators, including phenylalanine and chloride, as well as sweat rate. This combined measurement approach reveals a negative correlation between sweat phenylalanine levels and sweat rates among individuals, which further enables identification of individuals at high metabolic risk. By tracking phenylalanine fluctuations induced by protein intake during exercise and normalizing the concentration indicator by sweat rates to reduce interindividual variability, we demonstrate a reliable method to correlate and analyze sweat-blood phenylalanine levels for personal health monitoring.

Bioinspired nanoplatforms for human-machine interfaces: Recent progress in materials and device applications

The panoramic characteristics of human-machine interfaces (HMIs) have prompted the needs to update the biotechnology community with the recent trends, developments, and future research direction toward next-generation bioelectronics. Bioinspired materials are promising for integrating various bioelectronic devices to realize HMIs. With the advancement of scientific biotechnology, state-of-the-art bioelectronic applications have been extensively investigated to improve the quality of life by developing and integrating bioinspired nanoplatforms in HMIs. This review highlights recent trends and developments in the field of biotechnology based on bioinspired nanoplatforms by demonstrating recently explored materials and cutting-edge device applications. Section 1 introduces the recent trends and developments of bioinspired nanomaterials for HMIs. Section 2 reviews various flexible, wearable, biocompatible, and biodegradable nanoplatforms for bioinspired applications. Section 3 furnishes recently explored substrates as carriers for advanced nanomaterials in developing HMIs. Section 4 addresses recently invented biomimetic neuroelectronic, nanointerfaces, biointerfaces, and nano/microfluidic wearable bioelectronic devices for various HMI applications, such as healthcare, biopotential monitoring, and body fluid monitoring. Section 5 outlines designing and engineering of bioinspired sensors for HMIs. Finally, the challenges and opportunities for next-generation bioinspired nanoplatforms in extending the potential on HMIs are discussed for a near-future scenario. We believe this review can stimulate the integration of bioinspired nanoplatforms into the HMIs in addition to wearable electronic skin and health-monitoring devices while addressing prevailing and future healthcare and material-related problems in biotechnologies.

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.

Complete Glucose Electrooxidation Enabled by Coordinatively Unsaturated Copper Sites in Metal-Organic Frameworks

The electrocatalytic oxidation of glucose plays a vital role in biomass conversion, renewable energy, and biosensors, but significant challenges remain to achieve high selectivity and high activity simultaneously. In this study, we present a novel approach for achieving complete glucose electrooxidation utilizing Cu-based metal-hydroxide-organic framework (Cu-MHOF) featuring coordinatively unsaturated Cu active sites. In contrast to traditional Cu(OH)2 catalysts, the Cu-MHOF exhibits a remarkable 40-fold increase in electrocatalytic activity for glucose oxidation, enabling exclusive oxidation of glucose into formate and carbonate as the final products. The critical role of open metal sites in enhancing the adsorption affinity of glucose and key intermediates was confirmed by control experiments and density functional theory simulations. Subsequently, a miniaturized nonenzymatic glucose sensor was developed showing superior performance with a high sensitivity of 214.7 μA mM-1  cm-2 , a wide detection range from 0.1 μM to 22 mM, and a low detection limit of 0.086 μM. Our work provides a novel molecule-level strategy for designing catalytically active sites and could inspire the development of novel metal-organic framework for next-generation electrochemical devices.

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.

Ultrafast Response in Nonenzymatic Electrochemical Glucose Sensing with Ni(II)-MOFs by Dimensional Manipulation

Metal-organic frameworks (MOFs) are emerging as promising candidates for electrochemical glucose sensing owing to their ordered channels, tunable chemistry, and atom-precision metal sites. Herein, the efficient nonenzymatic electrochemical glucose sensing is achieved by taking advantage of Ni(II)-based metal-organic frameworks (Ni(II)-MOFs) and acquiring the ever-reported fastest response time. Three Ni(II)-MOFs ({[Ni6L2(H2O)26]4H2O}n (CTGU-33), {Ni(bib)1/2(H2L)1/2(H2O)3}n (CTGU-34), {Ni(phen)(H2L)1/2(H2O)2}n (CTGU-35)) have been synthesized for the first time, which use benzene-1,2,3,4,5,6-hexacarboxylic acid (H6L) as an organic ligand and introduce 1,4-bis(1-imidazoly)benzene (bib) or 1,10-phenanthroline (phen) as spatially auxiliary ligands. Bib and phen convert the coordination mode of CTGU-33, affording structural dimensions from 2D of CTGU-33 to 3D of CTGU-34 or 1D of CTGU-35. By tuning the dimension of the skeleton, CTGU-34 with 3D interconnected channels exhibits an ultrafast response of less than 0.4 s, which is superior to the existing nonenzymatic electrochemical sensors. Additionally, a low detection limit of 0.12 μM (S/N = 3) and a high sensitivity of 1705 μA mM-1 cm-2 are simultaneously achieved. CTGU-34 further showcases desirable anti-interference and cycling stability, which demonstrates a promising application prospect in the real-time detection of glucose.

Soft microfiber-based hollow microneedle array for stretchable microfluidic biosensing patch with negative pressure-driven sampling

Wearable point-of-care testing devices are essential for personalized and decentralized healthcare. They can collect biofluid samples from the human body and use an analyzer to detect biomolecules. However, creating an integrated system is challenging due to the difficulty of achieving conformality to the human body, regulating the collection and transport of biofluids, developing a biosensor patch capable of precise biomolecule detection, and establishing a simple operation protocol that requires minimal wearer attention. In this study, we propose using a hollow microneedle (HMN) based on soft hollow microfibers and a microneedle-integrated microfluidic biosensor patch (MIMBP) capable of integrated blood sampling and electrochemical biosensing of biomolecules. The soft MIMBP includes a stretchable microfluidic device, a flexible electrochemical biosensor, and a HMN array made from flexible hollow microfibers. The HMNs are fabricated by electroplating flexible and mechanically durable hollow microfibers made from a nanocomposite matrix of polyimide, a poly (vinylidene fluoride-co-trifluoroethylene) copolymer, and single-walled carbon nanotubes. The MIMBP uses the negative pressure generated by a single button push to collect blood and deliver it to a flexible electrochemical biosensor modified with a gold nanostructure and Pt nanoparticles. We have demonstrated that glucose can be accurately measured up to the molar range in whole human blood collected through the microneedle. The MIMBP platform with HMNs has great potential as a foundation for the future development of simple, wearable, self-testing systems for minimally invasive biomolecule detection. This platform capable of sequential blood collection and high sensitivity glucose detection, which are ideal for personalized and decentralized healthcare.

Advanced Textile-Based Wearable Biosensors for Healthcare Monitoring

With the innovation of wearable technology and the rapid development of biosensors, wearable biosensors based on flexible textile materials have become a hot topic. Such textile-based wearable biosensors promote the development of health monitoring, motion detection and medical management, and they have become an important support tool for human healthcare monitoring. Textile-based wearable biosensors not only non-invasively monitor various physiological indicators of the human body in real time, but they also provide accurate feedback of individual health information. This review examines the recent research progress of fabric-based wearable biosensors. Moreover, materials, detection principles and fabrication methods for textile-based wearable biosensors are introduced. In addition, the applications of biosensors in monitoring vital signs and detecting body fluids are also presented. Finally, we also discuss several challenges faced by textile-based wearable biosensors and the direction of future development.

Wearable sensor platforms for real-time monitoring and early warning of metabolic disorders in humans

Nowadays, the prevalence of metabolic syndromes (MSs) has attracted increasing concerns as it is closely related to overweight and obesity, physical inactivity and overconsumption of energy, making the diagnosis and real-time monitoring of the physiological range essential and necessary for avoiding illness due to defects in the human body such as higher risk of cardiovascular disease, diabetes, stroke and diseases related to artery walls. However, the current sensing techniques are inconvenient and do not continuously monitor the health status of humans. Alternatively, the use of recent wearable device technology is a preferable method for the prevention of these diseases. This can enable the monitoring of the health status of humans in different health domains, including environment and structure. The use wearable devices with the purpose of facilitating rapid treatment and real-time monitoring can decrease the prevalence of MS and long-time monitor the health status of patients. This review highlights the recent advances in wearable sensors toward continuous monitoring of blood pressure and blood glucose, and further details the monitoring of abnormal obesity, triglycerides and HDL. We also discuss the challenges and future prospective of monitoring MS in humans.

Screen-Printed Textile-Based Electrochemical Biosensor for Noninvasive Monitoring of Glucose in Sweat

Wearable sweat biosensors for noninvasive monitoring of health parameters have attracted significant attention. Having these biosensors embedded in textile substrates can provide a convenient experience due to their soft and flexible nature that conforms to the skin, creating good contact for long-term use. These biosensors can be easily integrated with everyday clothing by using textile fabrication processes to enhance affordable and scalable manufacturing. Herein, a flexible electrochemical glucose sensor that can be screen-printed onto a textile substrate has been demonstrated. The screen-printed textile-based glucose biosensor achieved a linear response in the range of 20-1000 µM of glucose concentration and high sensitivity (18.41 µA mM^-1 cm^-2, R² = 0.996). In addition, the biosensors show high selectivity toward glucose among other interfering analytes and excellent stability over 30 days of storage. The developed textile-based biosensor can serve as a platform for monitoring bio analytes in sweat, and it is expected to impact the next generation of wearable devices.

3D-printed electrochemical glucose device with integrated Fe(II)-MOF nanozyme

Estimation of glucose (GLU) levels in the human organism is very important in the diagnosis and monitoring of diabetes. Scientific advances in nanomaterials have led to the construction of new generations of enzymatic-free GLU sensors. In this work, an innovative 3D-printed device modified with a water-stable and non-toxic metal-organic framework of iron (Fe(II)-MOF), which serves as a nanozyme, has been developed for the voltammetric determination of GLU in artificial sweat. In contrast to existing MOF-based GLU sensors which exhibit electrocatalytic activity for the oxidation of GLU in alkaline media, the nanozyme Fe(II)-MOF/3D-printed device can operate in the acidic epidermal sweat environment. The enzymatic-free GLU sensor is composed of a 3-electrode 3D-printed device with the MOF nanozyme immobilized on the surface of the working electrode. GLU sensing is conducted by differential pulse voltammetry without interference from other co-existing metabolites in artificial sweat. The response is based on the oxidation of glucose to gluconolactone, induced by the redox activity of the Fe-centers of the MOF. GLU gives rise to an easily detectable and well-defined voltammetric peak at about - 1.2 V and the limit of detection is 17.6 μmol L-1. The synergy of a nanozyme with 3D printing technology results in an advanced, sensitive, and low-cost sensor, paving the way for on-skin applications.

Versatile sweat bioanalysis on demand with hydrogel-programmed wearables

Wearable sweat bioanalysis is promising for non-invasive diagnostics of diseases. However, collection of representative sweat samples without disturbing daily life and wearable bioanalysis of targets that are clinically significant are still challenging. In this work, we report on a versatile method for the sweat bioanalysis. The method is based on a thermoresponsive hydrogel which can imperceptibly absorb slowly secreted sweat without stimulation such as heat or sport exercise. The wearable bioanalysis is accomplished by programmed electric heating of hydrogel modules to 42°C to release absorbed sweat or preloaded reagents into a microfluidic detection channel. Using our method, not only one-step detection of glucose but also multi-step immunoassay of cortisol is accomplished within 1 h, even at a very low sweat rate. Our test results are also compared with those obtained with conventional blood samples and stimulated sweat samples to evaluate the applicability of our method to non-invasive clinical practice.

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.

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.

Non-invasive in-vivo glucose-based stress monitoring in plants

Plant stress responses involve a suite of genetically encoded mechanisms triggered by real-time interactions with their surrounding environment. Although sophisticated regulatory networks maintain proper homeostasis to prevent damage, the tolerance thresholds to these stresses vary significantly among organisms. Current plant phenotyping techniques and observables must be better suited to characterize the real-time metabolic response to stresses. This impedes practical agronomic intervention to avoid irreversible damage and limits our ability to breed improved plant organisms. Here, we introduce a sensitive, wearable electrochemical glucose-selective sensing platform that addresses these problems. Glucose is a primary plant metabolite, a source of energy produced during photosynthesis, and a critical molecular modulator of various cellular processes ranging from germination to senescence. The wearable-like technology integrates a reverse iontophoresis glucose extraction capability with an enzymatic glucose biosensor that offers a sensitivity of 22.7 nA/(μM·cm²), a limit of detection (LOD) of 9.4 μM, and a limit of quantification (LOQ) of 28.5 μM. The system's performance was validated by subjecting three different plant models (sweet pepper, gerbera, and romaine lettuce) to low-light and low-high temperature stresses and demonstrating critical differential physiological responses associated with their glucose metabolism. This technology enables non-invasive, non-destructive, real-time, in-situ, and in-vivo identification of early stress response in plants and provides a unique tool for timely agronomic management of crops and improving breeding strategies based on the dynamics of genome-metabolome-phenome relationships.

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.

Portable Prussian Blue-Based Sensor for Bacterial Detection in Urine

Bacterial infections can affect the skin, lungs, blood, and brain, and are among the leading causes of mortality globally. Early infection detection is critical in diagnosis and treatment but is a time- and work-consuming process taking several days, creating a hitherto unmet need to develop simple, rapid, and accurate methods for bacterial detection at the point of care. The most frequent type of bacterial infection is infection of the urinary tract. Here, we present a wireless-enabled, portable, potentiometric sensor for E. coli. E. coli was chosen as a model bacterium since it is the most common cause of urinary tract infections. The sensing principle is based on reduction of Prussian blue by the metabolic activity of the bacteria, detected by monitoring the potential of the sensor, transferring the sensor signal via Bluetooth, and recording the output on a laptop or a mobile phone. In sensing of bacteria in an artificial urine medium, E. coli was detected in ~4 h (237 ± 19 min; n = 4) and in less than 0.5 h (21 ± 7 min, n = 3) using initial E. coli concentrations of ~10³ and 10⁵ cells mL^-1, respectively, which is under or on the limit for classification of a urinary tract infection. Detection of E. coli was also demonstrated in authentic urine samples with bacteria concentration as low as 10⁴ cells mL^-1, with a similar response recorded between urine samples collected from different volunteers as well as from morning and afternoon urine samples.

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

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