A fluorometric skin-interfaced microfluidic device and smartphone imaging module for in situ quantitative analysis of sweat chemistry

Point-of-care testing of methamphetamine and cocaine utilizing wearable sensors

The imperative for the point-of-care testing of methamphetamine and cocaine in drug abuse prevention necessitates innovative solutions. To address this need, we have introduced a multi-channel wearable sensor harnessing CRISPR/Cas12a system. A CRISPR/Cas12a based system, integrated with aptamers specific to methamphetamine and cocaine, has been engineered. These aptamers function as signal-mediated intermediaries, converting methamphetamine and cocaine into nucleic acid signals, subsequently generating single-stranded DNA to activate the Cas12 protein. Additionally, we have integrated a microfluidic system and magnetic separation technology into the CRISPR system, enabling rapid and precise detection of cocaine and methamphetamine. The proposed sensing platform demonstrated exceptional sensitivity, achieving a detection limit as low as 0.1 ng/mL. This sensor is expected to be used for on-site drug detection in the future.

Fundamental Study of a Wristwatch Sweat Lactic Acid Monitor

A lactic acid (LA) monitoring system aimed at sweat monitoring was fabricated and tested. The sweat LA monitoring system uses a continuous flow of phosphate buffer saline, instead of chambers or cells, for collecting and storing sweat fluid excreted at the skin surface. To facilitate the use of the sweat LA monitoring system by subjects when exercising, the fluid control system, including the sweat sampling device, was designed to be unaffected by body movements or muscle deformation. An advantage of our system is that the skin surface condition is constantly refreshed by continuous flow. A real sample test was carried out during stationary bike exercise, which showed that LA secretion increased by approximately 10 μg/cm2/min compared to the baseline levels before exercise. The LA levels recovered to baseline levels after exercise due to the effect of continuous flow. This indicates that the wristwatch sweat LA monitor has the potential to enable a detailed understanding of the LA distribution at the skin surface.

Evaluation of sweat-based biomarkers using wearable biosensors for monitoring stress and fatigue: a systematic review

Objectives. This systematic review aims to report the evaluation of wearable biosensors for the real-time measurement of stress and fatigue using sweat biomarkers. Methods. A thorough search of the literature was carried out in databases such as PubMed, Web of Science and IEEE. A three-step approach for selecting research articles was developed and implemented. Results. Based on a systematic search, a total of 17 articles were included in this review. Lactate, cortisol, glucose and electrolytes were identified as sweat biomarkers. Sweat-based biomarkers are frequently monitored in real time using potentiometric and amperometric biosensors. Wearable biosensors such as an epidermal patch or a sweatband have been widely validated in scientific literature. Conclusions. Sweat is an important biofluid for monitoring general health, including stress and fatigue. It is becoming increasingly common to use biosensors that can measure a wide range of sweat biomarkers to detect fatigue during high-intensity work. Even though wearable biosensors have been validated for monitoring various sweat biomarkers, such biomarkers can only be used to assess stress and fatigue indirectly. In general, this study may serve as a driving force for academics and practitioners to broaden the use of wearable biosensors for the real-time assessment of stress and fatigue.

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.

A Miniaturized Wireless Micropump Enabled by Confined Acoustic Streaming

Miniaturization of health care, biomedical, and chemical systems is highly desirable for developing point-of-care testing (POCT) technologies. In system miniaturization, micropumps represent one of the major bottlenecks due to their undesirable pumping performance at such small sizes. Here, we developed a microelectromechanical system fabricated acoustic micropump based on an ultrahigh-frequency bulk acoustic wave resonator. The concept of an inner-boundary-confined acoustic jet was introduced to facilitate unidirectional flow. Benefitting from the high resonant frequency and confined acoustic streaming, the micropump reaches 32.620 kPa/cm3 (pressure/size) and 11.800 ml/min∙cm3 (flow rate/size), showing a 2-order-of-magnitude improvement in the energy transduction efficiency compared with the existing acoustic micropumps. As a proof of concept, the micropump was constructed as a wearable and wirelessly powered integrated drug delivery system with a size of only 9×9×9 mm3 and a weight of 1.16 g. It was demonstrated for ocular disease treatment through animal experimentation and a human pilot test. With superior pumping performance, miniaturized pump size, ultralow power consumption, and complementary metal-oxide-semiconductor compatibility, we expect it to be readily applied to various POCT applications including clinical diagnosis, prognosis, and drug delivery systems.

Fluorescence-Recovered Wearable Hydrogel Patch for In Vitro Detection of Glucose Based on Rare-Earth Nanoparticles

The physiological state of the human body can be indicated by analyzing the composition of sweat. In this research, a fluorescence-recovered wearable hydrogel patch has been designed and realized which can noninvasively monitor the glucose concentration in human sweat. Rare-earth nanoparticles (RENPs) of NaGdF4 doped with different elements (Yb, Er, and Ce) are synthesized and optimized for better luminescence in the near-infrared second (NIR-II) and visible region. In addition, RENPs are coated with CoOOH of which the absorbance has an extensive peak in the visible and NIR regions. The concentration of H2O2 in the environment can be detected by the fluorescence recovery degree of CoOOH-modified RENPs based on the fluorescence resonance energy transfer effect. For in vivo detection, the physiological state of oxidative stress at tumor sites can be visualized through its fluorescence in NIR-II with low background noise and high penetration depth. For the in vitro detection, CoOOH-modified RENP and glucose oxidase (GOx) were doped into a polyacrylamide hydrogel, and a patch that can emit green upconversion fluorescence under a 980 nm laser was prepared. Compared with the conventional electrochemical detection method, the fluorescence we presented has higher sensitivity and linear detection region to detect the glucose. This improved anti-interference sweat patch that can work in the dark environment was obtained, and the physiological state of the human body is conveniently monitored, which provides a new facile and convenient method to monitor the sweat status.

Skin-interfaced microfluidic sweat collection devices for personalized hydration management through thermal feedback

Non-electronic wearables that utilize skin-interfaced microfluidic technology have revolutionized the collection and analysis of human sweat, providing valuable biochemical information and indicating body hydration status. However, existing microfluidic devices often require constant monitoring of data during sweat assessment, thereby impeding the user experience and potentially missing anomalous physiological events, such as excessive sweating. Moreover, the complex manufacturing process hampers the scalability and large-scale production of such devices. Herein, we present a self-feedback microfluidic device with a unique dehydration reminder through a cost-effective "CAD-to-3D device" approach. It incorporates two independent systems for sweat collection and thermal feedback, including serpentine microchannels, reservoirs, petal-like bursting valves and heating chambers. The device operates by sequentially collecting sweat in the channels and reservoirs, and then activating thermal stimulators in the heating chambers through breaking the valves, initiating a chemical exothermic reaction. Human trials validate that the devices effectively alert users to potential dehydration by inducing skin thermal sensations triggered by sweat sampling. The proposed device offers facile scalability and customizable fabrication, and holds promise for managing hydration strategies in real-world scenarios, benefiting individuals engaged in sporting activities or exposed to high-temperature settings.

Carbon nanomaterials for sweat-based sensors: a review

Sweat is easily accessible from the human skin's surface. It is secreted by the eccrine glands and contains a wealth of physiological information, including metabolites and electrolytes like glucose and Na ions. Sweat is a particularly useful biofluid because of its easy and non-invasive access, unlike other biofluids, like blood. On the other hand, nanomaterials have started to show promise operation as a competitive substitute for biosensors and molecular sensors throughout the last 10 years. Among the most synthetic nanomaterials that are studied, applied, and discussed, carbon nanomaterials are special. They are desirable candidates for sensor applications because of their many intrinsic electrical, magnetic, and optical characteristics; their chemical diversity and simplicity of manipulation; their biocompatibility; and their effectiveness as a chemically resistant platform. Carbon nanofibers (CNFs), carbon dots (CDs), carbon nanotubes (CNTs), and graphene have been intensively investigated as molecular sensors or as components that can be integrated into devices. In this review, we summarize recent advances in the use of carbon nanomaterials as sweat sensors and consider how they can be utilized to detect a diverse range of analytes in sweat, such as glucose, ions, lactate, cortisol, uric acid, and pH.

Microfluidic-Based Non-Invasive Wearable Biosensors for Real-Time Monitoring of Sweat Biomarkers

Wearable biosensors are attracting great interest thanks to their high potential for providing clinical-diagnostic information in real time, exploiting non-invasive sampling of biofluids. In this context, sweat has been demonstrated to contain physiologically relevant biomarkers, even if it has not been exhaustively exploited till now. This biofluid has started to gain attention thanks to the applications offered by wearable biosensors, as it is easily collectable and can be used for continuous monitoring of some parameters. Several studies have reported electrochemical and optical biosensing strategies integrated with flexible, biocompatible, and innovative materials as platforms for biospecific recognition reactions. Furthermore, sampling systems as well as the transport of fluids by microfluidics have been implemented into portable and compact biosensors to improve the wearability of the overall analytical device. In this review, we report and discuss recent pioneering works about the development of sweat sensing technologies, focusing on opportunities and open issues that can be decisive for their applications in routine-personalized healthcare practices.

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

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

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.

Bionanotechnology and bioMEMS (BNM): state-of-the-art applications, opportunities, and challenges

The development of micro- and nanotechnology for biomedical applications has defined the cutting edge of medical technology for over three decades, as advancements in fabrication technology developed originally in the semiconductor industry have been applied to solving ever-more complex problems in medicine and biology. These technologies are ideally suited to interfacing with life sciences, since they are on the scale lengths as cells (microns) and biomacromolecules (nanometers). In this paper, we review the state of the art in bionanotechnology and bioMEMS (collectively BNM), including developments and challenges in the areas of BNM, such as microfluidic organ-on-chip devices, oral drug delivery, emerging technologies for managing infectious diseases, 3D printed microfluidic devices, AC electrokinetics, flexible MEMS devices, implantable microdevices, paper-based microfluidic platforms for cellular analysis, and wearable sensors for point-of-care testing.

Enhancing On-Skin Analysis: A Microfluidic Device and Smartphone Imaging Module for Real-Time Quantitative Detection of Multianalytes in Sweat

Wearable sweat sensors present exciting opportunities for advancing personal health monitoring and noninvasive biomarker measurements. However, existing sensors often fall short in accurate detection of low analyte volumes and concentrations and lack multimodal sensing capabilities. Herein, we present a highly portable four-channel microfluidic device capable of conducting simultaneous sweat sampling and fluorometric sensing of potential biomarkers, such as l-Tyr, l-Trp, Crt, and NH4+, specifically designed for kidney disease monitoring. Our microfluidic device seamlessly integrates with smartphones, facilitating easy data retrieval and analysis. The core of the sensing array is a novel fluorometric solid-state mechanism utilizing carbon polymer dots derived from dopamine, catechol, and o-phenylenediamine monomers embedded in gelatin hydrogels. The sensors exhibit exceptional performance, offering linear ranges of 5-275, 6-170, 4-220, and 5-170 μM, with impressively low detection limits of 1.5, 1.2, 1.3, and 1.4 μM for l-Tyr, l-Trp, Crt, and NH4+, respectively. Through meticulous optimization of operational variables, comprising the temperature, sample volume, and assay time, we achieved the best performance of the device. Furthermore, the sensors exhibited remarkable selectivity, effectively distinguishing between biologically similar species and other potential biological compounds found in sweat. Our evaluation also extended to monitoring kidney diseases in patients and healthy individuals, showcasing the device's utility in world scenarios. Promising results showcase the potential of low-cost, multidiagnostic microfluidic sensor arrays, especially with synthetic skin integration, for enhanced disease detection and healthcare outcomes.

3D-printed epidermal sweat microfluidic systems with integrated microcuvettes for precise spectroscopic and fluorometric biochemical assays

Systems for capture, storage and analysis of eccrine sweat can provide insights into physiological health status, quantify losses of water, electrolytes, amino acids and/or other essential species, and identify exposures to adverse environmental species or illicit drugs. Recent advances in materials and device designs serve as the basis for skin-compatible classes of microfluidic platforms and in situ colorimetric assays for precise assessments of sweat rate, sweat loss and concentrations of wide-ranging types of biomarkers in sweat. This paper presents a set of findings that enhances the performance of these systems through the use of microfluidic networks, integrated valves and microscale optical cuvettes formed by three dimensional printing in hard/soft hybrid materials systems, for accurate spectroscopic and fluorometric assays. Field studies demonstrate the capability of these microcuvette systems to evaluate the concentrations of copper, chloride, and glucose in sweat, along with the pH of sweat, with laboratory-grade accuracy and sensitivity.

Recent Advances in Skin-Interfaced Wearable Sweat Sensors: Opportunities for Equitable Personalized Medicine and Global Health Diagnostics

Recent advances in skin-interfaced wearable sweat sensors enable the noninvasive, real-time monitoring of biochemical signals associated with health and wellness. These wearable platforms leverage microfluidic channels, biochemical sensors, and flexible electronics to enable the continuous analysis of sweat-based biomarkers such as electrolytes, metabolites, and hormones. As this field continues to mature, the potential of low-cost, continuous personalized health monitoring enabled by such wearable sensors holds significant promise for addressing some of the formidable obstacles to delivering comprehensive medical care in under-resourced settings. This Perspective highlights the transformative potential of wearable sweat sensing for providing equitable access to cutting-edge healthcare diagnostics, especially in remote or geographically isolated areas. It examines the current understanding of sweat composition as well as recent innovations in microfluidic device architectures and sensing strategies by showcasing emerging applications and opportunities for innovation. It concludes with a discussion on expanding the utility of wearable sweat sensors for clinically relevant health applications and opportunities for enabling equitable access to innovation to address existing health disparities.

Optical Integration in Wearable, Implantable and Swallowable Healthcare Devices

Recent advances in materials and semiconductor technologies have led to extensive research on optical integration in wearable, implantable, and swallowable health devices. These optical systems utilize the properties of light─intensity, wavelength, polarization, and phase─to monitor and potentially intervene in various biological events. The potential of these devices is greatly enhanced through the use of multifunctional optical materials, adaptable integration processes, advanced optical sensing principles, and optimized artificial intelligence algorithms. This synergy creates many possibilities for clinical applications. This Perspective discusses key opportunities, challenges, and future directions, particularly with respect to sensing modalities, multifunctionality, and the integration of miniaturized optoelectronic devices. We present fundamental insights and illustrative examples of such devices in wearable, implantable, and swallowable forms. The constant pursuit of innovation and the dedicated approach to critical challenges are poised to influence diverse fields.

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.

Graphene-interfaced flexible and stretchable micro-nano electrodes: from fabrication to sweat glucose detection

Flexible and stretchable wearable electronic devices have received tremendous attention for their non-invasive and personal health monitoring applications. These devices have been fabricated by integrating flexible substrates and graphene nanostructures for non-invasive detection of physiological risk biomarkers from human bodily fluids, such as sweat, and monitoring of human physical motion tracking parameters. The extraordinary properties of graphene nanostructures in fully integrated wearable devices have enabled improved sensitivity, electronic readouts, signal conditioning and communication, energy harvesting from power sources through electrode design and patterning, and graphene surface modification or treatment. This review explores advances made toward the fabrication of graphene-interfaced wearable sensors, flexible and stretchable conductive graphene electrodes, as well as their potential applications in electrochemical sensors and field-effect-transistors (FETs) with special emphasis on monitoring sweat biomarkers, mainly in glucose-sensing applications. The review emphasizes flexible wearable sweat sensors and provides various approaches thus far employed for the fabrication of graphene-enabled conductive and stretchable micro-nano electrodes, such as photolithography, electron-beam evaporation, laser-induced graphene designing, ink printing, chemical-synthesis and graphene surface modification. It further explores existing graphene-interfaced flexible wearable electronic devices utilized for sweat glucose sensing, and their technological potential for non-invasive health monitoring applications.

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.

Reshaping healthcare with wearable biosensors

Wearable health sensors could monitor the wearer's health and surrounding environment in real-time. With the development of sensor and operating system hardware technology, the functions of wearable devices have been gradually enriched with more diversified forms and more accurate physiological indicators. These sensors are moving towards high precision, continuity, and comfort, making great contributions to improving personalized health care. At the same time, in the context of the rapid development of the Internet of Things, the ubiquitous regulatory capabilities have been released. Some sensor chips are equipped with data readout and signal conditioning circuits, and a wireless communication module for transmitting data to computer equipment. At the same time, for data analysis of wearable health sensors, most companies use artificial neural networks (ANN). In addition, artificial neural networks could help users effectively get relevant health feedback. Through the physiological response of the human body, various sensors worn could effectively transmit data to the control unit, which analyzes the data and provides feedback of the health value to the user through the computer. This is the working principle of wearable sensors for health. This article focuses on wearable biosensors used for healthcare monitoring in different situations, as well as the development, technology, business, ethics, and future of wearable sensors for health monitoring.

Soft Electronics for Health Monitoring Assisted by Machine Learning

Due to the development of the novel materials, the past two decades have witnessed the rapid advances of soft electronics. The soft electronics have huge potential in the physical sign monitoring and health care. One of the important advantages of soft electronics is forming good interface with skin, which can increase the user scale and improve the signal quality. Therefore, it is easy to build the specific dataset, which is important to improve the performance of machine learning algorithm. At the same time, with the assistance of machine learning algorithm, the soft electronics have become more and more intelligent to realize real-time analysis and diagnosis. The soft electronics and machining learning algorithms complement each other very well. It is indubitable that the soft electronics will bring us to a healthier and more intelligent world in the near future. Therefore, in this review, we will give a careful introduction about the new soft material, physiological signal detected by soft devices, and the soft devices assisted by machine learning algorithm. Some soft materials will be discussed such as two-dimensional material, carbon nanotube, nanowire, nanomesh, and hydrogel. Then, soft sensors will be discussed according to the physiological signal types (pulse, respiration, human motion, intraocular pressure, phonation, etc.). After that, the soft electronics assisted by various algorithms will be reviewed, including some classical algorithms and powerful neural network algorithms. Especially, the soft device assisted by neural network will be introduced carefully. Finally, the outlook, challenge, and conclusion of soft system powered by machine learning algorithm will be discussed.

Laser-Cutted Epidermal Microfluidic Patch with Capillary Bursting Valves for Chronological Capture, Storage, and Colorimetric Sensing of Sweat

Flexible wearable microfluidic devices show great feasibility and potential development in the collection and analysis of sweat due to their convenience and non-invasive characteristics in health-level feedback and disease prediction. However, the traditional production process of microfluidic patches relies on resource-intensive laboratory and high-cost facilities. In this paper, a low-cost laser-cutting technology is proposed to fabricate epidermal microfluidic patches for the collection, storage and colorimetric analysis of sweat. Two different types of capillary bursting valves are designed and integrated into microchannel layers to produce two-stage bursting pressure for the reliable routing of sweat into microreservoirs in sequential fashion, avoiding the mixing of old and new sweat. Additionally, an enzyme-based reagent is embedded into the microreservoirs to quantify the glucose level in sweat by using colorimetric methods, demonstrating a high detection sensitivity at the glucose concentration from 0.1 mM to 1 mM in sweat and an excellent anti-interference performance that prevents interference from substances probably existent in sweat. In vitro and on-body experiments demonstrate the validity of the low-cost, laser-cut epidermal microfluidic patch for the chronological analysis of sweat glucose concentration and its potential application in the monitoring of human physiological information.

Smartphone-based platforms implementing microfluidic detection with image-based artificial intelligence

The frequent outbreak of global infectious diseases has prompted the development of rapid and effective diagnostic tools for the early screening of potential patients in point-of-care testing scenarios. With advances in mobile computing power and microfluidic technology, the smartphone-based mobile health platform has drawn significant attention from researchers developing point-of-care testing devices that integrate microfluidic optical detection with artificial intelligence analysis. In this article, we summarize recent progress in these mobile health platforms, including the aspects of microfluidic chips, imaging modalities, supporting components, and the development of software algorithms. We document the application of mobile health platforms in terms of the detection objects, including molecules, viruses, cells, and parasites. Finally, we discuss the prospects for future development of mobile health platforms.

Moving toward smart biomedical sensing

The development of novel biomedical sensors as highly promising devices/tools in early diagnosis and therapy monitoring of many diseases and disorders has recently witnessed unprecedented growth; more and faster than ever. Nonetheless, on the eve of Industry 5.0 and by learning from defects of current sensors in smart diagnostics of pandemics, there is still a long way to go to achieve the ideal biomedical sensors capable of meeting the growing needs and expectations for smart biomedical/diagnostic sensing through eHealth systems. Herein, an overview is provided to highlight the importance and necessity of an inevitable transition in the era of digital health/Healthcare 4.0 towards smart biomedical/diagnostic sensing and how to approach it via new digital technologies including Internet of Things (IoT), artificial intelligence, IoT gateways (smartphones, readers), etc. This review will bring together the different types of smartphone/reader-based biomedical sensors, which have been employing for a wide variety of optical/electrical/electrochemical biosensing applications and paving the way for future eHealth diagnostic devices by moving towards smart biomedical sensing. Here, alongside highlighting the characteristics/criteria that should be met by the developed sensors towards smart biomedical sensing, the challenging issues ahead are delineated along with a comprehensive outlook on this extremely necessary field.

A Systematic Review on the Advanced Techniques of Wearable Point-of-Care Devices and Their Futuristic Applications

Personalized point-of-care testing (POCT) devices, such as wearable sensors, enable quick access to health monitoring without the use of complex instruments. Wearable sensors are gaining popularity owing to their ability to offer regular and continuous monitoring of physiological data by dynamic, non-invasive assessments of biomarkers in biofluids such as tear, sweat, interstitial fluid and saliva. Current advancements have concentrated on the development of optical and electrochemical wearable sensors as well as advances in non-invasive measurements of biomarkers such as metabolites, hormones and microbes. For enhanced wearability and ease of operation, microfluidic sampling, multiple sensing, and portable systems have been incorporated with materials that are flexible. Although wearable sensors show promise and improved dependability, they still require more knowledge about interaction between the target sample concentrations in blood and non-invasive biofluids. In this review, we have described the importance of wearable sensors for POCT, their design and types of these devices. Following which, we emphasize on the current breakthroughs in the application of wearable sensors in the realm of wearable integrated POCT devices. Lastly, we discuss the present obstacles and forthcoming potentials including the use of Internet of Things (IoT) for offering self-healthcare using wearable POCT.

Flexible Sweat Sensors: From Films to Textiles

Flexible sweat sensors have found widespread potential applications for long-term wear and tracking and real-time monitoring of human health. However, the main substrate currently used in common flexible sweat sensors is thin film, which has disadvantages such as poor air permeability and the need for additional wearables. In this Review, the recent progress of sweat sensors has been systematically summarized by the types of monitoring methods of sweat sensors. In addition, this Review introduces and compares the performance of sweat sensors based on thin film and textile substrates such as fiber/yarn. Finally, opportunities and suggestions for the development of flexible sweat sensors are presented by summarizing the integration methods of sensors and human body monitoring sites.

Novel Wearable Optical Sensors for Vital Health Monitoring Systems-A Review

Wearable sensors are pioneering devices to monitor health issues that allow the constant monitoring of physical and biological parameters. The immunity towards electromagnetic interference, miniaturization, detection of nano-volumes, integration with fiber, high sensitivity, low cost, usable in harsh environments and corrosion-resistant have made optical wearable sensor an emerging sensing technology in the recent year. This review presents the progress made in the development of novel wearable optical sensors for vital health monitoring systems. The details of different substrates, sensing platforms, and biofluids used for the detection of target molecules are discussed in detail. Wearable technologies could increase the quality of health monitoring systems at a nominal cost and enable continuous and early disease diagnosis. Various optical sensing principles, including surface-enhanced Raman scattering, colorimetric, fluorescence, plasmonic, photoplethysmography, and interferometric-based sensors, are discussed in detail for health monitoring applications. The performance of optical wearable sensors utilizing two-dimensional materials is also discussed. Future challenges associated with the development of optical wearable sensors for point-of-care applications and clinical diagnosis have been thoroughly discussed.

Microfluidic systems in clinical diagnosis

The use of microfluidic devices is highly attractive in the field of biomedical and clinical assessments, as their portability and fast response time have become crucial in providing opportune therapeutic treatments to patients. The applications of microfluidics in clinical diagnosis and point-of-care devices are continuously growing. The present review article discusses three main fields where miniaturized devices are successfully employed in clinical applications. The quantification of ions, sugars, and small metabolites is examined considering the analysis of bodily fluids samples and the quantification of this type of analytes employing real-time wearable devices. The discussion covers the level of maturity that the devices have reached as well as cost-effectiveness. The analysis of proteins with clinical relevance is presented and organized by the function of the proteins. The last section covers devices that can perform single-cell metabolomic and proteomic assessments. Each section discusses several strategically selected recent reports on microfluidic devices successfully employed for clinical assessments, to provide the reader with a wide overview of the plethora of novel systems and microdevices developed in the last 5 years. In each section, the novel aspects and main contributions of each reviewed report are highlighted. Finally, the conclusions and future outlook section present a summary and speculate on the future direction of the field of miniaturized devices for clinical applications.

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.

Microfluidic assessment of nutritional biomarkers: Concepts, approaches and advances

Among various approaches to understand the health status of an individual, nutritional biomarkers can provide valuable information, particularly in terms of deficiencies, if any, and their severity. Commonly, the approach revolves around molecular sciences, and the information gained can support prognosis, diagnosis, remediation, and impact assessment of therapies. Microfluidic platforms can offer benefits of low sample and reagent requirements, low cost, high precision, and lower detection limits, with simplicity in handling and the provision for complete automation and integration with information and communication technologies (ICTs). While several advances are being made, this work details the underlying concepts, with emphasis on different point-of-care devices for the analysis of macro and micronutrient biomarkers. In addition, the scope of using different wearable microfluidic sensors for real-time and noninvasive determination of biomarkers is detailed. While several challenges remain, a strong focus is given on recent advances, presenting the state-of-the-art of this field. With more such biomarkers being discovered and commercialization-driven research, trends indicate the wide prospects of this advancing field in supporting clinicians, food technologists, nutritionists, and others.

Ultrapermeable and Wet-Adhesive Monolayer Porous Film for Stretchable Epidermal Electrode

Noninvasive electrophysiological signal monitoring is significant for health care and scientific research. The simultaneous achievement of wet adhesion, stretchability, breathability, and low contact impedance is highly recommended in the epidermal electrode but still challenging. In this work, a monolayer porous film electrode with a pore size and wall thickness of less than ∼10 μm is fabricated via the breath figure method (BFM) and metal sputtering, and it was subsequently applied using epidermal electrophysiological monitoring. The ultrahigh permeability is comparable to the naked skin because the through holes of the monolayer porous film match well with the pores on human skin. The stretchability of 50% is realized with the combination of Au microcrack and the monolayer porous structure. The wet adhesion of 0.17 N/cm is established on the chemical bonding between the electrode and the epidermis. The contact impedance is comparable with the gold standard Ag/AgCl gel electrode, especially after sweating. Stable and precise electrophysiological signals are measured. Especially, the perspiration resistance of the monolayer porous film outperforms that of the gel electrode. The monolayer porous structure provides a new avenue to improve the breathability of the epidermal electronics.

Wearable chemical sensors for biomarker discovery in the omics era

Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.

A Soft Wearable Microfluidic Patch with Finger-Actuated Pumps and Valves for On-Demand, Longitudinal, and Multianalyte Sweat Sensing

Easy sample collection, physiological relevance, and ability to noninvasively and longitudinally monitor the human body are some of the key attributes of wearable sweat sensors. Examples typically include reversible sensors or an array of single-use sensors embedded in specialized microfluidics for temporal analysis of sweat. However, evolving this field to a level that truly represents "lab-on-skin" technology will require the incorporation of advanced functionalities that give the user the freedom to (1) choose the precise time for performing sample analysis and (2) select sensors from an array embedded within the device for performing condition-specific sample analysis. Here, we introduce new concepts in wearable microfluidic platforms that offer such capabilities. The described technology involves a series of finger-actuated pumps, valves, and sensors incorporated within soft, wearable microfluidics. The incoming sweat collects in the inlet chamber and can be analyzed by the user at the time of their choosing. On-demand sweat analyte assessment is achieved by pulling a thin tab to activate a pump which opens a valve and allows the pooled sweat to enter a chamber embedded with sensors for the desired analytes. The article describes a thorough characterization of the platform that demonstrates the robustness of the pumping, valving, and sensing aspects of the device under conditions mimicking real-life scenarios. A two-day-long human pilot study validates the system and illustrates the device's ability to offer on-demand, longitudinal, and multianalyte sensing. Our work represents the first example of a wearable system with such on-demand sensing capabilities and opens exciting avenues in sweat sensing for acquiring new insights into human physiology.

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

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

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

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

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.

Microfluidic wearable electrochemical sweat sensors for health monitoring

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

Simple, Skin-Attachable, and Multifunctional Colorimetric Sweat Sensor

In situ analysis of sweat provides a simple, convenient, cost-effective, and noninvasive approach for the early diagnosis of physical illness in humans and is particularly useful in family care. In this study, a flexible and skin-attachable colorimetric sweat sensor for multiplexed analysis is developed using a simple, cost-effective, and convenient method. The obtained sweat sensor can be used to simultaneously detect glucose, lactate, urea, and pH value in sweat, as well as sweat loss and skin temperature. Only 2.5 μL of sweat is enough for the whole test, and the sweat loss and chemical-sensing results can be read out conveniently by naked eyes or a smartphone. In addition, body temperature can also be detected with an additional electrical circuit. Our sweat sensor provides a new, cost-effective, and convenient approach for in vitro diagnosis of multiple components in sweat, and the easy fabrication and cost-effectiveness make our sensor commercializable in the near future.

Wearable SERS Sensor Based on Omnidirectional Plasmonic Nanovoids Array with Ultra-High Sensitivity and Stability

Surface-enhanced Raman spectroscopy (SERS) is a promising technology for wearable sensors due to its fingerprint spectrum and high detection sensitivity. However, since SERS-activity is sensitive to both the distribution of "hotspots" and excitation angle, it is profoundly challenging to develop a wearable SERS sensor with high stability under various deformations during movements. Herein, inspired by omnidirectional light-harvesting of the compound eye of Xenos Peckii, a wearable SERS sensor is developed using omnidirectional plasmonic nanovoids array (OPNA), which is prepared by assembling a monolayer of metal nanoparticles into the artificial plasmonic compound-eye (APC). Specifically, APC is an interconnected frame containing omnidirectional "pockets" and acts as an "armour", not only rendering a broadband and omnidirectional enhancement of "hotspots" in the delicate nanoparticles array, but also maintaining an integrity of the "hotspots" against external mechanical deformations. Furthermore, an asymmetry super-hydrophilic pattern is fabricated on the surface of OPNA, endowing the hydrophobic OPNA with the ability to spontaneously extract and concentrate the analytes from sweat. Such an armored SERS sensor can enable the wearable and in situ analysis with high sensitivity and stability, exhibiting great potential in point-of-care analysis.

Wearable biosensors for human fatigue diagnosis: A review

Fatigue causes deleterious effects to physical and mental health of human being and may cause loss of lives. Therefore, the adverse effects of fatigue on individuals and the society are massive. With the ever-increasing frequency of overtraining among modern military and sports personnel, timely, portable and accurate fatigue diagnosis is essential to avoid fatigue-induced accidents. However, traditional detection methods require complex sample preparation and blood sampling processes, which cannot meet the timeliness and portability of fatigue diagnosis. With the development of flexible materials and biosensing technology, wearable biosensors have attracted increased attention to the researchers. Wearable biosensors collect biomarkers from noninvasive biofluids, such as sweat, saliva, and tears, followed by biosensing with the help of biosensing modules continuously and quantitatively. The detection signal can then be transmitted through wireless communication modules that constitute a method for real-time understanding of abnormality. Recent developments of wearable biosensors are focused on miniaturized wearable electrochemistry and optical biosensors for metabolites detection, of which, few have exhibited satisfactory results in medical diagnosis. However, detection performance limits the wide-range applicability of wearable fatigue diagnosis. In this article, the application of wearable biosensors in fatigue diagnosis has been discussed. In fact, exploration of the composition of different biofluids and their potential toward fatigue diagnosis have been discussed here for the very first time. Moreover, discussions regarding the current bottlenecks in wearable fatigue biosensors and the latest advancements in biochemical reaction and data communication modules have been incorporated herein. Finally, the main challenges and opportunities were discussed for wearable fatigue diagnosis in the future.

A Review on Flexible Electrochemical Biosensors to Monitor Alcohol in Sweat

The continued focus on improving the quality of human life has encouraged the development of increasingly efficient, durable, and cost-effective products in healthcare. Over the last decade, there has been substantial development in the field of technical and interactive textiles that combine expertise in electronics, biology, chemistry, and physics. Most recently, the creation of textile biosensors capable of quantifying biometric data in biological fluids is being studied, to detect a specific disease or the physical condition of an individual. The ultimate goal is to provide access to medical diagnosis anytime and anywhere. Presently, alcohol is considered the most commonly used addictive substance worldwide, being one of the main causes of death in road accidents. Thus, it is important to think of solutions capable of minimizing this public health problem. Alcohol biosensors constitute an excellent tool to aid at improving road safety. Hence, this review explores concepts about alcohol biomarkers, the composition of human sweat and the correlation between alcohol and blood. Different components and requirements of a biosensor are reviewed, along with the electrochemical techniques to evaluate its performance, in addition to construction techniques of textile-based biosensors. Special attention is given to the determination of biomarkers that must be low cost and fast, so the use of biomimetic materials to recognize and detect the target analyte is turning into an attractive option to improve electrochemical behavior.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

Flexible Electronics and Devices as Human-Machine Interfaces for Medical Robotics

Medical robots are invaluable players in non-pharmaceutical treatment of disabilities. Particularly, using prosthetic and rehabilitation devices with human-machine interfaces can greatly improve the quality of life for impaired patients. In recent years, flexible electronic interfaces and soft robotics have attracted tremendous attention in this field due to their high biocompatibility, functionality, conformability, and low-cost. Flexible human-machine interfaces on soft robotics will make a promising alternative to conventional rigid devices, which can potentially revolutionize the paradigm and future direction of medical robotics in terms of rehabilitation feedback and user experience. In this review, the fundamental components of the materials, structures, and mechanisms in flexible human-machine interfaces are summarized by recent and renowned applications in five primary areas: physical and chemical sensing, physiological recording, information processing and communication, soft robotic actuation, and feedback stimulation. This review further concludes by discussing the outlook and current challenges of these technologies as a human-machine interface in medical robotics.

Smartphone-Based Biosensor Devices for Healthcare: Technologies, Trends, and Adoption by End-Users

Smart biosensors are becoming an important support for modern healthcare, even more so in the current context. Numerous smartphone-based biosensor developments were published in recent years, some highly effective and sensitive. However, when patents and patent applications related to smart biosensors for healthcare applications are analyzed, it is surprising to note that, after significant growth in the first half of the decade, the number of applications filed has decreased considerably in recent years. There can be many causes of this effect. In this review, we present the state of the art of different types of smartphone-based biosensors, considering their stages of development. In the second part, a critical analysis of the possible reasons why many technologies do not reach the market is presented. Both technical and end-user adoption limitations were addressed. It was observed that smart biosensors on the commercial stage are still scarce despite the great evolution that these technologies have experienced, which shows the need to strengthen the stages of transfer, application, and adoption of technologies by end-users.

Microscopic Imaging Methods for Organ-on-a-Chip Platforms

Microscopic imaging is essential and the most popular method for in situ monitoring and evaluating the outcome of various organ-on-a-chip (OOC) platforms, including the number and morphology of mammalian cells, gene expression, protein secretions, etc. This review presents an overview of how various imaging methods can be used to image organ-on-a-chip platforms, including transillumination imaging (including brightfield, phase-contrast, and holographic optofluidic imaging), fluorescence imaging (including confocal fluorescence and light-sheet fluorescence imaging), and smartphone-based imaging (including microscope attachment-based, quantitative phase, and lens-free imaging). While various microscopic imaging methods have been demonstrated for conventional microfluidic devices, a relatively small number of microscopic imaging methods have been demonstrated for OOC platforms. Some methods have rarely been used to image OOCs. Specific requirements for imaging OOCs will be discussed in comparison to the conventional microfluidic devices and future directions will be introduced in this review.