Toward portable breath acetone analysis for diabetes detection

Breath biomarkers in Non-Carcinogenic diseases

The analysis of volatile organic compounds (VOCs) from human matrices like breath, perspiration, and urine has received increasing attention from academic and medical researchers worldwide. These biological-borne VOCs molecules have characteristics that can be directly related to physiologic and pathophysiologic metabolic processes. In this work, gathers a total of 292 analytes that have been identified as potential biomarkers for the diagnosis of various non-carcinogenic diseases. Herein we review the advances in VOCs with a focus on breath biomarkers and their potential role as minimally invasive tools to improve diagnosis prognosis and therapeutic monitoring.

Breath-based biosensors and system development for noninvasive detection of diabetes: A review

BACKGROUND AND AIMS

In recent years, noninvasive techniques are becoming conspicuous for diabetes detection. Sweat, tear, saliva, urine and breath-based methods showing prominent results in breath acetone detection which is considered as a biomarker of diabetes. A concrete relationship between breath acetone and BG helps in the development of devices for diabetes detection.

METHODS

The primary source for this study includes scholarly publications that primarily focus on the development of biosensors and systems for diabetes detection using acetone present in breath. Articles were analysed to examine various types of biosensors with their sensing materials to provide acetone detection limits. Recent noninvasive systems and products have been investigated and determine the relationship between breath acetone and BG levels.

RESULTS

Breath-based biosensor technologies are capable for diabetes detection. The acetone biosensor detection ranges from 100 ppb to 100 ppm, and it can applicable from room temperature to 400 °C. In healthy volunteers, acetone level ranges from 0.32 to 2.19 ppm, while patients with diabetes exhibit a wider range of 0.22-21 ppm depending on the biosensor, detection method, and clinical circumstances of patients and lab conditions.

CONCLUSION

This manuscript presents an extensive analysis of breath-based biosensors and their potential for detection of diabetes. Acetone detection methods are promising but unable to provide concrete correlation between breath acetone and blood glucose levels. The present study motivates the continued research and development of biosensors, and electronic devices to provide linear relationship of breath acetone and BG for noninvasive diabetes detection applications.

Sensors Based on Tin and Indium Oxides for the Determination of Acetone in Human Breath

The properties of planar sensors based on tin dioxide and indium oxide used for the determination of acetone vapors have been studied. Sensors based on synthesized SnO2 and In2O3 nanopowders showed high sensitivity to low concentrations of acetone in a humid environment which simulates human exhalation. The addition of a small amount of AuIII ions to hydroxide sols significantly increases the threshold sensitivity and the sensor response in a wide range of acetone concentrations. In2O3-Au sensors have the maximum sensitivity at an operating temperature of 325 °C. The In2O3-Au-sensors reliably record the change in acetone concentration in the concentration range from a minimum of 0.1 to 5 ppm with high accuracy, which is necessary for rapid diagnostics of the condition of patients with diabetes (1.8-5.0 ppm). The high sensitivity of the obtained sensors is explained by the structural features and the surface conditions of oxides and gold nanoparticles, which depend on the sample synthesis conditions.

Larger-Than-Unity External Optical Field Confinement Enabled by Metamaterial-Assisted Comb Waveguide for Ultrasensitive Long-Wave Infrared Gas Spectroscopy

Nanophotonic waveguides that implement long optical pathlengths on chips are promising to enable chip-scale gas sensors. Nevertheless, current absorption-based waveguide sensors suffer from weak interactions with analytes, limiting their adoptions in most demanding applications such as exhaled breath analysis and trace-gas monitoring. Here, we propose an all-dielectric metamaterial-assisted comb (ADMAC) waveguide to greatly boost the sensing capability. By leveraging large longitudinal electric field discontinuity at periodic high-index-contrast interfaces in the subwavelength grating metamaterial and its unique features in refractive index engineering, the ADMAC waveguide features strong field delocalization into the air, pushing the external optical field confinement factor up to 113% with low propagation loss. Our sensor operates in the important but underdeveloped long-wave infrared spectral region, where absorption fingerprints of plentiful chemical bonds are located. Acetone absorption spectroscopy is demonstrated using our sensor around 7.33 μm, showing a detection limit of 2.5 ppm with a waveguide length of only 10 mm.

Detection of volatile organic compounds using mid-infrared silicon nitride waveguide sensors

Mid-infrared (mid-IR) sensors consisting of silicon nitride (SiN) waveguides were designed and tested to detect volatile organic compounds (VOCs). SiN thin films, prepared by low-pressure chemical vapor deposition (LPCVD), have a broad mid-IR transparent region and a lower refractive index (n_SiN = 2.0) than conventional materials such as Si (n_Si = 3.4), which leads to a stronger evanescent wave and therefore higher sensitivity, as confirmed by a finite-difference eigenmode (FDE) calculation. Further, in-situ monitoring of three VOCs (acetone, ethanol, and isoprene) was experimentally demonstrated through characteristic absorption measurements at wavelengths λ = 3.0–3.6 μm. The SiN waveguide showed a five-fold sensitivity improvement over the Si waveguide due to its stronger evanescent field. To our knowledge, this is the first time SiN waveguides are used to perform on-chip mid-IR spectral measurements for VOC detection. Thus, the developed waveguide sensor has the potential to be used as a compact device module capable of monitoring multiple gaseous analytes for health, agricultural and environmental applications.

Acetone Sensor Based on FAIMS-MEMS

In this paper, to address the problems of large blood draws, long testing times, and the inability to achieve dynamic detection of invasive testing for diabetes, stemming from the principle that type 1 diabetic patients exhale significantly higher levels of acetone than normal people, a FAIMS-MEMS gas sensor was designed to detect acetone, which utilizes the characteristics of high sensitivity, fast response, and non-invasive operation. It is prepared by MEMS processes, such as photolithography, etching, and sputtering, its specific dimensions are 4000 μm in length, 3000 μm in width and 800 μm in height and the related test system was built to detect acetone gas. The test results show that when acetone below 0.8 ppm is introduced, the voltage value detected by the sensor basically does not change, while when acetone gas exceeds 1.8 ppm, the voltage value detected by the sensor increases significantly. The detection accuracy of the sensor prepared by this method is about 0.02 ppm/mV, and the voltage change can reach 1 V with a response time of 3 s and a recovery time of 4 s when tested under 20 ppm acetone environment; this has good repeatability and stability, and has great prospects in the field of non-invasive detection of type 1 diabetes.

TiO2/Cu2O/CuO Multi-Nanolayers as Sensors for H2 and Volatile Organic Compounds: An Experimental and Theoretical Investigation

TiO₂/Cu₂O/CuO multi-nanolayers highly sensitive toward volatile organic compounds (VOCs) and H₂ have been grown in various thicknesses by a cost-effective and reproducible combined spray-sputtering-annealing approach. The ultrathin TiO₂ films were deposited by spray pyrolysis on top of sputtered-annealed Cu₂O/CuO nanolayers to enhance their gas sensing performance and improve their protection against corrosion at high operating temperatures. The prepared heterostructures were investigated using scanning electron microscopy (SEM), X-ray diffraction (XRD), and ultraviolet visible (UV-vis) and micro-Raman spectroscopy. The gas sensing properties were measured at several operating temperatures, where the nanolayered sensors with oxide thicknesses between 20 and 30 nm (Cu₂O/CuO nanolayers) exhibited a high response and an excellent selectivity to ethanol vapor after thermal annealing the samples at 420 °C. The results obtained at an operating temperature of 350 °C demonstrate that the CuO/Cu₂O nanolayers with thicknesses between 20 and 30 nm are sensitive mainly to ethanol vapor, with a response of ∼150. The response changes from ethanol vapors to hydrogen gas as the thickness of the CuO/Cu₂O nanolayers changes from 50 to 20 nm. Density functional theory-based calculations were carried out for the geometries of the CuO(1̅11)/Cu₂O(111) and TiO₂(111)/CuO(1̅11)/Cu₂O(111) heterostructures and their sensing mechanism toward alcohols of different chain lengths and molecular hydrogen. The reconstructed hexagonal Cu₂O(111) surface and the reconstructed monoclinic CuO(1̅11) and TiO₂(111) facets, all of which terminate in an O layer, lead to the lowest surface energies for each isolated material. We studied the formation of the binary and ternary heteroepitaxial interfaces for the surface planes with the best-matching lattices. Despite the impact of the Cu₂O(111) substrate in lowering the atomic charges of the CuO(1̅11) adlayer in the binary sensor, we found that it is the different surface structures of the CuO(1̅11)/Cu₂O(111) and TiO₂(111)/CuO(1̅11)/Cu₂O(111) devices that are fundamental in driving the change in the sensitivity response observed experimentally. The experimental data, supported by the computational results, are important in understanding the use of the multi-nanolayered films tested in this work as reliable, accurate, and selective sensor structures for the tracking of gases at low concentrations.

Pd-Doping-Induced Oxygen Vacancies in One-Dimensional Tungsten Oxide Nanowires for Enhanced Acetone Gas Sensing

Metal oxide semiconductors (MOS) with different nanostructures have been widely used as gas sensing materials due to the tunable interface structures and properties. However, further improvement of the sensing sensitivity and selectivity is still challenging in this area. Constructing appropriate heterogeneous interface structures and oxygen vacancies is one of the important strategies to tune the sensing properties of MOS. In the present study, interfacial heterostructures in Pd_xW₁₈O₄₉ nanowires (Pd_xW₁₈O₄₉ NWs) were fabricated and manipulated by doping different Pd contents through a simple hydrothermal process. Relevant characterization proved that the structure and composition of the one-dimensional (1D) nanomaterial can be effectively changed by Pd doping. It was found that the oxygen vacancy concentration increases first with the increase of Pd content, and when the Pd content increases to 7.18% (Pd_7.18%W₁₈O₄₉ NWs), the oxygen vacancy content reaches the maximum (52.5%). If the Pd content continues to increase, the oxygen vacancy ratio decreases. The gas sensing investigations illustrated that the Pd_xW₁₈O₄₉ NWs exhibited enhanced sensing properties than pure W₁₈O₄₉ NWs toward acetone. Among the as-prepared catalysts, the Pd_7.18%W₁₈O₄₉ NWs showed the best sensing response and the fastest response-recovery speeds (5 and 10 s, respectively) at a working temperature of 175 °C. In addition, this 1D nanostructure with fabricated heterostructures also delivers a good sensing selectivity and a wide detection range from 100 ppb to 300 ppm, with maintaining excellent performance in the presence of high concentrations of ethanol and carbon dioxide. The excellent gas sensing behavior could be attributed to the generated oxygen vacancies and the heterostructures upon Pd doping. This study offers a novel strategy for the design of high-performance gas sensors for ppb-level acetone sensing.

Mitigation of Humidity Interference in Colorimetric Sensing of Gases

Colorimetric sensing technologies have been widely used for both quantitative detection of specific analyte and recognition of a large set of analytes in gas phase, ranging from environmental chemicals to biomarkers in breath. However, the accuracy and reliability of the colorimetric gas sensors are threatened by the humidity interference in different application scenarios. Though substantial progress has been made toward new colorimetric sensors development, unless the humidity interference is well addressed, the colorimetric sensors cannot be deployed for real-world applications. Although there are comprehensive and insightful review articles about the colorimetric gas sensors, they have focused more on the progress in new sensing materials, new sensing systems, and new applications. There is a need for reviewing the works that have been done to solve the humidity issue, a challenge that the colorimetric gas sensors commonly face. In this review paper, we analyzed the mechanisms of the humidity interference and discussed the approaches that have been reported to mitigate the humidity interference in colorimetric sensing of environmental gases and breath biomarkers. Finally, the future perspectives of colorimetric sensing technologies are also discussed.

Investigation of Acetone Vapour Sensing Properties of a Ternary Composite of Doped Polyaniline, Reduced Graphene Oxide and Chitosan Using Surface Plasmon Resonance Biosensor

This work reports the use of a ternary composite that integrates p-Toluene sulfonic acid doped polyaniline (PANI), chitosan, and reduced graphene oxide (RGO) as the active sensing layer of a surface plasmon resonance (SPR) sensor. The SPR sensor is intended for application in the non-invasive monitoring and screening of diabetes through the detection of low concentrations of acetone vapour of less than or equal to 5 ppm, which falls within the range of breath acetone concentration in diabetic patients. The ternary composite film was spin-coated on a 50-nm-thick gold layer at 6000 rpm for 30 s. The structure, morphology and chemical composition of the ternary composite samples were characterized by FTIR, UV-VIS, FESEM, EDX, AFM, XPS, and TGA and the response to acetone vapour at different concentrations in the range of 0.5 ppm to 5 ppm was measured at room temperature using SPR technique. The ternary composite-based SPR sensor showed good sensitivity and linearity towards acetone vapour in the range considered. It was determined that the sensor could detect acetone vapour down to 0.88 ppb with a sensitivity of 0.69 degree/ppm with a linearity correlation coefficient of 0.997 in the average SPR angular shift as a function of the acetone vapour concentration in air. The selectivity, repeatability, reversibility, and stability of the sensor were also studied. The acetone response was 87%, 94%, and 99% higher compared to common interfering volatile organic compounds such as propanol, methanol, and ethanol, respectively. The attained lowest detection limit (LOD) of 0.88 ppb confirms the potential for the utilisation of the sensor in the non-invasive monitoring and screening of diabetes.

Catalytic Activation of Cobalt Doping Sites in ZIF-71-Coated ZnO Nanorod Arrays for Enhancing Gas-Sensing Performance to Acetone

Developing acetone gas sensors with high sensitivity is crucially important for many applications including nonevasive diagnosis of diabetes. In the present work, cobalt doping is used to catalyze acetone gas-sensing reactions and hence to promote the sensitivity of acetone gas sensors. In order to achieve this, ZIF-71 metal-organic framework (MOF) is synthesized onto ZnO nanorod arrays with various concentrations of Co doping to form composite ZnO@ZIF-71(Co) sensors, which are then evaluated as sensing materials for acetone detection. Such sensors are shown to be sensitive to a trace amount of acetone (50 ppb) and have a massively enhanced response of about 100 times that for the undoped sensor at an optimal Co/Zn ratio and operating temperature. Fourier-transform infrared spectroscopy and temperature-programmed desorption with density functional theory calculations are also made to assist in elucidating the catalytic gas-sensing mechanism for the Co-doped composite sensors ZnO@ZIF-71(Co). It demonstrated that the introduced Co site in ZIF-71(Co) can activate oxygen catalytically and increase active oxygen released to the ZnO surface. Meanwhile, the Co sites also promote the decomposition of acetone. These two steps together affect the catalytic oxidation of gases and finally enhance the sensitivity. This work introduces the catalytic effect of the MOF into the gas-sensing mechanism and provides an idea for broadening the application of MOF catalysis.

Swelling of Poly(methyl acrylate) Brushes in Acetone Vapor

Sensor platforms can benefit from the incorporation of polymer brushes since brushes can concentrate the analyte near the sensor surface. Brushes that absorb acetone vapor are of particular interest since acetone is an important marker for biological processes. We present a simple procedure to synthesize acetone-responsive poly(methyl acrylate) brushes. Using spectroscopic ellipsometry, we show that these brushes respond within seconds and swell by more than 30% when exposed to acetone vapor. Moreover, quartz crystal microbalance measurements demonstrate that the brushes can be exploited to increase the acetone detection sensitivity of sensors by more than a factor 6. Surprisingly, we find that the swelling ratio of the brushes in acetone vapor is independent of the grafting density and the degree of polymerization of the polymers in the brush. This is qualitatively different from swelling of the same brushes in liquid environments, where the swelling ratio decreases for increasing grafting densities. Yet, it indicates that the brushes are robust and reproducible candidates for implementation in vapor sensor systems.

Breakthroughs in the Design of Novel Carbon-Based Metal Oxides Nanocomposites for VOCs Gas Sensing

Nowadays, the detection of volatile organic compounds (VOCs) at trace levels (down to ppb) is feasible by exploiting ultra-sensitive and highly selective chemoresistors, especially in the field of medical diagnosis. By coupling metal oxide semiconductors (MOS e.g., SnO₂, ZnO, WO₃, CuO, TiO₂ and Fe₂O₃) with innovative carbon-based materials (graphene, graphene oxide, reduced graphene oxide, single-wall and multi-wall carbon nanotubes), outstanding performances in terms of sensitivity, selectivity, limits of detection, response and recovery times towards specific gaseous targets (such as ethanol, acetone, formaldehyde and aromatic compounds) can be easily achieved. Notably, carbonaceous species, highly interconnected to MOS nanoparticles, enhance the sensor responses by (i) increasing the surface area and the pore content, (ii) favoring the electron migration, the transfer efficiency (spillover effect) and gas diffusion rate, (iii) promoting the active sites concomitantly limiting the nanopowders agglomeration; and (iv) forming nano-heterojunctions. Herein, the aim of the present review is to highlight the above-mentioned hybrid features in order to engineer novel flexible, miniaturized and low working temperature sensors, able to detect specific VOC biomarkers of a human's disease.

Nanostructured Metal Oxide-Based Acetone Gas Sensors: A Review

Acetone is a well-known volatile organic compound that is widely used in different industrial and domestic areas. However, it can have dangerous effects on human life and health. Thus, the realization of sensitive and selective sensors for recognition of acetone is highly important. Among different gas sensors, resistive gas sensors based on nanostructured metal oxide with high surface area, have been widely reported for successful detection of acetone gas, owing to their high sensitivity, fast dynamics, high stability, and low price. Herein, we discuss different aspects of metal oxide-based acetone gas sensors in pristine, composite, doped, and noble metal functionalized forms. Gas sensing mechanisms are also discussed. This review is an informative document for those who are working in the field of gas sensors.

Light-activated inorganic CsPbBr2I perovskite for room-temperature self-powered chemical sensing

Halide perovskite materials are excellent light harvesters that have generated enormous interest for photovoltaic technology and an increasing number of other optoelectronic applications. Very recently, their use for miniaturized chemical sensors has shown a promising room-temperature response. Here, we present some insights on the use of CsPbBr2I (CPBI) perovskites for self-powered room-temperature sensing of several environmentally and medically relevant compounds demonstrating rapid detection of down to concentrations of 1 ppm. Notably, the photocurrent of these self-powered CPBI-based devices increases under exposure to both reducing (e.g. acetone, propane) and oxidizing (e.g. NO2, O2) gas molecules and decreases rapidly upon reverting to an inert atmosphere. In situ photoluminescence (PL) analysis of the CPBI during exposure to oxidizing molecules reveals a strongly increased PL intensity and longer lifetime indicating a prevalent role of CPBI trap states in the sensing mechanism. These findings provide new insights for the engineering of perovskite-based materials for their future chemical sensing applications.

Humidity-Independent Gas Sensors Using Pr-Doped In2O3 Macroporous Spheres: Role of Cyclic Pr3+/Pr4+ Redox Reactions in Suppression of Water-Poisoning Effect

Pure and 3-12 at. % Pr-doped In₂O₃ macroporous spheres were fabricated by ultrasonic spray pyrolysis and their acetone-sensing characteristics under dry and humid conditions were investigated to design humidity-independent gas sensors. The 12 at. % Pr-doped In₂O₃ sensor exhibited approximately the same acetone responses and sensor resistances at 450 °C regardless of the humidity variation, whereas the pure In₂O₃ exhibited significant deterioration in gas-sensing characteristics upon the change in the atmosphere, from dry to humid (relative humidity: 80%). Moreover, the 12 at. % Pr-doped In₂O₃ sensor exhibited a high response to acetone with negligible cross responses to interfering gases (NH₃, CO, benzene, toluene, NO₂, and H₂) under the highly humid atmosphere. The mechanism for the humidity-immune gas-sensing characteristics was investigated by X-ray photoelectron and diffuse reflectance infrared Fourier transform spectroscopies together with the phenomenological gas-sensing results and discussed in relation with Pr³⁺/Pr⁴⁺ redox pairs, regenerative oxygen adsorption, and scavenging of hydroxyl groups.

3D-Printed Chemiresistive Sensor Array on Nanowire CuO/Cu2O/Cu Heterojunction Nets

In this work, the one-step three-dimensional (3D) printing of 20 nm nanowire (NW)-covered CuO/Cu₂O/Cu microparticles (MPs) with diameters of 15-25 μm on the surface of the glass substrate forming an ordered net is successfully reported for the first time. 3D-printed Cu MP-based stripes formed nonplanar CuO/Cu₂O/Cu heterojunctions after thermal annealing at 425 °C for 2 h in air and were fully covered with a 20 nm NW net bridging MPs with external Au contacts. The morphological, vibrational, chemical, and structural investigations were performed in detail, showing the high crystallinity of the NWs and 3D-printed CuO/Cu₂O/Cu heterojunction lines, as well as the growth of CuO NWs on the surface of MPs. The gas-sensing measurements showed excellent selectivity to acetone vapor at an operating temperature of 350 °C with a high gas response about 150% to 100 ppm. The combination of the possibility of fast acetone vapor detection, low power consumption, and controllable size and geometry makes these 3D-printed devices ideal candidates for fast detection, as well as for acetone vapor monitoring (down to 100 ppm). This 3D-printing approach will pave a new way for many different devices through the simplicity and versatility of the fabrication method for the exact detection of acetone vapors in various atmospheres.

A comparison of online and offline measurement of exhaled breath for diabetes pre-screening by graphene-based sensor; from powder processing to clinical monitoring prototype

Several breath analysis studies have suggested a correlation between blood glucose (BG) levels and breath acetone, indicating acetone as a primary biomarker in exhaled breath for diabetes diagnosis. Herein, we have (i) fabricated and validated graphene-based chemi-resistive sensors for selective and sensitive detection of acetone, (ii) performed offline breath analysis by a static gas sensing set-up to acquire olfactory signals, and (iii) developed an LED-based portable on/off binary e-nose system for pre-screening diabetes through online analysis. The fabricated sensors showed selective detection for acetone with high sensitivity (5.66 for 1 ppm acetone vapor) and fast response and recovery times (10 s and 12 s) at low concentrations. The sensor responses of end tidal fractional breath (collected in Tedlar bags) in the fasting and postprandial conditions were compared with BG levels and glycated hemoglobin (HbA1c) levels taken at the same time in 30 volunteers (13 healthy and 17 diabetic subjects). The mean sensor responses of the diabetic subjects as obtained by offline analysis were 1.1 times higher than those of the healthy subjects. The optimal regression equation framed with the significant correlating variables for HbA1c estimation achieved an accuracy of 66.67%. The online breath analysis by on/off binary prototype exhibited an accuracy of 60.51%. Though there exists a minimal uncertainty in classification, the on/off type portable prototype is easy to operate, gives a quicker response with a refresh/recovery rate of 19 s and can be used for preliminary diagnosis, and can be used for preliminary diagnosis. This inexpensive sensor technology may revolutionize personalized medicine in the near future and greatly benefit the underprivileged.

Nanostructured Chemiresistive Gas Sensors for Medical Applications

Treating diseases at their earliest stages significantly increases the chance of survival while decreasing the cost of treatment. Therefore, compared to traditional blood testing methods it is the goal of medical diagnostics to deliver a technique that can rapidly predict and if required non-invasively monitor illnesses such as lung cancer, diabetes, melanoma and breast cancer at their very earliest stages, when the chance of recovery is significantly higher. To date human breath analysis is a promising candidate for fulfilling this need. Here, we highlight the latest key achievements on nanostructured chemiresistive sensors for disease diagnosis by human breath with focus on the multi-scale engineering of both composition and nano-micro scale morphology. We critically assess and compare state-of-the-art devices with the intention to provide direction for the next generation of chemiresistive nanostructured sensors.

Synergy between nanomaterials and volatile organic compounds for non-invasive medical evaluation

This article is an overview of the present and ongoing developments in the field of nanomaterial-based sensors for enabling fast, relatively inexpensive and minimally (or non-) invasive diagnostics of health conditions with follow-up by detecting volatile organic compounds (VOCs) excreted from one or combination of human body fluids and tissues (e.g., blood, urine, breath, skin). Part of the review provides a didactic examination of the concepts and approaches related to emerging sensing materials and transduction techniques linked with the VOC-based non-invasive medical evaluations. We also present and discuss diverse characteristics of these innovative sensors, such as their mode of operation, sensitivity, selectivity and response time, as well as the major approaches proposed for enhancing their ability as hybrid sensors to afford multidimensional sensing and information-based sensing. The other parts of the review give an updated compilation of the past and currently available VOC-based sensors for disease diagnostics. This compilation summarizes all VOCs identified in relation to sickness and sampling origin that links these data with advanced nanomaterial-based sensing technologies. Both strength and pitfalls are discussed and criticized, particularly from the perspective of the information and communication era. Further ideas regarding improvement of sensors, sensor arrays, sensing devices and the proposed workflow are also included.

CNT Foam-Embedded Micro Gas Preconcentrator for Low-Concentration Ethane Measurements

Breath analysis has become increasingly important as a noninvasive process for the clinical diagnosis of patients suffering from various diseases. Many commercial gas preconcentration instruments are already being used to overcome the detection limits of commercial gas sensors for gas concentrations which are as low as ~100 ppb in exhaled breath. However, commercial instruments are large and expensive, and they require high power consumption and intensive maintenance. In the proposed study, a micro gas preconcentrator (μ-PC) filled with a carbon nanotube (CNT) foam as an adsorbing material was designed and fabricated for the detection of low-concentration ethane, which is known to be one of the most important biomarkers related to chronic obstructive pulmonary disease (COPD) and asthma. A comparison of the performance of two gas-adsorbing materials, i.e., the proposed CNT foam and commercial adsorbing material, was performed using the developed μ-PC. The experimental results showed that the synthesized CNT foam performs better than a commercial adsorbing material owing to its lower pressure drop and greater preconcentration efficiency in the μ-PC. The present results show that the application of CNT foam-embedded μ-PC in portable breath analysis systems holds great promise.

Novel Zinc(II) Bis(Dipyrromethenate)-Doped Ethyl Cellulose Sensors for Acetone Vapor Fluorescence Detection

In this paper, we report on the results of spectrofluorimetric study of new fluorescent sensor based on [Zn₂L₂] doped in ethyl cellulose. The sensor optical signal is based on the rapid fluorescence quenching in the presence of acetone vapor. The acetone vapor detection limit in a gas mixture by means of sensor based on [Zn₂L₂] doped in ethyl cellulose is 1.68 ppb. Being highly sensitive to the acetone acetone presence, instant in response and easy to use, the sensor can find an application for the noninvasive diagnostics of diabetes as well as for the monitoring of the content of acetone acetone in the air at industrial and laboratory facilities. Graphical Abstract.

Miniaturized Bio-and Chemical-Sensors for Point-of-Care Monitoring of Chronic Kidney Diseases

This review reports the latest achievements in point-of-care (POC) sensor technologies for the monitoring of ammonia, creatinine and urea in patients suffering of chronic kidney diseases (CKDs). Abnormal levels of these nitrogen biomarkers are found in the physiological fluids, such as blood, urine and sweat, of CKD patients. Delocalized at-home monitoring of CKD biomarkers via integration of miniaturized, portable, and low cost chemical- and bio-sensors in POC devices, is an emerging approach to improve patients’ health monitoring and life quality. The successful monitoring of CKD biomarkers, performed on the different body fluids by means of sensors having strict requirements in term of size, cost, large-scale production capacity, response time and simple operation procedures for use in POC devices, is reported and discussed.

Superior Self-Powered Room-Temperature Chemical Sensing with Light-Activated Inorganic Halides Perovskites

Hybrid halide perovskite is one of the promising light absorber and is intensively investigated for many optoelectronic applications. Here, the first prototype of a self-powered inorganic halides perovskite for chemical gas sensing at room temperature under visible-light irradiation is presented. These devices consist of porous network of CsPbBr₃ (CPB) and can generate an open-circuit voltage of 0.87 V under visible-light irradiation, which can be used to detect various concentrations of O₂ and parts per million concentrations of medically relevant volatile organic compounds such as acetone and ethanol with very quick response and recovery time. It is observed that O₂ gas can passivate the surface trap sites in CPB and the ambipolar charge transport in the perovskite layer results in a distinct sensing mechanism compared with established semiconductors with symmetric electrical response to both oxidizing and reducing gases. The platform of CPB-based gas sensor provides new insights for the emerging area of wearable sensors for personalized and preventive medicine.

Toward breath analysis on a chip for disease diagnosis using semiconductor-based chemiresistors: recent progress and future perspectives

Semiconductor gas sensors using metal oxides, carbon nanotubes, graphene-based materials, and metal chalcogenides have been reviewed from the viewpoint of the sensitive, selective, and reliable detection of exhaled biomarker gases, and perspectives/strategies to realize breath analysis on a chip for disease diagnosis are discussed based on the concurrent design of high-performance sensing materials and miniaturized pretreatment components. Carbon-based sensing materials that show relatively high responses to NO and NH₃ at low or mildly raised temperatures can be applied to the diagnosis of asthma and renal disease. Halitosis can be diagnosed by employing sensing or additive materials such as CuO and Mo that have high chemical affinities for H₂S, while catalyst-loaded metal oxide nanostructure sensors or their arrays have been used to diagnose diabetes via the selective detection of acetone or by pattern recognition of sensor signals. For the ultimate miniaturization of a breath-analysis system into a tiny chip, preconditioning that includes preconcentration, dehumidification, and flow sensing needs to be either improved through the design of gas/moisture adsorbents or removed/simplified through the design of highly sensitive sensing materials that are less impervious to interference from humidity and temperature. Moreover, an abundant sensing library needs to be provided for the diagnosis of diseases (e.g. lung cancer) that are associated with multiple biomarker gases and for finding new methods to diagnose other diseases. For this aim, p-type oxide semiconductors with high catalytic activities, as well as combinatorial approaches, can be considered for the development of sensing materials that detect less-reactive large molecules, and high-throughput screening, respectively. Selectivity for a specific biomarker gas will simplify the system further. Breath analysis on a tiny chip using semiconductor chemiresistors with ultralow power consumption that is connected to the 'Internet of Things' will pave new roads for disease diagnosis and patient monitoring.

Analytical methodologies for broad metabolite coverage of exhaled breath condensate

Breath analysis has been gaining popularity as a non-invasive technique that is amenable to a broad range of medical uses. One of the persistent problems hampering the wide application of the breath analysis method is measurement variability of metabolite abundances stemming from differences in both sampling and analysis methodologies used in various studies. Mass spectrometry has been a method of choice for comprehensive metabolomic analysis. For the first time in the present study, we juxtapose the most commonly employed mass spectrometry-based analysis methodologies and directly compare the resultant coverages of detected compounds in exhaled breath condensate in order to guide methodology choices for exhaled breath condensate analysis studies. Four methods were explored to broaden the range of measured compounds across both the volatile and non-volatile domain. Liquid phase sampling with polyacrylate Solid-Phase MicroExtraction fiber, liquid phase extraction with a polydimethylsiloxane patch, and headspace sampling using Carboxen/Polydimethylsiloxane Solid-Phase MicroExtraction (SPME) followed by gas chromatography mass spectrometry were tested for the analysis of volatile fraction. Hydrophilic interaction liquid chromatography and reversed-phase chromatography high performance liquid chromatography mass spectrometry were used for analysis of non-volatile fraction. We found that liquid phase breath condensate extraction was notably superior compared to headspace extraction and differences in employed sorbents manifested altered metabolite coverages. The most pronounced effect was substantially enhanced metabolite capture for larger, higher-boiling compounds using polyacrylate SPME liquid phase sampling. The analysis of the non-volatile fraction of breath condensate by hydrophilic and reverse phase high performance liquid chromatography mass spectrometry indicated orthogonal metabolite coverage by these chromatography modes. We found that the metabolite coverage could be enhanced significantly with the use of organic solvent as a device rinse after breath sampling to collect the non-aqueous fraction as opposed to neat breath condensate sample. Here, we show the detected ranges of compounds in each case and provide a practical guide for methodology selection for optimal detection of specific compounds.

A Compendium of Volatile Organic Compounds (VOCs) Released By Human Cell Lines

Volatile organic compounds (VOCs) offer unique insights into ongoing biochemical processes in healthy and diseased humans. Yet, their diagnostic use is hampered by the limited understanding of their biochemical or cellular origin and their frequently unclear link to the underlying diseases. Major advancements are expected from the analyses of human primary cells, cell lines and cultures of microorganisms. In this review, a database of 125 reliably identified VOCs previously reported for human healthy and diseased cells was assembled and their potential origin is discussed. The majority of them have also been observed in studies with other human matrices (breath, urine, saliva, feces, blood, skin emanations). Moreover, continuing improvements of qualitative and quantitative analyses, based on the recommendations of the ISO-11843 guidelines, are suggested for the necessary standardization of analytical procedures and better comparability of results. The data provided contribute to arriving at a more complete human volatilome and suggest potential volatile biomarkers for future validation.

Dedication: This review is dedicated to the memory of Prof. Dr. Anton Amann, who sadly passed away on January 6, 2015. He was motivator and motor for the field of breath research.

Portable Device for Measuring Breath Acetone Based on Sample Preconcentration and Cavity Enhanced Spectroscopy

A portable and compact device is demonstrated for measuring acetone in breath samples. The device features a 7 cm long high finesse optical cavity as an optical sensor that is coupled to a miniature adsorption preconcentrator containing 0.5 g of polymer material. Acetone is trapped out of breath and released into the optical cavity where it is probed by a near-infrared diode laser operating at ∼1670 nm. With an optical cavity mirror reflectivity of 99.994%, a limit of detection of 159 ppbv (1σ) is demonstrated on samples from breath bags. Initial results on direct breath sampling are presented with a precision of 100 ppbv. The method is validated with measurements made using an ion-molecule reaction mass spectrometer. Data are presented on elevated breath acetone from two individuals following an overnight fast and exercise, and from a third individual during several days of routine behavior.

Highly Selective Sensing of CO, C6H6, and C7H8 Gases by Catalytic Functionalization with Metal Nanoparticles

We have fabricated multiple networked SnO2 nanowires and subsequently decorated them with uniformly distributed metal nanoparticles (NPs). The sensing tests indicated that the Pt-, Pd-, and Au-decorated SnO2 nanowires exhibited excellent sensing behavior, specifically for C7H8, C6H6, and CO gases, respectively. We discussed the associated sensing mechanisms in regard to the selective catalytic effects of metal NPs. In addition, by means of d-band theory, we explained the catalytic capabilities of each metal and proposed design principles for exploring new catalytic metals. The present study will pave the way for further development of high-selectivity sensors.

A composite structure based on reduced graphene oxide and metal oxide nanomaterials for chemical sensors

A hybrid nanostructure based on reduced graphene oxide and ZnO has been obtained for the detection of volatile organic compounds. The sensing properties of the hybrid structure have been studied for different concentrations of ethanol and acetone. The response of the hybrid material is significantly higher compared to pristine ZnO nanostructures. The obtained results have shown that the nanohybrid is a promising structure for the monitoring of environmental pollutants and for the application of breath tests in assessment of exposure to volatile organic compounds.

Perspective on Nanoparticle Technology for Biomedical Use

This review gives a short overview on the widespread use of nanostructured and nanocomposite materials for disease diagnostics, drug delivery, imaging and biomedical sensing applications. Nanoparticle interaction with a biological matrix/entity is greatly influenced by its morphology, crystal phase, surface chemistry, functionalization, physicochemical and electronic properties of the particle. Various nanoparticle synthesis routes, characterization, and functionalization methodologies to be used for biomedical applications ranging from drug delivery to molecular probing of underlying mechanisms and concepts are described with several examples (150 references).

Hierarchical nanostructured WO3-SnO2 for selective sensing of volatile organic compounds

It remains a challenge to find a suitable gas sensing material that shows a high response and shows selectivity towards various gases simultaneously. Here, we report a mixed metal oxide WO3-SnO2 nanostructured material synthesized in situ by a simple, single-step, one-pot hydrothermal method at 200 °C in 12 h, and demonstrate its superior sensing behavior towards volatile organic compounds (VOCs) such as ammonia, ethanol and acetone. SnO2 nanoparticles with controlled size and density were uniformly grown on WO3 nanoplates by varying the tin precursor. The density of the SnO2 nanoparticles on the WO3 nanoplates plays a crucial role in the VOC selectivity. The responses of the present mixed metal oxides are found to be much higher than the previously reported results based on single/mixed oxides and noble metal-doped oxides. In addition, the VOC selectivity is found to be highly temperature-dependent, with optimum performance obtained at 200 °C, 300 °C and 350 °C for ammonia, ethanol and acetone, respectively. The present results on the cost-effective noble metal-free WO3-SnO2 sensor could find potential application in human breath analysis by non-invasive detection.

An acetone bio-sniffer (gas phase biosensor) enabling assessment of lipid metabolism from exhaled breath

Several volatile organic compounds (VOCs) are released from human breath or skin. Like chemical substances in blood or urine, some of these vapors can provide valuable information regarding the state of the human body. A highly sensitive acetone biochemical gas sensor (bio-sniffer) was developed and used to measure exhaled breath acetone concentration, and assess lipid metabolism based on breath acetone analysis. A fiber-optic biochemical gas sensing system was constructed by attaching a flow-cell with nicotinamide adenine dinucleotide (NADH)-dependent secondary alcohol dehydrogenase (S-ADH) immobilized membrane onto a fiber-optic NADH measurement system. The NADH measurement system utilizes an ultraviolet-light emitting diode with peak emission of 335 nm as an excitation light source. NADH is consumed by the enzymatic reaction of S-ADH, and the consumption is proportional to the concentration of acetone vapor. Phosphate buffer which contained NADH was circulated into the flow-cell to rinse products and the excessive substrates from the optode. The change of fluorescent emitted from NADH is analyzed by the PMT. Hence, fluorescence intensity decreased as the acetone concentration increased. The relationship between fluorescence intensity and acetone concentration was identified from 20 ppb to 5300 ppb. This interval included the concentration of acetone vapor in the breath of healthy people and those suffering from disorders of carbohydrate metabolism. Finally, the acetone bio-sniffer was used to measure breath acetone during an exercise stress test on an ergometer after a period of fasting. The concentration of acetone in breath was shown to significantly increase after exercise. This biosensor allows rapid, highly sensitive and selective measurement of lipid metabolism.

Electrochemical sensor system for breath analysis of aldehydes, CO and NO

Bulky and hyphenated laboratory-based analytical instrumentation such as gas chromatography/mass spectrometry is still required to trace breath biomarkers in the low ppbV level. Innovative sensor-based technologies could provide on-site and point-of-care (POC) detection of volatile biomarkers such as breath aldehydes related to oxidative stress and cancer. An electrochemical sensor system was developed for direct detection of the total abundance of aldehydes in exhaled breath in the ppbV level and for simultaneous determination of the airway inflammation markers carbon monoxide (CO) and nitric oxide (NO). The sensor system was tested in vitro with gaseous standard mixtures and in vivo in spontaneously breathing patients and under mechanical ventilation in an animal model. The sensor system provided in vitro and in vivo detection of trace levels of aldehydes, CO and NO. Inertness of the tubing system was important for reliable results. Sensitivity of the aldehyde sensor increased with humidity. Response time for analysis of breath samples was about 22 s and relative standard deviations of sensor amplitudes were <5%. Detection limits in the low ppbV range and a linear range of more than two orders of magnitude could be achieved for volatile aldehydes. Cross sensitivities were moderate for alcohols such as ethanol or isopropanol and negligible for other typical breath volatile organic compounds such as acetone, isoprene or propofol. In proof of concept analyses in patients suffering from lung cancer and diabetes, aldehyde and CO sensor signals differed between the groups. Elevated CO levels indicated previous smoking. In a mechanically ventilated pig, continuous monitoring of breath aldehyde concentrations in the low ppbV was realized. Cumulative aldehyde measurements may add interesting and complementary information to the conventional parameters used in clinical breath research. POC applicability, easy handling and low cost of sensors facilitate measurements in large patient cohorts.

Gas sensors based on ultrathin porous Co3O4 nanosheets to detect acetone at low temperature

Gas sensors based on ultrathin porous Co₃O₄ nanosheets to detect acetone for diagnosing diabetes at a low operating temperature.

Comparison of breath gases, including acetone, with blood glucose and blood ketones in children and adolescents with type 1 diabetes

Previous studies have suggested that breath gases may be related to simultaneous blood glucose and blood ketone levels in adults with type 2 and type 1 diabetes. The aims of this study were to investigate these relationships in children and young people with type 1 diabetes in order to assess the efficacy of a simple breath test as a non-invasive means of diabetes management. Gases were collected in breath bags and measurements were compared with capillary blood glucose and ketone levels taken at the same time on a single visit to a routine hospital clinic in 113 subjects (59 male, age 7 years 11 months-18 years 3 months) with type 1 diabetes. The patients were well-controlled with relatively low concentrations of the blood ketone measured (β hydroxybutyrate, 0-0.4 mmol l(-1)). Breath acetone levels were found to increase with blood β hydroxybutyrate levels and a significant relationship was found between the two (Spearman's rank correlation ρ = 0.364, p < 10(-4)). A weak positive relationship was found between blood glucose and breath acetone (ρ = 0.16, p = 0.1), but led to the conclusion that single breath measurements of acetone do not provide a good measure of blood glucose levels in this cohort. This result suggests a potential to develop breath gas analysis to provide an alternative to blood testing for ketone measurement, for example to assist with the management of type 1 diabetes.

Laser-based method and sample handling protocol for measuring breath acetone

A robust method is demonstrated to measure acetone in human breath at sub parts-per-million by volume (ppmv) concentrations using diode laser cavity enhanced absorption spectroscopy. The laser operates in the near-infrared at about 1690 nm probing overtone transitions in acetone in a spectral region relatively free from interference from common breath species such as CO2, water, and methane. Using an optical cavity with a length of 45 cm, bound by mirrors of 99.997% reflectivity, a limit of detection of ∼180 parts-per-billion by volume (ppbv) (1σ) of breath acetone is achieved. The method is validated with measurements made with an ion-molecule reaction mass spectrometer. A technique to calibrate the optical cavity mirror reflectivity using a temperature dependent water vapor source is also described.

Rh-catalyzed WO3 with anomalous humidity dependence of gas sensing characteristics

An anomalous humidity dependence of gas sensing characteristics is found for a Rh-loaded WO₃ sensor, where the resistance and gas response increased in humid atmospheres.

A prototype portable breath acetone analyzer for monitoring fat loss

Acetone contained in our exhaled breath is a metabolic product of the breakdown of body fat and is expected to be a good indicator of fat-burning. Typically, gas chromatography or mass spectrometry are used to measure low-concentration compounds in breath but such large instruments are not suitable for daily use by diet-conscious people. Here, we prototype a portable breath acetone analyzer that has two types of semiconductor-based gas sensors with different sensitivity characteristics, enabling the acetone concentration to be calculated while taking into account the presence of ethanol, hydrogen, and humidity. To investigate the accuracy of our prototype and its application in diet support, experiments were conducted on healthy adult volunteers. Breath acetone concentrations obtained from our prototype and from gas chromatography showed a strong correlation throughout the experiments. Moreover, body fat in subjects with a controlled caloric intake and taking exercise decreased significantly, whereas breath acetone concentrations in those subjects increased significantly. These results prove that our prototype is practical and useful for self-monitoring of fat-burning at home or outside. Our prototype will help to prevent and alleviate obesity and diabetes.