A Multi-Technique Reconfigurable Electrochemical Biosensor: Enabling Personal Health Monitoring in Mobile Devices

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.

How to Assess the Measurement Performance of Mobile/Wearable Point-of-Care Testing Devices? A Systematic Review Addressing Sweat Analysis

Recent advances in technologies for biosensor integration in mobile or wearable devices have highlighted the need for the definition of proper validation procedures and technical standards that enable testing, verification and validation of the overall performance of these solutions. Thus, reliable assessment—in terms of limits of detection/quantitation, linearity, range, analytical and diagnostic sensitivity/specificity, accuracy, repeatability, reproducibility, cross-reactivity, diagnostic efficiency, and positive/negative prediction—still represents the most critical and challenging aspect required to progress beyond the status of feasibility studies. Considering this picture, this work aims to review and discuss the literature referring to the available methods and criteria reported in the assessment of the performance of point-of-care testing (PoCT) devices within their specific applications. In particular, without losing generality, we focused on mobile or wearable systems able to analyze human sweat. In performing this review, the focus was on the main challenges and trends underlined in the literature, in order to provide specific hints that can be used to set shared procedures and improve the overall reliability of the identified solutions, addressing the importance of sample management, the sensing components, and the electronics. This review can contribute to supporting an effective validation of mobile or wearable PoCT devices and thus to spreading the use of reliable approaches outside hospitals and clinical laboratories.

Bridging the gap between development of point-of-care nucleic acid testing and patient care for sexually transmitted infections

The incidence rates of sexually transmitted infections (STIs), including the four major curable STIs - chlamydia, gonorrhea, trichomoniasis and, syphilis - continue to increase globally, causing medical cost burden and morbidity especially in low and middle-income countries (LMIC). There have seen significant advances in diagnostic testing, but commercial antigen-based point-of-care tests (POCTs) are often insufficiently sensitive and specific, while near-point-of-care (POC) instruments that can perform sensitive and specific nucleic acid amplification tests (NAATs) are technically complex and expensive, especially for LMIC. Thus, there remains a critical need for NAAT-based STI POCTs that can improve diagnosis and curb the ongoing epidemic. Unfortunately, the development of such POCTs has been challenging due to the gap between researchers developing new technologies and healthcare providers using these technologies. This review aims to bridge this gap. We first present a short introduction of the four major STIs, followed by a discussion on the current landscape of commercial near-POC instruments for the detection of these STIs. We present relevant research toward addressing the gaps in developing NAAT-based STI POCT technologies and supplement this discussion with technologies for HIV and other infectious diseases, which may be adapted for STIs. Additionally, as case studies, we highlight the developmental trajectory of two different POCT technologies, including one approved by the United States Food and Drug Administration (FDA). Finally, we offer our perspectives on future development of NAAT-based STI POCT technologies.

Point-of-care human milk testing for maternal secretor status

We present an electrochemical impedimetric-based biosensor for monitoring the variation in human milk oligosaccharide (HMO) composition. 2′-Fucosyllactose (2’FL) is an HMO associated with infant growth, cognitive development, and protection from infectious diarrhea, one of the major causes of infant death worldwide. Due to genetic variation, the milk of some women (non-secretors) contains no or very little 2′FL with potential implications for infant health and development. However, there is currently no technology to analyze the presence and concentration of HMOs in human milk at the point-of-care (POC). The lack of such technology represents a major impediment to advancing human milk research and improving maternal-infant health. Towards this unmet need, we report an impedimetric assay for HMOs with an α-1,2 linkage, the most abundant of which is 2′FL. The sensor uses a lectin for affinity, specifically Ulex europaeusagglutininI (UEA), with electrochemical readout. In spiked studies, the sensor exhibited a high degree of linearity (R² = 0.991) over 0.5 to 3.0 μM with a 330-nM detection limit. The sensor performance was clinically validated using banked human milk samples and correctly identified all secretor vs. non-secretor samples. Furthermore, despite the short 35-min assay time and low sample volume (25 μL), the assay was highly correlated with HPLC measurements. This bedside human milk testing assay enables POC, “sample-to-answer” quantitative HMO measurement, and will be a valuable tool to assess milk composition.

Real-Time Multi-Ion-Monitoring Front-End With Interference Compensation by Multi-Output Support Vector Regressor

Ion-sensors play a major role in physiology and healthcare monitoring since they are capable of continuously collecting biological data from body fluids. Nevertheless, ion interference from background electrolytes present in the sample is a paramount challenge for a precise multi-ion-monitoring. In this work, we propose the first system combining a battery-powered portable multi-channel electronic front-end, and an embedded Multi-output Support Vector Regressor (M-SVR), that supplies an accurate, continuous, and real-time monitoring of sodium, potassium, ammonium, and calcium ions. These are typical analytes tracked during physical exercise. The front-end interface was characterized through a sensor array built with screen-printed electrodes. Nernstian sensitivity and limit of detection comparable to a bulky laboratory potentiometer were achieved in both water and artificial sweat. The multivariate calibration model was deployed on a Raspberry Pi where the activity of the target ions were locally computed. The M-SVR model was trained, optimized, and tested on an experimental dataset acquired following a design of experiments. We demonstrate that the proposed multivariate regressor is a compact, low-complexity, accurate, and unbiased estimator of sodium and potassium ions activity. A global normalized root mean-squared error improvement of 6.97%, and global mean relative error improvement of 10.26%, were achieved with respect to a standard Multiple Linear Regressor (MLR). Within a real-time multi-ion-monitoring task, the overall system enabled the continuous monitoring and accurate determination of the four target ions activity, with an average accuracy improvement of 27.73% compared to a simple MLR, and a prediction latency of [Formula: see text].

A Portable Wireless Urine Detection System With Power-Efficient Electrochemical Readout ASIC and ABTS-CNT Biosensor for UACR Detection

This work presents a portable wireless urine detection system which consists of an electrochemical readout application specific integrated circuit (ASIC) and a biosensor composed of 2, 2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) and carbon nanotube (ABTS-CNT) for the detection of urine albumin-to-creatinine ratio (UACR). The ASIC includes a potentiostat, a digital circuitry and a power management circuit which can perform electrochemistry techniques with a dual-channel screen-printing carbon electrode (SPCE). Electrochemical experiments on the proposed biosensor (SPCE|ABTS-CNT|Nafion) have revealed promising sensing characteristics for creatinine and human serum albumin detection. Practical urine tests has demonstrated the capability of the proposed urine detection system for UACR detection with both the power-efficient readout ASIC and the ABTS-CNT biosensor. A user-friendly prototype has also been designed which can be useful for either personal health administrationor homecare.

Scoping Review of Healthcare Literature on Mobile, Wearable, and Textile Sensing Technology for Continuous Monitoring

Remote monitoring of health can reduce frequent hospitalisations, diminishing the burden on the healthcare system and cost to the community. Patient monitoring helps identify symptoms associated with diseases or disease-driven disorders, which makes it an essential element of medical diagnoses, clinical interventions, and rehabilitation treatments for severe medical conditions. This monitoring can be expensive and time-consuming and provide an incomplete picture of the state of the patient. In the last decade, there has been a significant increase in the adoption of mobile and wearable devices, along with the introduction of smart textile solutions that offer the possibility of continuous monitoring. These alternatives fuel a technology shift in healthcare, one that involves the continuous tracking and monitoring of individuals. This scoping review examines how mobile, wearable, and textile sensing technology have been permeating healthcare by offering alternate solutions to challenging issues, such as personalised prescriptions or home-based secondary prevention. To do so, we have selected 222 healthcare literature articles published from 2007 to 2019 and reviewed them following the PRISMA process under the schema of a scoping review framework. Overall, our findings show a recent increase in research on mobile sensing technology to address patient monitoring, reflected by 128 articles published in journals and 19 articles in conference proceedings between 2014 and 2019, which represents 57.65% and 8.55% respectively of all included articles.

Web-drive based source measure unit for automated evaluations of ionic liquid-gated MoS2 transistors

For reliable characterization of two-dimensional semiconducting devices and continuous monitoring in toxic environments, construction of an electrical characterization-based massive database using a portable source measure unit (SMU) with a WiFi connection is desirable. The web-drive based SMU using a microcontroller developed here exhibits superior voltage source performance (∼1 mV) and voltage/current measurement (∼0.15 mV/∼1 nA) capabilities, with automatic construction of a measurement database for online storage using web-drive based software, which can be applied for reliable electrical characterization. Electrical characterization of ionic liquid-gated MoS₂ transistors was achieved with the designed SMU and showed results comparable with those obtained using a commercial semiconductor characterization system. Ionic liquid-gated transistors only require a small gate bias (∼1.5 V) for on-state operation because of the high gate capacitance originating from the thin dielectric layer constructed of an electrical double layer, which makes the device a promising candidate for low power consumption applications. Finally, several electrical parameters of the ionic liquid-gated transistor were extracted from the datasets and uploaded to the web-drive.

Impedance Spectroscopy Based on Linear System Identification

Impedance spectroscopy is a commonly used measurement technique for electrical characterization of a sample under test over a wide frequency range. Most measurement methods employ a sine wave excitation generator, which implies a point-by-point frequency sweep and a complex readout architecture. This paper presents a fast, wideband, measurement method for impedance spectroscopy based on linear system identification. The main advantage of the proposed method is the low hardware complexity, which consists of a three-level pulse waveform, an inverting voltage amplifier, and a general purpose analog-to-digital converter (ADC). A proof-of-concept prototype, which is implemented with off-the-shelf components, achieves an estimation fit of approximately 96%. The prototype operation is validated electrically using known RC component values and tested in real application conditions.

CMOS Interfaces for Internet-of-Wearables Electrochemical Sensors: Trends and Challenges

Smart wearables, among immediate future IoT devices, are creating a huge and fast growing market that will encompass all of the next decade by merging the user with the Cloud in a easy and natural way. Biological fluids, such as sweat, tears, saliva and urine offer the possibility to access molecular-level dynamics of the body in a non-invasive way and in real time, disclosing a wide range of applications: from sports tracking to military enhancement, from healthcare to safety at work, from body hacking to augmented social interactions. The term Internet of Wearables (IoW) is coined here to describe IoT devices composed by flexible smart transducers conformed around the human body and able to communicate wirelessly. In addition the biochemical transducer, an IoW-ready sensor must include a paired electronic interface, which should implement specific stimulation/acquisition cycles while being extremely compact and drain power in the microwatts range. Development of an effective readout interface is a key element for the success of an IoW device and application. This review focuses on the latest efforts in the field of Complementary Metal–Oxide–Semiconductor (CMOS) interfaces for electrochemical sensors, and analyses them under the light of the challenges of the IoW: cost, portability, integrability and connectivity.

Electrochemical Instrumentation of an Embedded Potentiostat System (EPS) for a Programmable-System-On-a-Chip

Under the main features required on portable devices in electrochemical instrumentation is to have a small size, low power consumption, economically affordable and precision in the measurements. This paper describes the development of a programmable Embedded Potentiostat System (EPS) capable of performing electrochemical sensing over system-on-a-chip platforms. Furthermore, the study explains a circuit design and develops some validation of the entire system. The hardware validation is performed by electrochemical experiments such as Double Step Chronoamperometry (DSC), Linear Sweep Voltammetry (LSV) and Cyclic Voltammetry (CV); moreover, a comparison of the experimental signals between a commercial potentiostat and the EPS was done by analysis of errors on the response signal. Results illustrate that the EPS is capable of handling currents in the range of absolute values of 86.44 to 3000 nA and having control voltages in the range of ±2 V. The device can support from 50 to 2000 samples per second. The EPS capabilities were compared with other compact potentiostats. The programmable EPS is an original approach which hugely reduces the hardware complexity and leads the way to create new applications for Point-of-Care or industrial developments with a reusable full electronics module.

Clinical detection of Hepatitis C viral infection by yeast-secreted HCV-core:Gold-binding-peptide

Access to affordable and field deployable diagnostics are key barriers to the control and eradication of many endemic and emerging infectious diseases. While cost, accuracy, and usability have all improved in recent years, there remains a pressing need for even less expensive and more scalable technologies. To that end, we explored new methods to inexpensively produce and couple protein-based biosensing molecules (affinity reagents) with scalable electrochemical sensors. Previous whole-cell constructs resulted in confounding measurements in clinical testing due to significant cross-reactivity when probing for host-immune (antibody) response to infection. To address this, we developed two complimentary strategies based on either the release of surface displayed or secretion of fusion proteins. These dual affinity biosensing elements couple antibody recognition (using antigen) and sensor surface adhesion (using gold-binding peptide-GBP) to allow single-step reagent production, purification, and biosensor assembly. As a proof-of-concept, we developed Hepatitis C virus (HCV)-core antigen-GBP fusion proteins. These constructs were first tested and optimized for consistent surface adhesion then the assembled immunosensors were tested for cross-reactivity and evaluated for performance in vitro. We observed loss of function of the released reagents while secreted constructs performed well in in vitro testing with 2 orders of dynamic range, and a limit of detection of 32 nM. Finally, we validated the secreted platform with clinical isolates (n = 3) with statistically significant differentiation of positive vs. non-infected serum (p < 0.0001) demonstrating the ability to clearly distinguish HCV positive and negative clinical samples.

PSoC-Stat: A single chip open source potentiostat based on a Programmable System on a Chip

In this paper we demonstrate a potentiostat built with a single commercially available integrated circuit (IC) that does not require any external electronic components to perform electrochemical experiments. This is done using the capabilities of the Programmable System on a Chip (PSoC®) by Cypress Semiconductor, which integrates all of the necessary electrical components. This is in contrast to other recent papers that have developed potentiostats but require technical skills or specialized equipment to produce. This eliminates the process of having to make a printed circuit board and soldering on electronic components. To control the device, a graphical user interface (GUI) was developed in the python programming language. Python is open source, with a style that makes it easy to read and write programs, making it an ideal choice for open source projects. As the developed device is open source and based on a PSoC, modification to implement other electrochemical techniques is straightforward and only requires modest programming skills, but no expensive equipment or difficult techniques. The potentiostat developed here adds to the growing amount of open source laboratory equipment. To demonstrate the PSoC potentiostat in a wide range of applications, we performed cyclic voltammetry (to measure vitamin C concentration in orange juice), amperometry (to measure glucose with a glucose strip), and stripping voltammetry experiments (to measure lead in water). The device was able to perform all experiments and could accurately measure Vitamin C, glucose, and lead.

Toward Wireless Health Monitoring via an Analog Signal Compression-Based Biosensing Platform

Wireless all-analog biosensor design for the concurrent microfluidic and physiological signal monitoring is presented in this paper. The key component is an all-analog circuit capable of compressing two analog sources into one analog signal by the analog joint source-channel coding (AJSCC). Two circuit designs are discussed, including the stacked-voltage-controlled voltage source (VCVS) design with the fixed number of levels, and an improved design, which supports a flexible number of AJSCC levels. Experimental results are presented on the wireless biosensor prototype, composed of printed circuit board realizations of the stacked-VCVS design. Furthermore, circuit simulation and wireless link simulation results are presented on the improved design. Results indicate that the proposed wireless biosensor is well suited for sensing two biological signals simultaneously with high accuracy, and can be applied to a wide variety of low-power and low-cost wireless continuous health monitoring applications.

Smartphone-based analytical biosensors

With the rapid development, mass production, and pervasive distribution of smartphones in recent years, they have provided people with portable, cost-effective, and easy-to-operate platforms to build analytical biosensors for point-of-care (POC) applications and mobile health.

CMOS Electrochemical Instrumentation for Biosensor Microsystems: A Review

Modern biosensors play a critical role in healthcare and have a quickly growing commercial market. Compared to traditional optical-based sensing, electrochemical biosensors are attractive due to superior performance in response time, cost, complexity and potential for miniaturization. To address the shortcomings of traditional benchtop electrochemical instruments, in recent years, many complementary metal oxide semiconductor (CMOS) instrumentation circuits have been reported for electrochemical biosensors. This paper provides a review and analysis of CMOS electrochemical instrumentation circuits. First, important concepts in electrochemical sensing are presented from an instrumentation point of view. Then, electrochemical instrumentation circuits are organized into functional classes, and reported CMOS circuits are reviewed and analyzed to illuminate design options and performance tradeoffs. Finally, recent trends and challenges toward on-CMOS sensor integration that could enable highly miniaturized electrochemical biosensor microsystems are discussed. The information in the paper can guide next generation electrochemical sensor design.