Adaptively resettable microfluidic patch for sweat rate and electrolytes detection

Skin-interfaced microfluidic patch has become a reliable device for sweat collection and analysis. However, the intractable problems of emptying the microchannel for reuse, and the channel's volumetric capacity limited by the size of the patch, directly hinder the practical application of sweat sensors. Herein, we report an adaptively resettable microfluidic sweat patch (Art-Sweat patch) capable of continuously monitoring both sweat rate (0.2-4.0 μL min-1) and total ionic charge concentration (10-200 mmol L-1). We develop a platform with a vertical and horizontal microchannel combined strategy, enabling repeatedly filling sweat and emptying the microchannel for autonomously resetting and detecting. The variation in the emptied volume is designed to be adaptively identified by the sensor, resulting in enhanced stability and an enlarged volumetric capacity of over 300 μL. By integrating with self-designed wireless transmission modules, the proposed Art-Sweat patch shows product-level wearability and high performance in monitoring variations in regional sweat rate and concentration for hydration status assessment.

Influence of topical menthol gel on thermoregulation and perception while walking in the heat

PURPOSE

Menthol is known to elicit opposing thermoregulatory and perceptual alterations during intense exercise. The current purpose was to determine the thermoregulatory and perceptual effects of topical menthol application prior to walking in the heat.

METHODS

Twelve participants walked (1.6 m s-1, 5% grade) for 30 min in the heat (38 °C, 60% relative humidity) with either a 4% menthol or control gel on the upper (shoulder to wrist) and lower (mid-thigh to ankle) limbs. Skin blood flow (SkBF), sweat (rate, composition), skin conductivity, heart rate, temperature (skin, core), and thermal perception were measured prior to and during exercise.

RESULTS

Skin conductivity expressed as time to 10, 20, 30, and 40 µS was delayed due to menthol (559 ± 251, 770 ± 292, 1109 ± 301, 1299 ± 335 s, respectively) compared to the control (515 ± 260, 735 ± 256, 935 ± 300, 1148 ± 298 s, respectively, p = 0.048). Sweat rate relative to body surface area was lower due to menthol (0.55 ± 0.16 L h-1 m(2)-1) than the control (0.64 ± 0.16 L h-1 m(2)-1, p = 0.049). Core temperature did not differ at baseline between the menthol (37.4 ± 0.3 °C) and control (37.3 ± 0.4 °C, p = 0.298) but was higher at 10, 20, and 30 min due to menthol (37.5 ± 0.3, 37.7 ± 0.2, 38.1 ± 0.3 °C, respectively) compared to the control (37.3 ± 0.4, 37.4 ± 0.3, 37.7 ± 0.3 °C, respectively, p < 0.05). The largest rise in core temperature from baseline was at 30 min during menthol (0.7 ± 0.3 °C) compared to the control (0.4 ± 0.2 °C, p = 0.004). Overall, the menthol treatment was perceived cooler, reaching "slightly warm" whereas the control treatment reached "warm" (p < 0.001).

CONCLUSION

Menthol application to the limbs impairs whole-body thermoregulation while walking in the heat despite perceiving the environment as cooler.

Effect of ice slurry ingestion on thermoregulatory responses during fixed-intensity cycling in humid and dry heat

PURPOSE

This study examined the thermoregulatory response and ergogenic effects of ice slurry (ICE) ingestion in hot environments with high and low relative humidity (RH).

METHODS

Eight males completed four trials in a crossover manner in dry (DRY: 34.7 ± 0.2 °C, 38 ± 2%RH) and humid heat (HUM: 34.8 °C ± 0.2 °C, 80 ± 1%RH). They ingested 8.0 g·kg-1 of ICE (0.0 °C) or 37.5 °C water (CON) during 30 min before exercise, and three aliquots (3.2 g·kg-1) of ICE or CON during 45-min cycling at 50%[Formula: see text]O2peak, followed by cycling to exhaustion at 80%[Formula: see text]O2peak (TTE). Body core temperature (Tcore), mean skin temperature (Tsk), heart rate (HR), thermal comfort, thermal sensation and rating of perceived exertion (RPE) were measured.

RESULTS

Relative to CON, ICE improved TTE by 76.5 ± 96.5% in HUM and 21.3 ± 44.9% in DRY (p = 0.044). End-exercise Tcore was lower in ICE versus CON in DRY (37.8 ± 0.4 °C versus 38.1 ± 0.3 °C, p = 0.005) and HUM (38.8 ± 0.4 °C versus 39.3 ± 0.6 °C, p = 0.004). ICE decreased HR, heat storage and heat strain index only in DRY (p < 0.001-0.018). ICE improved thermal sensation and comfort in DRY and HUM (p < 0.001-0.011), attenuated RPE in HUM (p = 0.012) but not in DRY (p = 0.065).

CONCLUSION

ICE tended to benefit performance in humid heat more than in dry heat. This is likely due to the reduced extent of hyperthermia in dry heat and the relative importance of sensory inputs in mediating exercise capacity.

Perspiration permeable, textile embeddable microfluidic sweat sensor

Epidermal microfluidic devices are continuously being developed for efficient sweat collection and sweat rate detection. However, most microfluidic designs ignore the use of airtight/adhesive substrate will block the natural perspiration of the covered sweat pores, which will seriously affect normal sweat production and long-term wearable comfort. Herein, we present a Janus textile-embedded microfluidic sensor platform with high breathability and directional sweat permeability for synchronous sweat rate and total electrolyte concentration detection. The device consists of a hollowed-out serpentine microchannel with interdigital electrodes and Janus textile. The dual-mode signal of the sweat rate (0.2-4.0 μL min-1) and total ionic charge concentration (10-200 mmol L-1) can be obtained synchronously by decoupling conductance step signals generated when sweat flows through alternating interdigitated spokes at equal intervals in the microchannel. Meanwhile, the hollowed-out microchannel structure significantly reduces the coverage area of the sensor on the skin, and the Janus textile-embedded device ensures a comfortable skin/device interface (fewer sweat pores are blocked) and improves breathability (503.15 g m-2 d-1) and sweat permeability (directional liquid transportation) during long-term monitoring. This device is washable and reusable, which shows the potential to integrate with clothing and smart textile, and thus facilitate the practicality of wearable sweat sensors for personalized healthcare.

Central versus peripheral mechanisms of cold-induced vasodilation: a study in the fingers and toes of people with paraplegia

PURPOSE

This study examined physiological and perceptual parameters related to cold-induced vasodilation (CIVD) in the fingers and toes of people with paraplegia and compared them with responses observed in able-bodied individuals.

METHODS

Seven participants with paraplegia and seven able-bodied individuals participated in a randomized matched-controlled study involving left-hand and -foot immersion in cold water (8 ± 1 °C) for 40 min during exposure to cool (16 ± 1 °C), thermoneutral (23 ± 1 °C), and hot (34 ± 1 °C) ambient conditions.

RESULTS

Similar CIVD occurrence was observed in the fingers in the two groups. In toes, three of the seven participants with paraplegia revealed CIVDs: one in cool, two in thermoneutral, and three in hot conditions. No able-bodied participants revealed CIVDs in cool and thermoneutral conditions, while four revealed CIVDs in hot conditions. The toe CIVDs of paraplegic participants were counterintuitive in several respects: they were more frequent in cool and thermoneutral conditions (compared to the able-bodied participants), emerged in these conditions despite lower core and skin temperatures of these participants, and were evident only in cases of thoracic level lesions (instead of lesions at lower spinal levels).

CONCLUSION

Our findings demonstrated considerable inter-individual variability in CIVD responses in both the paraplegic and able-bodied groups. While we observed vasodilatory responses in the toes of participants with paraplegia that technically fulfilled the criteria for CIVD, it is unlikely that they reflect the CIVD phenomenon observed in able-bodied individuals. Taken together, our findings favor the contribution of central over peripheral factors in relation to the origin and/or control of CIVD.

Rate normalization for sweat metabolomics biomarker discovery

As the demand for real-time exercise performance feedback increases, excreted sweat has become a biosource of interest for continuous human performance assessment. For sweat to truly fulfill this requirement, analyte concentrations must be normalized to adequately assess day-to-day differences within and among individuals. In this manuscript, data are presented highlighting the use of accurate localized sweat rate as a means for ion and global metabolomic data normalization. The results illustrate large sweat rate variability among individuals over the course of two distinct exercises protocols. Furthermore, the data show sweat rate is not symmetrical at similar locations among right and left forearms of individuals (p = 0.0007). Sweat ion conductivity analysis suggest overall sweat rate normalization reduces variability collectively among ion values and participants with principal component analysis showing 77.8% of variation in the data set attributable to sweat rate normalization. Global metabolomic analysis of sweat illustrated overall rate normalization increases the variability among test subjects with 72.7% of the variation explained by sweat rate normalization. Finally, overall rate normalized metabolomic features of sweat significantly correlated (ρ ≥ 0.7, ρ ≤ -0.7) with measured performance metrics of the individual, establishing the potential for sweat to be used as a biosource for performance monitoring. Collectively, these data illustrate the importance of accurate localized sweat rate determination, for analyte data normalization, in support for the use of sweat in biomarker discovery efforts to predict human performance.

Menstrual cycle and thermoregulation during exercise in the heat: A systematic review and meta-analysis

Research conducted on exercise in the heat has been largely conducted in males, leaving women understudied. Of research including women, results are inconsistent on the impact of menstrual cycle phase on thermoregulation.

OBJECTIVES

The purpose of this systematic review is to quantify published investigations in thermal physiology that include menstrual cycle comparisons and assess aggregate data of investigations that include menstrual cycle variation and aerobic exercise in the heat.

METHODS

367 research articles were identified via systematic review and inclusion criteria and yielded 9 papers included in this analysis for a total number of 83 research subjects. Effect size estimates (Hedge's g) were utilized for initial (pre-exercise) and post-exercise internal body temperature (rectal or esophageal, T_int), sweat rate, mean skin temperature, and exercise heart rate.

RESULTS

Pooled effect size showed significantly greater initial T_int (1.231±0.186, p<0.01) and post-exercise T_int (0.455±0.153, p<0.01) in the luteal compared to follicular phases. No significant differences were present in mean skin temperature, sweat rate, or exercise heart rate across menstrual phases in analyses of aggregate data.

CONCLUSIONS

The limited available data suggest that observed increases in initial T_int in the luteal phase are maintained throughout and post-exercise without an observed impact in sweat rate or mean skin temperature.

Caffeine and heat have additive but not interactive effects on physiologic strain: A factorial experiment

This study tested the interactive effects of heat and caffeine on exercise-induced physiological strain by using a 2x2 within-subjects factorial design. Thirty-five physically fit Caucasians underwent a bout of exercise under four conditions wherein ambient conditions (heat vs no heat) and caffeine (placebo vs caffeine; double-blinded) were manipulated. Exercise consisted of a 60-min walk and 5-min step/squat test while wearing weighted backpack. Primary outcomes include measures of physiologic strain (Core temperature [T_r] and heart rate [HR]). Secondary measures included blood pressure, markers of sweat loss, and creatine kinase (CK). Repeated measures models were created to evaluate the individual and combined effects of heat and caffeine. Key results indicated that heat and caffeine significantly increased T_r and HR after walking and stair-stepping. No significant heat by caffeine interactions were detected, and caffeine's main effects were relatively low (≤0.17 °C for T_r and ≤6.6 bpm for HR). Of note, heat and caffeine exhibited opposite effects on blood pressure: caffeine increased both systolic and diastolic blood pressure (by 6-7 mmHg) and heat decreased them (by 4-6 mm Hg; ps < 0.05). In summary, heat and caffeine affected physiologic strain during exercise but exhibited no synergistic effects. In contrast, neither factor affected muscle damage. Clinical implications for heat illness risk in the military are discussed.

Effects of catechin-enriched ion beverage intake on thermoregulatory function in a hot environment

We examined the effect of intake of a catechin-enriched ion beverage (Cat-I) on the thermoregulatory response in a hot environment. Eight healthy men were exposed to a hot environment for 90 min at an ambient temperature of 35 °C (relative humidity: 75%) combined with lower leg water immersion at 40 °C. At that time, either Cat-I, an ion beverage (Ion), or mineral water (Placebo) was consumed at three points: (1) at the start of lower leg immersion, (2) at 30 min after immersion, and (3) at 60 min after immersion. In all conditions, tympanic temperature (Tty) increased gradually during lower leg water immersion. However, the rate of increase of Tty tended to be suppressed after 30 min. The effect of drinking Cat-I had a limited detection period of approximately 60-70 min, and the rate of sweating was clearly increased with Cat-I compared with Ion and Placebo. Cat-I also tended to decrease the body temperature threshold at which sweating was induced compared with Ion or Placebo. These findings suggest that Cat-I efficiently suppressed the increase of body temperature in a hot environment.

Variables influencing wearable sensor outcome estimates in individuals with stroke and incomplete spinal cord injury: a pilot investigation validating two research grade sensors

Background

Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality of living. In this context, accurate measurement of physical activity estimates from these sensors are vital. However, wearable sensor manufacturers generally only provide standard proprietary algorithms based off of healthy individuals to estimate physical activity metrics which may lead to inaccurate estimates in population with neurological impairment like stroke and incomplete spinal cord injury (iSCI). The main objective of this cross-sectional investigation was to evaluate the validity of physical activity estimates provided by standard proprietary algorithms for individuals with stroke and iSCI. Two research grade wearable sensors used in clinical settings were chosen and the outcome metrics estimated using standard proprietary algorithms were validated against designated golden standard measures (Cosmed K4B2 for energy expenditure and metabolic equivalent and manual tallying for step counts). The influence of sensor location, sensor type and activity characteristics were also studied.

Methods

28 participants (Healthy (n = 10); incomplete SCI (n = 8); stroke (n = 10)) performed a spectrum of activities in a laboratory setting using two wearable sensors (ActiGraph and Metria-IH1) at different body locations. Manufacturer provided standard proprietary algorithms estimated the step count, energy expenditure (EE) and metabolic equivalent (MET). These estimates were compared with the estimates from gold standard measures. For verifying validity, a series of Kruskal Wallis ANOVA tests (Games-Howell multiple comparison for post-hoc analyses) were conducted to compare the mean rank and absolute agreement of outcome metrics estimated by each of the devices in comparison with the designated gold standard measurements.

Results

The sensor type, sensor location, activity characteristics and the population specific condition influences the validity of estimation of physical activity metrics using standard proprietary algorithms.

Conclusions

Implementing population specific customized algorithms accounting for the influences of sensor location, type and activity characteristics for estimating physical activity metrics in individuals with stroke and iSCI could be beneficial.

Electronic supplementary material

The online version of this article (10.1186/s12984-018-0358-y) contains supplementary material, which is available to authorized users.

Ratiometric sweat secretion optical test in cystic fibrosis, carriers and healthy subjects

We have simplified the published procedure (5) for measuring sweat rates in individual human sweat glands. Sweat secretion rates were obtained from sweat drops secreted on the forearm by multiple individual glands. We computed a ratio between CFTR-dependent (by intradermal microinjection of a β adrenergic cocktail) and CFTR-independent (by methacoline as cholinergic stimulus) sweat secretion rates. We obtained a reproducible, approximately linear readout of CFTR function with measurements performed by two different independent teams. We considered three groups (CF subjects, CF carriers and non-CF controls, n=22 in each group); their mean ratios was respectively 0.000, 0.104 and 0.205 The average ratio of CF subjects was consistent with diagnosis in 3 additional cases clinically resembling CF. All groups were clearly discriminated, with sensibility and specificity ranging from 82% to 100%. A software was developed for detecting sweat droplets. This bioassay is suitabile for multicentre studies focusing on CFTR targeted therapies, controversial diagnosis and functional relevance of rare CFTR mutations.

Effect of micro mist sauna bathing on thermoregulatory and circulatory functions and thermal sensation in humans

To examine the effects of micro mist sauna bathing, produced by water crushing method, we exposed ten male subjects to five cases of micro mist sauna, namely (1) room temperature (RT) 38 °C with 100 % (actually 91 %) relative humidity (RH), (2) RT 41.5 °C with 80 % (actually 81 %) RH, (3) RT 41.5 °C with 100 % (actually 96 %) RH, (4) RT 45.0 °C with 64 % (actually 61 %) RH, and (5) RT 45.0 °C with 100 % (actually 86 %) RH, and measured tympanic temperature, mean skin temperature, heart rate (HR), and cheek moisture content, as well as ratings of thermal and sweating sensation tympanic temperatures at RT 45 °C were significantly higher at 86 % RH than those at 61 % RH; however, those at RT 45 °C with 61 % RH were higher than those with 86 % RH during recovery. There were no significant differences at RT 41.5 °C between with 81 % RH and with 96 % RH. Mean skin temperature was the highest at RT 45 °C 86 % RH case, followed by at RT 41.5 °C 96 % RH, RT 45 °C 61 % RH, RT 41.5 °C 81 % RH, and finally at RT 38 °C 91 % RH. HR change showed the same order as for mean skin temperature. A significant difference in cheek moisture content was observed between RT 41.5 °C with 81 % RH and RT 45 °C with 86 % RH 10 min after the micro mist bathing. There were no significant differences between ratings of thermal sensation at RT 41.5 °C with 81 % RH and at RT 45 °C with 61 % RH and RT 45 °C with 61 % RH and RT 45 °C with 86 % RH. Between RT 45 °C with 86 % RH and RT 41.5 °C with 81 % RH, there was a tendency for interaction (0.05 < p < 0.1). Other cases showed significant higher ratings of thermal sensation at higher room temperature or higher relative humidity. The ratings of sweating sensation 10 min after the mist sauna bathing were significantly higher at higher RT and RH except between RT 41.5 °C 96 % RH and RT 45 °C 86 % RH which exhibited no significant difference. We concluded that the micro mist sauna produced by water crushing method induced more moderate and effective thermal effect during micro mist sauna bathing than the conventional mist sauna bathing. In addition, micro mist sauna is as effective for heating the human subjects as bathtub bathing as well as more moderate thermal and sweating sensations.

Sweating the small stuff: adequacy and accuracy in sweat chloride determination

OBJECTIVES

Sweat chloride testing is the gold standard for diagnosis of cystic fibrosis (CF). Our objectives were to: 1) describe variables that determine sweat rate; 2) determine the analytic and diagnostic capacity of sweat chloride analysis across the range of observed sweat rates; and 3) determine the biologic variability of sweat chloride concentration.

METHODS

A retrospective analysis was performed using data from all sweat chloride tests performed at St. Louis Children's Hospital over a 21-month period.

RESULTS

A total of 1397 sweat chloride tests (1155 sufficient [≥75 mg], 242 insufficient [<75 mg]), were performed on 904 individuals. The sweat weight collected from forearms was statistically greater than that collected from legs. There was a negligible correlation between sweat weight and chloride concentration (r=-0.06). The mean individual biologic CV calculated from individuals with two or more sweat collections ≥75 mg was 13.1% (95% CI: 11.3-14.9%; range 0-88%) yielding a reference change value of 36%. Using 60 mmol/L as the diagnostic chloride cutoff, 100% of CF cases were detected whether a minimum sweat weight of 75, 40, or 20 mg was required.

CONCLUSIONS

1) Collection of sweat from forearms is preferable to upper legs, particularly in very young infants; 2) sweat chloride concentrations are not highly dependent upon sweat rate; 3) a change in sweat chloride concentration exceeding 36% may be considered a clinically significant response to cystic fibrosis transmembrane receptor targeted therapy, and 4) sweat collections of less than 75 mg provide clinically accurate information.

Quantification of continual anthropogenic pollutants released in swimming pools

Disinfection in swimming pools is often performed by chlorination, However, anthropogenic pollutants from swimmers will react with chlorine and form disinfection by-products (DBPs). DBPs are unwanted from a health point of view, because some are irritating, while others might be carcinogenic. The reduction of anthropogenic pollutants will lead to a reduction in DBPs. This paper investigates the continual release of anthropogenic pollutants by means of controlled sweat experiments in a pool tank during laboratory time-series experiments (LTS experiments) and also during on-site experiments (OS experiments) in a swimming pool. The sweat released during the OS and LTS experiments was very similar. The sweat rate found was 0.1-0.2 L/m(2)/h at water temperatures below 29 °C and increased linearly with increasing water temperatures to 0.8 L/m(2)/h at 35 °C. The continual anthropogenic pollutant release (CAPR) not only consisted of sweat, particles (mainly skin fragments and hair) and micro-organisms, but also sebum (skin lipids) has to be considered. The release of most components can be explained by the composition of sweat. The average release during 30 min of exercise is 250 mg/bather non-purgeable organic carbon (NPOC), 77.3 mg/bather total nitrogen (TN), 37.1 mg/bather urea and 10.1 mg/bather ammonium. The release of NPOC cannot be explained by the composition of sweat and is most probably a result of sebum release. The average release of other components was 1.31 × 10(9) # particles/bather (2-50 μm), 5.2 μg/bather intracellular adenosine triphosphate (cATP) and 9.3 × 10(6) intact cell count/bather (iCC). The pool water temperature was the main parameter to restrain the CAPR. This study showed that a significant amount of the total anthropogenic pollutants release is due to unhygienic behaviour of bathers.