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Wearable patch biosensors for noninvasive and continuous diabetes management through sweat glucose analysis present a promising prospect. However, how to obtain sweat samples safely and effectively remains a huge challenge, especially in a resting state. In this work, we propose an innovative wearable patch biosensor through a heat-stimulated approach for sweat collection. A silver nanowire-loaded electrothermal film was designed as the heat source to stimulate sweat glands for sweat secretion. Subsequently, the secreted sweat sample was transported and enriched through microfluidic channels, which was continuously and sensitively analyzed by a Prussian blue and glucose oxidase comodified glucose electrochemical biosensor. Under optimal conditions, its sensitivity could achieve 14 μM sweat glucose within 15 min, which was 17 min shorter than that without heating. The specificity, reproducibility, and accuracy were also adequate. To achieve on-body perspiration monitoring of human subjects, the wearable patch biosensor was integrated with a portable electrochemical workstation, a temperature controller, and a power source. The glucose concentration was presented on a smartphone. Results showed that the glucose concentration in sweat detected by the wearable biosensor presented a highly consistent trend with the blood glucose measured by a blood glucose meter throughout the day with normal meals. Compared with other conventional sweat stimulation strategies, the simple device and safe principle made it more suitable for individuals who were sedentary or at rest. This work provides a new approach to realizing wearable patch biosensors for personalized health monitoring.

Wearable electrochemical sweat sensors are potentially promising for health monitoring in a continuous and non-invasive mode with high sensitivity. However, due to the complexity of sweat composition and the growth of skin bacteria, the wearable sweat sensors may gradually lose their sensitivity or even fail over time. To deal with this issue, herein, we proposed a new strategy to construct wearable sweat sensors with antifouling and antimicrobial capabilities. Amyloid albumin hydrogels (ABSAG) were doped with two-dimensional (2D) nanomaterial MXene and CeO 2 nanorods to obtain the antifouling and antimicrobial amyloid albumin composite hydrogels (ABSACG, CeO 2 /MXene/ABSAG), and the wearable sensors were prepared by modifying flexible screen-printed electrodes with the ABSACG. Within this sensing system, the hydrophilic ABSAG possesses strong hydration capability, and it can form a hydration layer on the electrode surface to resist biofouling in sweat. The 2D nanomaterial MXene dispersed in the hydrogel endows the hydrogel with good conductivity and electrocatalytic capability, while the doping of CeO 2 nanorods further improves the electrocatalytic performance of the hydrogel and also provides excellent antimicrobial capability. The designed wearable electrochemical sensors based on the ABSACG demonstrated satisfying antifouling and antimicrobial abilities, and they were capable of detecting dopamine accurately in human sweat. It is expected that wearable sensors utilizing the antifouling and antimicrobial ABSACG may find practical applications in human body fluids analysis and health monitoring., Competing Interests: Declaration of competing interest We declare that we do not have any commercial or associative interest that represents a conflict of interest in connection with the work submitted., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Wearable, noninvasive sweat sensors enable real-time monitoring of metabolites in human health management. However, the commercial enzyme-based and currently nonenzymatic glucose sensor represents sluggish glucose oxidation kinetics and a narrow sensing range. Rational design of sensitive materials is significant yet faces a huge challenge. Herein, we construct a single-atom Pt supported on NiCo-LDH/Ti 3 C 2 T x heterostructures (Pt 1 -NiCo-LDH/Ti 3 C 2 T x ) as the nonenzymatic electrochemical glucose sensor sensitive materials for selective detection of glucose level in human sweat. The obtained Pt 1 -NiCo-LDH/Ti 3 C 2 T x with improved structural stability and enhanced charge transfer efficiency shows a low oxidation peak potential of 0.49 V, high sensitivity of 506.6 μA mM -1 cm -2 , a low detection limit of 0.035 μM, and long-term stability toward the glucose detection. The wearable sensor, coupled with a wireless transmission module and a signal processing chip, is used for real-time perspiration glucose monitoring during outdoor exercise. The result is comparable to that of high-performance liquid chromatography (HPLC). This research provides a new paradigm for designing a wearable nonenzymatic electrochemical glucose sensor, enabling noninvasive real-time monitoring of glucose concentrations in human sweat.

The chloride (Cl-) sweat test remains the reference test in the diagnosis of cystic fibrosis, allowing direct assessment of CFTR (Cystic Fibrosis Transmembrane conductance Regulator) channel function. Under highly effective modulators such as the combination of Elexacaftor, Tezacaftor and Ivacaftor (ETI), the Cl- level in sweat significantly improves, as shown in our cohort of patients when ETI was introduced. In addition to its role in the diagnosis of the disease, the sweat test is also important for individual clinical trials (n-of-1) in patients not eligible for ETI and for newborn screening for cystic fibrosis.

Introduction: Excessive mucus secretion is pivotal in chronic obstructive pulmonary disease (COPD) pathophysiology, particularly in chronic bronchitis phenotypes. Cystic fibrosis transmembrane conductance regulator (CFTR) has been implicated in COPD-related hypersecretion with acquired dysfunction, and emerged as a therapeutic target. However, the clinical efficacy of CFTR-potentiators in COPD remains controversial., Methods: We searched PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal (CSTJ), and Wanfang Database to retrieve eligible studies published before 28 May 2024., Results: A total of 1172 COPD patients were included, meta-analysis showed that CFTR-potentiators significantly increased forced expiratory volume in 1 s (FEV 1 ) and decreased sweat chloride and fibrinogen levels, with moderate-to-high quality evidence. However, no significant effects were observed on the percentage of detected FEV 1 to predicted FEV 1 (FEV 1 % predicted), forced vital capacity (FVC), COPD assessment test (CAT) score, St. George's Respiratory Questionnaire (SGRQ) score, or acute exacerbation times, with low-to-moderate quality evidence., Conclusion: Our meta-analysis demonstrated CFTR-potentiators' potential efficacy in increasing FEV 1 , decreasing sweat chloride and fibrinogen levels, despite limited impacts on FEV 1 % predicted, FVC, CAT score, SGRQ score, and acute exacerbations, underscoring the necessity for future research to evaluate its effects on mucus hypersecretion, acute exacerbations, hospitalizations, and mortality in COPD management. Review registration PROSPERO Identifier: CRD42024538708.

Porous soft bioelectronics have attracted significant attention due to their high breathability, long-term biocompatibility, and other unique features inaccessible in nonporous counterparts. However, fabricating high-quality multimodal bioelectronic components that operate stably under strain on porous substrates, along with integrating microfluidics for sweat management, remains challenging. In this study, cellulose nanofibrils (CNF) are explored, biomass-derived sustainable biomaterials, as nanofibril interfaces with unprecedented interfacial robustness to enable high-quality printing of strain-resilient bioelectronics on porous substrates by reducing surface roughness and creating mechanical heterogeneity. Also, CNF-based microfluidics can provide continuous sweat collection and refreshment, crucial for accurate biochemical sensing. Building upon these advancements, a multimodal porous wearable bioelectronic system is further developed capable of simultaneously detecting electrocardiograms and glucose and beta-hydroxybutyrate in sweat for monitoring energy metabolism and consumption. This work introduces novel strategies for fabricating high-quality, strain-resilient porous bioelectronics with customizable multimodalities to meet arising personalized healthcare needs., (© 2024 Wiley‐VCH GmbH.)

The demand for glucose monitoring devices has witnessed continuous growth from the rising diabetic population. The traditional approach of blood glucose (BG) sensor strip testing generates only intermittent glucose readings. Interstitial fluid-based devices measure glucose dynamically, but their sensing approaches remain either minimally invasive or prone to skin irritation. Here, a sweat glucose monitoring system is presented, which completely operates under rest with no sweat stimulation and can generate real-time BG dynamics. Osmotically driven hydrogels, capillary action with paper microfluidics, and self-powered enzymatic biochemical sensor are used for simultaneous sweat extraction, transport, and glucose monitoring, respectively. The osmotic forces facilitate greater flux inflow and minimize sweat rate fluctuations compared to natural perspiration-based sampling. The epidermal platform is tested on fingertip and forearm under varying physiological conditions. Personalized calibration models are developed and validated to obtain real-time BG information from sweat. The estimated BG concentration showed a good correlation with measured BG concentration, with all values lying in the A+B region of consensus error grid (MARD = 10.56% (fingertip) and 13.17% (forearm)). Overall, the successful execution of such osmotically driven continuous BG monitoring system from passive sweat can be a useful addition to the next-generation continuous sweat glucose monitors., (© 2024 The Author(s). Advanced Science published by Wiley‐VCH GmbH.)

Background: New York (NY) State implemented a new cystic fibrosis (CF) newborn screen (NBS) algorithm in December 2017 with improvement in positive predictive value and unanticipated increased identification of infants with cystic fibrosis transmembrane conductance regulator (CFTR)-related metabolic syndrome (CRMS). Repeat sweat testing is recommended in infants with CRMS. During the COVID-19 pandemic infants with CRMS were lost to follow up. With this quality improvement (QI) initiative, we aimed to perform repeat sweat testing in 25% of infants lost to follow up. We also describe consensus recommendations for CRMS from the NY CF NBS Consortium., Methods: Our QI team identified the primary drivers contributing to absent follow up, outreached to families, and created a questionnaire to evaluate parental understanding of CRMS using QI-based strategies., Results: Of 350 infants diagnosed with CRMS during the study period, 179 (51.1%) infants were lost to follow up. A total of 31 (17.3%) were scheduled for repeat sweat tests and followed up at CF Centers. Families reported high satisfaction with the CRMS knowledge questionnaire., Conclusions: With this QI-based approach, we effectively recaptured infants with CRMS previously lost to follow up during the COVID-19 pandemic. Ongoing concerns about infection risk and lack of understanding on the part of families and pediatricians likely contributed to patients with CRMS lost to follow up. Consensus recommendations for CRMS include annual visits with repeat sweat testing until 2-6 years of age and education for adolescents about clinical and reproductive implications of CRMS., (© 2024 Wiley Periodicals LLC.)

Real-time detection of renal biomarkers is crucial for immediate and continuous monitoring of kidney function, facilitating early diagnosis and intervention in kidney-related disorders. This proactive approach enables timely adjustments in treatment plans, particularly in critical situations, and enhances overall patient care. Wearable devices emerge as a promising solution, enabling non-invasive and real-time data collection. This comprehensive review investigates numerous types of wearable sensors designed to detect kidney biomarkers in body fluids such as sweat. It critically evaluates the precision, dependability, and user-friendliness of these devices, contemplating their seamless integration into daily life for continuous health tracking. The review highlights the potential influence of wearable technology on individualized renal healthcare and its role in preventative medicine while also addressing challenges and future directions. The review's goal is to provide guidance to academics, healthcare professionals, and technologists working on wearable solutions for renal biomarker detection by compiling the body of current knowledge and advancements., (© 2024. The Author(s), under exclusive licence to The Japan Society for Analytical Chemistry.)

In this study, we developed a wearable nanozyme-enzyme electrochemical biosensor that enablies sweat lactate monitoring. The biosensor comprises a flexible electrode system prepared on a polyimide (PI) film and the Janus textile for unidirectional sweat transport. We obtained favorable electrochemical activities for hydrogen peroxide reduction by modifying the laser-scribed graphene (LSG) electrode with cerium dioxide (CeO 2 )-molybdenum disulphide (MoS 2 ) nanozyme and gold nanoparticles (AuNPs). By further immobilisation of lactate oxidase (LOx), the proposed biosensor achieves chronoamperometric lactate detection in artificial sweat within a range of 0.1-50.0 mM, a high sensitivity of 25.58 μA mM -1 cm -2 and a limit of detection (LoD) down to 0.135 mM, which fully meets the requirements of clinical diagnostics. We demonstrated accurate lactate measurements in spiked artificial sweat, which is consistent with standard ELISA results. To monitor the sweat produced by volunteers while exercising, we conducted on-body tests, showcasing the wearable biosensor's ability to provide clinical sweat lactate diagnosis for medical treatment and sports management., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Rationale: Clinical trials show that lumacaftor/ivacaftor (LUM/IVA) treatment has the potential to modify early cystic fibrosis (CF) disease progression in children as young as 2 years of age. Objectives: To assess the long-term impact of LUM/IVA treatment on CF disease progression in children aged 2-5 years. Methods: This phase 2 trial had two parts: part 1, a 48-week, randomized, double-blind, placebo-controlled study of LUM/IVA in children aged 2-5 years (previously reported) was followed by a 48-week open-label treatment period in which all children received LUM/IVA (part 2; reported here). Endpoints assessed in part 2 included absolute changes from baseline in chest magnetic resonance imaging (MRI) global score at Week 96; weight-for-age, stature-for-age, and body mass index (BMI)-for-age z -scores at Week 96; lung clearance index based on lung volume turnover required to reach 2.5% of starting N2 concentration (LCI 2.5 ) through Week 96; chest MRI morphological score, chest MRI perfusion score, weight, stature, BMI, and microbiology cultures (oropharyngeal swabs) at Week 96; sweat chloride, amount of immunoreactive trypsinogen, fecal elastase-1 concentration, and fecal calprotectin through Week 96; and number of pulmonary exacerbations, time to first pulmonary exacerbation, and number of CF-related hospitalizations. Results: Forty-nine children received one or more doses of LUM/IVA in the open-label period (33 in the LUM/IVA to LUM/IVA group and 16 in the placebo to LUM/IVA group), with a mean exposure of 47.1 (standard deviation [SD], 5.2) weeks. The mean absolute change in MRI global score (negative value indicates improvement) from baseline at Week 96 was -2.7 (SD, 7.0; 95% confidence interval [CI], -5.2 to -0.1) in the LUM/IVA to LUM/IVA group and -5.6 (SD, 6.9; 95% CI, -9.2 to -1.9) in the placebo to LUM/IVA group. Improvements in LCI 2.5 , sweat chloride concentration, and markers of pancreatic function and intestinal inflammation were also observed in both groups. Growth parameters remained stable in both groups. The majority of children had adverse events considered mild (38.8%) or moderate (40.8%). Two (4.1%) children discontinued LUM/IVA treatment because of adverse events (distal intestinal obstruction syndrome [ n  = 1] and alanine aminotransferase increase [ n  = 1]). Conclusions: These findings confirm the potential for early LUM/IVA treatment to alter the trajectory of CF disease progression, including CF lung disease, in children as young as 2 years of age. Clinical trial registered with ClinicalTrials.gov (NCT03625466).

Herein we report a wearable sweat sensor of a Janus fabric based on surface enhanced Raman scattering (SERS) technology, mainly detecting the two important metabolites glucose and lactate. Janus fabric is composed of electrospinning PU on a piece of medical gauze (cotton), working as the unidirectional moisture transport component (R = 1305%) to collect and transfer sweat efficiently. SERS tags with different structures act as the probe to recognize and detect the glucose and lactate in high sensitivity. Core-shell structured gold nanorods with DTNB inside (AuNRs@DTNB@Au) are used to detect lactate, while gold nanorods with MPBA (AuNRs@MPBA) are used to detect glucose. Through the characteristic SERS information, two calibration functions were established for the concentration determination of glucose and lactate. The concentrations of glucose and lactate in sweat of a 23 years volunteer during three-stage interval running are tested to be 95.5, 53.2, 30.5 μM and 4.9, 13.9, 10.8 mM, indicating the glucose (energy) consumption during exercise and the rapid accumulation of lactate at the early stage accompanied by the subsequent relief. As expected, this sensing system is able to provide a novel strategy for effective acquisition and rapid detection of essential biomarkers in sweat., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Developing Janus fabrics with excellent one-way sweat transport capacity is an attractive way for providing comfort sensation and protecting the health during exercise. In this work, a 3D wetting gradient Janus fabric (3DWGJF) is first proposed to address the issue of excessive sweat accumulation in women's breasts, followed by integration with a sponge pad to form a 3D wetting gradient Janus sports bra (3DWGJSB). The 3D wetting gradient enables the prepared fabric to control the horizontal migration of sweat in one-way mode (x/y directions) and then unidirectionally penetrate downward (z direction), finally keeping the water content on the inner side of 3DWGJF (skin side) at ≈0%. In addition, the prepared 3DWGJF has good water vapor transmittance rate (WVTR: 0.0409 g cm -2  h -1 ) and an excellent water evaporation rate (0.4704 g h -1 ). Due to the high adhesion of transfer prints to the fabrics and their excellent mechanical properties, the 3DWGJF is remarkably durable and capable of withstanding over 500 laundering cycles and 400 abrasion cycles. This work may inspire the design and fabrication of next-generation moisture management fabrics with an effective sweat-removal function for women's health., (© 2024 Wiley‐VCH GmbH.)

Background: Elexacaftor-tezacaftor-ivacaftor (ETI) is a highly effective cystic fibrosis (CF) transmembrane conductance regulator (CFTR) modulating therapy for people with CF and at least one F508del variant. However, there is limited data about the safety and efficacy of this therapy in pediatric populations and in real-world settings. This study aimed at evaluating the effectiveness, tolerability, and safety of ETI in children with CF., Methods: This was a prospective observational study including all children aged 6-11 years who initiated ETI therapy between October 2022 and March 2023 at the Pediatric CF Center of Milan (Italy). Study outcomes included changes in sweat chloride concentration, FEV 1 , LCI 2.5 , body mass index (BMI), tolerance, and safety. Mean changes in study outcomes from baseline through 24 weeks were estimated using mixed-effects regression models., Results: The study included 34 children with CF (median age: 8.3 years). At Week 12, we observed an average decrease in LCI 2.5 of 2.3 units (95% confidence interval [CI]: -3.1; -1.5). At Week 24, sweat chloride concentration decreased by 63 mEq/L (95% CI: -69; -58), FEV 1 increased by 8.8 percentage point (95% CI: 3.7; 13.9) and BMI increased by 0.15 standard deviation scores (95% CI: 0.04; 0.25). Skin rashes appeared in 6 patients which spontaneously resolved within a few days. One month after treatment initiation, one patient experienced an elevation in liver function test results, which subsequently decreased during follow-up visits without necessitating discontinuation of therapy., Conclusions: Our data indicate that ETI therapy is well tolerated by children with CF and is effective in improving signs of lung function abnormalities from early childhood., (© 2024 The Author(s). Pediatric Pulmonology published by Wiley Periodicals LLC.)

The pH of human sweat is highly related with a variety of diseases, whereas the monitoring of sweat pH still remains challenging for ordinary families. In this study, we developed a novel dual-emission Tb-MOF using DPA as the ligand and further designed and constructed a skin-attachable Tb-MOF ratio fluorescent sensor for real-time detection of human sweat pH. With the increased concentration of H + , the interaction of H + with carbonyl organic ligand leads to the collapse of the Tb-MOF crystal structure, resulting in the interruption of antenna effect, and correspondingly increasing the emission of the ligand at 380 nm and decreasing the emission of the central ion Tb 3+ at 544 nm. This Tb-MOF nanoprobe has a good linear response in the pH range of 4.12-7.05 (R 2  = 0.9914) with excellent anti-interference ability. Based on the merits of fast pH response and high sensitivity, the nanoprobe was further used to prepare flexible wearable sensor. The wearable sensor can detect pH in the linear range of 3.50-6.70, which covers the pH range of normal human sweat (4.50-6.50). Subsequently, the storage stability and detection accuracy of the sensors were evaluated. Finally, the sensor has been successfully applied for the detection of pH in actual sweat samples from 21 volunteer and the real-time monitoring of pH variation during movement processing. This skin-attachable Tb-MOF sensor, with the advantages of low cost, visible color change and long shelf-life, is appealing for sweat pH monitoring especially for ordinary families., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

As a typical chromogenic probe, 3,3',5,5'-tetramethylbenzidine (TMB) has been widely applied in the field of visual detection due to its low toxicity and highly sensitive response. Due to the hydrophobic nature of TMB, encapsulating it into a hydrogel, which serves as an ideal matrix for wearable sensors, presents significant challenges that complicate the fabrication of visual wearable devices. Herein, the TMB probe and bimetallic MOF nanozymes are coencapsulated in a hydrogel patch for the fabrication of reusable visual sensors. Hydrophobic TMB is oxidized to hydrophilic ox-TMB by a bimetallic MOF (CuFe-MOF), allowing its diffusion into a hydrophilic agarose hydrogel patch, where it is reduced back to TMB. This process allows the coimmobilization and coencapsulation of CuFe-MOF and TMB within the hydrogel patch. Leveraging the color change between TMB and ox-TMB, as a proof-of-concept application, a reusable visual "On-Off-On" sensor is simply constructed and successfully applied to detect vitamin C in human sweat. Color changes can be quickly read by the naked eye or by smart devices without the need for external equipment. Meanwhile, based on the reversible conversion relationship between TMB and ox-TMB, a reusable sensor construction strategy is proposed. This approach not only facilitates the use of a TMB probe in hydrogel applications but also offers inspiration for the development of point-of-care testing equipment, demonstrating significant application potential.

3-Hydroxyanthranillic acid (3HAA) is one of the key metabolites from the tryptophan (TRP) metabolism pathway and is associated with aging, age-associated diseases, and healthy lifespan extension. This study aims to detect 3HAA in the sweat of healthy older adults using simple, high-performance liquid chromatography (HPLC) method. Chromatographic separation using 20 mmol/L sodium acetate, 3 mmol/L zinc acetate, and 7% (v/v) acetonitrile as mobile phase is possible to simultaneous detect 3HAA, KYN, and TRP with UV and fluorescence detection, respectively, under 6 min. This method demonstrated excellent linearity with coefficient of determination (r 2 ) greater than 0.998 for all analytes. The linear range were 0.05-6 µg/mL for TRP, 0.1-6 µg/mL for KYN and 0.2-6 µg/mL for 3HAA. Percentage recoveries from spiked in human sweat ranged from 90 ± 7-101 ± 3 for TRP, 86 ± 1-92 ± 3 for KYN, and 96 ± 1-103 ± 4 for 3HAA. The precision (%RSD) of repeatability and reproducibility is less than 3% and 6%, respectively. This method was used in a cross-sectional study with 81 participants aged 50-79 years, selected randomly from a local primary healthcare hospital's sampling frame. A detectable amount of 3HAA was observed in all sweat samples, marking the first report of 3HAA presence in human sweat. Additionally, the results revealed that the 3HAA sweat levels increased with age analyzed in three different age groups ranging from 50-59, 60-69, and 70-79. These findings enhance our understanding of sweat profiles and their correlation with aging, potentially further improving early diagnosis, disease monitoring, and development of customized treatment programs for older adults., (© 2024. The Author(s).)

Electrochemistry-based wearable and wireless sweat analysis is emerging as a promising noninvasive method for real-time health monitoring by tracking chemical and biological markers without the need for invasive blood sampling. It offers the potential to remotely monitor human sweat conditions in relation to metabolic health, stress, and electrolyte balance, which have implications for athletes, patients with chronic conditions, and individuals for the early detection and management of health issues. The state-of-the-art mainstream technology is dominated by the concept of a wearable microfluidic chip, typically based on elastomeric PDMS. While outstanding sensing performance can be realized, the design suffers from the poor permeability of PDMS, which could cause skin redness or irritation. Here, we introduce an omnidirectionally permeable, deformable, and wearable sweat analysis system based on gold nanowire sponges. We demonstrate the concept of all-in-one soft sponge electrochemistry, where the working, reference, and counter electrodes and electrolytes are all integrated within the sponge matrix. The intrinsic porosity of sponge in conjunction with vertically aligned gold nanowire electrodes gives rise to a high electrochemically active surface area of ∼67 cm 2 . Remarkably, this all-in-one sponge-based electrochemical system exhibited stable performance under a pressure of 10 kPa and 300% omnidirectional strain. The gold sponge biosensing electrodes could be sandwiched between two biocompatible sweat pads, which can serve as natural sweat collection and outflow layers. This naturally biocompatible and permeable platform can be integrated with wireless communication circuits, leading to a wireless sweat analysis system for the real-time monitoring of glucose, lactate, and pH during exercise.

In humans, perspiration regulates core body temperature. Therefore, objectively evaluating it is essential for studying sweat gland function and mechanisms, particularly in antiperspirant efficacy studies. Various approaches have been developed for measuring human perspiration and evaluating antiperspirant efficacy, but are unsuitable for robust and routine clinical testing applications. This paper shows how infrared thermography, utilizing both high- and low-resolution modes, functions as a multiscale imaging modality. The high-resolution mode extracts physiological parameters (respiratory ~ 0.3 Hz and heart rate ~ 1.0 Hz) and visualizes the reduction of the sweat pore radii (from 359 ± 155 μm to 161 ± 47 μm) after antiperspirant application, consistent with known mechanisms of pore plugging and constriction induced by aluminum salts. The low-resolution mode quantitatively maps sweat retention in underarm clothing. All study participants in a clinical trial showed reduced sweat retention on their T-shirts due to antiperspirants, with reductions ranging from approximately 37-97% and an average reduction of 77.7 ± 22.1% using the developed methodology and tested antiperspirant. Overall, this non-invasive technique presents significant potential for clinical and personal care product evaluations, particularly in the early stages of product development., (© 2024. The Author(s).)

Uric acid is typically measured through blood tests, which can be inconvenient and uncomfortable for patients. Herein, we propose a wearable surface-enhanced Raman scattering (SERS) chip, incorporating a hydrogel membrane with integrated plasmonic trimers, for noninvasive monitoring of uric acid in sweat. The plasmonic trimers feature sub 5 nm nanogaps, generating strong electromagnetic fields to boost the Raman signal of surrounding molecules. Simultaneously, the hydrogel membrane pumps sweat through these gaps, efficiently capturing sweat biomarkers for SERS detection. The chip can achieve saturation adsorption of sweat within 5 min, eliminating variations in individual sweat production rates. Dynamic SERS tracking of uric acid and lactic acid levels during anaerobic exercise reveals a temporary suppression of uric acid metabolism, likely due to metabolic competition with lactic acid. Furthermore, long-term monitoring correlates well with blood test results, confirming that regular exercise helps reduce serum uric acid levels and supporting its potential in managing hyperuricemia.

The great majority of published microfluidic wearable platforms for sweat sensing focus on the development of the technology to fabricate the device, the integration of sensing materials and actuators and the fluidics of sweat within the device. However, very few papers have discussed the physiological relevance of the metabolites measured using these novel approaches. In fact, some of the analytes present in sweat, which serve as biomarkers in blood, do not show a correlation with blood levels. This discrepancy can be attributed to factors such as contamination during measurements, the metabolism of sweat glands, or challenges in obtaining significant samples. The objective of this review is to present a critical and meaningful insight into the real applicability and potential use of wearable technology for improving health and sport performance. It also discusses the current limitations and future challenges of microfluidics, aiming to provide accurate information about the actual needs in this field. This work is expected to contribute to the future development of more suitable wearable microfluidic technology for health and sports science monitoring, using sweat as the biofluid for analysis., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Wearable sensors enable the noninvasive continuous analysis of biofluid, which is of great importance for healthcare monitoring. In this work, a wearable sensor was seamlessly integrated with a microfluidic chip which was prepared by a three-dimensional printing technology for noninvasive and multiplexed analysis of metabolite and electrolytes in human sweat. The microfluidic chip could enable rapid sampling of sweat, which avoids the sweat evaporation and contamination. Using a Zn metal-organic framework as a sacrificial template, the hexagonal rod-shaped porous carbon nanorod (PCN) with high porosity, a large specific surface area, and excellent conductivity was synthesized and exhibited the robust electrocatalytic ability of uric acid (UA) oxidation. Therefore, the PCN-based sensor showed high sensitivity and good selectivity of UA with a wide linear range of 10-200 μM and a low detection limit of 4.13 μM. Meanwhile, the potentiometry-based ion-selective electrode was constructed for detection of pH and K + , respectively, with good sensitivity, selectivity, reproducibility, and stability. In addition, the testing under different bending states demonstrated that mechanical deformation had little effect on the electrochemical performance of the wearable sensors. Furthermore, we evaluated the utility of the wearable sensor for multiplexed real-time analysis of UA, pH, and K + in sweat during aerobic exercise, and the effect of the amount of consumed purine-rich foods on uric acid metabolite levels in sweat and urine was further investigated. The relationship between urine UA and sweat UA was obtained. Overall, this wearable sensor enables multiple electrolyte and metabolite analysis in different noninvasive biofluids, suggesting its potential application in personalized disease prevention.

Innovations in wearable sweat sensors hold great promise to provide deeper insights into molecular level health information non-invasively. Lactate, a key metabolite present in sweat, holds immense significance in assessing physiological conditions and performance in sports physiology and health sensing. This paper presents the development and characterization of stretchable electrodes with ultrahigh active surface area of 648 % for lactate sensing. The as-printed stretchable electrodes were functionalized with an electron transfer layer comprising Toluidine Blue O and multi-walled carbon nanotubes (MWCNTs), and an enzymatic layer consisting of lactate dehydrogenase with β-Nicotinamide adenine dinucleotide as the cofactor for lactate selectivity. This sensor achieves a dual-signal read-out in which both electrochemical and fluorescence signals were obtained during lactate detection, demonstrating promising sensor performance in terms of sensitivity and reliability. We demonstrate the robustness of the dual-signal sensor under simulated conditions of physical deformation and shifted excitation. Under these compromised conditions, the performance of the stretchable electrodes remained largely unaffected, showcasing their potential for robust and adaptable sensing platforms in wearable health monitoring applications., (© 2024 Wiley-VCH GmbH.)

The development of wearable devices for sweat analysis has experienced significant growth in the last two decades, being the main focus the monitoring of athletes health during workouts. One of the main challenges of these approaches has been to attain the continuous monitoring of sweat for time periods over 1 h. This is the main challenge addressed in this work by designing an analytical platform that combines the high performance of potentiometric sensors and a fluidic structure made of a plastic fabric into a multiplexed wearable device. The platform comprises Ion-Sensitive Field-Effect Transistors (ISFETs) manufactured on silicon, a tailor-made solid-state reference electrode, and a temperature sensor integrated into a patch-like polymeric substrate, together with the component that easily collects and drives samples under continuous capillary flow to the sensor areas. ISFET sensors for measuring pH, sodium, and potassium ions were fully characterized in artificial sweat solutions, providing reproducible and stable responses. Then, the real-time and continuous monitoring of the biomarkers in sweat with the wearable platform was assessed by comparing the ISFETs responses recorded during an 85-min continuous exercise session with the concentration values measured using commercial Ion-Selective Electrodes (ISEs) in samples collected at certain times during the session. The developed sensing platform enables the continuous monitoring of biomarkers and facilitates the study of the effects of various real working conditions, such as cycling power and skin temperature, on the target biomarker concentration levels., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Sweat is considered the most promising candidate to replace conventional blood samples for noninvasive sensing. There are many tools and optical and electrochemical methods that can be used for detecting sweat biomarkers. Electrochemical methods are known for their simplicity and cost-effectiveness. However, they need to be optimized in terms of selectivity and catalytic activity. Therefore, electrode modifiers such as nanostructures and metal-organic frameworks (MOFs) or combinations of them were examined for boosting the performance of the electrochemical sensors. The MOF structures can be prepared by hydrothermal/solvothermal, sonochemical, microwave synthesis, mechanochemical, and electrochemical methods. Additionally, MOF nanostructures can be prepared by controlling the synthesis conditions or mixing bulk MOFs with nanoparticles (NPs). In this review, we spotlight the previously examined MOF-based nanostructures as well as promising ones for the electrochemical determination of sweat biomarkers. The presence of NPs strongly improves the electrical conductivity of MOF structures, which are known for their poor conductivity. Specifically, Cu-MOF and Co-MOF nanostructures were used for detecting sweat biomarkers with the lowest detection limits. Different electrochemical methods, such as amperometric, voltammetric, and photoelectrochemical, were used for monitoring the signal of sweat biomarkers. Overall, these materials are brilliant electrode modifiers for the determination of sweat biomarkers.

The ZnFe prussian blue analogue [ZnFe(PBA)] was infused with Ti 3 C 2 T x (MXene) denoted as ZnFe(PBA)@Ti 3 C 2 T x and was prepared by an in-situ sonication method to use as a non-enzymatic screen printed electrode sensor. The advantage of non-enzymatic sensors is their excellent sensitivity, rapid detection, low cost and simple design. The synthesized ZnFe(PBA)@Ti 3 C 2 T x was characterized for its physical and chemical characterization by XRD, Raman, XPS, EDAX, and FESEM analysis. It possessed multiple functionalized layers and a cubic structure in the nanohybrid. Further, the sensor was investigated by using electroanalytical studies such as cyclic voltammetry and chronoamperometry analysis. The enhanced surface area with a cubic structure of ZnFe(PBA) and the excellent electrical response of Ti 3 C 2 nanosheet support the advancement of a non-enzymatic electrochemical glucose sensor with improved sensitivity of 973.42 µA mM -1 cm -2 with the limit of detection (LOD) of 3.036 µM (S/N = 3) and linear detection range (LDR) from 0.01 to 1 mM., (© 2024. The Author(s).)

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

Electrochemical analysis of glucose monitoring without painful blood collection provides a new noninvasive route for monitoring glucose levels. Thus, in this study, biobased cellulosic papers (methylated and phosphorylated one) based glucose monitoring sensor is developed. To achieve high hydrophilicity, microfibrillated cellulose (MFC) were functionalized using hexokinase mediated phosphorylation (-OH to -[Formula: see text]). The instinctive increased surface charge density from 36.2 ± 3.4 to 118.4 ± 1.2 µmol/g and decrease contact angle (45°-22°) confirms the increased hydrophilicity of paper. Furthermore, functionalized phos-MFC paper increase the capillary flow of sweat, required low quantity (1 µl) of sweat for accurate analysis of glucose level. Additionally, chemically induced methyl groups (-CH 3 ) make the sensor more barrier to other chemicals. In addition, a multilayer patch design combined with sensor miniaturization was used to lead to an increase in the efficiency of the sweat collection and sensing processes. Besides, this paper sensor integrated with artificial transdermal drug delivery unit (agarose gel as skin) for monitoring glucose levels in sweat. The patch monitoring system increase the accuracy of sensing with fluctuation in sweat vol. (1-4 µl), temperature (20-70 °C), and pH (4.0-7.0). In addition, temperature dependency artificial transdermal delivery (within agarose gel) of drug metformin agrees the measurement accuracy of sensor, called "switch system" without any error. As a result, the reported MFC paper based multi-patch disposable sensing system provides a novel closed-loop solution for the noninvasive sweat-based management of diabetes mellitus., (© 2024. The Author(s).)

Introduction: The assessment of Volatile Organic Compounds (VOCs) in exhaled breath or sweat represents a potential non-invasive and rapid diagnostic tool for respiratory diseases., Objective: To determine if trained dogs can reliably identify the odour associated with COVID19., Methods: This is a monocentric prospective study carried out in the Emergency Department (ED) of a university hospital fromJulyto November 2021.Axillary sweat samples from all patients were collected bytwo trained health care professionals. The samples were collected in the form of sterile gauze swabs placed under the armpits for at least 4 h for each patient.Then, Tubes wereshiftedto the double-blind dog training centre for VOC detection by two individuals., Results: Dogs were tested using a total of 129 axillary sweat samples; 69 of the 107 patients who tested positive for COVID-19 based on their odours had a positive PCR/Antigen test and 19 of the 22 patients who were tested negative for COVID-19 by the dogs had a negative PCR test. The sniffer dog infection detection method had a sensitivity of 95.83% and a specificity of 33.33%. The PPV was 64.49% and the NPVwas 86.36%. The measurement of the intensity of the connection between the two variables (disease/sign) was very strong ( Q  = 0.84). This link is statistically significant (X 2 = 19.13) with a probability p ≤ 0.001., Conclusion: Overall, the use of trained detection dogs as a screening method for SARS-CoV-2 is an interesting avenue of research that warrants further exploration and validation.

Sweat chloride concentration, a diagnostic feature in cystic fibrosis (CF), reflects CF transmembrane conductance regulator (CFTR) activity. CFTR modulator therapies, especially elexacaftor/tezacaftor/ivacaftor (ETI), has improved CF outcomes. We report nationwide, real-world data on sweat chloride concentration in people with CF (pwCF) with and without modulator therapies. All Danish pwCF with a minimum of one F508del allele were included. Sweat chloride measurements were stratified by genotype and modulator treatment. Differences were assessed using mixed-effects models. We included 977 sweat chloride measurements from 430 pwCF, 71% of which were F508del homozygous. Heterozygous and homozygous ETI-treated pwCF had an estimated mean sweat chloride concentration of 43 mmol/L (95% confidence interval: 39; 48) and 43 mmol/L (39; 47), respectively-48% and 59% lower than those without treatment. High variation in concentrations remained regardless of treatment status. Despite ETI treatment, 27% heterozygous and 23% homozygous pwCF had elevated concentrations (≥60 mmol/L). These real-world data confirm a substantial decrease in sweat chloride concentration during modulator treatment, especially ETI, where mean concentrations halved. However, large variation remained, including persistently high concentrations. These findings emphasize the potential of sweat chloride concentration as a treatment response biomarker and the need to explore its heterogeneity and relationship with clinical outcomes., (© 2024 The Author(s). APMIS published by John Wiley & Sons Ltd on behalf of Scandinavian Societies for Pathology, Medical Microbiology and Immunology.)

To enhance personalized diabetes management, there is a critical need for non-invasive wearable electrochemical sensors made from flexible materials to enable continuous monitoring of sweat glucose levels. The main challenge lies in developing glucose sensors with superior electrochemical characteristics and high adaptability. Herein, we present a wearable sensor for non-enzymatic electrochemical glucose analysis. The sensor was synthesized using hydrothermal and one-pot preparation methods, incorporating gold nanoparticles (AuNPs) functionalized onto aminated multi-walled carbon nanotubes (AMWCNTs) as an efficient catalyst, and crosslinked with carboxylated styrene butadiene rubber (XSBR) and PEDOT:PSS. The sensors were then integrated onto screen-printed electrodes (SPEs) to create flexible glucose sensors (XSBR-PEDOT:PSS-AMWCNTs/AuNPs/SPE). Operating under neutral conditions, the sensor exhibits a linear range of 50 μmol/L to 600 μmol/L, with a limit of detection limit of 3.2 μmol/L (S/N = 3), enabling the detection of minute glucose concentrations. The flexible glucose sensor maintains functionality after 500 repetitions of bending at a 180° angle, without significant degradation in performance. Furthermore, the sensor exhibits exceptional stability, repeatability, and resistance to interference. Importantly, we successfully monitored changes in sweat glucose levels by applying screen-printed electrodes to human skin, with results consistent with normal physiological blood glucose fluctuations. This study details the fabrication of a wearable sensor characterized by ease of manufacture, remarkable flexibility, high sensitivity, and adaptability for non-invasive blood glucose monitoring through non-enzymatic electrochemical analysis. Thus, this streamlined fabrication process presents a novel approach for non-invasive, real-time blood glucose level monitoring., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Abnormal amount of dopamine (DA) in human body is closely relate to various diseases, such as Parkinson's disease, pheochromocytoma. Real-time monitoring DA is crucial for disease warning, diagnosis and treatment. Currently, most methods rely on invasive blood testing for detecting DA, which is only completed with the aid of the medical staffs in hospitals. Herein, a non-invasive fluorescence visual strategy is developed for the real-time monitoring DA, based on luminescent nanoparticles and modified mesoporous zeolite imidazole framework (ZIF-8-NH 2 ) dodecahedrons. During the reaction process, DA is enriched through the spatial configuration of ZIF-8-NH 2 and hydrogen bonding effect. The luminescence of Cr 3+ -doped zinc gallate (ZnGa 2 O 4 :Cr 3+ , ZGC) is inhibited by the photo-induced electron transfer (PET) mechanism to realize sensitively detecting DA. The intelligent sensing platform based on the designed fluorescence probe and color recognition system is structured for real-time detection of DA in urine. Furthermore, a skin-fitting hydrogel patch is prepared by combining a fluorescent probe with chitosan, which enables sensitive and accurate detection of DA in sweat without the complex sample pretreatment. The non-invasive fluorescence detection method provides an effective strategy for quantitatively monitoring DA in human fluids., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Herein we introduce a novel water-based graphite ink modified with multiwalled carbon nanotubes, designed for the development of the first wearable self-powered biosensor enabling alcohol abuse detection through sweat analysis. The stencil-printed graphite (SPG) electrodes, printed onto a flexible substrate, were modified by casting multiwalled carbon nanotubes (MWCNTs), electrodepositing polymethylene blue (pMB) at the anode to serve as a catalyst for nicotinamide adenine dinucleotide (NADH) oxidation, and hemin at the cathode as a selective catalyst for H 2 O 2 reduction. Notably, alcohol dehydrogenase (ADH) was additionally physisorbed onto the anodic electrode, and alcohol oxidase (AOx) onto the cathodic electrode. The self-powered biosensor was assembled using the ADH/pMB-MWCNTs/SPG||AOx/Hemin-MWCNTs/SPG configuration, enabling the detection of ethanol as an analytical target, both at the anodic and cathodic electrodes. Its performance was assessed by measuring polarization curves with gradually increasing ethanol concentrations ranging from 0 to 50 mM. The biosensor demonstrated a linear detection range from 0.01 to 0.3 mM, with a detection limit (LOD) of 3 ± 1 µM and a sensitivity of 64 ± 2 μW mM -1 , with a correlation coefficient of 0.98 (RSD 8.1%, n = 10 electrode pairs). It exhibited robust operational stability (over 2800 s with continuous ethanol turnover) and excellent storage stability (approximately 93% of initial signal retained after 90 days). Finally, the biosensor array was integrated into a wristband and successfully evaluated for continuous alcohol abuse monitoring. This proposed system displays promising attributes for use as a flexible and wearable biosensor employing biocompatible water-based inks, offering potential applications in forensic contexts., (© 2024. The Author(s).)

Oxidative stress is widely recognized as a pivotal factor contributing to numerous Central Nervous System (CNS) ailments. The concentrations of hydrogen peroxide (H 2 O 2 ) and phosphorylated proteins within the human body serve as crucial indicators of oxidative stress. As such, the real-time monitoring of H 2 O 2 and phosphorylated proteins in sweat is vital for the early identification, diagnosis, and management of diseases linked to oxidative stress. In this context, we present a novel microfluidic wearable electrochemical sensor by modifying the electrode with Prussian blue (PB) and loading sulfur-rich vacancy-containing molybdenum disulfide (MoS 2-X ) onto Multi-walled carbon nanotube (CNTs) to form coaxially layered CNTs/MoS 2-X , which was then synthesized with highly dispersed titanium dioxide nanoparticles (TiO 2 ) to synthesize CNTs/MoS 2-X /TiO 2 composites for the detection of human sweat H 2 O 2 and phosphorylated proteins, respectively. This structure, with its sulfur vacancies and coaxial layering, significantly improved sensitivity of electrochemical sensors, allowing it to detect H 2 O 2 in a range of 0.01-1 mM with a detection limit of 4.80 μM, and phosphoproteins in a range of 0.01-1 mg/mL with a threshold of 0.917 μg/mL. Furthermore, the miniature sensor demonstrates outstanding performance in detecting analytes in both simulated and real sweat. Comprehensive biosafety assessments have validated the compatibility of the electrode material, underscoring the potential of sensor as a reliable and non-invasive method for tracking biomarkers linked to CNS disorders. This microfluidic wearable electrochemical biosensor with high performance and biosafety features shows great promise for the development of cutting-edge wearable technology devices for tracking CNS disease indicators., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:All animals were kept in a pathogen-free environment and fed ad lib. The procedures for care and use of animals were approved by the Ethics Committee of the Medical College of Qinghai Universityand all applicable institutional and governmental regulations concerning the ethical use of animals were followed. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Cortisol is established as a reliable biomarker for stress prompting intensified research in developing wearable sensors to detect it via eccrine sweat. Since cortisol is present in sweat in trace quantities, typically 8-140 ng/mL, developing such biosensors necessitates the design of bioreceptors with appropriate sensitivity and selectivity. In this work, we present a systematic biomimetic methodology and a semi-automated high-throughput screening tool which enables rapid selection of bioreceptors as compared to ab initio design of peptides via computational peptidology. Candidate proteins from databases are selected via molecular docking and ranked according to their binding affinities by conducting automated AutoDock Vina scoring simulations. These candidate proteins are then validated via full atomistic steered molecular dynamics computations including umbrella sampling to estimate the potential of mean force using GROMACS version 2022.6. These explicit molecular dynamic calculations are carried out in an eccrine sweat environment taking into consideration the protein dynamics and solvent effects. Subsequently, we present a candidate baseline peptide bioreceptor selected as a contiguous sequence of amino acids from the selected protein binding pocket favourably interacting with the target ligand (i.e., cortisol) from the active binding site of the proteins and maintaining its tertiary structure. A unique cysteine residue introduced at the N-terminus allows orientation-specific surface immobilization of the peptide onto the gold electrodes and to ensure exposure of the binding site. Comparative binding affinity simulations of this peptide with the target ligand along with commonly interfering species e.g., progesterone, testosterone and glucose are also presented to demonstrate the validity of this proposed peptide as a candidate baseline bioreceptor for future cortisol biosensor development., (© 2024. The Author(s).)

A novel bimetallic Fe/Co-metal-organic framework (MOF) hydrogel-based wearable sweat sensor was developed. Morphological and structural analysis of the hydrogel shows uniformly sized spines and spindle-shaped particles of the Fe/Co-MOF, and it has a high surface area (132.306 m 2  g -1 ) and porosity (0.059 cm 3  g -1 ) as confirmed by Brunauer-Emmett-Teller (BET) studies. The integration of the bimetallic MOF into a polyvinyl alcohol/chitosan (PVA/CS)-mixed matrix resulted in a multiple network hydrogel. The optimisation study investigated  the effects of different pH of the PBS electrolyte, scan rates, and accumulation time in voltammetry. The electrochemical methods such as cyclic voltammetry (CV), square wave voltammetry (SWV), and electrochemical impedance spectroscopy (EIS) provided information on the redox behaviour, electrochemical stability, and catalytic activity of the hydrogel. The sensor demonstrates a wide linear detection range from 0.05 µM to 100 mM, a superior sensitivity of 0.02 mA mM -1  cm -2 , and a lower limit of detection of 0.01 µM . Active sites distributed over the hydrogel surface, specifically Fe 2+ and Co 2+ within the MOF structure, catalyse the oxidation of L-lactic acid, resulting in electron transfer and the formation of pyruvic acid. Notably, the fabricated sensor exhibits high selectivity, effectively discriminating against interfering species such as uric acid, ascorbic acid, glucose, urea, dopamine, NaCl, and CaCl 2 . Real-time analysis conducted in a simulated sweat sample via the standard addition method resulted in good recovery percentages of a minimum of 98%. The work presented here is a versatile and simple platform for point-of-care testing, especially for athletes and military personnel., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Nonenzymatic electrochemical biosensors, renowned for their high sensitivity, multi-target analysis capabilities, and miniaturized integration, align well with the requirements of non-invasive, multi-index integrated, continuous monitoring, and user-friendly wearable biosensors in sports science. In the past three years, novel strategies targeting specific responses to sports biomarkers have opened new avenues for applications in sports science. However, these advancements also pose challenges in achieving adequate sensitivity and specificity for online analysis of complex sweat bio-samples. Our article focuses on three key nonenzymatic electrochemical biosensing strategies: antigen-antibody reactions, nucleic acid aptamer recognition, and molecular imprinting capture. We delve into strategies to enhance specificity and sensitivity in the application of biosensors in sports science, including shortening signal transduction paths through built-in signal probes, increasing reaction sites through increased surface area and the introduction of nanostructures, multi-target analyses, and microfluidic techniques.

Since screening for cystic fibrosis (CF) was incorporated into the newborn screening program, the number of recognised variants in the CF transmembrane conductance regulator (CFTR ) gene has significantly increased. This has led to the discovery of combinations of gene variants with an uncertain prognosis. One outcome is the designation of 'cystic fibrosis screen positive inconclusive diagnosis' (CFSPID). While the majority of these children are expected to be unaffected by their CFTR variants, a small proportion have been seen to develop symptoms or increasing sweat chloride levels over time, which may reflect dysfunction of the CFTR protein.As the number of children with CFSPID increases, paediatricians and those working in primary care are more likely to encounter them in their practice. It is important that professionals have an understanding of CFSPID: what it is and, importantly, what it is not (ie, they do not have CF). In this article, we hope to explore this using some example cases, illustrating the ways in which these children may present symptomatically and how to manage them., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Wearable electronics for long-term monitoring of physiological signals should be capable of removing sweat generated during daily motion, which significantly impacts signal stability, human comfort, and safety of the electronics. In this study, we developed a double-layer polyurethane (PU) membrane with sweat-directional transport ability that can be applied for monitoring strain signals. The PU membrane was composed of a hydrophilic, conductive layer and a relatively hydrophobic layer. The double-layer PU composite membrane exhibited varied pore size and opposite hydrophilicity on its two sides, enabling the spontaneous pumping of sweat from the hydrophobic side to the hydrophilic side, i.e., the directional transport of sweat. The membrane can be used as a strain sensor to monitor motion strain over a broad working range of 0% to 250% with high sensitivity (GF = 4.11). The sensor can also detect simple human movements even under sweating conditions. We believe that the strategy demonstrated here will provide new insights into the design of next-generation strain sensors.

Sweat contains abundant physiological and metabolic data to evaluate an individual's physical health. Since the non-exercise sweat secretion rate is low, with an average value of 1-10 μl h -1 cm -2 , sweat is generally collected during exercise for existing wearable sweat sensors. To expand their applications to include daily scenarios, these sensors developed for sports and fitness are challenged by the difficulty of collecting trace amounts of sweat. This study proposes a wearable patch inspired by the hierarchical structure of Sarracenia trichomes, allowing for the spontaneous and fast collection of a small amount of secreted sweat. The patch contains microfluidic channels featuring a 20 μm-wide rib structure, fully utilizing the capillary force, thereby eliminating the issue of sweat hysteresis. Furthermore, with only 0.5 μl of the sweat secreted at the collection site, it can converge on the detection medium located within the center reservoir. Volunteer verification demonstrated a twofold increase in sweat collection efficiency compared to traditional wearable patches. This patch serves as an efficient sweat-collection configuration, promising potential for diverse in situ sweat colorimetric analyses., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Zhinan Zhang reports financial support was provided by State Key Laboratory of Mechanical System and Vibration. Zhinan Zhang reports financial support was provided by the open project of National Research Center for Translational Medicine, Shanghai. Zhinan Zhang reports financial support was provided by High-end Foreign Experts Recruitment Plan. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

We introduce the FlexoSERS sensor, which is notable for its high stretchability, sensitivity, and patternability. Featuring a hierarchically oriented jellyfish-like architecture constructed from stretchable gold nanowires, this sensor provides an ultrasensitive SERS signal even under 50% strain, with an enhancement factor (EF) of 3.3 × 10 10 . Impressively, this heightened performance remains consistently robust across 2,500 stretch-release cycles. The integration of nanowires with 3D-printed hydrogel enables a customizable FlexoSERS sensor, facilitating localized sweat collection and detection. The FlexoSERS sensor successfully detects and quantifies uric acid (UA) in both artificial and human sweat and functions as a pH sensor with repeatability and sensitivity across a pH range of 4.2-7.8, enabling real-time sweat monitoring during exercise. In summary, the rational architectural design, scalable fabrication process, and hydrogel integration collectively position this nanowire-based FlexoSERS sensor as a highly promising platform for customizable wearable sweat diagnostics.

Traditional diagnostic methods, such as blood tests, are invasive and time-consuming, while sweat biomarkers offer a rapid physiological assessment. Surface-enhanced Raman spectroscopy (SERS) has garnered significant attention in sweat analysis because of its high sensitivity, label-free nature, and nondestructive properties. However, challenges related to substrate reproducibility and interference from the biological matrix persist with SERS. This study developed a novel ratio-based 3D hydrogel SERS chip, providing a noninvasive solution for real-time monitoring of pH and glucose levels in sweat. Encapsulating the probe molecule (4-MBN) in nanoscale gaps to form gold nanoflower-like nanotags with internal standards and integrating them into an agarose hydrogel to create a 3D flexible SERS substrate significantly enhances the reproducibility and stability of sweat analysis. Gap-Au nanopetals modified with probe molecules are uniformly dispersed throughout the porous hydrogel structure, facilitating the effective detection of the pH and glucose in sweat. The 3D hydrogel SERS chip demonstrates a strong linear relationship in pH and glucose detection, with a pH response range of 5.5-8.0 and a glucose detection range of 0.01-5 mM, with R 2 values of 0.9973 and 0.9923, respectively. In actual sweat samples, the maximum error in pH detection accuracy is only 1.13%, with a lower glucose detection limit of 0.25 mM. This study suggests that the ratio-based 3D hydrogel SERS chip provides convenient, reliable, and rapid detection capabilities with substantial application potential for analyzing body fluid pH and glucose.

Ketones, such as beta-hydroxybutyrate (BHB), are important metabolites that can be used to monitor for conditions such as diabetic ketoacidosis (DKA) and ketosis. Compared to conventional approaches that rely on samples of urine or blood evaluated using laboratory techniques, processes for monitoring of ketones in sweat using on-body sensors offer significant advantages. Here, we report a class of soft, skin-interfaced microfluidic devices that can quantify the concentrations of BHB in sweat based on simple and low-cost colorimetric schemes. These devices combine microfluidic structures and enzymatic colorimetric BHB assays for selective and accurate analysis. Human trials demonstrate the broad applicability of this technology in practical scenarios, and they also establish quantitative correlations between the concentration of BHB in sweat and in blood. The results represent a convenient means for managing DKA and aspects of personal nutrition/wellness.

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

A wearable potentiometric device is reported based on an innovative butterfly-like paper-based microfluidic system, allowing for continuous monitoring of pH and Na + levels in sweat during physical activity. Specifically, the use of the butterfly-like configuration avoids evaporation phenomena and memory effects, enabling precise and timely biomarker determination in sweat. Two ad hoc modified screen-printed electrodes were embedded in the butterfly-like paper-based microfluidics, and the sensing device was further integrated with a portable and miniaturized potentiostat, leveraging Bluetooth technology for efficient data transmission. First, the paper-based microfluidic configuration was tested for optimal fluidic management to obtain optimized performance of the device. Subsequently, the two electrodes were individually tested to detect the two biomarkers, namely pH and Na + . The results demonstrated highly promising near-Nernstian (0.056 ± 0.002 V/dec) and super-Nernstian (- 0.080 ± 0.003 V/pH) responses, for Na + and pH detection, respectively. Additionally, several important parameters such as storage stability, interferents, and memory effect by hysteresis study were also investigated. Finally, the butterfly-like paper-based microfluidic wearable device was tested for Na + and pH monitoring during the physical activity of three volunteers engaged in different exercises, obtaining a good correlation between Na + increase and dehydration phenomena. Furthermore, one volunteer was tested through a cardiopulmonary test, demonstrating a correlation between sodium Na + increase and the energetic effort by the volunteer. Our wearable device highlights the high potential to enable early evaluation of dehydration and open up new opportunities in sports activity monitoring., (© 2024. The Author(s).)