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The development of wearable devices provides approaches for the realization of self-health care. Easily carried wearable devices allow individual health monitoring at any place whenever necessary. There are various interesting monitoring targets, including body motion, organ pressure, and biomarkers. An efficient use of space in one small device is a promising resolution to increase the functions of wearable devices. Through integration of a microfluidic system into wearable devices, embedding complicated structures in one design becomes possible and can enable multifunction analyses within a limited device volume. This article reviews the reported microfluidic wearable devices, introduces applications to different biofluids, discusses characteristics of the design strategies and sensing principles, and highlights the attractive configurations of each device. This review seeks to provide a detailed summary of recent advanced microfluidic wearable devices. The overview of advanced key components is the basis for the development of future microfluidic wearable devices. Expected final online publication date for the Annual Review of Analytical Chemistry, Volume 16 is June 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Electrochemical biosensors have been applied in a broad range of clinical applications for pathogen biomarker detection and medical applications and diagnosis due to the sensitivity of electrochemical methods and the bioselectivity of the components. The complexity of clinical conditions with various biofoulants (proteins, cells, polysaccharides and lipids) severely influences the reliability and stability of sensors for direct detection or immersion under changing conditions. Therefore, designing an antifouling sensing platform that can effectively reduce undesired binding to maintain biosensor performance in optimized analysis is necessary. For this purpose, the fundamental mechanisms of fouling materials and commonly used biocompatible antifouling components have been discussed, and the relevant effective modification strategies are introduced in this review. Recent advances in these strategies are demonstrated in examples with analysis of essential modification methods for reliable sensing in non-specific binding solutions or complex biofluids. The challenges and future perspectives of modification strategies for current clinical application are also discussed in this review.

Since polymerase chain reaction (PCR) has become a vital tool for disease diagnosis, the development of precise applied PCR technologies in point-of care testing (POCT) has become more significant. The microfluidic-based PCR platform offers a great opportunity for on-site diagnosis efficiency, and the system is aimed at user-friendly access. Herein, we demonstrate a microfluidic system with simple operation that provides reliable nucleic acid results from 18 uniform droplets via LAMP qPCR detection. By using only micropipette regulation, users are able to control the nanoliter scale of the droplets in this valve-free and pump-free microfluidic (MF) chip. Based on the oil enclosure method and impermeable fabrication, we successfully preserved the reagent inside the microfluidic system, which significantly reduced the fluid loss and condensation. The relative standard deviation (RSD) of the fluorescence intensity between the droplets and during the heating process was

Summary Sweat-based wearable devices have attracted increasing attention by providing abundant physiological information and continuous measurement through noninvasive healthcare monitoring. Sweat pressure generated via sweat glands to the skin surface associated with osmotic effects may help to elucidate such parameters as physiological conditions and psychological factors. This study introduces a wearable device for measuring secretion sweat pressure through noninvasive, continuous monitoring. Secretion pressure is detected by a microfluidic chip that shows the resistance variance from a paired electrode pattern and transfers digital signals to a smartphone for real-time display. A human study demonstrates this measurement with different exercise activities, showing the pressure ranges from 1.3 to 2.5 kPa. This device is user-friendly and applicable to exercise training and personal health care. The convenience and easy-to-wear characteristics of this device may establish a foundation for future research investigating sweat physiology and personal health care., Graphical Abstract, Highlights • A wearable device sensing secreted sweat pressure for personal health care • A noninvasive method for real-time pressure monitoring displayed on a smartphone • Widely adopted in different individuals for ionic and temperature calibrations • Successful in situ measurements with exercise for 30 min, Sensor; Electronic Engineering; Biomedical Engineering; Electronic Materials

Extreme point-of-care testing (POCT) is a medical test performed at or near patients at a resource-limited condition. POCT technology has advantages over traditional medical lab tests for molecular detection and infection diagnosis, such as being simple, portable, low-cost, and user-friendly. However, some POCT devices might rely on bulky equipment, and some might be easily influenced by components in biofluid, which might result in higher prices and lower accuracy. In this paper, we demonstrated a low-cost method for detecting bacterial infection in the early stage. We designed a hand-powered centrifugal microfluidic (CMF) disc with magnetic chitosan beads (MCBs) to detect specific circulating antibodies in human whole blood. Nine identical units was used for calibration curve plotting and sample testing. The MCBs, generated with another microfluidic chip and coated with MBL proteins (biomarker of drug-resistant Streptococcus pneumoniae, DRSP, taken as an example for bacterial infection), were served as the substrate of sandwich-structured enzyme-linked immunosorbent assays (ELISA) and as the micro stirring sphere at the same time. The limit of detection (LOD) in PBS and human whole blood were 22.67 ng/mL and 24.83 ng/mL, respectively. The comparison between calibration curves from the antibody spiked in human whole blood and that in PBS was shown to prove the high compatibility and low interference of biofluid, and the recovery rate was 92 %. In conclusion, since our low-cost, time-saving, and user-friendly hand-powered CMF device with minimally consumed electricity detected the target antibody precisely, we believe that other similar assays would be feasible as well. Therefore, we are firmly convinced that this alternative POCT device may lead to the development of next-generation healthcare diagnoses.

Objective: Pleural effusion is common problem, but the rapid and reliable diagnosis for specific pathogenic effusions are lacking. This study aimed to identify the diagnosis based on clinical variables to differentiate pleural tuberculous exudates from other pleural effusions. We also investigated the role of renin-angiotensin system (RAS) and matrix metalloproteinase (MMPs) in the pathogenesis of pleural exudates.Experimental design: The major components in RAS and extracellular matrix metabolism, including angiotensin converting enzyme (ACE), ACE2, MMP-2 and MMP-9 activities, were measured and compared in the patients with transudative (n = 45) and exudative (n = 80) effusions. The exudative effusions were come from the patients with tuberculosis (n = 20), pneumonia (n = 32), and adenocarcinoma (n = 28).Results: Increased ACE and equivalent ACE2 activities, resulting in a significantly increased ACE/ACE2 ratio in exudates, were detected compared to these values in transudates. MMP-9 activity in exudates was significantly higher than that in transudates. The significant correlation between ACE and ACE2 activity that was found in transudates was not found in exudates. Advanced analyses showed significantly increased ACE and MMP-9 activities, and decreased ACE2 activity in tuberculous pleural effusions compared with those in pneumonia and adenocarcinoma effusions. The results indicate that increased ACE and MMP-9 activities found in the exudates were mainly contributed from a higher level of both enzyme activities in the tuberculous pleural effusions.Conclusion: Interplay between ACE and ACE2, essential functions in the RAS, and abnormal regulation of MMP-9 probably play a pivotal role in the development of exudative effusions. Moreover, the ACE/ACE2 ratio combined with MMP-9 activity in pleural fluid may be potential biomarkers for diagnosing tuberculous pleurisy.

Objective: Pleural effusion is common problem, but the rapid and reliable diagnosis for specific pathogenic effusions are lacking. This study aimed to identify the diagnosis based on clinical variables to differentiate pleural tuberculous exudates from other pleural effusions. We also investigated the role of renin-angiotensin system (RAS) and matrix metalloproteinase (MMPs) in the pathogenesis of pleural exudates. Experimental design: The major components in RAS and extracellular matrix metabolism, including angiotensin converting enzyme (ACE), ACE2, MMP-2 and MMP-9 activities, were measured and compared in the patients with transudative (n = 45) and exudative (n = 80) effusions. The exudative effusions were come from the patients with tuberculosis (n = 20), pneumonia (n = 32), and adenocarcinoma (n = 28). Results: Increased ACE and equivalent ACE2 activities, resulting in a significantly increased ACE/ACE2 ratio in exudates, were detected compared to these values in transudates. MMP-9 activity in exudates was significantly higher than that in transudates. The significant correlation between ACE and ACE2 activity that was found in transudates was not found in exudates. Advanced analyses showed significantly increased ACE and MMP-9 activities, and decreased ACE2 activity in tuberculous pleural effusions compared with those in pneumonia and adenocarcinoma effusions. The results indicate that increased ACE and MMP-9 activities found in the exudates were mainly contributed from a higher level of both enzyme activities in the tuberculous pleural effusions. Conclusion: Interplay between ACE and ACE2, essential functions in the RAS, and abnormal regulation of MMP-9 probably play a pivotal role in the development of exudative effusions. Moreover, the ACE/ACE2 ratio combined with MMP-9 activity in pleural fluid may be potential biomarkers for diagnosing tuberculous pleurisy.

Boronic acids (BAs) provide strong potential in orientation immobilization of antibody and the modification method is crucial for efficiency optimization. A highly effective method has been developed for rapid antibody immobilization on gold electrodes through the electrodeposition of a BA–containing linker in this study. Aniline-based BA forms a condense layer while antibody could automatically immobilize on the surface of the electrode. Compare to traditional self-assembled monolayer method, the electrodeposition process dramatically reduces the modification time from days to seconds. It also enhances the immobilized efficiency from 95 to 408 (ng/cm2) with a strong preference being exhibited for shorter aniline-based linkers.