Wearable Contact Lens Biosensors for Continuous Glucose Monitoring Using Smartphones

Nanotechnology-Based Diagnostics for Diseases Prevalent in Developing Countries: Current Advances in Point-of-Care Tests

The introduction of point-of-care testing (POCT) has revolutionized medical testing by allowing for simple tests to be conducted near the patient's care point, rather than being confined to a medical laboratory. This has been especially beneficial for developing countries with limited infrastructure, where testing often involves sending specimens off-site and waiting for hours or days for results. However, the development of POCT devices has been challenging, with simplicity, accuracy, and cost-effectiveness being key factors in making these tests feasible. Nanotechnology has played a crucial role in achieving this goal, by not only making the tests possible but also masking their complexity. In this article, recent developments in POCT devices that benefit from nanotechnology are discussed. Microfluidics and lab-on-a-chip technologies are highlighted as major drivers of point-of-care testing, particularly in infectious disease diagnosis. These technologies enable various bioassays to be used at the point of care. The article also addresses the challenges faced by these technological advances and interesting future trends. The benefits of point-of-care testing are significant, especially in developing countries where medical care is shifting towards prevention, early detection, and managing chronic conditions. Infectious disease tests at the point of care in low-income countries can lead to prompt treatment, preventing infections from spreading.

Reshaping healthcare with wearable biosensors

Wearable health sensors could monitor the wearer's health and surrounding environment in real-time. With the development of sensor and operating system hardware technology, the functions of wearable devices have been gradually enriched with more diversified forms and more accurate physiological indicators. These sensors are moving towards high precision, continuity, and comfort, making great contributions to improving personalized health care. At the same time, in the context of the rapid development of the Internet of Things, the ubiquitous regulatory capabilities have been released. Some sensor chips are equipped with data readout and signal conditioning circuits, and a wireless communication module for transmitting data to computer equipment. At the same time, for data analysis of wearable health sensors, most companies use artificial neural networks (ANN). In addition, artificial neural networks could help users effectively get relevant health feedback. Through the physiological response of the human body, various sensors worn could effectively transmit data to the control unit, which analyzes the data and provides feedback of the health value to the user through the computer. This is the working principle of wearable sensors for health. This article focuses on wearable biosensors used for healthcare monitoring in different situations, as well as the development, technology, business, ethics, and future of wearable sensors for health monitoring.

Moving toward smart biomedical sensing

The development of novel biomedical sensors as highly promising devices/tools in early diagnosis and therapy monitoring of many diseases and disorders has recently witnessed unprecedented growth; more and faster than ever. Nonetheless, on the eve of Industry 5.0 and by learning from defects of current sensors in smart diagnostics of pandemics, there is still a long way to go to achieve the ideal biomedical sensors capable of meeting the growing needs and expectations for smart biomedical/diagnostic sensing through eHealth systems. Herein, an overview is provided to highlight the importance and necessity of an inevitable transition in the era of digital health/Healthcare 4.0 towards smart biomedical/diagnostic sensing and how to approach it via new digital technologies including Internet of Things (IoT), artificial intelligence, IoT gateways (smartphones, readers), etc. This review will bring together the different types of smartphone/reader-based biomedical sensors, which have been employing for a wide variety of optical/electrical/electrochemical biosensing applications and paving the way for future eHealth diagnostic devices by moving towards smart biomedical sensing. Here, alongside highlighting the characteristics/criteria that should be met by the developed sensors towards smart biomedical sensing, the challenging issues ahead are delineated along with a comprehensive outlook on this extremely necessary field.

Biosensors for healthcare: current and future perspectives

Biosensors are utilized in several different fields, including medicine, food, and the environment; in this review, we examine recent developments in biosensors for healthcare. These involve three distinct types of biosensor: biosensors for in vitro diagnosis with blood, saliva, or urine samples; continuous monitoring biosensors (CMBs); and wearable biosensors. Biosensors for in vitro diagnosis have seen a significant expansion recently, with newly reported clustered regularly interspaced short palindromic repeats (CRISPR)/Cas methodologies and improvements to many established integrated biosensor devices, including lateral flow assays (LFAs) and microfluidic/electrochemical paper-based analytical devices (μPADs/ePADs). We conclude with a discussion of two novel groups of biosensors that have drawn great attention recently, continuous monitoring and wearable biosensors, as well as with perspectives on the commercialization and future of biosensors.

A Systematic Review on the Advanced Techniques of Wearable Point-of-Care Devices and Their Futuristic Applications

Personalized point-of-care testing (POCT) devices, such as wearable sensors, enable quick access to health monitoring without the use of complex instruments. Wearable sensors are gaining popularity owing to their ability to offer regular and continuous monitoring of physiological data by dynamic, non-invasive assessments of biomarkers in biofluids such as tear, sweat, interstitial fluid and saliva. Current advancements have concentrated on the development of optical and electrochemical wearable sensors as well as advances in non-invasive measurements of biomarkers such as metabolites, hormones and microbes. For enhanced wearability and ease of operation, microfluidic sampling, multiple sensing, and portable systems have been incorporated with materials that are flexible. Although wearable sensors show promise and improved dependability, they still require more knowledge about interaction between the target sample concentrations in blood and non-invasive biofluids. In this review, we have described the importance of wearable sensors for POCT, their design and types of these devices. Following which, we emphasize on the current breakthroughs in the application of wearable sensors in the realm of wearable integrated POCT devices. Lastly, we discuss the present obstacles and forthcoming potentials including the use of Internet of Things (IoT) for offering self-healthcare using wearable POCT.

Redox-Mediated Gold Nanoparticles with Glucose Oxidase and Egg White Proteins for Printed Biosensors and Biofuel Cells

Glucose oxidase (GOx)-based electrodes are important for bioelectronics, such as glucose sensors. It is challenging to effectively link GOx with nanomaterial-modified electrodes while preserving enzyme activity in a biocompatible environment. To date, no reports have used biocompatible food-based materials, such as egg white proteins, combined with GOx, redox molecules, and nanoparticles to create the biorecognition layer for biosensors and biofuel cells. This article demonstrates the interface of GOx integrated with egg white proteins on a 5 nm gold nanoparticle (AuNP) functionalized with a 1,4-naphthoquinone (NQ) and conjugated with a screen-printed flexible conductive carbon nanotube (CNT)-modified electrode. Egg white proteins containing ovalbumin can form three-dimensional scaffolds to accommodate immobilized enzymes and adjust the analytical performance. The structure of this biointerface prevents the escape of enzymes and provides a suitable microenvironment for the effective reaction. The bioelectrode's performance and kinetics were evaluated. Using redox-mediated molecules with the AuNPs and the three-dimensional matrix made of egg white proteins improves the transfer of electrons between the electrode and the redox center. By engineering the layer of egg white proteins on the GOx-NQ-AuNPs-mediated CNT-functionalized electrodes, we can modulate analytical performances such as sensitivity and linear range. The bioelectrodes demonstrate high sensitivity and can prolong the stability by more than 85% after 6 h of continuous operation. The use of food-based proteins with redox molecule-modified AuNPs and printed electrodes demonstrates advantages for biosensors and energy devices due to their small size, large surface area, and ease of modification. This concept holds a promise for creating biocompatible electrodes for biosensors and self-sustaining energy devices.

Glasswing-Butterfly-Inspired Multifunctional Scleral Lens and Smartphone Raman Spectrometer for Point-of-Care Tear Biomarker Analysis

Augmenting contact lenses with sensing capabilities requires incorporating multiple functionalities within a diminutive device. Inspired by multifunctional biophotonic nanostructures of glasswing butterflies, a nanostructured scleral lens with enhanced optical, bactericidal, and sensing capabilities is reported. When used in conjunction with a smartphone-integrated Raman spectrometer, the feasibility of point-of-care applications is demonstrated. The bioinspired nanostructures made on parylene films are mounted on the anterior and posterior side of a scleral lens to create a nanostructured lens. Compared to unstructured parylene, nanostructured parylene minimizes glare by 4.3-fold at large viewing angles up to 80^o . When mounted on a scleral lens, the nanostructures block 2.8-fold more ultraviolet (UVA) light while offering 1.1-fold improved transmission in the visible regime. Furthermore, the nanostructures exhibit potent bactericidal activity against Escherichia coli, killing 89% of tested bacteria within 4 h. The same nanostructures, when gold-coated, are used to perform rapid label-free multiplex detection of lysozyme and lactoferrin, the protein biomarkers of the chronic dry eye disease, in whole human tears using drop-coating deposition Raman spectroscopy. The detection of both proteins in whole human tear samples from different subjects using the nanostructured lens produced excellent correlation with commercial enzyme-based assays while simultaneously displaying a 1.5-fold lower standard deviation.

Review of glaucoma medication adherence monitoring in the digital health era

Current glaucoma treatments aim to lower intraocular pressure, often with topical ocular hypotensive medications. Unfortunately, the effectiveness of these medications depends on sustained patient adherence to regimens which may involve instilling multiple medications several times daily. Patient adherence to glaucoma medications is often low. Recent innovations in digital sensor technologies have been leveraged to confirm eyedrop medication usage in real-time and relay this information back to providers. Some sensors have also been designed to deliver medication reminders and notifications as well as assist with correct eyedrop administration technique. Here, we review recent innovations targeted at improving glaucoma medication adherence and discuss their limitations.

Novel Wearable Optical Sensors for Vital Health Monitoring Systems-A Review

Wearable sensors are pioneering devices to monitor health issues that allow the constant monitoring of physical and biological parameters. The immunity towards electromagnetic interference, miniaturization, detection of nano-volumes, integration with fiber, high sensitivity, low cost, usable in harsh environments and corrosion-resistant have made optical wearable sensor an emerging sensing technology in the recent year. This review presents the progress made in the development of novel wearable optical sensors for vital health monitoring systems. The details of different substrates, sensing platforms, and biofluids used for the detection of target molecules are discussed in detail. Wearable technologies could increase the quality of health monitoring systems at a nominal cost and enable continuous and early disease diagnosis. Various optical sensing principles, including surface-enhanced Raman scattering, colorimetric, fluorescence, plasmonic, photoplethysmography, and interferometric-based sensors, are discussed in detail for health monitoring applications. The performance of optical wearable sensors utilizing two-dimensional materials is also discussed. Future challenges associated with the development of optical wearable sensors for point-of-care applications and clinical diagnosis have been thoroughly discussed.

Wearable artificial intelligence biosensor networks

The demand for high-quality healthcare and well-being services is remarkably increasing due to the ageing global population and modern lifestyles. Recently, the integration of wearables and artificial intelligence (AI) has attracted extensive academic and technological attention for its powerful high-dimensional data processing of wearable biosensing networks. This work reviews the recent developments in AI-assisted wearable biosensing devices in disease diagnostics and fatigue monitoring demonstrating the trend towards personalised medicine with highly efficient, cost-effective, and accurate point-of-care diagnosis by finding hidden patterns in biosensing data and detecting abnormalities. The reliability of adaptive learning and synthetic data and data privacy still need further investigation to realise personalised medicine in the next decade. Due to the worldwide popularity of smartphones, they have been utilised for sensor readout, wireless data transfer, data processing and storage, result display, and cloud server communication leading to the development of smartphone-based biosensing systems. The recent advances have demonstrated a promising future for the healthcare system because of the increasing data processing power, transfer efficiency and storage capacity and diversifying functionalities.

Glucose sensing based on hydrogel grating incorporating phenylboronic acid groups

We proposed a hydrogel grating sensor functionalized with phenylboronic acid (PBA) group for glucose concentration detection. A PBA functionalized polyacrylamide hydrogel film was first prepared via ultraviolet polymerization. Then, the diffraction grating was written on the hydrogel film via the femto-second (fs) laser point-by-point direct inscription. Binding between the PBA groups in the hydrogel and glucose molecules would lead to the swelling of hydrogel and the thus grating structure, thus modifying the diffraction properties of the grating. We experimentally characterized the swelling and transmission of the grating with different glucose concentrations. Sensitivity of the sensor was defined as variations in relative diffraction efficiency in response to glucose concentration changes, and was experimentally found to 0.61%/mM. The proposed sensor showed fast response towards the presence of glucose, and its reusability and biocompatibility were also confirmed. The use of fs-laser inscription technique does not require a pre-fabricated template, and would allow to directly modify the fabrication parameters such as scanning speed, pulse energy and frequency. Therefore, one is able to conveniently optimize the grating structure and improve the inscription efficiency. The proposed hydrogel grating could be potentially fabricated into wearable sensors, namely, contact lenses, for continuous monitoring of tear glucose level with rapid response.

The development of wearable technologies and their potential for measuring nutrient intake: Towards precision nutrition

Appropriate food intake and nutritional status are crucial for the maintenance of health and disease prevention. Conventional dietary assessment is mainly based on comparisons of nutrient intakes with reference intakes, failing to meet the needs of personalised nutritional guidance based on individual nutritional status. Given their capability of providing insights into health information non-invasively in real time, wearable technologies offer great opportunities for nutrition monitoring. Nutrient metabolic profiles can be monitored immediately and continuously which could potentially offer the possibility for the tracking and guiding of nutrient intake. Here, we review and highlight the recent advances in wearable sensors from the perspective of sensing technologies for nutrient detection in biofluids. The integration of biosensors with wearable devices serves as an ideal platform for the analysis of biofluids including sweat, saliva and tears. The wearable sensing systems applied to the analysis of typical nutrients and important metabolites are demonstrated in terms of carbohydrates, proteins, lipids, vitamins, minerals and others. Taking advantage of their high flexibility and lightweight, wearable sensors have been widely developed for the in situ quantitative detection of metabolic biomarkers. The technical principles, detection methods and applications are summarised. The challenges and future perspectives for wearable nutrition monitoring devices are discussed including the need to better determine relationships among nutrient metabolic profile, nutrient intake and food intake. With the development of materials, sensing techniques and manufacturing processes, wearable technologies are paving the way towards personalised precision nutrition, although there is still a long way to go before they can be utilised for practical clinical applications. Joint research efforts between nutrition scientists, doctors, engineers and sensor researchers are essential to further accelerate the realisation of reliable and practical wearable nutrition monitoring platforms.

Bioinspired Colloidal Photonic Composites: Fabrications and Emerging Applications

Organisms in nature have evolved unique structural colors and stimuli-responsive functions for camouflage, warning, and communication over millions of years, which are essential to their survival in harsh conditions. Inspired by these characteristics, colloidal photonic composites (CPCs) composed of colloidal photonic crystals embedded in the polymeric matrix are artificially prepared and show great promise in applications. This review focuses on the summary of building blocks, i.e., colloidal particles and polymeric matrices, and constructive strategies from the perspective of designing CPCs with robust performance and specific functionality. Furthermore, their state-of-the-art applications are also discussed, including colorful coatings, anti-counterfeiting, and regulation of photoluminescence, especially in the field of visualized sensing. Finally, current challenges and potential for future developments in this field are discussed. The purpose of this review is not only to clarify the design principle for artificial CPCs but also to serve as a roadmap for the exploration of next-generation photonic materials.

Nanofiber Based on Electrically Conductive Materials for Biosensor Applications

Biosensors are analytical tools that enable the transmission of different signals produced from the target analyte to a transducer for the production of real-time clinical diagnostic devices by obtaining meaningful results. Recent research demonstrates that the production of structured nanofiber through various methods has come to light as a potential platform for enhancing the functionality of biosensing devices. The general trend is towards the use of nanofibers for electrochemical biosensors. However, optical and mechanical biosensors are being developed by functionalization of nanofibers. Such nanofibers exhibit a high surface area to volume ratio, surface porosity, electroconductivity and variable morphology. In addition, nanosized structures have shown to be effective as membranes for immobilizing bioanalytes, offering physiologically active molecules a favorable microenvironment that improves the efficiency of biosensing. Cost effective, wearable biosensors are crucial for point of care diagnostics. This review aims to examine the electrically conductive materials, potential forming methods, and wide-ranging applications of nanofiber-based biosensing platforms, with an emphasis on transducers incorporating mechanical, electrochemical and optical and bioreceptors involving cancer biomarker, urea, DNA, microorganisms, primarily in the last decade. The appealing properties of nanofibers mats and the attributes of the biorecognition components are also stated and explored. Finally, consideration is given to the difficulties now affecting the design of nanofiber-based biosensing platforms as well as their future potential.

Wearable chemical sensors for biomarker discovery in the omics era

Biomarkers are crucial biological indicators in medical diagnostics and therapy. However, the process of biomarker discovery and validation is hindered by a lack of standardized protocols for analytical studies, storage and sample collection. Wearable chemical sensors provide a real-time, non-invasive alternative to typical laboratory blood analysis, and are an effective tool for exploring novel biomarkers in alternative body fluids, such as sweat, saliva, tears and interstitial fluid. These devices may enable remote at-home personalized health monitoring and substantially reduce the healthcare costs. This Review introduces criteria, strategies and technologies involved in biomarker discovery using wearable chemical sensors. Electrochemical and optical detection techniques are discussed, along with the materials and system-level considerations for wearable chemical sensors. Lastly, this Review describes how the large sets of temporal data collected by wearable sensors, coupled with modern data analysis approaches, would open the door for discovering new biomarkers towards precision medicine.

Determination of reducing carbohydrates in natural honey samples by optical micrometry method

The present article deals with the determination of the total amount of glucose and fructose in natural honey samples by the optical micrometry (OM) method. (Poly)vinyl alcohol spherical granules impregnated with a 0.05 mol/l borax solution were chosen as a sensitive element. It was shown that the formation of chelate esters of boron with polymer and carbohydrates is a pH-dependent process, and that the pH range 8.5–10.0 is the most appropriate for quantifying the total amount of reducing carbohydrates because glucose and fructose are undiscriminated. The impregnated polymer is not sensitive to the sucrose presence in the solution due to the absence of cis-diol fragments in it. Subsequently, the OM method was tested in the analysis of natural honey samples. The relative standart deviation in the case of OM method is less than 6%, and the results are similar to those obtained by the iodometric titration method. This makes the OM method suitable for laboratory-scale applications.

Graphene and Its Derivatives: Synthesis and Application in the Electrochemical Detection of Analytes in Sweat

Wearable sensors and invasive devices have been studied extensively in recent years as the demand for real-time human healthcare applications and seamless human-machine interaction has risen exponentially. An explosion in sensor research throughout the globe has been ignited by the unique features such as thermal, electrical, and mechanical properties of graphene. This includes wearable sensors and implants, which can detect a wide range of data, including body temperature, pulse oxygenation, blood pressure, glucose, and the other analytes present in sweat. Graphene-based sensors for real-time human health monitoring are also being developed. This review is a comprehensive discussion about the properties of graphene, routes to its synthesis, derivatives of graphene, etc. Moreover, the basic features of a biosensor along with the chemistry of sweat are also discussed in detail. The review mainly focusses on the graphene and its derivative-based wearable sensors for the detection of analytes in sweat. Graphene-based sensors for health monitoring will be examined and explained in this study as an overview of the most current innovations in sensor designs, sensing processes, technological advancements, sensor system components, and potential hurdles. The future holds great opportunities for the development of efficient and advanced graphene-based sensors for the detection of analytes in sweat.

Emerging Applications of Electrochemical Impedance Spectroscopy in Tear Film Analysis

Human tear film, with a flow rate of 1-3 µL/min, is a rich bodily fluid that transmits a variety of metabolites and hormones containing proteins, lipids and electrolytes that provide clues about ocular and systemic diseases. Analysis of disease biomarkers such as proteins, mRNA, enzymes and cytokines in the tear film, collected by noninvasive methods, can provide significant results for sustaining a predictive, preventive and personalized medicine regarding various diseases such as glaucoma, diabetic retinopathy, keratoconus, dry eye, cancer, Alzheimer's disease, Parkinson's disease and COVID-19. Electrochemical impedance spectroscopy (EIS) offers a powerful technique for analyzing these biomarkers. EIS detects electrical equivalent circuit parameters related to biorecognition of receptor-analyte interactions on the electrode surface. This method is advantageous as it performs a label-free detection and allows the detection of non-electroactive compounds that cannot be detected by direct electron transfer, such as hormones and some proteins. Here, we review the opportunities regarding the integration of EIS into tear fluid sampling approaches.

Ultra-Thin Flexible Encapsulating Materials for Soft Bio-Integrated Electronics

Recently, bioelectronic devices extensively researched and developed through the convergence of flexible biocompatible materials and electronics design that enables  more precise diagnostics and therapeutics in human health care and opens up the potential to expand into various fields, such as clinical medicine and biomedical research. To establish an accurate and stable bidirectional bio-interface, protection against the external environment and high mechanical deformation is essential for wearable bioelectronic devices. In the case of implantable bioelectronics, special encapsulation materials and optimized mechanical designs and configurations that provide electronic stability and functionality are required for accommodating various organ properties, lifespans, and functions in the biofluid environment. Here, this study introduces recent developments of ultra-thin encapsulations with novel materials that can preserve or even improve the electrical performance of wearable and implantable bio-integrated electronics by supporting safety and stability for protection from destruction and contamination as well as optimizing the use of bioelectronic systems in physiological environments. In addition, a summary of the materials, methods, and characteristics of the most widely used encapsulation technologies is introduced, thereby providing a strategic selection of appropriate choices of recently developed flexible bioelectronics.

Smartphone based aptasensors as intelligent biodevice for food contamination detection in food and soil samples: Recent advances

Nowadays, the integration of conventional analytical approaches with smartphones has been developed novel, emerging and affordable devices for improving on-site detection platforms in the fields of food safety. Smartphone-based aptasensors as the next generation of portable aptasensing technique has attracted considerable attention as it offers a semi-automated user interface that can be exploited by inexpert characters. Wireless data transferability is an undeniable advantage that home-testing platforms have as well as it can suggest high computational power. In addition, these types of biodevices can provide real-time monitoring in terms of exchanging digital networks in real-time. To elaborate, the ability of smartphones to connect through the Internet is one of the most critical advantages of smartphone-based aptasensor that can be uploaded to Cloud databases and results can be disseminated as spatio-temporal maps across the globe. This review focused on the recent progress and technical breakthroughs of aptasensor on the smartphone as a groundbreaking enterprise in the field of biochemical analysis, importantly in the aspect of the combination of different types of biosensors including electrochemical, optical and colorimetric. In our opinion, this review can broaden our understanding of using smartphones as a portable sensing approach by addressing the current challenges and future perspectives.

Recent Advances in Intelligent Wearable Medical Devices Integrating Biosensing and Drug Delivery

The primary roles of precision medicine are to perform real-time examination, administer on-demand medication, and apply instruments continuously. However, most current therapeutic systems implement these processes separately, leading to treatment interruption and limited recovery in patients. Personalized healthcare and smart medical treatment have greatly promoted research on and development of biosensing and drug-delivery integrated systems, with intelligent wearable medical devices (IWMDs) as typical systems, which have received increasing attention because of their non-invasive and customizable nature. Here, the latest progress in research on IWMDs is reviewed, including their mechanisms of integrating biosensing and on-demand drug delivery. The current challenges and future development directions of IWMDs are also discussed.

Fluorescence Sensing Technologies for Ophthalmic Diagnosis

Personalized and point-of-care (POC) diagnoses are critical for ocular physiology and disease diagnosis. Real-time monitoring and continuous sampling abilities of tear fluid and user-friendliness have become the key characteristics for the applied ophthalmic techniques. Fluorescence technologies, as one of the most popular methods that can fulfill the requirements of clinical ophthalmic applications for optical sensing, have been raised and applied for tear sensing and diagnostic platforms in recent decades. Wearable sensors in this case have been increasingly developed for ocular diagnosis. Contact lenses, as one of the commercialized and popular tools for ocular dysfunction, have been developed as a platform for fluorescence sensing in tears diagnostics and real-time monitoring. Numbers of biochemical analytes have been examined through developed fluorescent contact lens sensors, including pH values, electrolytes, glucose, and enzymes. These sensors have been proven for monitoring ocular conditions, enhancing and detecting medical treatments, and tracking efficiency of related ophthalmic surgeries at POC settings. This review summarizes the applied ophthalmic fluorescence sensing technologies in tears for ocular diagnosis and monitoring. In addition, the cooperation of fabricated fluorescent sensor with mobile phone readout devices for diagnosing ocular diseases with specific biomarkers continuously is also discussed. Further perspectives for the developments and applications of fluorescent ocular sensing and diagnosing technologies are also provided.

Lab-on-a-Contact Lens: Recent Advances and Future Opportunities in Diagnostics and Therapeutics

The eye is one of the most complex organs in the human body, containing rich and critical physiological information (e.g., intraocular pressure, corneal temperature, and pH) as well as a library of metabolite biomarkers (e.g., glucose, proteins, and specific ions). Smart contact lenses (SCLs) can serve as a wearable intelligent ocular prosthetic device capable of noninvasive and continuous monitoring of various essential physical/biochemical parameters and drug loading/delivery for the treatment of ocular diseases. Advances in SCL technologies and the growing public interest in personalized health are accelerating SCL research more than ever before. Here, the current status and potential of SCL development through a comprehensive review from fabrication to applications to commercialization are discussed. First, the material, fabrication, and platform designs of the SCLs for the diagnostic and therapeutic applications are discussed. Then, the latest advances in diagnostic and therapeutic SCLs for clinical translation are reviewed. Later, the established techniques for wearable power transfer and wireless data transmission applied to current SCL devices are summarized. An outlook, future opportunities, and challenges for developing next-generation SCL devices are also provided. With the rise in interest of SCL development, this comprehensive and essential review can serve as a new paradigm for the SCL devices.

Current and Future Perspectives on Microfluidic Tear Analytic Devices

Most current invasive analytic devices for disease diagnosis and monitoring require the collection of blood, which causes great discomfort for patients and may potentially cause infection. This explains the great need for noninvasive devices that utilize other bodily fluids like sweat, saliva, tears, or urine. Among them, eye tears are easily accessible, less complex in composition, and less susceptible to dilution. Tears also contain valuable clinical information for the diagnosis of ocular and systemic diseases as the tear analyte level shows great correlation with the blood analyte level. These unique advantages make tears a promising platform for use in clinical settings. As the volume of tear film and the rate of tear flow are only microliters in size, the use of microfluidic technology in analytic devices allows minimal sample consumption. Hence, more and more microfluidic tear analytic devices have been proposed, and their working mechanisms can be broadly categorized into four main types: (a) electrochemical, (b) photonic crystals, (c) fluorescence, and (d) colorimetry. These devices are being developed toward the application of point-of-care tests with rapid yet accurate results. This review aims to provide a general overview of the recent developmental trend of microfluidic devices for tear analysis. Moreover, the fundamental principle behind each type of device along with their strengths and weaknesses will be discussed, especially in terms of their abilities and potential in being used in point-of-care settings.

Lab-on-a-chip technologies for minimally invasive molecular sensing of diabetic retinopathy

Diabetic retinopathy (DR) is the most common diabetic eye disease and the worldwide leading cause of vision loss in working-age adults. It progresses from mild to severe non-proliferative or proliferative DR based on several pathological features including the magnitude of blood-retinal barrier breakdown and neovascularization. Available pharmacological and retinal laser photocoagulation interventions are mostly applied in the advanced stages of DR and are inefficient in halting disease progression in a significantly high percentage of patients. Yet, recent evidence has shown that some therapies could potentially limit DR progression if applied at early stages, highlighting the importance of early disease diagnostics. In the past few decades, different imaging modalities have proved their utility for examining retinal and optic nerve changes in patients with retinal diseases. However, imaging based-methodologies solely rely on morphological examination of the retinal vascularization and are not suitable for recurrent and personalized patient evaluation. This raises the need for new technologies to enable accurate and early diagnosis of DR. In this review, we critically discuss the potential clinical benefit of minimally-invasive molecular biomarker identification and profiling of diabetic patients who are at risk of developing DR. We provide a comparative overview of conventional and recently developed lab-on-a-chip technologies for quantitative assessment of potential DR molecular biomarkers and discuss their advantages, current limitations and challenges for future practical implementation and continuous patient monitoring at the point-of-care.

Sense and Learn: Recent Advances in Wearable Sensing and Machine Learning for Blood Glucose Monitoring and Trend-Detection

Diabetes mellitus is characterized by elevated blood glucose levels, however patients with diabetes may also develop hypoglycemia due to treatment. There is an increasing demand for non-invasive blood glucose monitoring and trends detection amongst people with diabetes and healthy individuals, especially athletes. Wearable devices and non-invasive sensors for blood glucose monitoring have witnessed considerable advances. This review is an update on recent contributions utilizing novel sensing technologies over the past five years which include electrocardiogram, electromagnetic, bioimpedance, photoplethysmography, and acceleration measures as well as bodily fluid glucose sensors to monitor glucose and trend detection. We also review methods that use machine learning algorithms to predict blood glucose trends, especially for high risk events such as hypoglycemia. Convolutional and recurrent neural networks, support vector machines, and decision trees are examples of such machine learning algorithms. Finally, we address the key limitations and challenges of these studies and provide recommendations for future work.

Syntheses of Gold and Silver Nanocomposite Contact Lenses via Chemical Volumetric Modulation of Hydrogels

Integration of nanomaterials into hydrogels has emerged as a prominent research tool utilized in applications such as sensing, cancer therapy, and bone tissue engineering. Wearable contact lenses functionalized with nanoparticles have been exploited in therapeutics and targeted therapy. Here, we report the fabrication of gold and silver nanocomposite commercial contact lenses using a breathing-in/breathing-out (BI-BO) method, whereby a hydrated contact lens is shrunk in an aprotic solvent and then allowed to swell in an aqueous solution containing nanoparticles. The morphology and optical properties of the gold and silver nanoparticles were characterized through transmission electron microscopy and ultraviolet-visible spectroscopy. The transmission spectra of nanocomposite contact lenses indicated that the nanoparticles' loading amount within the lens depended primarily on the number of BI-BO cycles. Nanocomposites were stable for a minimum period of 1 month, and no nanoparticle leaching was observed. Wettability and water content analysis of the nanocomposites revealed that the contact lenses retained their intrinsic material properties after the fabrication process. The dispersion of the nanoparticles within the contact lens media was determined through scanning electron microscopy imaging. The nanocomposite lenses can be deployed in color filtering and antibacterial applications. In fact, the silver nanocomposite contact lens showed blue-light blocking capabilities by filtering a harmful high-energy blue-light range (400-450 nm) while transmitting the visible light beyond 470 nm, which facilitates enhanced night vision and color distinction. The ease of fabricating these nanocomposite contact lenses via the BI-BO method could enable the incorporation of nanoparticles with diverse morphologies into contact lenses for various biomedical applications.

Rapid Colorimetric pH-Responsive Gold Nanocomposite Hydrogels for Sensing Applications

Surface functionalization of metallic nanoparticles (NPs) with external groups can be engineered to fabricate sensors that are responsive to various stimuli like temperature, pH, and numerous ions. Herein, we report the synthesis of gold nanoparticles (GNPs) functionalized with 3-mercaptopropionic acid (GNPs-MPA) and the doping of these nanoparticles into hydrogel materials using the breathing-in/breathing-out (BI-BO) method. MPA has a carboxyl group that becomes protonated and, thus, ionized at a pH below its pK_a (4.32); hence, the GNPs-MPA solutions and gels were mostly pH-responsive in the range of 3–5. Optical properties were assessed through ultraviolet-visible (UV-Vis) spectroscopy, namely: transmission and absorption, and the parameters used to quantify the pH changes were the full width at half maximum (FWHM) and position of surface plasmon resonance (SPR). The solutions and gels gradually changed their colors from red to indigo with pH decrementation from 5 to 3, respectively. Furthermore, the solutions’ and doped gels’ highest FWHM sensitivities towards pH variations were 20 nm and 55 nm, respectively, while the SPR’s position sensitivities were 18 nm and 10 nm, respectively. Also, transmission and scanning electron microscopy showed synchronized dispersion and aggregation of NPs with pH change in both solution and gel forms. The gel exhibited excellent repeatability and reversibility properties, and its response time was instantaneous, which makes its deployment as a colorimetric pH-triggered sensor practical. To the best of our knowledge, this is the first study that has incorporated GNPs into hydrogels utilizing the BI-BO method and demonstrated the pH-dependent optical and colorimetric properties of the developed nanocomposites.

The Current State of Optical Sensors in Medical Wearables

Optical sensors play an increasingly important role in the development of medical diagnostic devices. They can be very widely used to measure the physiology of the human body. Optical methods include PPG, radiation, biochemical, and optical fiber sensors. Optical sensors offer excellent metrological properties, immunity to electromagnetic interference, electrical safety, simple miniaturization, the ability to capture volumes of nanometers, and non-invasive examination. In addition, they are cheap and resistant to water and corrosion. The use of optical sensors can bring better methods of continuous diagnostics in the comfort of the home and the development of telemedicine in the 21st century. This article offers a large overview of optical wearable methods and their modern use with an insight into the future years of technology in this field.

Wearable Smart Contact Lenses for Continual Glucose Monitoring: A Review

Diabetes mellitus is a chronic disease requiring a careful management to prevent its collateral complications, such as cardiovascular and Alzheimer's diseases, retinopathy, nephropathy, foot and hearing impairment, and neuropathy. Self-monitoring of blood glucose at point-of-care settings is an established practice for diabetic patients. However, current technologies for glucose monitoring are invasive, costly, and only provide single snapshots for a widely varying parameter. On the other hand, tears are a source of physiological information that mirror the health state of an individual by expressing different concentrations of metabolites, enzymes, vitamins, salts, and proteins. Therefore, the eyes may be exploited as a sensing site with substantial diagnostic potential. Contact lens sensors represent a viable route for targeting minimally-invasive monitoring of disease onset and progression. Particularly, glucose concentration in tears may be used as a surrogate to estimate blood glucose levels. Extensive research efforts recently have been devoted to develop smart contact lenses for continual glucose detection. The latest advances in the field are reviewed herein. Sensing technologies are described, compared, and the associated challenges are critically discussed.

Current Understanding of the Applications of Photocrosslinked Hydrogels in Biomedical Engineering

Hydrogel materials have great application value in biomedical engineering. Among them, photocrosslinked hydrogels have attracted much attention due to their variety and simple convenient preparation methods. Here, we provide a systematic review of the biomedical-engineering applications of photocrosslinked hydrogels. First, we introduce the types of photocrosslinked hydrogel monomers, and the methods for preparation of photocrosslinked hydrogels with different morphologies are summarized. Subsequently, various biomedical applications of photocrosslinked hydrogels are reviewed. Finally, some shortcomings and development directions for photocrosslinked hydrogels are considered and proposed. This paper is designed to give researchers in related fields a systematic understanding of photocrosslinked hydrogels and provide inspiration to seek new development directions for studies of photocrosslinked hydrogels or related materials.

Salivary biomarkers of neurodegenerative and demyelinating diseases and biosensors for their detection

Salivary analysis is gaining increasing interest as a novel and promising field of research for the diagnosis of neurodegenerative and demyelinating diseases related to aging. The collection of saliva offers several advantages, being noninvasive, stress-free, and repeatable. Moreover, the detection of biomarkers directly in saliva could allow an early diagnosis of the disease, leading to timely treatments. The aim of this manuscript is to highlight the most relevant researchers' findings relatively to salivary biomarkers of neurodegenerative and demyelinating diseases, and to describe innovative and advanced biosensing strategies for the detection of salivary biomarkers. This review is focused on five relevant aging-related neurodegenerative disorders (Alzheimer's disease, Parkinson's disease, Amyotrophic Lateral Sclerosis, Huntington's disease, Multiple Sclerosis) and the salivary biomarkers most commonly associated with them. Advanced biosensors enabling molecular diagnostics for the detection of salivary biomarkers are presented, in order to stimulate future research in this direction and pave the way for their clinical application.

Emerging biosensing and transducing techniques for potential applications in point-of-care diagnostics

With the deepening of our understanding in life science, molecular biology, nanotechnology, optics, electrochemistry and other areas, an increasing number of biosensor design strategies have emerged in recent years, capable of providing potential practical applications for point-of-care (POC) diagnosis in various human diseases. Compared to conventional biosensors, the latest POC biosensor research aims at improving sensor precision, cost-effectiveness and time-consumption, as well as the development of versatile detection strategies to achieve multiplexed analyte detection in a single device and enable rapid diagnosis and high-throughput screening. In this review, various intriguing strategies in the recognition and transduction of POC (from 2018 to 2021) are described in light of recent advances in CRISPR technology, electrochemical biosensing, and optical- or spectra-based biosensing. From the perspective of promoting emerging bioanalytical tools into practical POC detecting and diagnostic applications, we have summarized key advances made in this field in recent years and presented our own perspectives on future POC development and challenges.

Glucose-Sensing Photonic Nanochain Probes with Color Change in Seconds

Glucose-sensing photonic crystals are promising for the significant advance of continuous glucose monitoring systems due to the naked-eye colorimetric readouts and noninvasive detection of diabetes, but the long response time hampers their practical applications. Here, for the first time probes of photonic nanochains (PNCs) are demonstrated that are capable of continuously and reversibly sensing glucose concentration ([glucose]) variation within seconds by color change without power consumption, much faster by 2-3 orders of magnitude than previous ones. They are comprised of 1D equidistant arrays of magnetic nanoparticles enveloped by tens-of-nanometer-thick phenylboronic acid-functionalized hydrogels, and fabricated by developing selective concentration polymerization of monomers in binary microheterogeneous solvents of dimethyl sulfoxide (DMSO) and H2 O. In this process, both 3-acrylamido phenylboronic acid (AAPBA) and N-2-hydroxyethyl acrylamide (HEAAm) are preferentially dissolved in the small volume of free DMSO concentrated in the vicinity of poly vinylpyrrolidone coated Fe3 O4 colloidal nanoparticles (Fe3 O4 @PVP), yielding Fe3 O4 @PVP@poly(AAPBA-co-HEAAm) PNCs after UV irradiation under magnetic field. The PNCs in phosphate buffered solution have a wavelength-shift range up to 130 nm when [glucose] changes from 0 to 20 × 10-3 m. The results can facilitate real-time glucose monitoring and provide an alternative to produce functional organic-inorganic nanostructures.

Smartphone-Operated Wireless Chemical Sensors: A Review

Wireless chemical sensors have been developed as a result of advances in chemical sensing and wireless communication technology. Because of their mobility and widespread availability, smartphones have been extensively combined with sensors such as hand-held detectors, sensor chips, and test strips for biochemical detection. Smartphones are frequently used as controllers, analyzers, and displayers for quick, authentic, and point-of-care monitoring, which may considerably streamline the design and lower the cost of sensing systems. This study looks at the most recent wireless and smartphone-supported chemical sensors. The review is divided into four different topics that emphasize the basic types of wireless smartphone-operated chemical sensors. According to a study of 114 original research publications published during recent years, market opportunities for wireless and smartphone-supported chemical sensor systems include environmental monitoring, healthcare and medicine, food quality, sport, and fitness. The issues and illustrations for each of the primary chemical sensors relevant to many application areas are covered. In terms of performance, the advancement of technologies related to chemical sensors will result in smaller and more lightweight, cost-effective, versatile, and durable devices. Given the limitations, we suggest that wireless and smartphone-supported chemical sensor systems play a significant role in the sensor Internet of Things.

Remote Healthcare for Elderly People Using Wearables: A Review

The growth of health care spending on older adults with chronic diseases faces major concerns that require effective measures to be adopted worldwide. Among the main concerns is whether recent technological advances now offer the possibility of providing remote health care for the aging population. The benefits of suitable prevention and adequate monitoring of chronic diseases by using emerging technological paradigms such as wearable devices and the Internet of Things (IoT) can increase the detection rates of health risks to raise the quality of life for the elderly. Specifically, on the subject of remote health monitoring in older adults, a first approach is required to review devices, sensors, and wearables that serve as tools for obtaining and measuring physiological parameters in order to identify progress, limitations, and areas of opportunity in the development of health monitoring schemes. For these reasons, a review of articles on wearable devices was presented in the first instance to identify whether the selected articles addressed the needs of aged adults. Subsequently, the direct review of commercial and prototype wearable devices with the capability to read physiological parameters was presented to identify whether they are optimal or usable for health monitoring in older adults.

A photonic crystal material for the online detection of nonpolar hydrocarbon vapors

A modern level of nanotechnology allows us to create conceptually new test systems for chemical analyses and to develop sensitive and compact sensors for various types of substances. However, at present, there are very few commercially available compact sensors for the determination of toxic and carcinogenic substances, such as organic solvents that are used in some construction materials. This article contains an overview of how 3D photonic crystals are used for the creation of a new test system for nonpolar organic solvents. The morphology and structural parameters of the photonic crystals, based upon a crystalline colloidal array with a sensing matrix of polydimethylsiloxane, have been determined by using scanning electron microscopy and by the results of specular reflectance spectroscopy based on the Bragg-Snell law. A new approach has been proposed for the application of this sensor in chemical analysis for the qualitative detection of saturated vapors of volatile organic compounds due to configuration changes of the photonic bandgap, recorded by diffuse reflectance spectroscopy. The exposure of the sensor to aromatic (benzene, toluene and p-xylene) and aliphatic (n-pentane, n-heptane, n-octane and n-decane) hydrocarbons has been analyzed. The reconstitution of spectral parameters of the sensor during the periodic detection of saturated vapors of toluene has been evaluated.

Optical Hydrogel Detector for pH Measurements

Measuring pH has become a major key for determining health conditions, and food safety. The traditional pH assessment approaches are costly and offer low sensitivity. Here, a novel pH sensor based on a pH-responsive hydrogel has been developed. A Fresnel lens pattern was replicated on the surface of the pH-responsive hydrogel using the replica mould method. The pH sensors were tested in a pH range of 4-7. Introducing various pH solutions to the pH sensor led to volumetric shifts as the hydrogel swelled with pH. Consequently, the dimensions of the replicated Fresnel lens changed, modifying the focal length and the focus efficiency of the optical sensor. As a result, the measured optical power at a fixed distance from the sensor changed with pH. The optical sensor showed the best performance in the acidic region when pH changed from 4.5 to 5.5, in which the recorded power increased by 13%. The sensor exhibited high sensitivity to pH changes with a short respond time in a reversible manner. The developed pH optical sensor may have applications in medical point-of-care diagnostics and wearable continuous pH detection devices.

A Meta-Analysis of Wearable Contact Lenses for Medical Applications: Role of Electrospun Fiber for Drug Delivery

In recent years, wearable contact lenses for medical applications have attracted significant attention, as they enable continuous real-time recording of physiological information via active and noninvasive measurements. These devices play a vital role in continuous monitoring of intraocular pressure (IOP), noninvasive glucose monitoring in diabetes patients, drug delivery for the treatment of ocular illnesses, and colorblindness treatment. In specific, this class of medical devices is rapidly advancing in the area of drug loading and ocular drug release through incorporation of electrospun fibers. The electrospun fiber matrices offer a high surface area, controlled morphology, wettability, biocompatibility, and tunable porosity, which are highly desirable for controlled drug release. This article provides an overview of the advances of contact lens devices in medical applications with a focus on four main applications of these soft wearable devices: (i) IOP measurement and monitoring, (ii) glucose detection, (iii) ocular drug delivery, and (iv) colorblindness treatment. For each category and application, significant challenges and shortcomings of the current devices are thoroughly discussed, and new areas of opportunity are suggested. We also emphasize the role of electrospun fibers, their fabrication methods along with their characteristics, and the integration of diverse fiber types within the structure of the wearable contact lenses for efficient drug loading, in addition to controlled and sustained drug release. This review article also presents relevant statistics on the evolution of medical contact lenses over the last two decades, their strengths, and the future avenues for making the essential transition from clinical trials to real-world applications.

Emerging Theranostic Nanomaterials in Diabetes and Its Complications

Diabetes mellitus (DM) refers to a group of metabolic disorders that are characterized by hyperglycemia. Oral subcutaneously administered antidiabetic drugs such as insulin, glipalamide, and metformin can temporarily balance blood sugar levels, however, long-term administration of these therapies is associated with undesirable side effects on the kidney and liver. In addition, due to overproduction of reactive oxygen species and hyperglycemia-induced macrovascular system damage, diabetics have an increased risk of complications. Fortunately, recent advances in nanomaterials have provided new opportunities for diabetes therapy and diagnosis. This review provides a panoramic overview of the current nanomaterials for the detection of diabetic biomarkers and diabetes treatment. Apart from diabetic sensing mechanisms and antidiabetic activities, the applications of these bioengineered nanoparticles for preventing several diabetic complications are elucidated. This review provides an overall perspective in this field, including current challenges and future trends, which may be helpful in informing the development of novel nanomaterials with new functions and properties for diabetes diagnosis and therapy.

Free-standing conductive hydrogel electrode for potentiometric glucose sensing

Flexible conductive polymer hydrogels are attracting attention as an electrode material. Electrochemical biosensors with conductive polymer hydrogels have been developed because they have some advantages such as biocompatibility, high conductivity, 3D nanostructure, solvated surface, and enlarged interface. Conductive polymer hydrogels bearing receptor molecules such as enzymes in its 3D nanostructure enable the detection of target analytes with high sensitivity. However, because such hydrogels are fragile, they cannot stand on their own and a supporting substrate is required to fabricate them. This means that the loss of mechanical toughness is detrimental for their application to flexible biosensors. In this study, we have proposed a free-standing conductive hydrogel electrode with no coating on a substrate, which is composed of polyaniline with phenyl boronic acid including polyvinyl alcohol, for potentiometric glucose sensing. In addition, its electrical responsivity to glucose has been confirmed by investigating its mechanical properties at various glucose concentrations, considering the hydrogel compositions.

A free-standing conductive hydrogel electrode with no coating on a substrate is proposed for potentiometric glucose sensing.

Identification of tear-based protein and non-protein biomarkers: Its application in diagnosis of human diseases using biosensors

Discovery of robust, selective and specific biomarkers are important for early diagnosis and monitor progression of human diseases. Eye being a common target for several human diseases, vision impediment and complications are often associated with systemic and ocular diseases. Tears are bodily fluids that are closest to eye and are rich in protein content and other metabolites. As a biomarker repository, it advantages over other bodily fluids due to the ability to collect it non-invasively. In this review, we highlight some recent advancements in identification of tear-based protein biomarkers like lacryglobin and cystatin SA for cancer; interleukin-6 and immunoglobulin-A antibody for COVID-19; tau, amyloid-β-42 and lysozyme-C for Alzheimer's disease; peroxiredoxin-6 and α-synuclein for Parkinson's disease; kallikrein, angiotensin converting enzyme and lipocalin-1 for glaucoma; lactotransferrin and lipophilin-A for diabetic retinopathy and zinc-alpha-2 glycoprotein-1, prolactin and calcium binding protein-A4 for eye thyroid disease. We also discussed identification of tear based non-protein biomarkers like lysophospholipids and acetylcarnitine for glaucoma, 8-hydroxy-2'-deoxyquanosine and malondialdehyde for thyroid eye disease. We elucidate technological advancement in developing tear-based biosensors for diagnosis and monitoring diseases such as diabetes, diabetic retinopathy and Alzheimer's disease. Altogether, the study of tears as potential biomarkers for early diagnosis of human diseases is promising.

Applications of Advanced Materials for Non-Enzymatic Glucose Monitoring: From Invasive to the Wearable Device

Diabetes mellitus (DM) is a global health problem leading to many complications and disabilities in life adjusting activities and even dead. Monitoring glucose levels is a key factor in diagnosis and management of DM. Conventional glucose sensors consisted of immobilized enzymes, are so susceptible to environmental conditions. In this way, nonenzymatic biosensors have attracted extensive attentions in many clinical diagnostics applications. To date, the finger pricking test is a common enzyme-based glucometer that is an invasive and inconvenient and may lead to infections in the injection sites. So, working on the possibility of cutaneous or subcutaneous insertion of devices as a noninvasive or minimally-invasive systems for continuous glucose controlling approaches through human biofluids (blood, perspiration, tears, saliva, etc.) have stimulated growing interest. This review summarizes recent nonenzymatic and noninvasive biofluids glucose monitoring systems which are highly resilience and stretchable to continuously adapt to body movements during common physical activity. Sensors are based on their constituent materials including carbon-based, metal nanoparticles, polymer, and hydrogel systems are classified for electrochemical, and optical glucose detection. Finally, we address the drawbacks and challenges of enzyme-free sensors which are aroused sustaining research passion to be used in point-of-care medical diagnostics applications.

The Application of Wearable Glucose Sensors in Point-of-Care Testing

Diabetes and its complications have become a worldwide concern that influences human health negatively and even leads to death. The real-time and convenient glucose detection in biofluids is urgently needed. Traditional glucose testing is detecting glucose in blood and is invasive, which cannot be continuous and results in discomfort for the users. Consequently, wearable glucose sensors toward continuous point-of-care glucose testing in biofluids have attracted great attention, and the trend of glucose testing is from invasive to non-invasive. In this review, the wearable point-of-care glucose sensors for the detection of different biofluids including blood, sweat, saliva, tears, and interstitial fluid are discussed, and the future trend of development is prospected.