Paper–Plastic Hybrid Microfluidic Device for Smartphone-Based Colorimetric Analysis of Urine

Paper-based optical sensor arrays for simultaneous detection of multi-targets in aqueous media: A review

Sensor arrays, which draw inspiration from the mammalian olfactory system, are fundamental concepts in high-throughput analysis based on pattern recognition. Although numerous optical sensor arrays for various targets in aqueous media have demonstrated their diverse applications in a wide range of research fields, practical device platforms for on-site analysis have not been satisfactorily established. The significant limitations of these sensor arrays lie in their solution-based platforms, which require stationary spectrophotometers to record the optical responses in chemical sensing. To address this, this review focuses on paper substrates as device components for solid-state sensor arrays. Paper-based sensor arrays (PSADs) embedded with multiple detection sites having cross-reactivity allow rapid and simultaneous chemical sensing using portable recording apparatuses and powerful data-processing techniques. The applicability of office printing technologies has promoted the realization of PSADs in real-world scenarios, including environmental monitoring, healthcare diagnostics, food safety, and other relevant fields. In this review, we discuss the methodologies of device fabrication and imaging analysis technologies for pattern recognition-driven chemical sensing in aqueous media.

Microfluidic sensors for the detection of emerging contaminants in water: A review

In recent years, numerous emerging contaminants have been identified in surface water, groundwater, and drinking water. Developing novel sensing methods for detecting diverse emerging pollutants in water is urgently needed, as even at low concentrations, these pollutants can pose a serious threat to human health and environmental safety. Traditional testing methods are based on laboratory equipment, which is highly sensitive but complex to operate, costly, and not suitable for on-site monitoring. Microfluidic sensors offer several benefits, including rapid evaluation, minimal sample usage, accurate liquid manipulation, compact size, automation, and in-situ detection capabilities. They provide promising and efficient analytical tools for high-performance sensing platforms in monitoring emerging contaminants in water. In this paper, recent research advances in microfluidic sensors for the detection of emerging contaminants in water are reviewed. Initially, a concise overview is provided about the various substrate materials, corresponding microfabrication techniques, different driving forces, and commonly used detection techniques for microfluidic devices. Subsequently, a comprehensive analysis is conducted on microfluidic detection methods for endocrine-disrupting chemicals, pharmaceuticals and personal care products, microplastics, and perfluorinated compounds. Finally, the prospects and future challenges of microfluidic sensors in this field are discussed.

Point-of-care image-based quantitative urinalysis with commercial reagent strips: Design and clinical evaluation

Urinalysis is a useful test as an indicator of health or disease and as such, is a part of routine health screening. Urinalysis can be undertaken in many ways, one of which is reagent strips used in the general evaluation of health and to aid in the diagnosis and monitoring of kidney disease. To be effective, the test must be performed properly, and the results interpreted correctly. However, different light conditions and colour perception can vary between users leading to ambiguous readings. This has led to camera devices being used to capture and generate the estimated biomarker concentrations, but image colour can be affected by variations in illumination and inbuilt image processing. Therefore, a new portable device with embedded image processing techniques is presented in this study to provide quantitative measurements that are invariant to changes in illumination. The device includes a novel calibration process and uses the ratio of RGB values to compensate for variations in illumination across an image and improve the accuracy of quantitative measurements. Results show that the proposed calibration method gives consistent homogeneous illumination across the whole image. Comparisons against other existing methods and clinical results show good performance with a correlation to the clinical values. The proposed device can be used for point-of-care testing to provide reliable results consistent with clinical values.

A computer vision enhanced smart phone platform for microfluidic urine glucometry

Glucose is an important biomarker for diagnosing and prognosing various diseases, including diabetes and hypoglycemia, which can have severe side effects, symptoms, and even lead to death in patients. As a result, there is a need for quick and economical glucose level measurements to help identify those at potential risk. With the increase in smartphone users, portable smartphone glucose sensors are becoming popular. In this paper, we present a disposable microfluidic glucose sensor that accurately and rapidly quantifies glucose levels in human urine using a combination of colorimetric analysis and computer vision. This glucose sensor implements a disposable microfluidic device based on medical-grade tapes and glucose analysis strips on a glass slide integrated with a custom-made polydimethylsiloxane (PDMS) micropump that accelerates capillary flow, making it economical, convenient, rapid, and equipment-free. After absorbing the target solution, the disposable device is slid into the 3D-printed main chassis and illuminated exclusively with Light Emitting Diode (LED) illumination, which is pivotal to color-sensitive experiments. After collecting images, the images are imported into the algorithm to measure the glucose levels using computer vision and average RGB values measurements. This article illustrates the impressive accuracy and consistency of the glucose sensor in quantifying glucose in sucrose water. This is evidenced by the close agreement between the computer vision method used by the sensor and the traditional method of measuring in the biology field, as well as the small variation observed between different sensor performances. The exponential regression curve used in the study further confirms the strong relationship between glucose concentrations and average RGB values, with an R-square value of 0.997 indicating a high degree of correlation between these variables. The article also emphasizes the potential transferability of the solution described to other types of assays and smartphone-based sensors.

Development of the viscosity biosensor for the detection of DNase I based on the flow distance on the paper with DNA mucus

Deoxyribonuclease I (DNase I) is a biomarker which has important applications in various biological processes. Thus, it is highly important to develop a user-friendly method for the detection of DNase I. Here, we present a paper-based distance sensor for the rapid detection of DNase I based on changes in the viscosity of DNA mucus. The viscosity of DNA mucus varies with different concentrations of DNase I, showing different water flow lengths on the pH test papers, this makes the quantification of DNase I possible. This method has a wide linear range (0.01-10 U/mL), excellent sensitivity, remarkable specificity and excellent reproducibility. The detection limit reaches 0.003 U/mL. Additionally, it can be well applied to detection of DNase I inhibitors, assay of DNase I in human serum and quality evaluation of nucleic acid scavengers. In general, this study offers a brief, convenient, label-free, and economical method to construct paper-based distance sensors using DNA mucus, which is very promising in the detection of DNase I in various applications.

Cell phone microscopy enabled low-cost manufacturable colorimetric urine glucose test

Glucose serves as a pivotal biomarker crucial for the monitoring and diagnosis of a spectrum of medical conditions, encompassing hypoglycemia, hyperglycemia, and diabetes, all of which may precipitate severe clinical manifestations in individuals. As a result, there is a growing demand within the medical domain for the development of rapid, cost-effective, and user-friendly diagnostic tools. In this research article, we introduce an innovative glucose sensor that relies on microfluidic devices meticulously crafted from disposable, medical-grade tapes. These devices incorporate glucose urine analysis strips securely affixed to microscope glass slides. The microfluidic channels are intricately created through laser cutting, representing a departure from traditional cleanroom techniques. This approach streamlines production processes, enhances cost-efficiency, and obviates the need for specialized equipment. Subsequent to the absorption of the target solution, the disposable device is enclosed within a 3D-printed housing. Image capture is seamlessly facilitated through the use of a smartphone camera for subsequent colorimetric analysis. Our study adeptly demonstrates the glucose sensor's capability to accurately quantify glucose concentrations within sucrose solutions. This is achieved by employing an exponential regression model, elucidating the intricate relationship between glucose concentrations and average RGB (Red-Green-Blue) values. Furthermore, our comprehensive analysis reveals minimal variation in sensor performance across different instances. Significantly, this study underscores the potential adaptability and versatility of our solution for a wide array of assay types and smartphone-based sensor systems, making it particularly promising for deployment in resource-constrained settings and undeveloped countries. The robust correlation established between glucose concentrations and average RGB values, substantiated by an impressive R-square value of 0.98709, underscores the effectiveness and reliability of our pioneering approach within the medical field.

Paper-based colorimetric sensors for point-of-care testing

By eliminating the need for sample transportation and centralized laboratory analysis, point-of-care testing (POCT) enables on-the-spot testing, with results available within minutes, leading to improved patient management and overall healthcare efficiency. Motivated by the rapid development of POCT, paper-based colorimetric sensing, a powerful analytical technique that exploits the changes in color or absorbance of a chemical species to detect and quantify analytes of interest, has garnered increasing attention. In this review, we strive to provide a bird's eye view of the development landscape of paper-based colorimetric sensors that harness the unique properties of paper to create low-cost, easy-to-use, and disposable analytical devices, thematically covering both fundamental aspects and categorized applications. In the end, we authors summarized the review with the remaining challenges and emerging opportunities. Hopefully, this review will ignite new research endeavors in the realm of paper-based colorimetric sensors.

Urine protein quantification in human urine on boron-doped diamond electrodes based on the electrochemical reaction of Coomassie brilliant blue

Urinalysis is attracting interest in personal healthcare management as part of a general move to improve quality of life. Urine contains various metabolites and the protein level in urine is an indicator of kidney function. In this study, a novel electrochemical sensing system based on boron-doped diamond (BDD) electrodes was developed for the detection of protein concentrations in human urine. BDD electrodes have the advantages of a wide electrochemical potential window and low non-specific adsorption, making them ideal for simple, rapid, and compact devices for home detection of bio-relevant substances. Coomassie brilliant blue (CBB), a dye that selectively and strongly binds to urine proteins, was found to be a redox-active indicator to show a decrease in its redox currents in relation to the concentration of protein in urine samples. Our detailed studies of BDD electrodes showed their limit of detection to be 2.57 μg mL-1 and that they have a linear response that ranges from 0 to 400 μg mL-1 in urine samples. We also investigated the detection of urine protein in different urine samples. Our results agreed with those obtained using conventional colorimetric analysis. We believe this to be the first study of electrochemical detection of urine protein in urine samples on BDD electrodes, which is of great significance to be able to obtain results with electrical signals rapidly compared to conventional colorimetric analysis. This CBB-BDD technique has the potential to assist healthcare management in the form of a rapid daily diagnostic test to judge whether a more detailed examination is needed.

Evaluation of a smartphone-based colorimetric method for urinalysis dipstick readings in cats

OBJECTIVES

The aim of the study was to compare the diagnostic performances of a smartphone-based colorimetric method (SBCM) for urinalysis with a semi-automated point-of-care (POC) analyser using standardised solutions and cat urine.

METHODS

Artificial solutions (negative and positive quality controls, and purposely designed artificial urine) and natural urine from 216 cats were used. Two urine reagent strips were simultaneously dipped in each sample. One dipstick was read by the SBCM and the other by the POC analyser at the same time. Results for pH, proteins, bilirubin, 'blood', glucose and ketones were considered. Overall agreement and sensitivity, specificity and accuracy of the SBCM were determined based on selected cut-offs.

RESULTS

For the artificial solutions, 80 comparisons were obtained for each analyte and each expected concentration. The overall agreement (exactly the same result) between the two methods was 78.4%. SBCM sensitivity, specificity and accuracy were 99.0%, 100% and 99.3%, respectively. The correlation between the two methods was almost perfect (Cohen's kappa coefficient = 0.9851). For natural urine samples, the overall agreement (including pH) was 68.6%. Using optimal cut-offs for the SBCM determined from the results of analysis of artificial solutions, the sensitivity, specificity and accuracy of the SBCM were 100%, 76.02% and 80.5%, respectively. In this situation, the correlation between the two methods was moderate (Cohen's kappa coefficient = 0.5401). This was mostly due to a high rate of false-positive results for bilirubin (61.1%).

CONCLUSIONS AND RELEVANCE

With proper cut-off use (ie, considering positive or negative results) the SBCM evaluated here has a perfect sensitivity and appropriate diagnostic performances for proteins, 'blood', glucose and ketones. Based on these experimental data, this method appears suitable for dipstick urinalysis but positive results for bilirubin and proteins have to be confirmed.

Dual-signal readout paper-based wearable biosensor with a 3D origami structure for multiplexed analyte detection in sweat

In this research, we design and implement a small, convenient, and noninvasive paper-based microfluidic sweat sensor that can simultaneously detect multiple key biomarkers in human sweat. The origami structure of the chip includes colorimetric and electrochemical sensing regions. Different colorimetric sensing regions are modified with specific chromogenic reagents to selectively identify glucose, lactate, uric acid, and magnesium ions in sweat, as well as the pH value. The regions of electrochemical sensing detect cortisol in sweat by molecular imprinting. The entire chip is composed of hydrophilically and hydrophobically treated filter paper, and 3D microfluidic channels are constructed by using folding paper. The thread-based channels formed after the hydrophilic and hydrophobic modifications are used to control the rate of sweat flow, which in turn can be used to control the sequence of reactions in the differently developing colored regions to ensure that signals of the best color can be captured simultaneously by the colorimetric sensing regions. Finally, the results of on-body experiments verify the reliability of the proposed sweat sensor and its potential for the noninvasive identification of a variety of sweat biomarkers.

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.

A customizable automated container-free multi-strip detection and line recognition system for colorimetric analysis with lateral flow immunoassay for lean meat powder based on machine vision and smartphone

Ractopamine (RAC) and clenbuterol (CLE) are feed additives with adverse effects of consuming too much to food safety. It is necessary to develop an efficient and accurate colorimetric analysis method for immune-based detection of RAC and CLE. Traditional human-vision-based colorimetric analysis for lateral flow immunoassay (LFIA) is non-quantifiable and low-in-automation, while container-based and analysis-instrument-based methods are unrepeatable and high-cost. Therefore, a container-free colorimetric analysis method was developed with LFIAs image captured in dark background under smartphone flash. A multi-strip detection algorithm based on contours extraction, as well as line recognition algorithm based on grayscale projection of LFIA was developed. Finally, relative grayscale (RGS) of lines were calculated and then input into editable fitting curves to estimate concentrations. Results showed the multi-strip detection algorithm reached 98.85% and 93.70% of Recall and intersection over union (IoU), while the line recognition algorithm reached 95.07% and 97.95% of Recall and color similarity, respectively. As a result, an App was fabricated through employing LFIA of RAC and CLE, with colorimetric analysis accuracy of 98.25% and 94.50%, respectively. This study provides a container-free multi-strip colorimetric analysis method with low-cost and illumination robustness, which is a substitution for container-based and single-strip colorimetric analysis methods.

Smartphone-Based Quantitative Detection of Ochratoxin A in Wheat via a Lateral Flow Assay

Ochratoxin A (OTA) poses a severe health risk to livestock along the food chain. Moreover, according to the International Agency for Research on Cancer, it is also categorized as being possibly carcinogenic to humans. The lack of intelligent point-of-care test (POCT) methods restricts its early detection and prevention. This work establishes a smartphone-enabled point-of-care test for OTA detection via a fluorescent lateral flow assay within 6 min. By using a smartphone and portable reader, the assay allows for the recording and sharing of the detection results in a cloud database. This intelligent POCT provided (iPOCT) a linearity range of 0.1-3.0 ng/mL and a limit of detection (LOD) of 0.02 ng/mL (0.32 µg/kg in wheat). By spiking OTA in blank wheat samples, the recoveries were 89.1-120.4%, with a relative standard deviation (RSD) between 3.9-9.1%. The repeatability and reproducibility were 94.2-101.7% and 94.6-103.4%, respectively. This work provides a promising intelligent POCT method for food safety.

Advances in Microfluidics for Single Red Blood Cell Analysis

The utilizations of microfluidic chips for single RBC (red blood cell) studies have attracted great interests in recent years to filter, trap, analyze, and release single erythrocytes for various applications. Researchers in this field have highlighted the vast potential in developing micro devices for industrial and academia usages, including lab-on-a-chip and organ-on-a-chip systems. This article critically reviews the current state-of-the-art and recent advances of microfluidics for single RBC analyses, including integrated sensors and microfluidic platforms for microscopic/tomographic/spectroscopic single RBC analyses, trapping arrays (including bifurcating channels), dielectrophoretic and agglutination/aggregation studies, as well as clinical implications covering cancer, sepsis, prenatal, and Sickle Cell diseases. Microfluidics based RBC microarrays, sorting/counting and trapping techniques (including acoustic, dielectrophoretic, hydrodynamic, magnetic, and optical techniques) are also reviewed. Lastly, organs on chips, multi-organ chips, and drug discovery involving single RBC are described. The limitations and drawbacks of each technology are addressed and future prospects are discussed.

Recent Trends in Metal Nanoparticles Decorated 2D Materials for Electrochemical Biomarker Detection

Technological advancements in the healthcare sector have pushed for improved sensors and devices for disease diagnosis and treatment. Recently, with the discovery of numerous biomarkers for various specific physiological conditions, early disease screening has become a possibility. Biomarkers are the body's early warning systems, which are indicators of a biological state that provides a standardized and precise way of evaluating the progression of disease or infection. Owing to the extremely low concentrations of various biomarkers in bodily fluids, signal amplification strategies have become crucial for the detection of biomarkers. Metal nanoparticles are commonly applied on 2D platforms to anchor antibodies and enhance the signals for electrochemical biomarker detection. In this context, this review will discuss the recent trends and advances in metal nanoparticle decorated 2D materials for electrochemical biomarker detection. The prospects, advantages, and limitations of this strategy also will be discussed in the concluding section of this review.

Smartphone-Facilitated Mobile Colorimetric Probes for Rapid Monitoring of Chemical Contaminations in Food: Advances and Outlook

Smartphone-derived colorimetric tools have the potential to revolutionize food safety control by enabling citizens to carry out monitoring assays. To realize this, it is of paramount significance to recognize recent study efforts and figure out important technology gaps in terms of food security. Driven by international connectivity and the extensive distribution of smartphones, along with their built-in probes and powerful computing abilities, smartphone-based sensors have shown enormous potential as cost-effective and portable diagnostic scaffolds for point-of-need tests. Meantime, the colorimetric technique is of particular notice because of its benefits of rapidity, simplicity, and high universality. In this study, we tried to outline various colorimetric platforms using smartphone technology, elucidate their principles, and explore their applications in detecting target analytes (pesticide residues, antibiotic residues, metal ions, pathogenic bacteria, toxins, and mycotoxins) considering their sensitivity and multiplexing capability. Challenges and desired future perspectives for cost-effective, accurate, reliable, and multi-functions smartphone-based colorimetric tools have also been debated.

Simultaneous Cross-type Detection of Water Quality Indexes via a Smartphone-App Integrated Microfluidic Paper-Based Platform

Water quality guarantee in remote areas necessitates the development of portable, sensitive, fast, cost-effective, and easy-to-use water quality detection methods. The current work reports on a microfluidic paper-based analytical device (μPAD) integrated with a smartphone app for the simultaneous detection of cross-type water quality parameters including pH, Cu(II), Ni(II), Fe(III), and nitrite. The shapes, baking time, amount, and ratios of reaction reagent mixtures of wax μPAD were optimized to improve the color uniformity and intensity effectively. An easy-to-use smartphone app was established for recording, analyzing, and directly reading the colorimetric signals and target concentrations on μPAD. The results showed that under the optimum conditions, the current analytical platform has reached the detection limits of 0.4, 1.9, 2.9, and 1.1 ppm for nitrite, Cu(II), Ni(II), and Fe(III), respectively, and the liner ranges are 2.3-90 ppm (nitrite), 3.8-400 ppm (Cu(II)), 2.9-1000 ppm (Ni(II)), 2.8-500 ppm (Fe(III)), and 5-9 (pH). The proposed portable smartphone-app integrated μPAD detection system was successfully applied to real industrial wastewater and river water quality monitoring. The proposed method has great potential for field water quality detection.

Flash Characterization of Smartphones Used in Point-of-Care Diagnostics

Rapidly growing interest in smartphone cameras as the basis of point-of-need diagnostic and bioanalytical technologies increases the importance of quantitative characterization of phone optical performance under real-world operating conditions. In the context of our development of lateral-flow immunoassays based on phosphorescent nanoparticles, we have developed a suite of tools for characterizing the temporal and spectral profiles of smartphone torch and flash emissions, and their dependence on phone power state. In this work, these tools are described and documented to make them easily available to others, and demonstrated by application to characterization of Apple iPhone 5s, iPhone 6s, iPhone 8, iPhone XR, and Samsung Note8 flash performance as a function of time and wavelength, at a variety of power settings. Flash and torch intensity and duration vary with phone state and among phone models. Flash has high variability when the battery charge is below 10%, thus, smartphone-based Point-of-Care (POC) tests should only be performed at a battery level of at least 15%. Some output variations could substantially affect the results of assays that rely on the smartphone flash.

Nanozyme-based colorimetric biosensor with a systemic quantification algorithm for noninvasive glucose monitoring

Diabetes mellitus accompanies an abnormally high glucose level in the bloodstream. Early diagnosis and proper glycemic management of blood glucose are essential to prevent further progression and complications. Biosensor-based colorimetric detection has progressed and shown potential in portable and inexpensive daily assessment of glucose levels because of its simplicity, low-cost, and convenient operation without sophisticated instrumentation. Colorimetric glucose biosensors commonly use natural enzymes that recognize glucose and chromophores that detect enzymatic reaction products. However, many natural enzymes have inherent defects, limiting their extensive application. Recently, nanozyme-based colorimetric detection has drawn attention due to its merits including high sensitivity, stability under strict reaction conditions, flexible structural design with low-cost materials, and adjustable catalytic activities. This review discusses various nanozyme materials, colorimetric analytic methods and mechanisms, recent machine learning based analytic methods, quantification systems, applications and future directions for monitoring and managing diabetes.

Quadruple analyte responsive platform: Point-of-care testing and multi-coding logic computation based on metal ions recognition and selective response

While it is recognized that instrumentation techniques can provide precise and sensitive solutions to heavy metal ion monitoring, it remains challenging to transform laboratory testing into a convenient, on-site, and quantitative sensing platform for point-of-care testing (POCT) in a resource-constrained setting. To address these limitations, an affordable and user-friendly colorimetric POCT sensing system is proposed here for selectively monitoring four metal ions (Fe³⁺, Co²⁺, Pb²⁺, and Cd²⁺) based on the sulfur quantum dots (S dots). Quadruple distinct visual signals (green, brown, precipitation, and bright yellow) are presented on the fabricated paper-based analytical devices (PADs) when mixing S dots and metal ions. The high-quality photographs of the PADs are captured by a scanner, while a smartphone App converts visual signals to HSV values. The quantitative analysis relies on the digital colorimetric reading, and the limits of detection are 0.59, 0.47, 0.82, and 0.53 μM for Fe³⁺, Co²⁺, Cd²⁺, and Pb²⁺, respectively. This metal ions-responsive platform is engineered as a smart strategy for multiple logic operations (YES, NOT, AND, INHIBIT, and NOR) by integrating multi-responsive blocks into the S dots with encoded patterns, which improves the computing capability. Accordingly, this strategy demonstrates its potential for on-site environmental testing and sophisticated molecular computation.

A new and accessible instrumentation to determine urea in UHT milk using digital image analysis

This research demonstrates the development, optimization and application of a new low-cost detection system, based on digital image analysis, for the detection of urea in ultra-high-temperature (UHT) milk samples. The apparatus built in the laboratory, allows the capture of images through a simple system built by polyvinyl chloride (PVC) tubes, a digital microscope and a peristaltic mini-pump, after the colorimetric reaction between urea and diacetylmonoxime (butane-2,3-dionammonoxime). The red, green and blue (RGB) and hue, saturation and value (HSV) color systems were studied, with the saturation channel of the HSV color system selected as the analytical signal. Subsequently, the experimental chemical conditions were evaluated through multivariate experimental designs and the optimal conditions were defined. The proposed method was validated, and the detection and quantification limits presented by the method were 0.35 mg L^-1 and 0.52 mg L^-1, respectively; precision, ranged between 1.6  and 2.8 %. The results were compared with those obtained using the mid-infrared technique and no statistically significant differences were observed at a 95 % confidence level. The proposed method was applied to eight UHT milk samples that presented urea content ranging from 187 to 386 mg L^-1. The mean values obtained are in agreement with values presented in other studies for the determination of urea in milk. The results indicated that the system described and validated here is promising and can be applied to assess the authenticity and quality of milk.

Cyclic swelling enabled, electrically conductive 3D porous structures for microfluidic urinalysis devices

Urinalysis is a simple and non-invasive approach for the diagnosis and monitoring of organ health and also is often used as a facile technique in assessment of substance abuse. However, quantitative urinalysis is predominantly limited to clinical laboratories. Here, we present an electrical sensing based, reusable, cellular microfluidic device that offers a fast urinalysis through quantitative reading of the electrical signals. The spatial soft porous scaffolds decorated with electrically conductive multiwalled carbon nanotubes that are capable of physically interacting with biomarkers in urine are developed through a cyclic swelling/absorption process of soft materials and are utilized to manufacture the cellular microfluidic device. The sensing capability, sensitivity and reusability (via sunlight exposure) of the device to monitor red blood cells, Escherichia coli, and albumin are systemically demonstrated by programming mechanical deformation of porous scaffolds. Ex vivo experiments in disease mouse models confirm the diagnosis robustness of the device in comparable results with existing biochemical tests. The full integration of electrically conductive nanomaterials into soft scaffolds provides a foundation for devising bioelectronic devices with mechanically programmable microfluidic features in a low-cost manner, with broad applications for rapid disease diagnoses through body fluid.

Smartphone-based mobile biosensors for the point-of-care testing of human metabolites

Rapid, accurate, portable and quantitative profiling of metabolic biomarkers is of great importance for disease diagnosis and prognosis. The recent development in the optical and electric biosensors based on the smartphone is promising for profiling of metabolites with advantages of rapid, reliability, accuracy, low-cost and multi-analytes analysis capability. In this review, we introduced the optical biosensing platforms including colorimetric, fluorescent and chemiluminescent sensing, and electrochemical biosensing platforms including wired and wireless communication. Challenges and future perspectives desired for reliable, accurate, cost-effective, and multi-functions smartphone-based biosensing systems were also discussed. We envision that such smartphone-based biosensing platforms will allow daily and comprehensive metabolites monitoring in the future, thus unlocking the potential to transform clinical diagnostics into non-clinical self-testing. We also believed that this progress report will encourage future research to develop advanced, integrated and multi-functional smartphone-based Point-of-Care testing (POCT) biosensors for the monitoring and diagnosis as well as personalized treatments of a spectrum of metabolic-disorder related diseases.

Microfluidic Point-of-Care (POC) Devices in Early Diagnosis: A Review of Opportunities and Challenges

The early diagnosis of infectious diseases is critical because it can greatly increase recovery rates and prevent the spread of diseases such as COVID-19; however, in many areas with insufficient medical facilities, the timely detection of diseases is challenging. Conventional medical testing methods require specialized laboratory equipment and well-trained operators, limiting the applicability of these tests. Microfluidic point-of-care (POC) equipment can rapidly detect diseases at low cost. This technology could be used to detect diseases in underdeveloped areas to reduce the effects of disease and improve quality of life in these areas. This review details microfluidic POC equipment and its applications. First, the concept of microfluidic POC devices is discussed. We then describe applications of microfluidic POC devices for infectious diseases, cardiovascular diseases, tumors (cancer), and chronic diseases, and discuss the future incorporation of microfluidic POC devices into applications such as wearable devices and telemedicine. Finally, the review concludes by analyzing the present state of the microfluidic field, and suggestions are made. This review is intended to call attention to the status of disease treatment in underdeveloped areas and to encourage the researchers of microfluidics to develop standards for these devices.

Artificial Intelligence-Controlled Microfluidic Device for Fluid Automation and Bubble Removal of Immunoassay Operated by a Smartphone

There have been tremendous innovations in microfluidic clinical diagnostics to facilitate novel point-of-care testing (POCT) over the past decades. However, the automatic operation of microfluidic devices that minimize user intervention still lacks reliability and repeatability because microfluidic errors such as bubbles and incomplete filling pose a major bottleneck in commercializing the microfluidic devices for clinical testing. In this work, for the first time, various states of microfluid were recognized to control immunodiagnostics by artificial intelligence (AI) technology. The developed AI-controlled microfluidic platform was operated via an Android smartphone, along with a low-cost polymer device to effectuate enzyme-linked immunosorbent assay (ELISA). To overcome the limited machine-learning capability of smartphones, the region-of-interest (ROI) cascading and conditional activation algorithms were utilized herein. The developed microfluidic chip was incorporated with a bubble trap to remove any bubbles detected by AI, which helps in preventing false signals during immunoassay, as well as controlling the reagents' movement with an on-chip micropump and valve. Subsequently, the developed immunosensing platform was tested for conducting real ELISA using a single microplate from the 96-well to detect the Human Cardiac Troponin I (cTnI) biomarker, with a detection limit as low as 0.98 pg/mL. As a result, the developed platform can be envisaged as an AI-based revolution in microfluidics for point-of-care clinical diagnosis.

A pH-independent electrochemical aptamer-based biosensor supports quantitative, real-time measurement in vivo

An electrochemical aptamer-based sensor, enabling in vivo measurements of drug concentrations directly in the bladder of living rats under pH-variable conditions, was developed employing a π-extended tetrathiafulvalene (exTTF) as redox reported.

A Paper-Based IL-6 Test Strip Coupled With a Spectrum-Based Optical Reader for Differentiating Influenza Severity in Children

Influenza virus infection is a major worldwide public health problem. Influenza virus infections are associated with a high hospitalization rate in children between the ages of 5 and 14. The predominant reason for poor influenza prognosis is the lack of any effective means for early diagnosis. Early diagnosis of severe illness is critical to improving patient outcome, and could be especially useful in areas with limited medical resources. Accurate, inexpensive, and easy-to-use diagnostic tools could improve early diagnosis and patient outcome, and reduce overall healthcare costs. We developed an interleukin-6 paper-based test strip that used colloidal gold-conjugated antibodies to detect human interleukin-6 protein. These complexes were captured on a paper-based test strip patterned with perpendicular T lines that were pre-coated with anti-human interleukin-6 antibodies. Applied serum samples interacted with these antibodies and presented as colored bands that could be read using a spectrum-based optical reader. The full-spectrum of the reflected light interleukin-6 protein signal could be obtained from the spectral optics module, and the standard could be used to quantitatively analyze interleukin 6 level in serum. We retrospectively evaluated 10 children (23 serum samples) with severe influenza virus infections, 26 children (26 serum samples) with mild influenza virus infections, and 10 healthy children (10 serum samples). Our system, the combined use of a paper-based test strip and a spectrum-based optical reader, provided both qualitative and quantitative information. When used with the optical reader, the detection limit was improved from a qualitative, naked-eye level of 400 pg/ml to a quantitative, optical reader level of 76.85 pg/ml. After monitoring serum interleukin-6 level via our system, we found a high correlation between our system results and those obtainable using a conventional sandwich enzyme-linked immunosorbent assay method (Rho = 0.706, p < 0.001). The sensitivity and specificity for differentiating between severe and mild influenza using our combined method (test strip coupled with optical reader) were 78.3 and 50.0%, respectively. When interleukin-6 was combined with serum C-reaction protein, the sensitivity and specificity were 85.7 and 95.5%, and the receiver operating characteristic area-under-the-curve was quite high (AUC = 0.911, p < 0.001). The potential advantages of our system, i.e., a paper-based test strip coupled with a spectrum-based optical reader, are as follows: 1) simple user operation; 2) rapid turnaround times–within 20 min; 3) high detection performance; and, 4) low-cost fabrication.

Eco-friendly pH detecting paper-based analytical device: Towards process intensification

This work describes the development of a miniaturized paper-based pH detection platform using natural dye extracted from red cabbage (Brassica oleracea). The easily available paper was used as a substrate and the requisite patterned zone was created with the aid of a punching machine. Experimental parameters were optimized to obtain the best signal readout. The performance of the device at different pH values was quantitatively assessed using digital image analysis with various color space models. Regression analysis suggested that a∗ parameter in CIEL∗a∗b∗ color space model, which captures the variations on the red-green scale, exhibited the best fit with experimental data (R² = 0.9754). This parameter was used for the quantitative estimation of pH variations in a wide range of pH (1-12). A series of real test samples were examined using the paper-based device and results validated with a standard pH meter. The use of paper and natural dye makes the device eco-friendly. The simplicity of fabrication, ease of usage and low reagent and sample volume requirements render the methodology suitable for in situ measurements of pH. The approach demonstrated here would pave the way for the development of clean, sustainable and intensified chemical sensor technologies.

Recent innovations in cost-effective polymer and paper hybrid microfluidic devices

Hybrid microfluidic systems that are composed of multiple different types of substrates have been recognized as a versatile and superior platform, which can draw benefits from different substrates while avoiding their limitations. This review article introduces the recent innovations of different types of low-cost hybrid microfluidic devices, particularly focusing on cost-effective polymer- and paper-based hybrid microfluidic devices. In this article, the fabrication of these hybrid microfluidic devices is briefly described and summarized. We then highlight various hybrid microfluidic systems, including polydimethylsiloxane (PDMS)-based, thermoplastic-based, paper/polymer hybrid systems, as well as other emerging hybrid systems (such as thread-based). The special benefits of using these hybrid systems have been summarized accordingly. A broad range of biological and biomedical applications using these hybrid microfluidic devices are discussed in detail, including nucleic acid analysis, protein analysis, cellular analysis, 3D cell culture, organ-on-a-chip, and tissue engineering. The perspective trends of hybrid microfluidic systems involving the improvement of fabrication techniques and broader applications are also discussed at the end of the review.

Pushbutton-activated microfluidic cartridge as a user-friendly sample preparation tool for diagnostics

Microfluidic technologies have several advantages in sample preparation for diagnostics but suffer from the need for an external operation system that hampers user-friendliness. To overcome this limitation in microfluidic technologies, a number of user-friendly methods utilizing capillary force, degassed poly(dimethylsiloxane), pushbutton-driven pressure, a syringe, or a pipette have been reported. Among these methods, the pushbutton-driven, pressure-based method has a great potential to be widely used as a user-friendly sample preparation tool for point-of-care testing or portable diagnostics. In this Perspective, we focus on the pushbutton-activated microfluidic technologies toward a user-friendly sample preparation tool. The working principle and recent advances in pushbutton-activated microfluidic technologies are briefly reviewed, and future perspectives for wide application are discussed in terms of integration with the signal analysis system, user-dependent variation, and universal and facile use.

Smartphone-based colorimetric detection systems for glucose monitoring in the diagnosis and management of diabetes

Diabetes is a group of metabolic conditions resulting in high blood sugar levels over prolonged periods that affects hundreds of millions of patients worldwide. Measuring glucose concentration enables patient-specific insulin therapy, and is essential to reduce the severity of the disease, potential complications, and related mortalities. Recent advances and developments in smartphone-based colorimetric glucose detection systems are discussed in this review. The importance of glucose monitoring, data collection, transfer, and analysis, via non-invasive/invasive methods is highlighted. The review also presents various approaches using 3D-printed materials, screen-printed electrodes, polymer templates, designs allowing multiple glucose analysis, bioanalytes and/or nanostructures for glucose detection. The positive effects of advances in improving the performance of smartphone-based platforms are introduced along with future directions and trends in the application of emerging technologies in smartphone-based diagnostics.

Flipped Quick-Response Code Enables Reliable Blood Grouping

Accurate and rapid blood typing plays a vital role in a variety of biomedical and forensic scenarios, but recognizing weak agglutination remains challenging. Herein, we demonstrated a flipping identification with a prompt error-discrimination (FLIPPED) platform for automatic blood group readouts. Bromocresol green dye was exploited as a characteristic chromatography indicator for the differentiation of plasma from whole blood by presenting a teal color against a brown color. After integrating these color changes into a quick-response (QR) code, prompt typing of ABO and Rhesus groups was automatically achieved and data could be uploaded wirelessly within 30 s using a commercially available smartphone to facilitate blood cross-matching. We further designed a color correction model and algorithm to remove potential errors from scanning angles and ambient light intensities, by which weak agglutination could be accurately recognized. With comparable accuracy and repeatability to classical column assay in grouping 450 blood samples, the proposed approach further demonstrates to be a versatile sample-to-result platform for clinical diagnostics, food safety, and environmental monitoring.

Capillary Microfluidics for Monitoring Medication Adherence

Medication adherence is a medical and societal issue worldwide, with approximately half of patients failing to adhere to prescribed treatments. The goal of this Minireview is to examine how recent work on microfluidics for point-of-care diagnostics may be used to enhance adherence to medication. It specifically focuses on capillary microfluidics since these devices are self-powered, easy to use, and well established for diagnostics and drug monitoring. Considering that an improvement in medication adherence can have a much larger effect than the development of new medical treatments, it is long overdue for the research communities working in chemistry, biology, pharmacology, and material sciences to consider developing technologies to enhance medication adherence. For these reasons, this Minireview is not meant to be exhaustive but rather to provide a quick starting point for researchers interested in joining this complex but intriguing and exciting field of research.

A WiFi scanner in conjunction with disposable multiplex paper assay for the quantitation of disease markers in blood plasma

Herein we report a quantitative, multiplex assay for disease markers in plasma based on an integrated setup of a portable scanner and a disposable paper-based analytical device (PAD). The quantitative analysis relies on the digital colorimetric reading of the three-layer PAD with 30 assay sites for performing respective chromogenic reactions for plasma uric acid, glucose, and triglyceride, which are considered as important risk factors for cardiovascular diseases. A portable scanner with WiFi transmission capability was used to produce high-quality color images of the PADs and wirelessly transfer them to a smartphone or other mobile devices for data processing. The concentrations of biomarkers in both standard solutions and plasma samples can be directly obtained using a custom-designed smartphone app that is also capable of constructing calibration curves. The detection limits of uric acid, glucose, and triglyceride were determined to be 0.50 mg/dL, 0.84 mmol/L, and 14 mg/dL, respectively, which are below the normal limits and adequate for clinical validation. Owing to the distinct advantages-simple, portable, and cost-effective-this mobile assay protocol can be used for point-of-care (POC) settings or resource-limited situations, and potentially for the diagnosis and prevention of infectious diseases.

Applications, challenges, and needs for employing synthetic biology beyond the lab

Synthetic biology holds great promise for addressing global needs. However, most current developments are not immediately translatable to 'outside-the-lab' scenarios that differ from controlled laboratory settings. Challenges include enabling long-term storage stability as well as operating in resource-limited and off-the-grid scenarios using autonomous function. Here we analyze recent advances in developing synthetic biological platforms for outside-the-lab scenarios with a focus on three major application spaces: bioproduction, biosensing, and closed-loop therapeutic and probiotic delivery. Across the Perspective, we highlight recent advances, areas for further development, possibilities for future applications, and the needs for innovation at the interface of other disciplines.

Nano-Interstice Driven Powerless Blood Plasma Extraction in a Membrane Filter Integrated Microfluidic Device

Blood plasma is a source of biomarkers in blood and a simple, fast, and easy extraction method is highly required for point-of-care testing (POCT) applications. This paper proposes a membrane filter integrated microfluidic device to extract blood plasma from whole blood, without any external instrumentation. A commercially available membrane filter was integrated with a newly designed dual-cover microfluidic device to avoid leakage of the extracted plasma and remaining blood cells. Nano-interstices installed on both sides of the microfluidic channels actively draw the extracted plasma from the membrane. The developed device successfully supplied 20 μL of extracted plasma with a high extraction yield (~45%) in 16 min.

Fully integrated rapid microfluidic device translated from conventional 96-well ELISA kit

In this work, a fully integrated active microfluidic device transforming a conventional 96-well kit into point-of-care testing (POCT) device was implemented to improve the performance of traditional enzyme-linked immunosorbent assay (ELISA). ELISA test by the conventional method often requires the collection of 96 samples for its operation as well as longer incubation time from hours to overnight, whereas our proposed device conducts ELISA immediately individualizing a 96-well for individual patients. To do that, a programmable and disposable on-chip pump and valve were integrated on the device for precise control and actuation of microfluidic reagents, which regulated a reaction time and reagent volume to support the optimized protocols of ELISA. Due to the on-chip pump and valve, ELISA could be executed with reduced consumption of reagents and shortening the assay time, which are crucial for conventional ELISA using 96-well microplate. To demonstrate highly sensitive detection and easy-to-use operation, this unconventional device was successfully applied for the quantification of cardiac troponin I (cTnI) of 4.88 pg/mL using a minimum sample volume of 30 µL with a shorter assay time of 15 min for each ELISA step. The limit of detection (LOD) thus obtained was significantly improved than the conventional 96-well platform.

Application of smartphone-based spectroscopy to biosample analysis: A review

The emergence of the smartphones has brought extensive changes to our lifestyles, from communicating with one another, to shopping and enjoyment of entertainment, and from studying to functioning at the workplace (and in the field). At the same time, this portable device has also provided new possibilities in scientific research and applications. Based on the growing awareness of good health management, researchers have coupled health monitoring to smartphone sensing technologies. Along the way, there have been developed a variety of smartphone-based optical detection platforms for analyzing biological samples, including standalone smartphone units and integrated smartphone sensing systems. In this review, we outline the applications of smartphone-based optical sensors for biosamples. These applications focus mainly on three aspects: Microscopic imaging sensing, colorimetric sensing and luminescence sensing. We also discuss briefly some limitations of the current state of smartphone-based spectroscopy and present prospects of the future applicability of smartphone sensors.

Open software platform for automated analysis of paper-based microfluidic devices

Development of paper-based microfluidic devices that perform colorimetric measurements requires quantitative image analysis. Because the design geometries of paper-based microfluidic devices are not standardized, conventional methods for performing batch measurements of regularly spaced areas of signal intensity, such as those for well plates, cannot be used to quantify signal from most of these devices. To streamline the device development process, we have developed an open-source program called ColorScan that can automatically recognize and measure signal-containing zones from images of devices, regardless of output zone geometry or spatial arrangement. This program, which measures color intensity with the same accuracy as standard manual approaches, can rapidly process scanned device images, simultaneously measure identified output zones, and effectively manage measurement results to eliminate requirements for time-consuming and user-dependent image processing procedures.

Urine biopsy technologies: Cancer and beyond

Since the discovery of circulating tumor cells in 1869, technological advances in the study of biomarkers from liquid biopsy have made it possible to diagnose disease in a less invasive way. Although blood-based liquid biopsy has been used extensively for the detection of solid tumors and immune diseases, the potential of urine-based liquid biopsy has not been fully explored. Advancements in technologies for the harvesting and analysis of biomarkers are providing new opportunities for the characterization of other disease types. Liquid biopsy markers such as exfoliated bladder cancer cells, cell-free DNA (cfDNA), and exosomes have the potential to change the nature of disease management and care, as they allow a cost-effective and convenient mode of patient monitoring throughout treatment. In this review, we addressed the advancement of research in the field of disease detection for the key liquid biopsy markers such as cancer cells, cfDNA, and exosomes, with an emphasis on urine-based liquid biopsy. First, we highlighted key technologies that were widely available and used extensively for clinical urine sample analysis. Next, we presented recent technological developments in cell and genetic research, with implications for the detection of other types of diseases, besides cancer. We then concluded with some discussions on these areas, emphasizing the role of microfluidics and artificial intelligence in advancing point-of-care applications. We believe that the benefits of urine biopsy provide diagnostic development potential, which will pave opportunities for new ways to guide treatment selections and facilitate precision disease therapies.

An immunoassay cassette with a handheld reader for HIV urine testing in point-of-care diagnostics

Currently, most HIV tests are performed with blood samples, or alternatively saliva samples are used for HIV testing. Simple HIV tests need to be performed in hospitals or other medical agencies instead of more invasive HIV blood tests. To enable point-of-care (POC) HIV diagnostics, based on a recently developed lateral flow strip for HIV urine testing, a microfluidic immunoassay cassette with a handheld optical reader is developed. Based on lateral flow strip with gold colloid reporter, the integrated immunoassay cassette can perform sample introduction, metering, discharging, applying and detection which simplifies HIV testing. An indicator is incorporated into the cassette to guide sample introduction based on color change, and further, the excess test sample is stored inside the sealed cassette to avoid any contamination. The low-cost handheld optical reader can provide a test result within a few seconds, which is useful for simple, sensitive and affordable HIV onsite detection. Instead of using normal white LEDs, a customized back light module embedded with green LEDs is adopted to illuminate the lateral flow strip with an appropriate working current to achieve optimal performance. Compared to the standard lateral flow strips using a benchtop reader, with the disposable immunoassay cassette assisted by the handheld optical reader, more convenient, easier-to-operate, and more affordable HIV urine testing can be achieved in POC diagnostics.

Paper-Based Device for Naked Eye Urinary Albumin/Creatinine Ratio Evaluation

This paper introduces the concept of "Drawing-PADs" (Drawing paper-based microfluidic analytical devices) allowing to intuitively evaluate the urinary albumin (Alb) index, a clinically important parameter used for the early detection of renal deficiencies related to diabetes, among others. To enable regular monitoring of the Alb index, a simple examination method suitable for self-diagnosis is highly desirable. The Drawing-PADs rely on the simultaneous naked eye detection of Alb and creatinine (Cre) on a single device according to the distance-based microfluidic PAD (μPAD) approach. The Alb index is visualized by simply drawing a straight line connecting the top of two color-changed assay channel sections (Alb and Cre channels), followed by visually confirming the position of the intercept of the drawn straight line. The semiquantitative Alb index evaluation performed with Drawing-PADs does not require any equipment such as a camera, software, or a color reference chart. The obtained results are independent of the sample volume and are not influenced by changes in the absolute Alb and Cre concentrations caused by urine excretion variations, making spot urine assays possible. Classification of Alb index values according to clinically relevant criteria (normoalbuminuria, microalbuminuria, and macroalbuminuria) is readily achieved within 15 min and has been validated for 15 human urine samples including diabetic patients and healthy volunteers.

Towards practical sample preparation in point-of-care testing: user-friendly microfluidic devices

Microfluidic technologies offer a number of advantages for sample preparation in point-of-care testing (POCT), but the requirement for complicated external pumping systems limits their wide use. To facilitate sample preparation in POCT, various methods have been developed to operate microfluidic devices without complicated external pumping systems. In this review, we introduce an overview of user-friendly microfluidic devices for practical sample preparation in POCT, including self- and hand-operated microfluidic devices. Self-operated microfluidic devices exploit capillary force, vacuum-driven pressure, or gas-generating chemical reactions to apply pressure into microchannels, and hand-operated microfluidic devices utilize human power sources using simple equipment, including a syringe, pipette, or simply by using finger actuation. Furthermore, this review provides future perspectives to realize user-friendly integrated microfluidic circuits for wider applications with the integration of simple microfluidic valves.

O. Microfluidic Point-of-Care Devices: New Trends and Future Prospects for eHealth Diagnostics

Point-of-care (PoC) diagnostics is promising for early detection of a number of diseases, including cancer, diabetes, and cardiovascular diseases, in addition to serving for monitoring health conditions. To be efficient and cost-effective, portable PoC devices are made with microfluidic technologies, with which laboratory analysis can be made with small-volume samples. Recent years have witnessed considerable progress in this area with "epidermal electronics", including miniaturized wearable diagnosis devices. These wearable devices allow for continuous real-time transmission of biological data to the Internet for further processing and transformation into clinical knowledge. Other approaches include bluetooth and WiFi technology for data transmission from portable (non-wearable) diagnosis devices to cellphones or computers, and then to the Internet for communication with centralized healthcare structures. There are, however, considerable challenges to be faced before PoC devices become routine in the clinical practice. For instance, the implementation of this technology requires integration of detection components with other fluid regulatory elements at the microscale, where fluid-flow properties become increasingly controlled by viscous forces rather than inertial forces. Another challenge is to develop new materials for environmentally friendly, cheap, and portable microfluidic devices. In this review paper, we first revisit the progress made in the last few years and discuss trends and strategies for the fabrication of microfluidic devices. Then, we discuss the challenges in lab-on-a-chip biosensing devices, including colorimetric sensors coupled to smartphones, plasmonic sensors, and electronic tongues. The latter ones use statistical and big data analysis for proper classification. The increasing use of big data and artificial intelligence methods is then commented upon in the context of wearable and handled biosensing platforms for the Internet of things and futuristic healthcare systems.