Strategy to enhance the wettability of bioacive paper-based sensors

Microfluidics-Based Blood Typing Devices: An In-Depth Overview

Identification of correct blood types holds paramount importance in understanding the pathophysiological parameters of patients, therapeutic interventions, and blood transfusion. Considering the wide applications of blood typing, the requirement of centralized laboratory facilities is not well suited on many occasions. In this context, there has been a significant development of such blood typing devices on different microfluidic platforms. The advantages of these microfluidic devices offer easy, rapid test protocols, which could potentially be adapted in resource-limited settings and thereby can truly lead to the decentralization of testing facilities. The advantages of pump-free liquid transport (i.e., low power consumption) and biodegradability of paper substrates (e.g., reduction in medical wastes) make it a more preferred platform in comparison to other microfluidic devices. However, these devices are often coupled with some inherent challenges, which limit their potential to be used on a mass commercial scale. In this context, our Review offers a succinct summary of the recent development, especially to understand the importance of underlying facets for long-term sustainability. Our Review also delineates the role of integration with digital technologies to minimize errors in interpreting the readouts.

Development of Novel Paper-Based Assay for Direct Serum Separation

Background: Many conventional laboratory tests require serum separation using a clot activator/gel tube, followed by centrifugation in an equipped laboratory. The aim of this study is development of novel, equipment-free, paper-based assay for direct and efficient serum separation. Methods: Fresh blood was directly applied to wax-channeled filter paper treated with clotting activator/s and then observed for serum separation. The purity, efficiency, recovery, reproducibility, and applicability of the assay were validated after optimization. Results: Serum was successfully separated using activated partial thromboplastin time (APTT) reagent and calcium chloride-treated wax-channeled filter paper within 2 min. The assay was optimized using different coagulation activators, paper types, blood collection methods, and incubation conditions. Confirmation of serum separation from cellular components was achieved by direct visualization of the yellow serum band, microscopic imaging of the pure serum band, and absence of blood cells in recovered serum samples. Successful clotting was evaluated by the absence of clotting of recovered serum by prolonged prothrombin time and APTT, absence of fibrin degradation products, and absence of Staphylococcus aureus-induced coagulation. Absence of hemolysis was confirmed by undetectable hemoglobin from recovered serum bands. The applicability of serum separated in paper was tested directly by positive color change on paper using bicinchoninic acid protein reagent, on recovered serum samples treated with Biuret and Bradford reagents in tubes, or measurement of thyroid-stimulating hormone and urea compared to standard serum samples. Serum was separated using the paper-based assay from 40 voluntary donors and from the same donor for 15 days to confirm reproducibility. Dryness of coagulants in paper prevents serum separation that can be re-stored by a re-wetting step. Conclusions: Paper-based serum separation allows for development of sample-to-answer paper-based point-of-care tests or simple and direct blood sampling for routine diagnostic tests.

Three-dimensional microfluidic tape-paper-based sensing device for blood total bilirubin measurement in jaundiced neonates

More than 60% newborns experience hyperbilirubinemia and jaundice within the initial week after birth due to the accumulation of total bilirubin in blood. Left untreated high levels of bilirubin may result in brain impairment. Simple, fast, accurate, low-cost and timely point-of-care (POC) analysis of total bilirubin is an unmet need especially in resource-limited areas. This work introduces a novel sensing device, named a "tape-paper sensor", capable of separating plasma from whole blood and measuring total bilirubin by a colorimetric diazotization method. The tape-paper sensing method overcomes non-homogeneous color distribution caused by the "coffee stain" effect, which improves the accuracy of colorimetric evaluation on paper-based analytical devices. The level of hemolysis in the plasma extracted by the device is evaluated, confirming no interference in the detection of total bilirubin. The accuracy of the tape-paper sensing approach for neonatal blood sample measurement is verified by comparison with the hospital pathology laboratory method. The small volume of samples and reagents, minimal equipment (an office scanner), fast detection (<10 min) and low fabrication cost (∼A$ 0.6) reveal the suitability of the device for POC use and in resource-limited settings. The tape-paper sensor is a low-cost, fast, and user-friendly device for measurement of blood total bilirubin levels in neonatal jaundice diagnostics.

A cellulose-based photoacoustic sensor to measure heparin concentration and activity in human blood samples

Heparin is an indispensable drug in anticoagulation therapy but with a narrow therapeutic window, which dictates regular testing and dose adjustment. However, current monitoring tools have a long turnaround time or are operator intensive. In this work, we describe a cellulose-based photoacoustic sensor for heparin. The sensors have a turnaround time of 6 min for whole blood samples and 3 min for plasma samples regardless of heparin concentration. These sensors have a limit of detection of 0.28 U/ml heparin in human plasma and 0.29 U/ml in whole blood with a linear response (Pearson's r = 0.99) from 0 to 2 U/ml heparin in plasma and blood samples. The relative standard deviation was < 12.5% in plasma and < 17.5% in whole blood. This approach was validated with heparin-spiked whole human blood and had a linear correlation with the activated partial thromboplastin time (aPTT) (r = 0.99). We then studied 16 sets of clinical samples-these had a linear correlation with the activated clotting time (ACT) (Pearson's r = 0.86, P < 0.0001). The photoacoustic signal was also validated against the cumulative heparin dose (Pearson's r = 0.71, P < 0.0001). This approach could have applications in bed-side heparin assays for continuous heparin monitoring.

Activity and Longevity of Antibody in Paper-Based Blood Typing Diagnostics

Paper-based diagnostics provide a low-cost, reliable and easy to use mode of blood typing. The shelf-life of such products, however, can be limited due to the reduced activity of reagent antibodies sorbed on the paper cellulose fibers. This study explores the effects of aging on antibody activity for periods up to 12 months on paper and in solution under different aging and drying conditions-air-dried, lyophilized, and kept as a liquid. Paper kept wet with undiluted antibody is shown to have the longest shelf-life and the clearest negatives. Antibody diluted with bovine serum albumin (BSA) protects against the lyophilization process, however, beyond 9 months aging, false positives are seen. Paper with air-dried antibodies is not suitable for use after 1 month aging. These results inform preparation and storage conditions for the development of long shelf-life blood grouping paper-based diagnostics.

Low-Cost Chemical-Responsive Adhesive Sensing Chips

Chemical-responsive adhesive sensing chip is a new low-cost analytical platform that uses adhesive tape loaded with indicator reagents to detect or quantify the target analytes by directly sticking the tape to the samples of interest. The chemical-responsive adhesive sensing chips can be used with paper to analyze aqueous samples; they can also be used to detect and quantify solid, particulate, and powder analytes. The colorimetric indicators become immediately visible as the contact between the functionalized adhesives and target samples is made. The chemical-responsive adhesive sensing chip expands the capability of paper-based analytical devices to analyze solid, particulate, or powder materials via one-step operation. It is also a simpler alternative way, to the covalent chemical modification of paper, to eliminate indicator leaching from the dipstick-style paper sensors. Chemical-responsive adhesive chips can display analytical results in the form of colorimetric dot patterns, symbols, and texts, enabling clear understanding of assay results by even nonprofessional users. In this work, we demonstrate the analyses of heavy metal salts in silica powder matrix, heavy metal ions in water, and bovine serum albumin in an aqueous solution. The detection is one-step, specific, sensitive, and easy-to-operate.

Cellulose: from biocompatible to bioactive material

The immobilization of biomolecules onto cellulose paper turns this environmentally friendly material into a platform for diagnostic devices.

Fabrication of a detection platform with boronic-acid-containing zwitterionic polymer brush

Development of technologies for biomedical detection platform is critical to meet the global challenges of various disease diagnoses, especially for point-of-use applications. Because of its natural simplicity, effectiveness, and easy repeatability, random covalent-binding technique is widely adopted in antibody immobilization. However, its antigen-binding capacity is relatively low when compared to site-specific immobilization of antibody. Herein, we report that a detection platform modified with boronic acid (BA)-containing sulfobetaine-based polymer brush. Mainly because of the advantage of oriented immobilization of antibody endowed with BA-containing three-dimensional polymer brush architecture, the platform had a high antigen-binding capacity. Notably, nonspecific protein adsorption was also suppressed by the zwitterionic pendants, thus greatly enhanced signal-to-noise (S/N) values for antigen recognition. Furthermore, antibodies captured by BA pendants could be released in dissociation media. This new platform is promising for potential applications in immunoassays.

Electrochemical detection of glucose from whole blood using paper-based microfluidic devices

Electrochemical paper-based analytical devices (ePADs) with integrated plasma isolation for determination of glucose from whole blood samples have been developed. A dumbbell shaped ePAD containing two blood separation zones (VF2 membranes) with a middle detection zone was fabricated using the wax dipping method. The dumbbell shaped device was designed to separate plasma while generating homogeneous flow to the middle detection zone of the ePAD. The proposed ePADs work with whole blood samples with 24-60% hematocrit without dilution, and the plasma was completely separated within 4 min. Glucose in isolated plasma separated was detected using glucose oxidase immobilized on the middle of the paper device. The hydrogen peroxide generated from the reaction between glucose and the enzyme pass through to a Prussian blue modified screen printed electrode (PB-SPEs). The currents measured using chronoamperometry at the optimal detection potential for H2O2 (-0.1 V versus Ag/AgCl reference electrode) were proportional to glucose concentrations in the whole blood. The linear range for glucose assay was in the range 0-33.1 mM (r(2)=0.987). The coefficients of variation (CVs) of currents were 6.5%, 9.0% and 8.0% when assay whole blood sample containing glucose concentration at 3.4, 6.3, and 15.6mM, respectively. Because each sample displayed intra-individual variation of electrochemical signal, glucose assay in whole blood samples were measured using the standard addition method. Results demonstrate that the ePAD glucose assay was not significantly different from the spectrophotometric method (p=0.376, paired sample t-test, n=10).