Distance-based microfluidic quantitative detection methods for point-of-care testing

Smartphone-deployable and all-in-one machine vision for visual quantification analysis based on distance readout of electrophoresis titration biosensor

As a class of point-of-care (POC) assays with visible distance readout (thermometer style), the electrophoresis titration (ET) biosensor affords high robustness, versatility, and simplicity for point-of-care quantification. However, naked-eye observation of the distance readout is unreliable in POC settings and manual processing of distance readout is time-consuming. Herein, we developed a smartphone-deployable and all-in-one machine vision for four ET biosensors (bovine serum albumin, melamine, uric acid, glutathione) to classify and quantify the samples simultaneously. To ensure accurate and rapid quantification on the smartphone, we customized the decolorization methods and edge detection operators to balance the region of interest (ROI) extraction performance and processing speed. We then established a dataset of 180 distance readout images to endow our machine vision with the ability to classify four sample types. Consequently, our machine vision demonstrated high accuracy in determining the sample type (>97.2%) and concentration (>97.3%). Moreover, expanding its applications to other targets was readily achieved by including distance readout images of other ET biosensors (e.g., hemoglobin A1c) in the dataset. Therefore, our strategy of constructing machine vision is compatible with the versatile ET biosensor technique, suggesting that the same strategy can be used for other thermometer-style POC assays.

Humidity-enhanced microfluidic plasma separation on Chinese Xuan-papers

The first step in blood testing necessitates blood separation to obtain an adequate volume of plasma. Traditional centrifugation is bulky, expensive and electricity-powered, which is not suitable for micro-scale blood plasma separation in point-of-care testing (POCT) cases. Microfluidic paper-based plasma separation devices present a promising alternative for plasma separation in such occasions. However, they are limited in terms of plasma yield, which hinders analyte detection. Herein, we proposed a humidity-enhanced paper-based microfluidic plasma separation method to address this issue. Specifically, paper was first treated by blood-typing antibodies, then samples of whole blood were introduced into the prepared paper. After waiting for 5 min for RBC agglutination and plasma wicking under high humidity, micro-scale plasma separation from whole blood was achieved. As a result, an extremely high plasma yield of up to 60.1% could be separated from whole blood through using Xuan-paper. Meanwhile, the purity of plasma could reach 99.99%. Finally, this innovative approach was effortlessly integrated into distance-based glucose concentration detection, enabling rapid determination of blood glucose levels through naked-eye observation. Considering the simplicity and inexpensiveness of this method, we believe that this technology could be integrated to more paper-based microfluidic analytical devices for rapid and accurate detection of plasma analytes in POCT.

Unveiling the state of the art: a systematic review and meta-analysis of paper-based microfluidic devices

Introduction

This systematic review and meta-analysis present a comprehensive evaluation of paper-based microfluidic devices, focusing on their applications in immunoassays. These devices are emerging as innovative solutions to democratize access to diagnostic technologies, especially in resource-limited settings. Our review consolidates findings from diverse studies to outline advancements in paper-based microfluidic technology, including design intricacies and operational efficacy. Key advantages such as low cost, portability, and ease of use are highlighted.

Materials and Methods

The review categorizes literature based on the design and operational nuances of these diagnostic tools, exploring various methodologies, fabrication techniques, detection methods, and applications, particularly in protein science. The meta-analysis extends to the diverse applications of these technologies, providing a framework for classifying and stratifying their uses in diagnostics.

Results and discussion

Notable findings include a critical analysis of performance metrics, such as sensitivity and specificity. The review addresses challenges, including the need for further validation and optimization for broader clinical applications. A critical discussion on the validation processes, including cross-validation and rigorous control testing, is provided to ensure the robustness of microfluidic devices. This study offers novel insights into the computational strategies underpinning these technologies and serves as a comprehensive roadmap for future research, potentially broadening the impact across the protein science universe.

Quantitative and equipment-free paper-based agglutination assay of bacterial cells

Background: point-of-care (POC) tests are useful for bedside/home applications, emergencies, frequent follow-ups, and resource-limited areas. Limited quantitative and equipment-free POC assays have been reported. This study aims to develop, validate, and apply a simple, quantitative, paper-based POC assay. Methods: wax-channeled paper treated with specific anti-Brucella and anti-Salmonella antibodies was used for distance-based chromatographic elution of stained bacterial cell agglutinations. Results: a qualitative paper-based agglutination POC test was developed using color intensity, tail appearance, and "+/-" signs that clearly distinguish the positive and negative results. The optimization of the test for paper type, microfluidic channel design, antibody and bacterial cell concentrations, and elution methods was carried out. Quantitative assay transformation was successfully developed using the color intensity of the original reaction zone, intensity of elution tail, and distance-based migration that correspond to bacterial agglutination size. The migration distance of eluted bacterial agglutination bands corresponds to the target concentration with good linearity and minimal variability. Reporting of colored band migration with numbers using microfluidic patterns was used to enhance non-technical end-user applications. A distance-based POC assay prototype was then successfully used for the accurate detection of known and unknown samples in comparison with standard assays. Conclusions: the migration distance of an eluted stained bacterial agglutination correlated with anti-bacterial antibody concentrations. A simple, cheap, quantitative, and equipment-free paper-based POC assay of bacterial cell agglutination was developed. This test can be used for simple "+/-" results, thermometer-like quantification, or text reporting with numbers corresponding to target concentrations. The assay has extended applications to different human disease biomarkers.

Integrating of analytical techniques with enzyme-mimicking nanomaterials for the fabrication of microfluidic systems for biomedical analysis

Bioanalysis faces challenges in achieving fast, reliable, and point-of-care (POC) determination methods for timely diagnosis and prognosis of diseases. POC devices often display lower sensitivity compared to laboratory-based methods, limiting their ability to quantify low concentrations of target analytes. To enhance sensitivity, the synthesis of new materials and improvement of the efficiency of the analytical strategies are necessary. Enzyme-mimicking materials have revolutionized the field of the fabrication of new high-throughput sensing devices. The integration of microfluidic chips with analytical techniques offers several benefits, such as easy miniaturization, need for low biological sample volume, etc., while also enhancing the sensitivity of the probe. The use enzyme-like nanomaterials in microfluidic systems can offer portable strategies for real-time and reliable detection of biological agents. Colorimetry and electrochemical methods are commonly utilized in the fabrication of nanozyme-based microfluidic systems. The review summarizes recent developments in enzyme-mimicking materials-integrated microfluidic analytical methods in biomedical analysis and discusses the current challenges, advantages, and potential future directions.

Designing and prototyping a novel biosensor based on a volumetric bar-chart chip for urea detection

A volumetric bar-chart chip (V-chip) is a microfluidic device based on distance-based quantitative measurement that visualizes analyte concentration without the need for apparatus or data processing. This typically utilizes special receptors and catalysis parts that generate oxygen, so ink can be moved inside the channels, and enables instant visual quantitation of the analyte. However, the low stability of some macromolecules, the use of expensive catalysts, and difficulty in controlling the process cause inaccurate readings, and therefore, limit further development and the use of these systems. In this article, we introduced a novel approach that eliminates the use of catalysts in V-chips and provides an efficient and simple path in the design of biosensors. The product of the enzymatic reaction of urease with urea is bicarbonate, which turns into CO2 gas in an acidic environment. Therefore, the amount of gas produced is proportional to the amount of urea in the sample, and it can be quantitatively measured by visual detection from the amount of ink movement caused by CO2 gas pressure. This biosensor has a linear response range of 0 to 1000 μg ml-1 and a detection limit of 3.6 μg ml-1 in raw milk. The recovery of urea in raw milk at 100 and 400 μg ml-1 concentrations was 96.5% and 98.9%, respectively. This volumetric chip shows potential for determining urea levels in real samples without requiring additional equipment. The combination of the sensitivity and specificity of enzymatic reactions, inherent gas-generating reactions, and the processability of microchips discussed in this paper can be the basis for the comprehensive development of volumetric chips, which can create a new path for the development of efficient and cheap biosensors.

Sandwich-type aptamer-based biosensors for thrombin detection

Thrombin, a proteolytic enzyme, plays an essential role in catalyzing many blood clotting reactions. Thrombin can act as a marker for some blood-related diseases, such as leukemia, thrombosis, Alzheimer's disease and liver disease. Therefore, its diagnosis is of great importance in the fields of biological and medical research. Biosensors containing sandwich-type structures have attracted much consideration owing to their superior features such as reproducible and stable responses with easy improvement in the sensitivity of detection. Sandwich-type platforms can be designed using a pair of receptors that are able to bind to diverse locations of the same target. Herein, we investigate recent advances in the progress and applications of thrombin aptasensors containing a sandwich-type structure, in which two thrombin-binding aptamers (TBAs) identify different parts of the thrombin molecule, leading to the formation of a sandwich structure and ultimately signal detection. We also discuss the pros and cons of these approaches and outline the most logical approach in each section.

Sodium alginate hydrogelation mediated paper-based POCT sensor for visual distance reading and smartphone-assisted colorimetric dual-signal determination of L-lactate

Herein, we present a paper-based POCT sensor based on lactate dehydrogenase-mediated alginate gelation combined with visual distance reading and smartphone-assisted colorimetric dual-signal analysis to determine the concentration of L-lactate in yogurt samples. In this research, L-lactate was transformed into pyruvate by lactate dehydrogenase. Pyruvate then triggered the gelation of a sol mixture, increasing the viscosity (ηs) of the mixture, which was shown as a decrease in the diffusion diameter on the paper-based sensor. In addition, protons from pyruvate accelerated the degradation of Rhodamine B, causing color fading of the mixture, which was analyzed using RGB analysis application software. Under optimal experimental conditions, the linear ranges of visual distance reading and smartphone-assisted colorimetric analysis were 0.1-15 μM and 0.3-15 μM and the detection limits were 0.03 μM and 0.07 μM, respectively. As a proof-of-concept application, we exploited the paper-based sensor to determine the concentration of L-lactate in yogurt samples. The results from the dual-signal paper-based sensor were consistent with the ones from HPLC analysis. In short, this study developed a simple, convenient, cost-effective, and feasible method for the quantitative detection of L-lactate in real samples.

A portable polymeric electrochromism-based visual biosensing device with distance readout

A distance-based visual electrochromic biosensing device is proposed. With this device, the naked eye is capable of discerning the distance of discoloration, which exhibits a positive correlation with the concentration of the detected substance.

A dual-mode assay kit using a portable potentiostat connected to a smartphone via Bluetooth communication and a potential-power angle-based paper device susceptible for low-cost point-of-care testing of iodide and dopamine

BACKGROUND

Considering that the brain controls most of the body's activities, it is very important to measure the factors affecting its function, such as dopamine and iodide. Due to the growing population in the world, it is necessary to provide fast, cheap and accurate methods with the capability of on-site analysis and without the need for invasive sampling and operator skill. As a result, there is a strong desire to replace laboratory instruments with small sensors for point-of-care testing. Paper-based analytical devices (PADs) are one of the popular zero-cost approaches to achieve this goal.

RESULTS

We developed a simple and disposable diagnostic paper system based on electroanalytical and potential-power angle-based methods. First, we prepared an angle-based analytical system capable of performing semi-quantitative iodide analysis simply by reading the colored angle traveled. This system design is based on a channel containing complex reagents and two pencil-drawn electrodes to apply a constant voltage accelerating the anions migration. Meanwhile, a three-electrode system based on conductive pencil graphite is developed to measure dopamine concentration based on linear sweep voltammetry. For the quantitative analysis, the voltammetric data was wirelessly transmitted to a mobile device via Bluetooth communication. In this context, a power supply providing the required voltage for the migration of iodide ions, a portable potentiostat system, and a mobile application for measuring dopamine were developed. The calibration curves for I- and dopamine range from 3.5 × 10-4-47.0 × 10-4 and 10.0 × 10-6-1000.0 × 10-6 mol L-1 with LODs of 2.3 × 10-4 and 5.0 × 10-6 mol L-1, respectively.

SIGNIFICANCE AND NOVELTY

A new portable dual-mode voltage-assisted integrated PAD platform was designed for iodide and dopamine analysis. The characteristics of this device allow non-experts to carry out in-field analysis using sub-100 μL saliva sample with a time-to-result of <10 min along with reducing the overall cost and operational complexity.

Development of a C-reactive protein quantification method based on flow rate measurement of an ink solution pushed out by oxygen gas generated by catalase reaction

A novel determination method for protein biomarkers based on on-chip flow rate measurement was developed using a microchip with organic photodiodes (OPDs). This quantitative method is based on the flow rate measurement of an ink solution pushed out by oxygen gas generated through catalase reaction. The amount of oxygen gas generated in the sample reservoir is dependent on the concentration of the analyte; therefore, the flow rate of the ink solution is also dependent on the concentration of the analyte. The concentration of the analyte can thus be estimated by measurement of the ink solution flow rate. The ink solution flow rate was estimated by measuring the migration time of the ink solution between two points using two OPDs placed below the microchannel. The principle of this method was demonstrated by the measurement of catalase using the microchip. In addition, the developed method was applied to the determination of C-reactive protein (CRP), a biomarker of inflammation, based on a catalase-linked immunosorbent assay (C-LISA). The limit of detection for CRP was 0.20 µg/mL. The method was also applied to the determination of CRP in human serum, and the quantitative values obtained by this method were in excellent agreement with those obtained by the conventional enzyme-linked immunosorbent assay (ELISA) method. The developed method does not require a photodetector with high sensitivity and is thus capable of downsizing; therefore, this will be useful for on-site analyses such as point-of-care testing and field measurements.

Nano-Structural Superwetting Surfaces for Highly Reliable On-Site Detection of Bisphenol A

In the domain of big data geographic screening for environmental pollutants, the expeditious dissemination of testing results to environmental investigation professionals is pivotal in facilitating comprehensive analysis and the implementation of more efficacious strategies for managing environmental issues. However, this endeavor can prove to be particularly arduous when conducting examinations in remote, resource-scarce rural areas and field environments, where deficient infrastructure often emerges as the principal impediment to unimpeded environmental monitoring. Therefore, the development of a reliable and portable monitoring strategy with the ability to analyze large amounts of data is highly required. Here, a deep-learning (DL)-assisted portable sensing strategy was developed based on thermal and pH dual-responsive nano-structural superwetting surfaces, for highly reliable, quick, and field monitoring of environmental pollutants. In our experiment, bisphenol A (BPA) was selected as the representative pollute. The achieved limit of detection, attaining a remarkably low value of 1.05 μM, unequivocally adhered to stringent international testing standards for evaluating the migration of BPA in thermal paper. Based on a DL image classification algorithm, highly precise predictions regarding the migration of BPA concentration were achieved, with an accuracy rate exceeding 99%. Furthermore, it successfully facilitated automated and exceedingly reliable monitoring of the migration of BPA from thermal paper within the principal provinces of thermal paper production in China. This strategy engenders the potential to establish correlations between environmental pollutant concentrations in specific regions and the prevalence of certain human ailments.

Quantitative injection strip platform using water-soluble paper and magnet based on a lateral flow assay

Quantitative analysis for lateral flow immunoassay (LFA) strips was conducted continuously. Quantitative analysis means measuring concentration, which represents the number of molecules per unit volume. In this study, we designed a quantitative injection (QI) strip by modifying the structure of general LFA strips to inject the same unit volume. To achieve the injection of the same unit volume, we used water-soluble paper and magnet. In addition, the QI strip was fabricated to enable the physical separation of the gold conjugate pad from the nitrocellulose membrane (NC membrane) at the optimized time after sample injection. The optimized time refers to the time from the point at which the sample started flowing on the NC membrane to the point at which the strip was separated. At the samples of same concentration, the LFA strip increases detection signals as the volume of injected sample increases. In contrast to the LFA strip, the QI strip maintained consistent detection signals even with increasing volume of injected sample. Furthermore, the QI strip demonstrated an 11-fold lower deviation compared to the LFA strip. These results are attributed to the separation function of the QI strip. In conclusion, the QI strip is more suitable for quantitative analysis compared to the LFA strip due to the same unit volume without additional equipment such as a pipette. This study is expected to contribute to the development of user-friendly POCT and strip-based quantitative analysis.

Dual-Mode Undistorted Visual Fluorescent Sensing Strategy through Manipulating the Coffee-Ring Effect on Microfluidic Paper-Based Chip

To overcome the insufficient sensitivity due to distortion of the fluorescent images by mobile devices, we first developed a novel dual-mode strategy for undistorted visual fluorescent sensing on μPAD by technically manipulating the coffee-ring effect of the fluid sample. Based on the manipulating coffee-ring effect, we divided the horizontal direction of the resulting fluorescence image into 600 pixels and obtained more accurate quantitative information to avoid image distortion. The bovine serum albumin-stabilized gold nanoclusters-copper ion complex was used as the fluorescent probe, combined with a small imaging box and a smartphone, to achieve a rapid testing of histidine in human urine. The output image was analyzed in dual mode: RGB numerical analysis in pixel units and the direct measurement of the fluorescent strips length (limit of detection (LOD) is 0.021 and 0.5 mM, respectively), and improved antidistortion for visual fluorescent sensing. This strategy can overcome the distortion of a smartphone-visualized fluorescent image and shows great potential for rapid and convenient analysis.

The development of a paper-based distance sensor for the detection of Pb2+ assisted with the target-responsive DNA hydrogel

Due to the serious risks of lead pollution to human health, it plays a great role in constructing a simple, inexpensive, portable, and user-friendly strategy for Pb²⁺ detection in environmental samples. Herein, a paper-based distance sensor is developed to detect Pb²⁺ assisted with the target-responsive DNA hydrogel. Pb²⁺ can activate DNAzyme to cleave its substrate strand, which results in the hydrolysis of the DNA hydrogel. The released water molecules trapped in the hydrogel can flow along the patterned pH paper due to the capillary force. The water flow distance (WFD) is significantly influenced by the amount of water released from the collapsed DNA hydrogel triggered by the addition of various Pb²⁺ concentrations. In this way, Pb²⁺ can be quantitatively detected without using specialized instruments and labeled molecules, and the limit of detection (LOD) of Pb²⁺ is 3.0 nM. Additionally, the Pb²⁺ sensor works well in lake water and tap water. Overall, this simple, inexpensive, portable, and user-friendly method is very promising for quantitative and in-field detection of Pb²⁺ with excellent sensitivity and selectivity.

Naked-Eye Readout Distance Quantitative Lateral Flow Assay Based on the Permeability Changes of Enzyme-Catalyzed Hydrogelation

Traditional lateral flow assay (LFA) is restricted to providing qualitative or semi-quantitative results and often requires special equipment for obtaining quantitative results. Herein, we proposed a naked-eye readout distance quantitative lateral flow assay based on the permeability changes in enzyme-catalyzed hydrogelation, which not only has the advantages of being simple, immediate, of high efficiency and low cost, and accurate in quantification but also avoids the use of special equipment. The developed LFA method includes three principal components of a nitrocellulose (NC) membrane containing a control line (C line) loading goat anti-rabbit (GAR) antibodies and a test line (T line) loading specific antibodies, alginate-tyramine conjugates forming a hydrogel in the presence of hydrogen peroxide (H₂O₂) and horseradish peroxidase (HRP), and the HRP-AuNPs-Ab probe only labeling targets captured on the T line. Hemoglobin A1c (HbA1c) was chosen as a representative example to demonstrate the feasibility of our method. Under the optimal conditions, the developed LFA method shows excellent performance in standard samples and real human blood samples where the results of real human blood samples show a high linear correlation with the clinical data obtained by ion exchange chromatography (R² = 0.9929) and the margin of recovery is only 3.8%. All results demonstrated that our developed LFA method not only has enormous potential in the quantitative detection of HbA1c in clinical complex samples but also can serve as a versatile method for highly efficient detection of other target biomolecules due to the fungibility of antibodies.

Design of Raman reporter-embedded magnetic/plasmonic hybrid nanostirrers for reliable microfluidic SERS biosensors

Magnetic-based microfluidic SERS biosensors hold great potential in various biological analyses due to their integrated advantages including easy manipulation, miniaturization and ultrasensitivity. However, it remains challenging to collect reliable SERS nanoprobe signals for quantitative analysis due to the irregular aggregation of magnetic carriers in a microfluidic chamber. Here, magnetic/plasmonic hybrid nanostirrers embedded with a Raman reporter are developed as capture carriers to improve the reliability of microfluidic SERS biosensors. Experimental results revealed that SERS signals from magnetic hybrid nanostirrers could serve as microenvironment beacons of their irregular aggregation, and a signal filtering method was proposed through exploring the relationship between the intensity range of beacons and the signal reproducibility of SERS nanoprobes using interleukin 6 as a model target analyte. Using the signal filtering method, reliable SERS nanoprobe signals with high reproducibility could be picked out from similar microenvironments according to their beacon intensity, and then the influence of irregular aggregation of magnetic carriers on the SERS nanoprobe could be eliminated. The filtered SERS nanoprobe signals also exhibited excellent repeatability from independent tests, which lay a solid foundation for a reliable working curve and subsequent accurate bioassay. This study provides a simple but promising route for reliable microfluidic SERS biosensors, which will further promote their practical application in biological analysis.

Application of Microfluidics for Bacterial Identification

Bacterial infections continue to pose serious public health challenges. Though anti-bacterial therapeutics are effective remedies for treating these infections, the emergence of antibiotic resistance has imposed new challenges to treatment. Often, there is a delay in prescribing antibiotics at initial symptom presentation as it can be challenging to clinically differentiate bacterial infections from other organisms (e.g., viruses) causing infection. Moreover, bacterial infections can arise from food, water, or other sources. These challenges have demonstrated the need for rapid identification of bacteria in liquids, food, clinical spaces, and other environments. Conventional methods of bacterial identification rely on culture-based approaches which require long processing times and higher pathogen concentration thresholds. In the past few years, microfluidic devices paired with various bacterial identification methods have garnered attention for addressing the limitations of conventional methods and demonstrating feasibility for rapid bacterial identification with lower biomass thresholds. However, such culture-free methods often require integration of multiple steps from sample preparation to measurement. Research interest in using microfluidic methods for bacterial identification is growing; therefore, this review article is a summary of current advancements in this field with a focus on comparing the efficacy of polymerase chain reaction (PCR), loop-mediated isothermal amplification (LAMP), and emerging spectroscopic methods.

Diagnosis of disease relevant nucleic acid biomarkers with off-the-shelf devices

Changes in the level of nucleic acids in blood may be correlated with some clinical disorders like cancer, stroke, trauma and autoimmune diseases, and thus, nucleic acids can serve as potential biomarkers for pathological processes. The requirement of technical equipment and operator expertise in effective information readout of modern molecular diagnostic technologies significantly restricted application outside clinical laboratories. The ability to detect nucleic acid biomarkers with off-the-shelf devices, which have the advantages of portability, simplicity, low cost and short response time, is critical to provide a prompt clinical result in circumstances where the laboratory instruments are not available. This review throws light on the current strategies and challenges for nucleic acid diagnosis with commercial portable devices, indicating the future prospect of portable diagnostic devices and making a great difference in improving the healthcare and disease surveillance in resource-limited areas.

Paper-based microfluidic devices for food adulterants: Cost-effective technological monitoring systems

Analytical sciences have witnessed emergent techniques for efficient clinical and industrial food adulterants detection. In this review, the contributions made by the paper-based devices are highlighted for efficient and rapid detection of food adulterants and additives, which is the need of the hour and how different categories of techniques have been developed in the past decade for upgrading the performance for point-of-care testing. A simple strategy with an arrangement for detecting specific adulterants followed by the addition of samples to obtain well-defined qualitative or quantitative signals for confirming the presence of target species. The paper-based microfluidics-based technology advances and prospects for food adulterant detection are discussed given the high-demand from the food sectors and serve as a valued technology for food researchers working in interdisciplinary technological frontiers.

Traffic light type paper-based analytical device for intuitive and semi-quantitative naked-eye signal readout

Microfluidic paper-based analytical devices (μPADs) have attracted great attention as potential candidates for point-of-care testing (POCT). Nevertheless, only a limited number of μPADs expected to satisfy the standard of Clinical Laboratory Improvement Amendments (CLIA) waived tests as issued by the US Food and Drug Administration (FDA) have been reported. This work introduces a "traffic light type μPAD", enabling highly intuitive semi-quantitative equipment-free naked-eye readout with no need for calibration, subjective interpretation or calculation. Assay results are displayed as traffic light colours reporting 5 analyte concentration levels (green/green & yellow/yellow/yellow & red/red). The device has been designed to never display all three colours simultaneously, eliminating any risk for misinterpretation. The mechanism relies on the modulation of sample flow through a network of paperfluidic channels modified with a hydrophobic to hydrophilic phase-switching substance responsive to H₂O₂. User operation is limited to sample application, followed by observing a clear and time-independent traffic light signal after approximately 10-30 min. Multiple factors influencing the H₂O₂ concentration-dependent appearance of a specific traffic light signal were studied. Making use of the possibilities for customising the concentration threshold levels for traffic light colour appearance, quantification of glucose at 5 levels in a clinically relevant concentration range was demonstrated in artificial urine as a model proof-of-concept. This platform is expected to offer the possibility for the future detection of other important metabolites.

A Distance-Based Microfluidic Paper-Based Biosensor for Glucose Measurements in Tear Range

The prevalence of diabetes has increased over the past years. Therefore, developing minimally invasive, user-friendly, and cost-effective glucose biosensors is necessary especially in low-income and developing countries. Cellulose paper-based analytical devices have attracted the attention of many researchers due to affordability, not requiring trained personnel, and complex equipment. This paper describes a microfluidic paper-based analytical device (μPAD) for detecting glucose concentration in tear range with the naked eye. The paper-based biosensor fabricated by laser CO2; and glucose oxidase/horseradish peroxidase (GOx/HRP) enzyme solution coupled with tetramethylbenzidine (TMB) were utilized as reagents. A sample volume of 10 μl was needed for the biosensor operation and the results were observable within 5 min. The color intensity-based and distance-based results were analyzed by ImageJ and Tracker to evaluate the device performance. Distance-based results showed a linear behavior in 0.1-1.2 mM with an R² = 0.9962 and limit of detection (LOD) of 0.1 mM. The results could be perceived by the naked eye without needing additional equipment or trained personnel in a relatively short time (3-5 min).

The CRISPR-Cas toolbox for analytical and diagnostic assay development

Clustered Regularly Interspaced Short Palindromic Repeats (CRISPR) and CRISPR-associated (Cas) systems have revolutionized biological and biomedical sciences in many ways. The last few years have also seen tremendous interest in deploying the CRISPR-Cas toolbox for analytical and diagnostic assay development because CRISPR-Cas is one of the most powerful classes of molecular machineries for the recognition and manipulation of nucleic acids. In the short period of development, many CRISPR-enabled assays have already established critical roles in clinical diagnostics, biosensing, and bioimaging. We describe in this review the recent advances and design principles of CRISPR mediated analytical tools with an emphasis on the functional roles of CRISPR-Cas machineries as highly efficient binders and molecular scissors. We highlight the diverse engineering approaches for molecularly modifying CRISPR-Cas machineries and for devising better readout platforms. We discuss the potential roles of these new approaches and platforms in enhancing assay sensitivity, specificity, multiplexity, and clinical outcomes. By illustrating the biochemical and analytical processes, we hope this review will help guide the best use of the CRISPR-Cas toolbox in detecting, quantifying and imaging biologically and clinically important molecules and inspire new ideas, technological advances and engineering strategies for addressing real-world challenges such as the on-going COVID-19 pandemic.

Microfluidic devices based on textile threads for analytical applications: state of the art and prospects

Microfluidic devices based on textile threads have interesting advantages when compared to systems made with traditional materials, such as polymers and inorganic substrates (especially silicon and glass). One of these significant advantages is the device fabrication process, made more cheap and simple, with little or no microfabrication apparatus. This review describes the fundamentals, applications, challenges, and prospects of microfluidic devices fabricated with textile threads. A wide range of applications is discussed, integrated with several analysis methods, such as electrochemical, colorimetric, electrophoretic, chromatographic, and fluorescence. Additionally, the integration of these devices with different substrates (e.g., 3D printed components or fabrics), other devices (e.g., smartphones), and microelectronics is described. These combinations have allowed the construction of fully portable devices and consequently the development of point-of-care and wearable analytical systems.

Multicolor and photothermal dual-mode assay of alkaline phosphatase based on the UV light-assisted etching of gold nanorods

A multicolor and photothermal dual-mode assay for sensitive alkaline phosphatase (ALP) determination was realized based on the 3,3',5,5'-tetramethylbenzidine (TMB)-induced etching of gold nanorods (AuNRs). TMB was oxidized under ultraviolet light irradiation to form TMB⁺. In the presence of ALP, ascorbic acid phosphate (AAP) is converted to ascorbic acid, which can then reduce the levels of TMB⁺, resulting in lower concentrations of TMB⁺. The remaining TMB⁺ was transformed into TMB²⁺ after the addition of HCl solution. AuNRs were etched by TMB²⁺ to produce a multicolor and photothermal change. Based on the degree of AuNRs etching, this highly sensitive dual-mode assay provided a linear range of 1.0-8.0 mU/mL, with detection limits of 0.34 mU/mL for the multicolor assay and 0.11 mU/mL for the photothermal assay. This method was successfully applied to the determination of ALP in serum samples.

A fluorescent and colorimetric dual-channel sensor based on acid phosphatase-triggered blocking of internal filtration effect

A colorimetric and fluorescent dual-channel detection method for acid phosphatase (ACP) activity has been constructed, based on the internal filtering effect between oxidized 3,3',5,5'-tetramethylbenzidine (oxTMB) and rhodamine B (RB). Au³⁺, which in situ form gold nanoparticles (AuNPs), can oxidize colorless 3,3',5,5'-tetramethylbenzidine (TMB) to oxTMB (blue color). The fluorescence of RB can be quenched by oxTMB due to the spectral overlap of emission of RB and absorption of oxTMB. By means of the above process, ACP can be determined because ACP promotes the hydrolysis of 2-phospho-L-ascorbic acid trisodium salt (AAP) to generate ascorbic acid (AA), which can inhibit the internal filtering effect between RB and oxTMB. No material preparation was needed for the determination of ACP. The colorimetric and fluorimetric methods can quantify ACP in the range 0.06-5.0 mU/mL and 0.03-5.0 mU/mL, respectively. Furthermore, a smartphone-assisted sensing platform has been constructed for on-site monitoring of ACP in the range 0.75-50 mU/mL, and the detection limit is 0.3 mU/mL. The methods developed can measure ACP in human serum successfully.

Visual and quantitative detection of E. coli O157:H7 by coupling immunomagnetic separation and quantum dot-based paper strip

Simple and visual quantitative detection of foodborne pathogens can effectively reduce the outbreaks of foodborne diseases. Herein, we developed a simple and sensitive quantum dot (QD)-based paper device for visual and quantitative detection of Escherichia coli (E. coli) O157:H7 based on immunomagnetic separation and nanoparticle dissolution-triggered signal amplification. In this study, E. coli O157:H7 was magnetically separated and labeled with silver nanoparticles (AgNPs), and the AgNP labels can be converted into millions of Ag ions, which subsequently quench the fluorescence of QDs in the paper strip, which along with the readout can be visualized and quantified by the change in length of fluorescent quenched band. Owing to the high capture efficiency and effective signal amplification, as low as 500 cfu mL^-1 of E. coli O157:H7 could be easily detected by naked eyes. Furthermore, this novel platform was successfully applied to detect E. coli O157:H7 in spiked milk samples with good accuracy, indicating its potential in the detection of foodborne pathogens in real samples.

In situ Raman enhancement strategy for highly sensitive and quantitative lateral flow assay

As a paper-based analytical platform, lateral flow assay (LFA) gets benefit from the rapid analysis, low cost, high selectivity, good stability, and user-friendliness, and thus has been widely used in rapid screening or assisted diagnosis. Nevertheless, LFA still suffers from low detection sensitivity via the naked eye, limiting its applications to qualitative and semi-quantitative tests. To enhance the signal readout, various nanoparticle signal tags have been employed to replace traditional colloidal gold nanoparticles (AuNPs), such as fluorescent nanoparticles (FNPs), magnetic nanoparticles (MNPs), and Raman reporter-labeled nanoparticles. In particular, Raman reporter-labeled nanoparticles are extremely sensitive due to remarkable signal enhancement effect on metal surface. However, the application of LFA is still hampered by the poor stability of Raman reporter-labeled nanoparticles. Herein, we developed an in situ Raman enhancement strategy to create a surface-enhanced Raman scattering (SERS) signal on the AuNPs, shortened as "i-SERS," which not only preserves the original advantages of the colloidal gold strip (AuNPs-LFA), but also realizes highly sensitive and quantitative detection. We applied the i-SERS for procalcitonin (PCT) detection. The experimental process takes only 16 min, and the limit of detection (LOD) is 0.03 ng mL^-1, far below the value using AuNPs-LFA. These results indicate that i-SERS assay was highly sensitive and suitable for the rapid detection of PCT.

Smartphone-Based Fully Automated Optofluidic Device with Laser Irradiation-Induced Image Whitening

Herein, we have developed a fully automated optofluidic device to execute enzyme-linked immunosorbent assay (ELISA) using an active 96-well hybrid lab-on-a-chip (LOC) device. To automate the solution loading into the reaction zone of the device and the post-assayed signal analysis, laser irradiation-induced image whitening was utilized with a smartphone-based optical platform. Two optical phenomena were utilized in our platform to detect the liquid in the reaction chamber using a smartphone. First, by Fresnel's equation, the refraction difference between air and water resulted in the intensity change of the reflected light from the reaction chamber. Therefore, when the liquid was entering into the reaction chamber, the intensity of the reflected light was changed. Second, when the light intensity increases, the smartphone-captured image whitens out due to saturation, even when the red color light was incident. Therefore, by measuring the RGB value of the smartphone image, the intensity changes by the liquid movement in the reaction chamber were successfully monitored. Our platform showed a low detection limit of 7.81 pg/mL for the detection of the NT-proBNP human cardiac biomarker with almost a half standard deviation, compared to the manually operated LOC-based ELISA. As a fully automated LOC adopting a conventional 96-well ELISA platform, we thus concluded that the developed platform can be widely applied for point-of-care clinical tests.

Towards Microfluidic-Based Exosome Isolation and Detection for Tumor Therapy

Exosomes are a class of cell-secreted, nano-sized extracellular vesicles with a bilayer membrane structure of 30-150 nm in diameter. Their discovery and application have brought breakthroughs in numerous areas, such as liquid biopsies, cancer biology, drug delivery, immunotherapy, tissue repair, and cardiovascular diseases. Isolation of exosomes is the first step in exosome-related research and its applications. Standard benchtop exosome separation and sensing techniques are tedious and challenging, as they require large sample volumes, multi-step operations that are complex and time-consuming, requiring cumbersome and expensive instruments. In contrast, microfluidic platforms have the potential to overcome some of these limitations, owing to their high-precision processing, ability to handle liquids at a microscale, and integrability with various functional units, such as mixers, actuators, reactors, separators, and sensors. These platforms can optimize the detection process on a single device, representing a robust and versatile technique for exosome separation and sensing to attain high purity and high recovery rates with a short processing time. Herein, we overview microfluidic strategies for exosome isolation based on their hydrodynamic properties, size filtration, acoustic fields, immunoaffinity, and dielectrophoretic properties. We focus especially on advances in label-free isolation of exosomes with active biological properties and intact morphological structures. Further, we introduce microfluidic techniques for the detection of exosomal proteins and RNAs with high sensitivity, high specificity, and low detection limits. We summarize the biomedical applications of exosome-mediated therapeutic delivery targeting cancer cells. To highlight the advantages of microfluidic platforms, conventional techniques are included for comparison. Future challenges and prospects of microfluidics towards exosome isolation applications are also discussed. Although the use of exosomes in clinical applications still faces biological, technical, regulatory, and market challenges, in the foreseeable future, recent developments in microfluidic technologies are expected to pave the way for tailoring exosome-related applications in precision medicine.

A distance-based capillary biosensor using wettability alteration

Distance-based detection methods with a quantitative readout are of great significance to point-of-care testing (POCT), are low-cost and user-friendly, and can be integrated into portable analytical devices. Here, we submit a visual quantitative distance-based sensor by capillary force alteration in a capillary tube. This sensor converts the wettability alteration caused by the target molecules into a capillary rise height signal. Moreover, the sensor profits from isothermal amplification technology, achieving the detection of miRNAs with high sensitivity and specificity by visually reading the height of the water in the capillary tube. The proposed biosensor shows great potential in routine clinical diagnosis as well as POCT in resource-limited settings.

Tutorial: design and fabrication of nanoparticle-based lateral-flow immunoassays

Lateral-flow assays (LFAs) are quick, simple and cheap assays to analyze various samples at the point of care or in the field, making them one of the most widespread biosensors currently available. They have been successfully employed for the detection of a myriad of different targets (ranging from atoms up to whole cells) in all type of samples (including water, blood, foodstuff and environmental samples). Their operation relies on the capillary flow of the sample throughout a series of sequential pads, each with different functionalities aiming to generate a signal to indicate the absence/presence (and, in some cases, the concentration) of the analyte of interest. To have a user-friendly operation, their development requires the optimization of multiple, interconnected parameters that may overwhelm new developers. In this tutorial, we provide the readers with: (i) the basic knowledge to understand the principles governing an LFA and to take informed decisions during lateral flow strip design and fabrication, (ii) a roadmap for optimal LFA development independent of the specific application, (iii) a step-by-step example procedure for the assembly and operation of an LF strip for the detection of human IgG and (iv) an extensive troubleshooting section addressing the most frequent issues in designing, assembling and using LFAs. By changing only the receptors, the provided example procedure can easily be adapted for cost-efficient detection of a broad variety of targets.

Use of an ether-derived 3-hydroxy-4-pyridinone chelator as a new chromogenic reagent in the development of a microfluidic paper-based analytical device for Fe(III) determination in natural waters

This article reports on the development and validation of a disposable microfluidic paper-based analytical device (μPAD) for on-hand, in-situ, and cheap Fe(III) determination in natural waters complying with World Health Organization guidelines. The developed μPAD used 3-hydroxy-4-pyridinone (3,4-HPO) as a colour reagent due to its considerably lower toxicity than traditionally used iron analytical reagents. It was selected among a group of hydrophilic 3,4-HPO chelators containing ether-derived chains in their structure which were prepared using green methods. The relatively high water solubility of these chelators improved the detection limit and applicability as μPAD reagents. Under optimal conditions, the μPAD is characterised by a quantification range between 0.25 and 2.0 mg/L, a detection limit of 55 μg/L and 15 min of analysis time. The signal stability extends up to 4 h and the device is stable for at least one month. The reagent consumption is below 0.2 mg per analysis and the μPAD method was validated by analysis certified reference materials and by comparison with atomic absorption results (RD < 10%). The newly developed μPAD was successfully applied to the determination of iron in river, well and tap waters with no need of any prior sample pre-treatment.

Polarization holographic microscope slide for birefringence imaging of anisotropic samples in microfluidics

Birefringence is an important optical property of anisotropic materials arising from anisotropies of tissue microstructures. Birefringence parameters have been found to be important to understand optical anisotropic architecture of many materials and polarization imaging has been applied in many researches in the field of biology and medicine. Here, we propose a scheme to miniaturize a double-channel polarization holographic interferometer optics to create a polarization holographic microscope slide (P-HMS) suitable for integrating with microfluidic lab-on-a-chip (LoC) systems. Based on the P-HMS combined with a simple reconstruction algorithm described in the paper, we can not only simultaneously realize holographic imaging of two orthogonal polarization components of dynamic samples in a microfluidic channel but also quantitative measurement of 2D birefringence information, both including the birefringence phase retardation and optic-axis orientation. This chip interferometer allows for off-axis double-channel polarization digital holographic recording using only a single illumination beam without need of any beam splitter or mirror. Its quasi-common path configuration and self-aligned design also make it tolerant to vibrations and misalignment. This work about the P-HMS could play a positive role in promoting the application of birefringence imaging in microfluidic LoC technology.

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.

A portable pencil-like immunosensor for point-of-care testing of inflammatory biomarkers

Portable devices for immunoassays are in high demand for point-of-care testing (POCT) of biomarkers. Here, we report a robust portable pencil-like immunosensor (PPS) platform for the determination of three inflammatory biomarkers including interleukin-6 (IL-6), procalcitonin (PCT), and C-reactive protein (CRP) in human serum samples. The PPS platform is composed of a unique pencil-like optical-fiber-based sensor, a reagent strip consisting of a series of pencil-cap-like wells, and a battery-powered photon counting detector for recording chemiluminescence. The PPS probe moves from well to well with a plug-into/out approach and goes through the immunoassay steps. Each fiber probe in the PPS platform can be sequentially used in up to 10 assays by simply propelling the intact probe out of the pencil body. The PPS platform is well-integrated into a portable suitcase-like device (32 cm × 23 cm × 11 cm) and is only 3 kg in weight. The sensor has good repeatability and can maintain 90% response after 14 days of storage at room temperature, showing its ability for assays in the field. The good linear relationship and efficient dynamic range with a limit-of-detection (LOD) of 1.05 pg/mL for IL-6, 10.64 pg/mL for PCT, and 29.40 ng/mL for CRP are obtained. The assay results are compared with clinical methods, and the findings confirm the high accuracy and precision of the proposed method. The proposed PPS platform is versatile and operable with minimal instruments and technical skills and simplifies the process of immune analysis, thus has great prospects for POCT of biomarkers. Graphical abstract.