Smartphone-Based Dual-Modality Imaging System for Quantitative Detection of Color or Fluorescent Lateral Flow Immunochromatographic Strips

Smartphone based lateral flow immunoassay quantifications

Lateral Flow Immunoassay (LFI) is a disposable tool designed to detect target substances using minimal resources. For qualitative analysis, LFI does not require a device (i.e., reader) to interpret test results. However, various studies have been conducted to implement quantitative analysis using LFI systems, incorporating LFI along with electrical/electronic readers, to overcome the limitations associated with qualitative LFI analysis. The reader used for the quantitative analysis of LFI should ensure mobility for easy on-site diagnostics and inspections, be user-friendly in operation, and have a fast processing speed until the results are obtained. Due to these requirements, smartphones are increasingly utilized as readers in quantitative analysis of LFI. Among the various components constituting a smartphone, high-performance cameras can serve as sensors converting visual signals into electrical signals. With powerful processing units, large storage capacity, and network capabilities for transmitting analysis results, smartphones are also utilized as interfaces for quantitative analysis. Absolutely, the widespread global use of smartphones is a key advantage, leading to their utilization as diagnostic devices for acquiring, analyzing, storing, and transmitting assay test results. This paper summarizes research cases where smartphones are utilized as readers for quantitative LFI systems used in confirming contamination in food or the environment, detecting drugs, and diagnosing diseases in humans or animals. The systems are classified based on the types of label particles used in the assay, and efforts to improve the quantitative analysis performance for each are examined. Cases where smartphones were used as LFI readers for the diagnosis of the 2019 Coronavirus Disease (COVID-19), which has recently caused significant global damage, have also been investigated.

A smartphone-based immunochromatographic strip platform for on-site quantitative detection of antigenic targets

To report the testing signal of an immunochromatographic assay for on-site quantitative detection, a portable and user-friendly smartphone-based biosensing platform is developed in this study. This innovative system is composed of an ambient light sensor inherent smartphone reader and a 3D-printed handhold device, a quantitative tool capable of directly interpreting carbon nanoparticle (CNP)-conjugated immunochromatographic strips. To showcase the platform capability, the smartphone-based immunochromatography system (SPICS) reader and device were successfully used in CNP strips for rapid detection of the early pregnancy marker human chorionic gonadotropin in female urine (HCG; limit of detection [LOD]: 0.30 mIU mL-1), prostate-specific antigen in patient blood (PSA; LOD: 0.28 ng mL-1) and ampicillin residue in animal milk (AMP; LOD: 0.23 ng mL-1). The results were fully correlated with conventional commercial instruments (R2 = 0.99). The SPICS platform exhibits significant advantages, including portability, cost-effectiveness, easy operation, and rapid and quantitative detection, making it a valuable on-site diagnosis tool for use in home and community healthcare facilities.

Recent advances and challenges in the analysis of natural toxins

Natural toxins (NTs) are poisonous secondary metabolites produced by living organisms developed to ward off predators. Especially low molecular weight NTs (MW<∼1 kDa), such as mycotoxins, phycotoxins, and plant toxins, are considered an important and growing food safety concern. Therefore, accurate risk assessment of food and feed for the presence of NTs is crucial. Currently, the analysis of NTs is predominantly performed with targeted high pressure liquid chromatography tandem mass spectrometry (HPLC-MS/MS) methods. Although these methods are highly sensitive and accurate, they are relatively expensive and time-consuming, while unknown or unexpected NTs will be missed. To overcome this, novel on-site screening methods and non-targeted HPLC high resolution mass spectrometry (HRMS) methods have been developed. On-site screening methods can give non-specialists the possibility for broad "scanning" of potential geographical regions of interest, while also providing sensitive and specific analysis at the point-of-need. Non-targeted chromatography-HRMS methods can detect unexpected as well as unknown NTs and their metabolites in a lab-based approach. The aim of this chapter is to provide an insight in the recent advances, challenges, and perspectives in the field of NTs analysis both from the on-site and the laboratory perspective.

A Portable Fluorescent Lateral Flow Immunoassay Platform for Rapid Detection of FluA

The spread of the FluA virus poses significant public health concerns worldwide. Fluorescent lateral flow immunoassay (LFIA) test strips have emerged as vital tools for the early detection and monitoring of influenza infections. However, existing quantitative virus-detection methods, particularly those utilizing smartphone-based sensing platforms, encounter accessibility challenges in resource-limited areas and among the elderly population. Despite their advantages in speed and portability, these platforms often lack user-friendliness for these demographics, impeding their widespread utilization. To address these challenges, this study proposes leveraging the optical pick-up unit (OPU) sourced from commercial optical drives as a readily available fluorescence excitation module for the quantitative detection of antibodies labeled with quantum-dot fluorescent microspheres. Additionally, we utilize miniaturized and high-performance optical components and 3D-printed parts, along with a customized control system, to develop an affordable point-of-care testing (POCT) device. Within the system, a stepping motor scans the test strip from the T-line to the C-line, enabling the calculation of the fluorescence-intensity ratio between the two lines. This simple yet effective design facilitates rapid and straightforward field or at-home testing for FluA. The proposed prototype platform demonstrates promising performance, achieving a limit of detection (LOD) of 2.91 ng/mL, a total detection time of no more than 15 min, and dimensions of 151 mm × 11.2 mm × 10.8 mm3. We believe that the proposed approach holds great potential for improving access to an accurate influenza diagnosis.

Accelerated Development of a COVID-19 Lateral Flow Test in an Academic Setting: Lessons Learned

The COVID-19 pandemic further demonstrated the need for usable, reliable, and cost-effective point-of-care diagnostics that can be broadly deployed, ideally for self-testing at home. Antigen tests using more-detectable reporter labels (usually at the cost of reader complexity) achieve better diagnostic sensitivity, supporting the value of higher-analytical-sensitivity reporter technologies in lateral flow.We developed a new approach to simple, inexpensive lateral flow assays (LFAs) of great sensitivity, based on the glow stick peroxyoxalate chemistry widely used in emergency settings and in children's toys. At the peak of the COVID-19 pandemic, we had the opportunity to participate in the pandemic-driven NIH Rapid Acceleration of Diagnostics (RADx) initiative aiming to develop a deployable lateral flow diagnostic for SARS-CoV-2 nucleoprotein based on our novel glow stick-inspired light-emitting reporter technology. During this project, we screened more than 250 antibody pairs for analytical sensitivity and specificity directly in LFA format, using recombinant nucleoprotein and then gamma-irradiated virions spiked into negative nasal swab extracts. Membranes and other LFA materials and swabs and extraction reagent components also were screened and selected. Optimization of conjugate preparation and spraying as well as pretreatment/conditioning of the sample pad led to the final optimized LFA strip. Technology development also included optimization of excitation liquid enclosed in disposable droppers, design of a custom cartridge and smartphone-based reader, and app development, even a prototype reader usable with any mobile phone. Excellent preclinical performance was first demonstrated with contrived samples and then with leftover clinical samples. Moving beyond traditional academic focus areas, we were able to establish a quality management system (QMS), produce large numbers of customized LFA cassettes by contract injection molding, build in-house facilities to assemble and store thousands of complete tests for verification and validation and usability studies, and source kitting/packaging services and quality standard reagents and build partnerships for clinical translation, regulatory guidance, scale up, and market deployment. We were not able to bring this early stage technology to the point of commercialization within the limited time and resources available, but we did achieve strong proof-of-concept and advance translational aspects of the platform including initial high-performance LFAs, reading by the iPhone app using only a $2 plastic dark box with no lens, and convenient, usable excitation liquid packaging in droppers manufacturable in very large numbers.In this Account, we aim to provide a concise overview of our 18-month sprint toward the practical development of a deployable antigen lateral flow assay under pandemic conditions and the challenges and successes experienced by our team. We highlight what it takes to coach a technically savvy but commercially inexperienced academic team through the accelerated translation of an early stage technology into a useful product. Finally, we provide a guided tutorial and workflow to empower others interested in the rapid development of translatable LFAs.

Portable, Automated and Deep-Learning-Enabled Microscopy for Smartphone-Tethered Optical Platform Towards Remote Homecare Diagnostics: A Review

Globally new pandemic diseases induce urgent demands for portable diagnostic systems to prevent and control infectious diseases. Smartphone-based portable diagnostic devices are significantly efficient tools to user-friendly connect personalized health conditions and collect valuable optical information for rapid diagnosis and biomedical research through at-home screening. Deep learning algorithms for portable microscopes also help to enhance diagnostic accuracy by reducing the imaging resolution gap between benchtop and portable microscopes. This review highlighted recent progress and continued efforts in a smartphone-tethered optical platform through portable, automated, and deep-learning-enabled microscopy for personalized diagnostics and remote monitoring. In detail, the optical platforms through smartphone-based microscopes and lens-free holographic microscopy are introduced, and deep learning-based portable microscopic imaging is explained to improve the image resolution and accuracy of diagnostics. The challenges and prospects of portable optical systems with microfluidic channels and a compact microscope to screen COVID-19 in the current pandemic are also discussed. It has been believed that this review offers a novel guide for rapid diagnosis, biomedical imaging, and digital healthcare with low cost and portability.

Influence of Taijiquan Exercise on Mentality and Emotion Regulation by Intelligent Medical Big Data Analysis

Taijiquan training emphasizes the relaxation of the mind and the body, pay attention to maintain the peace of mind, and minimize the impact of external interference on the body so as to make the mind more comfortable. This study mainly explores the influence of Taijiquan practice on emotion regulation based on intelligent medical health big data analysis. The significance of Taijiquan in developing and improving the positive emotions of middle-aged people and maintaining physical and mental health is expounded. There are two methods of data collection: full collection and incremental collection. In this study, when the psychological testing equipment was launched, a full amount of historical data was collected; after the psychological testing equipment was online, the collection method was generally carried out in the way of incremental collection. The subjects exercised Taijiquan three times a week, one hour each time, and the exercise content was the 24-style Taijiquan designated by the workstation. At the same time, the subjects were asked not to engage in other regular physical exercise projects in their spare time. By longitudinal tracking and comparison of the Taijiquan intervention group after participating in the Taijiquan exercise intervention, the differences in the state of mind and emotion regulation strategies, and 12 subjects were selected voluntarily to participate in the emotional Stroop (the color words used in the classic Stroop paradigm were replaced with emotional and nonemotional words written in different colors, and the subjects were still tasked with responding to colors) experimental paradigm. In this paper, the moderate-intensity Taijiquan project is selected, which is in line with the effective value threshold theory of exercise load. It studies the effects of exercise on the body shape, cardiopulmonary function, flexibility, and balance ability of the body according to the metabolism theory and the movement balance theory of the human body adapting to the environment. Before the experiment, there was no significant difference between the Taijiquan training group and the control group, but after the experiment, there was a significant difference between the Taijiquan training group and the control group (P<0.05). Taijiquan has a significant effect on improving students' body shape, cardiopulmonary function, flexibility, balance, and mood.

Lateral Flow Immunoassay Reader Technologies for Quantitative Point-of-Care Testing

Due to the recent pandemic caused by coronavirus disease 2019 (COVID-19), the lateral flow immunoassay used for its rapid antigen test is more popular than ever before. However, the history of the lateral flow immunoassay is about 60 years old, and its original purpose of use, such as a COVID-19 rapid antigen test or a pregnancy test, was the qualitative detection of a target analyte. Recently, the demand for quantitative analysis of lateral flow immunoassays is increasing in various fields. Lateral flow immunoassays for quantitative detection using various materials and sensor technologies are being introduced, and readers for analyzing them are being developed. Quantitative analysis readers are highly anticipated for their future development in line with technological advancements such as optical, magnetic field, photothermal, and electrochemical sensors and trends such as weight reduction, miniaturization, and cost reduction of systems. In addition, the sensing, processing, and communication functions of portable personal devices such as smartphones can be used as tools for the quantitative analysis of lateral flow immunoassays. As a result, lateral flow immunoassays can efficiently achieve the goal of rapid diagnosis by point-of-care testing. Readers used for the quantification of lateral flow immunoassays were classified according to the adopted sensor technology, and the research trends in each were reviewed in this paper. The development of a quantitative analysis system was often carried out in the assay aspect, so not only the readers but also the assay development cases were reviewed if necessary. In addition, systems for quantitative analysis of COVID-19, which have recently been gaining importance, were introduced as a separate section.

An Overview for the Nanoparticles-Based Quantitative Lateral Flow Assay

The development of the lateral flow assay (LFA) has received much attention in both academia and industry because of their broad applications to food safety, environmental monitoring, clinical diagnosis, and so forth. The user friendliness, low cost, and easy operation are the most attractive advantages of the LFA. In recent years, quantitative detection has become another focus of LFA development. Here, the most recent studies of quantitative LFAs are reviewed. First, the principles and corresponding formats of quantitative LFAs are introduced. In the biomaterial and nanomaterial sections, the detection, capture, and signal amplification biomolecules and the optical, fluorescent, luminescent, and magnetic labels used in LFAs are described. The invention of dedicated strip readers has drawn further interest in exploiting the better performance of LFAs. Therefore, next, the development of dedicated reader devices is described and the usefulness and specifications of these devices for LFAs are discussed. Finally, the applications of LFAs in the detection of metal ions, biotoxins, pathogenic microorganisms, veterinary drugs, and pesticides in the fields of food safety and environmental health and the detection of nucleic acids, biomarkers, and viruses in clinical analyses are summarized.

Ten Years of Lateral Flow Immunoassay Technique Applications: Trends, Challenges and Future Perspectives

The Lateral Flow Immunoassay (LFIA) is by far one of the most successful analytical platforms to perform the on-site detection of target substances. LFIA can be considered as a sort of lab-in-a-hand and, together with other point-of-need tests, has represented a paradigm shift from sample-to-lab to lab-to-sample aiming to improve decision making and turnaround time. The features of LFIAs made them a very attractive tool in clinical diagnostic where they can improve patient care by enabling more prompt diagnosis and treatment decisions. The rapidity, simplicity, relative cost-effectiveness, and the possibility to be used by nonskilled personnel contributed to the wide acceptance of LFIAs. As a consequence, from the detection of molecules, organisms, and (bio)markers for clinical purposes, the LFIA application has been rapidly extended to other fields, including food and feed safety, veterinary medicine, environmental control, and many others. This review aims to provide readers with a 10-years overview of applications, outlining the trends for the main application fields and the relative compounded annual growth rates. Moreover, future perspectives and challenges are discussed.

Development of a smartphone-based lateral-flow imaging system using machine-learning classifiers for detection of Salmonella spp

Salmonella spp. are a foodborne pathogen frequently found in raw meat, egg products, and milk. Salmonella is responsible for numerous outbreaks, becoming a frequent major public-health concern. Many studies have recently reported handheld and rapid devices for microbial detection. This study explored a smartphone-based lateral-flow assay analyzer which employed machine-learning algorithms to detect various concentrations of Salmonella spp. from the test line images. When cell numbers are low, a faint test line is difficult to detect, leading to misleading results. Hence, this study focused on the development of a smartphone-based lateral-flow assay (SLFA) to distinguish ambiguous concentrations of test line with higher confidence. A smartphone cradle was designed with an angled slot to maximize the intensity, and the optimal direction of the optimal incident light was found. Furthermore, the combination of color spaces and the machine-learning algorithms were applied to the SLFA for classifications. It was found that the combination of L*a*b and RGB color space with SVM and KNN classifiers achieved the high accuracy (95.56%). A blind test was conducted to evaluate the performance of devices; the results by machine-learning techniques reported less error than visual inspection. The smartphone-based lateral-flow assay provided accurate interpretation with a detection limit of 5 × 10⁴ CFU/mL commercially available lateral-flow assays.

Red Zn2SiO4:Eu3+ and Mg2TiO4:Mn4+ nanophosphors for on-site rapid optical detections: Synthesis and characterization

This study reports the synthesis and characterization of the red nanophosphors Zn₂SiO₄:Eu³⁺ (ZSO:Eu³⁺) and Mg₂TiO₄:Mn⁴⁺ (MTO:Mn⁴⁺). The use of phosphors as a fluorescence label for lateral flow immunochromatographic assay (LFIA) has also been described. The optimal photoluminescence (PL) for ZSO:Eu³⁺ was obtained when it was synthesized with 7 mol% of Eu³⁺ and annealed at 1100 °C for 1 h. Long fluorescence lifetime (1.01 ms), high activation energy E a (0.28 eV), and low PL degeneration (10% at 110 °C) are the characteristics of ZSO:Eu³⁺. MTO:Mn⁴⁺ also exhibited high PL intensity along with a high E _a of 0.32 eV. The emission wavelengths of phosphors are biocompatible with the optical bio-window of tissues. When human immunoglobulin G (human IgG) at a constant concentration of 100 μg/mL was used for detection, the PL ratios of the test line to the control line were 2.15 and 2.28 for the ZSO:Eu³⁺- and MTO:Mn⁴⁺-labeled LFIA, respectively. Thus, the ZSO:Eu³⁺ and MTO:Mn⁴⁺ nanophosphors are capable of human IgG recognition and are the promising candidates as fluorescent labels for on-site rapid optical biodetection.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s00339-021-04733-0.

Recent Advancements in Enzyme-Based Lateral Flow Immunoassays

Paper-based lateral-flow immunoassays (LFIAs) have achieved considerable commercial success and their impact in diagnostics is continuously growing. LFIA results are often obtained by visualizing by the naked eye color changes in given areas, providing a qualitative information about the presence/absence of the target analyte in the sample. However, this platform has the potential to provide ultrasensitive quantitative analysis for several applications. Indeed, LFIA is based on well-established immunological techniques, which have known in the last year great advances due to the combination of highly sensitive tracers, innovative signal amplification strategies and last-generation instrumental detectors. All these available progresses can be applied also to the LFIA platform by adapting them to a portable and miniaturized format. This possibility opens countless strategies for definitively turning the LFIA technique into an ultrasensitive quantitative method. Among the different proposals for achieving this goal, the use of enzyme-based immunoassay is very well known and widespread for routine analysis and it can represent a valid approach for improving LFIA performances. Several examples have been recently reported in literature exploiting enzymes properties and features for obtaining significative advances in this field. In this review, we aim to provide a critical overview of the recent progresses in highly sensitive LFIA detection technologies, involving the exploitation of enzyme-based amplification strategies. The features and applications of the technologies, along with future developments and challenges, are also discussed.

A Comparative Study of Approaches to Improve the Sensitivity of Lateral Flow Immunoassay of the Antibiotic Lincomycin

This study provides a comparative assessment of the various nanodispersed markers and related detection techniques used in the immunochromatographic detection of an antibiotic lincomycin (LIN). Improving the sensitivity of the competitive lateral flow immunoassay is important, given the increasing demands for the monitoring of chemical contaminants in food. Gold nanoparticles (AuNPs) and CdSe/ZnS quantum dots (QDs) were used for the development and comparison of three approaches for the lateral flow immunoassay (LFIA) of LIN, namely, colorimetric, fluorescence, and surface-enhanced Raman spectroscopy (SERS)-based LFIAs. It was demonstrated that, for colorimetric and fluorescence analysis, the detection limits were comparable at 0.4 and 0.2 ng/mL, respectively. A SERS-based method allowed achieving the gain of five orders of magnitude in the assay sensitivity (1.4 fg/mL) compared to conventional LFIAs. Therefore, an integration of a SERS reporter into the LFIA is a promising tool for extremely sensitive quantitative detection of target analytes. However, implementation of this time-consuming technique requires expensive equipment and skilled personnel. In contrast, conventional AuNP- and QD-based LFIAs can provide simple, rapid, and inexpensive point-of-care testing for practical use.

Accuracy of an Affordable Smartphone-Based Teledermoscopy System for Color Measurements in Canine Skin

Quality smartphone cameras and affordable dermatoscopes have enabled teledermoscopy to become a popular medical and veterinary tool for analyzing skin lesions such as melanoma and erythema. However, smartphones acquire images in an unknown RGB color space, which prevents a standardized colorimetric skin analysis. In this work, we supplemented a typical veterinary teledermoscopy system with a conventional color calibration procedure, and we studied two mid-priced smartphones in evaluating native and erythematous canine skin color. In a laboratory setting with the ColorChecker, the teledermoscopy system reached CIELAB-based color differences ΔE of 1.8-6.6 (CIE76) and 1.1-4.5 (CIE94). Intra- and inter-smartphone variability resulted in the color differences (CIE76) of 0.1, and 2.0-3.9, depending on the selected color range. Preliminary clinical measurements showed that canine skin is less red and yellow (lower a* and b* for ΔE of 10.7) than standard Caucasian human skin. Estimating the severity of skin erythema with an erythema index led to errors between 0.5-3%. After constructing a color calibration model for each smartphone, we expedited clinical measurements without losing colorimetric accuracy by introducing a simple image normalization on a white standard. To conclude, the calibrated teledermoscopy system is fast and accurate enough for various colorimetric applications in veterinary dermatology.

Quantitative hematocrit measurement of whole blood in a point-of-care lateral flow device using a smartphone flow tracking app

We present a rapid and quantitative point-of-care (PoC) system based on a smartphone application that is capable of accurately tracking the flow of red blood cells (RBCs) through a no-reaction lateral flow assay (nrLFA) device. Utilizing only the camera feed from the smartphone and built-in image processing, the nrLFA is identified and RBC fluid flow distances and rates are recorded in parallel with the test without the need of any custom hardware or enclosure. We demonstrated the application by first measuring and then calculating hematocrit (Hct) values of whole blood samples with nominal content of 28%, 35%, 40%, and 45% Hct on the nrLFA platform. The PoC system was able to accurately measure (to within 1% Hct of nominal values) whole blood Hct in ~10-20 s after sample dispensing.

A smartphone-based dual detection mode device integrated with two lateral flow immunoassays for multiplex mycotoxins in cereals

In this study, a smartphone-based quantitative dual detection mode device, integrated with gold nanoparticles (GNPs) and time-resolved fluorescence microspheres (TRFMs) lateral flow immunoassays (LFIA) for multiplex mycotoxins in cereals were established. The most frequently used visible light and fluorescence detection modes were integrated in one device. A user-friendly application was self-written to rapidly quantify results. GNPs-LFIA and TRFMs-LFIA were used to detect aflatoxin B1 (AFB1), zearalenone (ZEN), deoxynivalenol (DON), T-2 toxin (T-2), and fumonisin B1 (FB1). The visible limits of detection (vLODs) were 10/2.5/1.0/10/0.5, 2.5/0.5/0.5/2.5/0.5 μg/kg for the two methods, respectively. The quantitative limits of detection (qLODs) were 0.59/0.24/0.32/0.9/0.27, 0.42/0.10/0.05/0.75/0.04 μg/kg, respectively. The recoveries of both LFIAs ranged from 84.0%-110.0%. A parallel analysis in 30 naturally contaminated cereal samples was conducted by liquid chromatography-tandem mass spectrometry (LC-MS/MS), the results showed good consistency, indicating the practical reliability of the established methods. The developed two smartphone-based LFIAs provide a promising technique for multiplex, highly sensitive, and on-site detection of mycotoxins.

Smartphone-imaged multilayered paper-based analytical device for colorimetric analysis of carcinoembryonic antigen

Paper-based immunoassays are effective methods that employ microfluidic paper-based analytical devices (μPADs) for the rapid, simple, and accurate quantification of analytes in point-of-care diagnosis. In this study, we developed a wax-printed multilayered μPAD for the colorimetric detection of carcinoembryonic antigen (CEA), where the device contained a movable and rotatable detection layer to allow the μPAD to switch the state of the sample solutions, i.e., flowing or storing in the sensing zones. A smartphone with a custom-developed program served as an automated colorimetric reader to capture and analyze images from the μPAD, before calculating and displaying the test results. After optimizing the crucial conditions for the assay, the proposed method exhibited a wide linear dynamic range from 0.5 to 70 ng/mL, with a low CEA detection limit of 0.015 ng/mL. The clinical performance of this method was successfully validated using 50 positive and 40 negative human serum samples, thereby demonstrating the high sensitivity of 98.0% and specificity of 97.5% in the detection of CEA. The proposed method is greatly simplified compared with the cumbersome steps required for traditional immunoassays, but without any loss of accuracy and stability, as well as reducing the time needed to detect CEA. Complex and bulky instruments are replaced with a smartphone. The proposed detection platform could potentially be applied in point-of-care testing. Graphical abstract.

Lateral flow biosensors based on the use of micro- and nanomaterials: a review on recent developments

This review (with 187 refs.) summarizes the progress that has been made in the design of lateral flow biosensors (LFBs) based on the use of micro- and nano-materials. Following a short introduction into the field, a first section covers features related to the design of LFBs, with subsections on strip-based, cotton thread-based and vertical flow- and syringe-based LFBs. The next chapter summarizes methods for sample pretreatment, from simple method to membrane-based methods, pretreatment by magnetic methods to device-integrated sample preparation. Advances in flow control are treated next, with subsections on cross-flow strategies, delayed and controlled release and various other strategies. Detection conditionst and mathematical modelling are briefly introduced in the following chapter. A further chapter covers methods for reliability improvement, for example by adding other validation lines or adopting different detection methods. Signal readouts are summarized next, with subsections on color-based, luminescent, smartphone-based and SERS-based methods. A concluding section summarizes the current status and addresses challenges in future perspectives. Graphical abstractRecent development and breakthrough points of lateral flow biosensors.

Developing Gold Nanoparticles-Conjugated Aflatoxin B1 Antifungal Strips

Lateral flow immunochromatographic assays are a powerful diagnostic tool for point-of-care tests, based on their simplicity, specificity, and sensitivity. In this study, a rapid and sensitive gold nanoparticle (AuNP) immunochromatographic strip is produced for detecting aflatoxin B1 (AFB1) in suspicious fungi-contaminated food samples. The 10 nm AuNPs were encompassed by bovine serum albumin (BSA) and AFB1 antibody. Thin-layer chromatography, gel electrophoresis and nuclear magnetic resonance spectroscopy were employed for analysing the chemical complexes. Various concentrations of AFB1 antigen (0-16 ng/mL) were tested with AFB1 antibody-BSA-AuNPs (conjugated AuNPs) and then analysed by scanning electron microscopy, ultraviolet-visible spectroscopy, and Zetasizer. The results showed that the AFB1 antibody was coupled to BSA by the N-hydroxysuccinimide ester method. The AuNPs application has the potential to contribute to AFB1 detection by monitoring a visible colour change from red to purple-blue, with a detection limit of 2 ng/mL in a 96-well plate. The lateral flow immunochromatographic strip tests are rapid, taking less than 10 min., and they have a detection capacity of 10 ng/g. The smartphone analysis of strips provided the results in 3 s, with a detection limit of 0.3 ng/g for AFB1 when the concentration was below 10 ng/g. Excellent agreement was found with AFB1 determination by high-performance liquid chromatography in the determination of AFB1 among 20 samples of peanuts, corn, rice, and bread.

Towards Lateral Flow Quantitative Assays: Detection Approaches

Point-of-care (POC) or bedside analysis is a global trend in modern diagnostics. Progress in POC testing has largely been provided by advanced manufacturing technology for lateral flow (immunochromatographic) test strips. They are widely used to rapidly and easily control a variety of biomarkers of infectious diseases and metabolic and functional disorders, as well as in consumer protection and environmental monitoring. However, traditional lateral flow tests rely on visual assessment and qualitative conclusion, which limit the objectivity and information output of the assays. Therefore, there is a need for approaches that retain the advantages of lateral flow assays and provide reliable quantitative information about the content of a target compound in a sample mixture. This review describes the main options for detecting, processing, and interpreting immunochromatographic analysis results. The possibilities of modern portable detectors that register colored, fluorescent, magnetic, and conductive labels are discussed. Prospects for further development in this direction are also examined.

Pt-Ni(OH)2 nanosheets amplified two-way lateral flow immunoassays with smartphone readout for quantification of pesticides

Excessive use of herbicide and insecticide causes bioaccumulation in the environment and increases potential toxicity for people and animals. Portable systems for rapid assays of herbicide and insecticide residues have attracted prominent interests. Here, we developed a two-dimensional (2D) Pt-Ni(OH)₂ nanosheets (NSs) amplified two-way lateral flow immunoassay (LFI) with a smartphone-based readout for simultaneous detection of acetochlor and fenpropathrin. The 2D Pt-Ni(OH)₂ NSs were synthesized and used as the enhanced signal label in the immunoassay due to their high peroxidase-like activity and low migration speed. The two-way LFI was designed to eliminate potential cross-reaction between two targets. Portable detection system was developed based on a smartphone-based readout, which scans the LFI and provides the accurate testing result. The universal use of smartphones makes the developed platform suitable for cheap and on-site applications. Using the integrated platform, detection of acetochlor and fenpropathrin simultaneously was successfully achieved with the detection limits of 0.63 ng/mL and 0.24 ng/mL, respectively. To confirm the performance of the on-site application, we detected 10 non-spiked samples and 3 spiked samples. The obtained detection results were consistent with the data from gas chromatography analysis. The estimated recoveries ranged from 97.12% to 111.46%, indicating the practical reliability of our developed assay. The developed smartphone-based platform exhibits enhanced sensitivity, which provides a promising technique for on-site, multiplex, highly sensitive detection of pesticides.

Detection platforms for point-of-care testing based on colorimetric, luminescent and magnetic assays: A review

Along with the considerable potential and increasing demand of the point-of-care testing (POCT), corresponding detection platforms have attracted great interest in both academic and practical fields. The first few generations of conventional detection devices tend to be costly, complicated to operate and hard to move on account of early limitations in the level of technological development and relatively high requirement of performance. Owing to the requirements for rapidity, simplicity, accuracy and cost controlling in the POCT, reader systems are urgently needed to be developed, upgraded and modified constantly, realizing on-site testing and healthcare management without a specific place or cumbersome operation. Accordingly, numerous rapid detection platforms with diverse size and performance have emerged such as bench-top apparatuses, handheld devices and intelligent detection devices. This review discusses various devices developed mainly for the detection of lateral flow test strips (LFTSs) or microfluidic strips in the POCT and summarizes these devices by size and portability. Furthermore, on the basis of various detection methods and diverse probes usually containing specific nanoparticles composites, three most common aspects of detection rationale in the POCT are selected to elaborate each kind of detection platforms in this paper: colorimetric assay, luminescent detection and magnetic signal detection. Herein, we focus on their structures, detection mechanisms and assay results, accompany with discussions and comments on the performances, costs and potential application, as well as advantages and limitations of each technique. In addition, perspectives on the future advances of detection platforms and some conclusions are proposed.

Machine Learning Approach to Enhance the Performance of MNP-Labeled Lateral Flow Immunoassay

The use of magnetic nanoparticle (MNP)-labeled immunochromatography test strips (ICTSs) is very important for point-of-care testing (POCT). However, common diagnostic methods cannot accurately analyze the weak magnetic signal from ICTSs, limiting the applications of POCT. In this study, an ultrasensitive multiplex biosensor was designed to overcome the limitations of capturing and normalization of the weak magnetic signal from MNPs on ICTSs. A machine learning model for sandwich assays was constructed and used to classify weakly positive and negative samples, which significantly enhanced the specificity and sensitivity. The potential clinical application was evaluated by detecting 50 human chorionic gonadotropin (HCG) samples and 59 myocardial infarction serum samples. The quantitative range for HCG was 1-1000 mIU mL^-1 and the ideal detection limit was 0.014 mIU mL^-1, which was well below the clinical threshold. Quantitative detection results of multiplex cardiac markers showed good linear correlations with standard values. The proposed multiplex assay can be readily adapted for identifying other biomolecules and also be used in other applications such as environmental monitoring, food analysis, and national security.

Office-Based Diagnosis of Demodex Using Smartphone

Demodex is an important pathogen in ophthalmology. It is believed to cause a variety of eyelid and eyelash diseases. Currently, light microscopes are being used for imaging demodex. However, microscopes are not available everywhere. Also, it is not cost-effective to perform light microscopy in every case. In this case, we demonstrate a new method: imaging demodex using cell phone. A 90-diopter noncontact double aspheric lens was attached to the posterior camera of the smartphone with clear tape. An eyelash of a patient with blepharitis was removed. A video was taken using smartphone. There was a moving demodex parasite in the root of the eyelash. A clear video image could be taken using the smartphone. A smartphone and a 90-diopter lens are adequate for the imaging and diagnosis of demodex.

Significant Sensitivity Improvement for Camera-Based Lateral Flow Immunoassay Readers

Recent developments in smartphone-based strip readers have further improved the performances of lateral flow test kits. Most smartphone cameras encode an unaltered and nonlinear power-law transfer function that maps the light intensity to a pixel value; this poses some limitations for camera-based strip readers. For faint-color test lines which are almost as white such as with nitrocellulose pads, the slope of the transfer function is low. Therefore, it is difficult to differentiate between the faint test lines and the white background. We show that by manually setting the camera exposure time-instead of using the automatic settings-to the high-slope region of the transfer function, the reader's sensitivity can be improved. We found that the sensitivity and the limit of detection of the Acidovorax avenae subsp. citrulli (Aac) test kit were enhanced up to 3-fold and 5-fold, respectively, when using the readers at the optimal camera settings, compared to the automatic mode settings. This simple technique can be readily applied to any existing camera-based colorimetric strip reader to significantly improve its performance.

A simple and compact smartphone-based device for the quantitative readout of colloidal gold lateral flow immunoassay strips

Colloidal gold lateral flow immunoassay strips (AuNPs-LFIS) have been widely applied as qualitative diagnostic tools for point-of-care tests (POCT). If strip readers were incorporated, their use could be extended to quantitative analysis. However, their cost and non-portability render commercial strip readers unavailable for use in either home testing, community or rural hospital diagnosis. This is particularly true for on-site testing. Here, a smartphone-based reader was designed and 3D-printed for quantitatively assess AuNPs-LFIS. The basic principle of the devise was relying on a smartphone's ambient light sensor (SPALS). This sensor was harnessed to measure the transmitted light intensities originating from the T-lines on the strips, the transmitted light intensities vary with concentration of AuNP on the T-lines. To validate this approach, our newly developed smartphone's ambient light sensor-based reader (SPALS-reader) was used to readout AuNPs-LFIS of three analytical targets: cadmium ion (Cd²⁺; limit of detection (LOD) was 0.16 ng/mL), clenbuterol (CL; LOD was 0.046 ng/mL), and porcine epidemic diarrhea virus (PEDV; LOD was 0.055 μg/mL). The result showed good consistency with the results of conventional image analysis approaches, indicating that the smartphone-based device is appropriate for use in AuNPs-LFIS readouts. Compared with the traditional analysis method, the developed AuNPs-LFIS reader is easier operated, lower cost and more portable, which provided an on-site quantitative analysis tool for AuNPs-LFIS and enhances the applied range of AuNPs-LFIS.

Effective Bioactivity Retention of Low-Concentration Antibodies on HFBI-Modified Fluorescence ICTS for Sensitive and Rapid Detection of PSA

Nowadays, increasing analytical sensitivity is still a big challenge in constructing membrane-based fluorescence immunochromatography test strips (FICTS). However, the bioactivity of antibody (Ab) immobilized on the test line (T line) of porous nitrocellulose membrane (PNM), which directly influences the analytical sensitivity, is less studied. In this work, a novel amphiphilic hydrophobin (HFBI) protein was introduced to modify the T line to effectively retain the Abs' bioactivity. The results indicated that HFBI could self-assemble on the PNM and immobilize the Abs in the "stand-up" orientation. Compared with the conventional FICTS, the HFBI-modified FICTS with only 0.2 mg/mL of monoclonal Abs on T line enable more accurate quantitative detection and better sensitivity (0.06 ng/mL for prostate specific antigen), which is more than 2 orders of magnitude lower than that of the conventional FICTS with the same concentration of monoclonal Abs on T line. Furthermore, the accuracy of this HFBI-modified FICTS was investigated by testing 150 clinical serum samples and the detection results were coincident with those by electrochemiluminescence immunoassay. Our results provide a novel and promising strategy of Ab immobilization on FICTS for near-patient and point-of-care application.