Microfluidic paper-based analytical devices: from POCKET to paper-based ELISA

Low-tech vs. high-tech approaches in μPADs as a result of contrasting needs and capabilities of developed and developing countries focusing on diagnostics and point-of-care testing

Paper-based analysis has captivated scientists' attention in the field of analytical chemistry and related areas for the last two decades. Arguably no other area of modern chemical analysis is so broad and diverse in its approaches spanning from simple 'low-tech' low-cost paper-based analytical devices (PADs) requiring no or simple instrumentation, to sophisticated PADs and microfluidic paper-based analytical devices (μPADs) featuring elements of modern material science and nanomaterials affording high selectivity and sensitivity. Correspondingly diverse is the applicability, covering resource-limited scenarios on the one hand and most advanced approaches on the other. Herein we offer a view reflecting this diversity in the approaches and types of devices. The core idea of this article rests in dividing μPADs according to their type into two groups: A) instrumentation-free μPADs for resource-limited scenarios or developing countries and B) instrumentation-based μPADs as futuristic POC devices for e-diagnostics mainly aimed at developed countries. Each of those two groups is presented and discussed with the view of the main requirements in the given area, the most common targets, sample types and suitable detection approaches either implementing high-tech elements or low-tech low-cost approaches. Finally, a socioeconomic perspective is offered in discussing the fabrication and operational costs of μPADs, and, future perspectives are offered.

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

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

Sensory materials for microfluidic paper based analytical devices - A review

The microfluidic paper-based analytical devices (μPADs) have grown-up swiftly over the decade due to its low cost, simple fabrication procedure, resource-limitedness, non-toxicity and their environmentally benign nature. The μPADs, also identified as point-of-care devices or health care devices have successfully applied in several fields such as diagnostics, biological, food safety, environmental, electrochemical and most importantly colorimetric/fluorimetric sensors, owing to the attractive passive motions of analyte without any external forces. In recent years, a large number of colorimetric and fluorimetric probes have been reported that can selectively recognize the analytes in μPADs. However, there is no organized review on its structure-activity relationship. In this review, we have focused to summarize the colorimetric and fluorimetric probes utilized in μPADs. This review discuss about the relationships between the structure and functions of various probes as signaling units of the efficient μPADs. The probes including nanomaterials, nanozymes, polymers and organic molecules, their structural activity with regard to sensing performances along with their limit of detection are also discussed. This review is expected to assist readers for better understanding of the sensing mechanisms of various chemo and bio-probes utilized in μPADs, as well as promote their advancement in the field. On the other hand, this review also helps the researchers for enhancement of μPADs and paves way for synergistic application of existing molecular probes as an effective diagnostic tool for the worldwide pandemic novel corona virus COVID-19.

Paper-Based Immunosensors with Bio-Chemiluminescence Detection

Since the introduction of paper-based analytical devices as potential diagnostic platforms a few decades ago, huge efforts have been made in this field to develop systems suitable for meeting the requirements for the point-of-care (POC) approach. Considerable progress has been achieved in the adaptation of existing analysis methods to a paper-based format, especially considering the chemiluminescent (CL)-immunoassays-based techniques. The implementation of biospecific assays with CL detection and paper-based technology represents an ideal solution for the development of portable analytical devices for on-site applications, since the peculiarities of these features create a unique combination for fitting the POC purposes. Despite this, the scientific production is not paralleled by the diffusion of such devices into everyday life. This review aims to highlight the open issues that are responsible for this discrepancy and to find the aspects that require a focused and targeted research to make these methods really applicable in routine analysis.

Glucose oxidase-mediated sodium alginate gelation: Equipment-Free detection of glucose in fruit samples

In this study, a paper-based sensor, combined with a visual distance-readout method, was developed to determine glucose in fruit samples based on the glucose oxidase-mediated sodium alginate gelation. The type of filter paper, the concentration of sodium alginate and the enzymatic reaction conditions were systematically investigated. Under optimal conditions, the increase in diffusion diameter showed a good linear relationship with glucose concentration between 1.4-7.0 mM, and the limit of quantification was 1.4 mM. Finally, the applicability of the proposed strategy was successfully verified by measuring glucose concentrations in fruit samples. The results generated by the developed paper-based sensor were in good agreement with the results obtained from a glucose assay kit. The recoveries were 91.8%-99.1%. In short, the present study developed a simple, low-cost and efficient method for assessing fruit quality and for guiding fruit intake for diabetic patients, especially in remote or resource-limited regions.

Sponge particulates for biomedical applications: Biofunctionalization, multi-drug shielding, and theranostic applications

Sponge particulates have attracted enormous attention in biomedical applications for superior properties, including large porosity, elastic deformation, capillary action, and three-dimensional (3D) reaction environment. Especially, the tiny porous structures make sponge particulates a promising platform for drug delivery, tissue engineering, anti-infection, and wound healing by providing abundant reservoirs of broad surface and internal network for cargo shielding and shuttling. To control the sponge-like morphology and improve the diversity of drug loading, some optimized preparation techniques of sponge particulates have been developed, contributing to the simplified preparation process and improved production reproducibility. Bio-functionalized strategies, including target modification, cell membrane camouflage, and hydrogel of sponge particulates have been applied to modulate the properties, improve the performance, and extend the applications. In this review, we highlight the unique physical properties and functions, current manufacturing techniques, and an overview of spongy particulates in biomedical applications, especially in inhibition of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infectivity. Moreover, the current challenges and prospects of sponge particulates are discussed rationally, providing an insight into developing vibrant fields of sponge particulates-based biomedicine.

Highly selective simultaneous determination of Cu(ii), Co(ii), Ni(ii), Hg(ii), and Mn(ii) in water samples using microfluidic paper-based analytical devices

A new paper-based analytical device design was fabricated by a wax printing method for simultaneous determination of Cu(ii), Co(ii), Ni(ii), Hg(ii), and Mn(ii). Colorimetry was used to quantify these heavy metal ions using bathocuproine (Bc), dimethylglyoxime (DMG), dithizone (DTZ), and 4-(2-pyridylazo) resorcinol (PAR) as complexing agents. The affinity of complexing agents to heavy metal ions is dependent on the formation constant (Kf). To enhance the selectivity for heavy metal ion determination, the new device was designed with two pretreatment zones, where masking agents remove the interfering ions. It was found that two pretreatment zones worked better than a single pretreatment zone at removing interferences. The reaction time, sample and complexing agent volumes, and complexing agent concentrations were optimized. The analytical results were achieved with the lowest detectable concentrations of 0.32, 0.59, 5.87, 0.20, and 0.11 mg L-1 for Cu(ii), Co(ii), Ni(ii), Hg(ii), and Mn(ii), respectively. The linear ranges were found to be 0.32-63.55 mg L-1 (Cu(ii)), 0.59-4.71 mg L-1 (Co(ii)), 5.87-352.16 mg L-1 (Ni(ii)), 0.20-12.04 mg L-1 (Hg(ii)), and 0.11-0.55 mg L-1 (Mn(ii)). The lowest detectable concentration and linearity for the five metal ions allow the application of this device for the determination of heavy metal ions in various water samples. The sensor showed high selectivity and efficiency for simultaneous determination of Cu(ii), Co(ii), Ni(ii), Hg(ii), and Mn(ii) in drinking, tap, and pond water samples on a single device and detection with the naked eye. The results illustrated that the proposed sensor showed good accuracy and precision agreement with the standard ICP-OES method.

Strategies for the detection of target analytes using microfluidic paper-based analytical devices

Microfluidic paper-based analytical devices (μPADs) have developed rapidly in recent years, because of their advantages, such as small sample volume, rapid detection rates, low cost, and portability. Due to these characteristics, they can be used for in vitro diagnostics in the laboratory, or in the field, for a variety of applications, including food evaluation, disease screening, environmental monitoring, and drug testing. This review will present various detection methods employed by μPADs and their respective applications for the detection of target analytes. These include colorimetry, electrochemistry, chemiluminescence (CL), electrochemiluminescence (ECL), and fluorescence-based methodologies. At the same time, the choice of labeling material and the design of microfluidic channels are also important for detection results. The construction of novel nanocomponents and different smart structures of paper-based devices have improved the performance of μPADs and we will also highlight some of these in this manuscript. Additionally, some key challenges and future prospects for the use of μPADs are briefly discussed.

Research advances and applications of biosensing technology for the diagnosis of pathogens in sustainable agriculture

Plant diseases significantly impact the global economy, and plant pathogenic microorganisms such as nematodes, viruses, bacteria, fungi, and viroids may be the etiology for most infectious diseases. In agriculture, the development of disease-free plants is an important strategy for the determination of the survival and productivity of plants in the field. This article reviews biosensor methods of disease detection that have been used effectively in other fields, and these methods could possibly transform the production methods of the agricultural industry. The precise identification of plant pathogens assists in the assessment of effective management steps for minimization of production loss. The new plant pathogen detection methods include evaluation of signs of disease, detection of cultured organisms, or direct examination of contaminated tissues through molecular and serological techniques. Laboratory-based approaches are costly and time-consuming and require specialized skills. The conclusions of this review also indicate that there is an urgent need for the establishment of a reliable, fast, accurate, responsive, and cost-effective testing method for the detection of field plants at early stages of growth. We also summarized new emerging biosensor technologies, including isothermal amplification, detection of nanomaterials, paper-based techniques, robotics, and lab-on-a-chip analytical devices. However, these constitute novelty in the research and development of approaches for the early diagnosis of pathogens in sustainable agriculture.

Hybrid 3D printed-paper microfluidics

3D printed and paper-based microfluidics are promising formats for applications that require portable miniaturized fluid handling such as point-of-care testing. These two formats deployed in isolation, however, have inherent limitations that hamper their capabilities and versatility. Here, we present the convergence of 3D printed and paper formats into hybrid devices that overcome many of these limitations, while capitalizing on their respective strengths. Hybrid channels were fabricated with no specialized equipment except a commercial 3D printer. Finger-operated reservoirs and valves capable of fully-reversible dispensation and actuation were designed for intuitive operation without equipment or training. Components were then integrated into a versatile multicomponent device capable of dynamic fluid pathing. These results are an early demonstration of how 3D printed and paper microfluidics can be hybridized into versatile lab-on-chip devices.

Enhancing the performance of paper-based electrochemical impedance spectroscopy nanobiosensors: An experimental approach

Accurate, rapid, and low-cost molecular diagnostics is essential in managing outbreaks of infectious diseases, such as the pandemic of coronavirus disease 2019 (COVID-19). Accordingly, microfluidic paper-based analytical devices (μPADs) have emerged as promising diagnostic tools. Among the extensive efforts to improve the performance and usability of diagnostic tools, biosensing mechanisms based on electrochemical impedance spectroscopy (EIS) have shown great promise because of their label-free operation and high sensitivity. However, the method to improve EIS biosensing on μPADs is less explored. Here, we present an experimental approach to enhancing the performance of paper-based EIS biosensors featuring zinc oxide nanowires (ZnO NWs) directly grown on working electrodes (WEs). Through a comparison of different EIS settings and an examination of ZnO-NW effects on EIS measurements, we show that ZnO-NW-enhanced WEs function reliably with Faradaic processes utilizing iron-based electron mediators. We calibrate paper-based EIS biosensors with different morphologies of ZnO NWs and achieve a low limit of detection (0.4 pg ml⁻¹) in detecting p24 antigen as a marker for human immunodeficiency virus (HIV). Through microscopic imaging and electrochemical characterization, we reveal that the morphological and the electrochemical surface areas of ZnO-NW-enhanced WEs indicate the sensitivities and sensing ranges of the EIS nanobiosensors. Finally, we report that the EIS nanobiosensors are capable of differentiating the concentrations (blank, 10 ng ml⁻¹, 100 ng ml⁻¹, and 1 μg ml⁻¹) of IgG antibody (CR3022) to SARS-CoV-2 in human serum samples, demonstrating the efficacy of these devices for COVID-19 diagnosis. This work provides a methodology for the rational design of high-performance EIS μPADs and has the potential to facilitate diagnosis in pandemics.

Enhanced paper-based ELISA for simultaneous EVs/exosome isolation and detection using streptavidin agarose-based immobilization

EVs/exosomes are considered as the next generation of biomarkers, including for liquid biopsies. Consequently, the quantification of EVs/exosomes is crucial for facilitating EV/exosome research and applications. Paper-based enzyme-linked immunosorbent assay (p-ELISA) is a portable diagnostic system with low cost that is simple and easy to use; however, it shows low sensitivity and linearity. In this study, we develop p-ELISA for targeting EVs/exosomes by using streptavidin agarose resin-based immobilization (SARBI). This method reduces assay preparation times, provides strong binding, and retains good sensitivity and linearity. The time required for the total assay, including preparation steps and surface immobilization, was shortened to ∼2 h. We evaluated SARBI p-ELISA systems with/without CD63 capture Ab and then with fetal bovine serum (FBS) and EVs/exosome-depleted fetal bovine serum (dFBS). The results provide evidence supporting the selective capture ability of SARBI p-ELISA. We obtain semiquantitative p-ELISA results using an exosome standard (ES) and human serum (HS), with R2 values of 0.95 and 0.92, respectively.

Microfluidics in Haemostasis: A Review

Haemostatic disorders are both complex and costly in relation to both their treatment and subsequent management. As leading causes of mortality worldwide, there is an ever-increasing drive to improve the diagnosis and prevention of haemostatic disorders. The field of microfluidic and Lab on a Chip (LOC) technologies is rapidly advancing and the important role of miniaturised diagnostics is becoming more evident in the healthcare system, with particular importance in near patient testing (NPT) and point of care (POC) settings. Microfluidic technologies present innovative solutions to diagnostic and clinical challenges which have the knock-on effect of improving health care and quality of life. In this review, both advanced microfluidic devices (R&D) and commercially available devices for the diagnosis and monitoring of haemostasis-related disorders and antithrombotic therapies, respectively, are discussed. Innovative design specifications, fabrication techniques, and modes of detection in addition to the materials used in developing micro-channels are reviewed in the context of application to the field of haemostasis.

Paper-based nucleic acid amplification tests for point-of-care diagnostics

There has been a recent resurgence in the use of paper as a substrate for developing point-of-care medical diagnostic tests, possibly triggered by expiring patents published in the 1990s. A hallmark of this resurgence has been the development of advanced shapes and structures made from paper to conduct multi-step fluidic operations using the wicking action of porous materials. Such devices indicate a distinct improvement over lateral flow immunoassays, which are restricted to conducting one-step operations. New developments in paper-based diagnostic devices have triggered interest in the development of paper-based point-of-care nucleic acid amplification tests (NAATs). NAATs can identify extremely low levels of specific nucleic acid sequences from clinical samples and are the most sensitive of all available tests for infectious disease diagnosis. Because traditional PCR-based NAATs require expensive instruments, the development of portable paper-based NAAT's has become an exciting field of research. This article aims to review and analyse the current state of development of paper-based NAATs. We project paper-based NAATs as miniaturized chemical processes and shed light on various schemes of operation used for converting the multiple steps of the chemical processes into paper microfluidic devices. We conclude by elaborating on the challenges that must be overcome in the near future so that progress can be made towards the development of fully functional and commercial paper-based NAATs.

Microfluidic Paper-based Analytical Devices (μPADs): Miniaturization and Enzyme Storage Studies

This paper describes the design and development of miniaturized microfluidic paper-based analytical devices (μPADs) for biological assays and enzyme storage instruments. Here, a glucose assay utilizing glucose oxidase (GOx), horseradish peroxidase (HRP), and potassium iodide (KI) is used as the model system. The efficacy of the miniaturized devices is further examined by assessing the activity of acetylcholinesterase (AChE). Two types of μPADs were developed: one, "strip" chips of detection zones of area 0.5, 0.1 cm² and, two, "grid" chips of detection zone 0.05 cm². The devices are easily fabricated via a wax printing process whereby lines of wax are deposited onto chromatographic paper and heated to create rows of hydrophobic barriers. The "strip" chips were subjected to three different temperature environments (-20, 0, and 20°C) over 30 days and glucose assays conducted at intermittent times yielding a correlation between corrected average inverse yellow intensity, days, and glucose concentration. Calculated and experimentally derived color intensity values for 1, 4, and 9 mM glucose concentrations after a 7-day storage study showed a good correlation (0.89 - 15.76% error). Both types of μPADs are effective platforms as potential point-of-care (POC) diagnostic devices and display minimal enzyme denaturation. μPADs of this size show promise as alternative devices for resource-limited regions and especially those areas where materials and instrumentation are not always available.

A paper/polymer hybrid CD-like microfluidic SpinChip integrated with DNA-functionalized graphene oxide nanosensors for multiplex qLAMP detection

A paper/poly(methyl methacrylate) (PMMA) hybrid CD-like microfluidic SpinChip integrated with DNA probe-functionalized graphene oxide (GO) nanosensors was developed for multiplex quantitative LAMP detection (mqLAMP). This approach can simply and effectively address a major challenging problem of multiplexing in current LAMP methods.

Microfluidic paper-based analytical devices for potential use in quantitative and direct detection of disease biomarkers in clinical analysis

Clinicians, working in the health-care diagnostic systems of developing countries, currently face the challenges of rising costs, increased number of patient visits, and limited resources. A significant trend is using low-cost substrates to develop microfluidic devices for diagnostic purposes. Various fabrication techniques, materials, and detection methods have been explored to develop these devices. Microfluidic paper-based analytical devices (μPADs) have gained attention for sensing multiplex analytes, confirming diagnostic test results, rapid sample analysis, and reducing the volume of samples and analytical reagents. μPADs, which can provide accurate and reliable direct measurement without sample pretreatment, can reduce patient medical burden and yield rapid test results, aiding physicians in choosing appropriate treatment. The objectives of this review are to provide an overview of the strategies used for developing paper-based sensors with enhanced analytical performances and to discuss the current challenges, limitations, advantages, disadvantages, and future prospects of paper-based microfluidic platforms in clinical diagnostics. μPADs, with validated and justified analytical performances, can potentially improve the quality of life by providing inexpensive, rapid, portable, biodegradable, and reliable diagnostics.

Paper strip-embedded graphene quantum dots: a screening device with a smartphone readout

Simple, inexpensive and rapid sensing systems are very demanded for a myriad of uses. Intrinsic properties of emerging paper-based analytical devices have demonstrated considerable potential to fulfill such demand. This work reports an easy-to-use, low cost, and disposable paper-based sensing device for rapid chemical screening with a smartphone readout. The device comprises luminescent graphene quantum dots (GQDs) sensing probes embedded into a nitrocellulose matrix where the resonance energy transfer phenomenon seems to be the sensing mechanism. The GQDs probes were synthesized from citric acid by a pyrolysis procedure, further physisorbed and confined into small wax-traced spots on the nitrocellulose substrate. The GQDs were excited by an UV LED, this, is powered by a smartphone used as both; energy source and imaging capture. The LED was contained within a 3D-printed dark chamber that isolates the paper platform from external light fluctuations leading to highly reproducible data. The cellulose-based device was proven as a promising screening tool for phenols and polyphenols in environmental and food samples, respectively. It opens up new opportunities for simple and fast screening of organic compounds and offers numerous possibilities for versatile applications. It can be especially useful in remote settings where sophisticated instrumentation is not always available.

Development of a point-of-care diagnostic for influenza detection with antiviral treatment effectiveness indication

Currently, diagnosis of influenza is performed either through tedious polymerase chain reaction (PCR) or through rapid antigen detection assays. The rapid antigen detection assays available today are highly specific but not very sensitive, and most importantly, lack the ability to show if the strain of influenza detected is susceptible to antiviral agents, such as Tamiflu and Relenza. The ability to rapidly determine if a patient has an infectious disease and what type of treatment the infection will respond to, would significantly reduce the treatment decision time, shorten the impact of symptoms, and minimize transfer to others. In this study, a novel, point-of-care style μPAD (microfluidic paper-based diagnostic) for influenza has been developed with the ability to determine antiviral susceptibility of the strain for treatment decision. The assay exploits the enzymatic activity of surface proteins present on all influenza strains, and potential false positive responses can be mitigated. A sample can be added to the device, distributed to 4 different reagent zones, and development of the enzymatic substrate under different buffer conditions takes place on bottom of the device. Analysis can be performed by eye or through a colorimetric image analysis smartphone application.

Multiplexed instrument-free meningitis diagnosis on a polymer/paper hybrid microfluidic biochip

Neisseria meningitidis (N. meningitidis), Streptococcus pneumoniae (S. pneumoniae), and Haemophilus influenzae type b (Hib) are three most common pathogens accounting for most bacterial meningitis, a serious global infectious disease with high fatality, especially in developing nations. Because the treatment and antibiotics differ among each type, the identification of the exact bacteria causing the disease is vital. Herein, we report a polymer/paper hybrid microfluidic biochip integrated with loop-mediated isothermal amplification (LAMP) for multiplexed instrument-free diagnosis of these three major types of bacterial meningitis, with high sensitivity and specificity. Results can be visually observed by the naked eye or imaged by a smartphone camera under a portable UV light source. Without using any specialized laboratory instrument, the limits of detection of a few DNA copies per LAMP zone for N. meningitidis, S. pneumoniae and Hib were achieved within 1h. In addition, these three types of microorganisms spiked in artificial cerebrospinal fluid (ACSF) were directly detected simultaneously, avoiding cumbersome sample preparation procedures in conventional methods. Compared with the paper-free non-hybrid microfluidic biochip over a period of three months, the hybrid microfluidic biochip was found to have a much longer shelf life. Hence, this rapid, instrument-free and highly sensitive microfluidic approach has great potential for point-of-care (POC) diagnosis of multiple infectious diseases simultaneously, especially in resource-limited settings.

Magnetic paper – based ELISA for IgM-dengue detection

“Magnetic Paper – Based ELISA” for IgM-dengue antibodies detection provide a system with improved analytical response.

A paper/polymer hybrid microfluidic microplate for rapid quantitative detection of multiple disease biomarkers

Enzyme linked immunosorbent assay (ELISA) is one of the most widely used laboratory disease diagnosis methods. However, performing ELISA in low-resource settings is limited by long incubation time, large volumes of precious reagents, and well-equipped laboratories. Herein, we developed a simple, miniaturized paper/PMMA (poly(methyl methacrylate)) hybrid microfluidic microplate for low-cost, high throughput, and point-of-care (POC) infectious disease diagnosis. The novel use of porous paper in flow-through microwells facilitates rapid antibody/antigen immobilization and efficient washing, avoiding complicated surface modifications. The top reagent delivery channels can simply transfer reagents to multiple microwells thus avoiding repeated manual pipetting and costly robots. Results of colorimetric ELISA can be observed within an hour by the naked eye. Quantitative analysis was achieved by calculating the brightness of images scanned by an office scanner. Immunoglobulin G (IgG) and Hepatitis B surface Antigen (HBsAg) were quantitatively analyzed with good reliability in human serum samples. Without using any specialized equipment, the limits of detection of 1.6 ng/mL for IgG and 1.3 ng/mL for HBsAg were achieved, which were comparable to commercial ELISA kits using specialized equipment. We envisage that this simple POC hybrid microplate can have broad applications in various bioassays, especially in resource-limited settings.

A paper/polymer hybrid microfluidic microplate for rapid quantitative detection of multiple disease biomarkers

Enzyme linked immunosorbent assay (ELISA) is one of the most widely used laboratory disease diagnosis methods. However, performing ELISA in low-resource settings is limited by long incubation time, large volumes of precious reagents, and well-equipped laboratories. Herein, we developed a simple, miniaturized paper/PMMA (poly(methyl methacrylate)) hybrid microfluidic microplate for low-cost, high throughput, and point-of-care (POC) infectious disease diagnosis. The novel use of porous paper in flow-through microwells facilitates rapid antibody/antigen immobilization and efficient washing, avoiding complicated surface modifications. The top reagent delivery channels can simply transfer reagents to multiple microwells thus avoiding repeated manual pipetting and costly robots. Results of colorimetric ELISA can be observed within an hour by the naked eye. Quantitative analysis was achieved by calculating the brightness of images scanned by an office scanner. Immunoglobulin G (IgG) and Hepatitis B surface Antigen (HBsAg) were quantitatively analyzed with good reliability in human serum samples. Without using any specialized equipment, the limits of detection of 1.6 ng/mL for IgG and 1.3 ng/mL for HBsAg were achieved, which were comparable to commercial ELISA kits using specialized equipment. We envisage that this simple POC hybrid microplate can have broad applications in various bioassays, especially in resource-limited settings.

Opportunities and challenges for the application of microfluidic technologies in point-of-care veterinary diagnostics

There is a growing need for low-cost, rapid and reliable diagnostic results in veterinary medicine. Point-of-care (POC) tests have tremendous advantages over existing laboratory-based tests, due to their intrinsic low-cost and rapidity. A considerable number of POC tests are presently available, mostly in dipstick or lateral flow formats, allowing cost-effective and decentralised diagnosis of a wide range of infectious diseases and public health related threats. Although, extremely useful, these tests come with some limitations. Recent advances in the field of microfluidics have brought about new and exciting opportunities for human health diagnostics, and there is now great potential for these new technologies to be applied in the field of veterinary diagnostics. This review appraises currently available POC tests in veterinary medicine, taking into consideration their usefulness and limitations, whilst exploring possible applications for new and emerging technologies, in order to widen and improve the range of POC tests available.

Multifunctional Microspheres Encoded with Upconverting Nanocrystals and Magnetic Nanoparticles for Rapid Separation and Immunoassays

Immunoassays based on the downconversion target materials (organic dyes or quantum dots) lead to fairly strong spectral interference between the coded signal and reporter signal, which seriously affects the detection accuracy and hampers their applications. In this work, a new kind of upconverting nanocrystals encoded magnetic microspheres (UCNMMs) were designed and prepared successfully to solve the problem mentioned above. The UCNMMs were obtained by incorporating magnetic Fe3O4 nanoparticles and upconverting nanocrystals with polystyrene microspheres. Due to that upconverting nanocrystals (UCNs) and reporter signals are excitated by near-infrared and UV/visible light separately, immunoassays based on UCNMMs do not occur optical spectral interferences. Furthermore, these new functionalized UCNMMs have excellent properties in binding biomolecules and fast separating, which would have large potential applications in multiplexed assays.

Lab-on-a-chip workshop activities for secondary school students

The ability to engage and inspire younger generations in novel areas of science is important for bringing new researchers into a burgeoning field, such as lab-on-a-chip. We recently held a lab-on-a-chip workshop for secondary school students, for which we developed a number of hands-on activities that explained various aspects of microfluidic technology, including fabrication (milling and moulding of microfluidic devices, and wax printing of microfluidic paper-based analytical devices, so-called μPADs), flow regimes (gradient formation via diffusive mixing), and applications (tissue analysis and μPADs). Questionnaires completed by the students indicated that they found the workshop both interesting and informative, with all activities proving successful, while providing feedback that could be incorporated into later iterations of the event.

Sensitive biomolecule detection in lateral flow assay with a portable temperature-humidity control device

Lateral flow assays (LFAs) have currently attracted broad interest for point-of-care (POC) diagnostics, but their application has been restricted by poor quantification and limited sensitivity. While the former has been currently solved to some extent by the development of handheld or smartphone-based readers, the latter has not been addressed fully, particularly the potential influences of environmental conditions (e.g., temperature and relative humidity (RH)), which have not yet received serious attention. The present study reports the use of a portable temperature-humidity control device to provide an optimum environmental requirement for sensitivity improvement in LFAs, followed by quantification by using a smartphone. We found that a RH beyond 60% with temperatures of 55-60°C and 37-40°C produced optimum nucleic acid hybridization and antigen-antibody interaction in LFAs, respectively representing a 10-fold and 3-fold signal enhancement over ambient conditions (25°C, 60% RH). We envision that in the future the portable device could be coupled with a fully integrated paper-based sample-to-answer biosensor for sensitive detection of various target analytes in POC settings.

A microfluidic paper-based analytical device for the assay of albumin-corrected fructosamine values from whole blood samples

BACKGROUND

A method for acquiring albumin-corrected fructosamine values from whole blood using a microfluidic paper-based analytical system that offers substantial improvement over previous methods is proposed.

RESULTS

The time required to quantify both serum albumin and fructosamine is shortened to 10 min with detection limits of 0.50 g dl(-1) and 0.58 mM, respectively (S/N = 3). The proposed system also exhibited good within-run and run-to-run reproducibility. The results of the interference study revealed that the acceptable recoveries ranged from 95.1 to 106.2%. The system was compared with currently used large-scale methods (n = 15), and the results demonstrated good agreement among the techniques.

CONCLUSION

The microfluidic paper-based system has the potential to continuously monitor glycemic levels in low resource settings.

Paper-based sample-to-answer molecular diagnostic platform for point-of-care diagnostics

Nucleic acid testing (NAT), as a molecular diagnostic technique, including nucleic acid extraction, amplification and detection, plays a fundamental role in medical diagnosis for timely medical treatment. However, current NAT technologies require relatively high-end instrumentation, skilled personnel, and are time-consuming. These drawbacks mean conventional NAT becomes impractical in many resource-limited disease-endemic settings, leading to an urgent need to develop a fast and portable NAT diagnostic tool. Paper-based devices are typically robust, cost-effective and user-friendly, holding a great potential for NAT at the point of care. In view of the escalating demand for the low cost diagnostic devices, we highlight the beneficial use of paper as a platform for NAT, the current state of its development, and the existing challenges preventing its widespread use. We suggest a strategy involving integrating all three steps of NAT into one single paper-based sample-to-answer diagnostic device for rapid medical diagnostics in the near future.

Printed Flexible Plastic Microchip for Viral Load Measurement through Quantitative Detection of Viruses in Plasma and Saliva

We report a biosensing platform for viral load measurement through electrical sensing of viruses on a flexible plastic microchip with printed electrodes. Point-of-care (POC) viral load measurement is of paramount importance with significant impact on a broad range of applications, including infectious disease diagnostics and treatment monitoring specifically in resource-constrained settings. Here, we present a broadly applicable and inexpensive biosensing technology for accurate quantification of bioagents, including viruses in biological samples, such as plasma and artificial saliva, at clinically relevant concentrations. Our microchip fabrication is simple and mass-producible as we print microelectrodes on flexible plastic substrates using conductive inks. We evaluated the microchip technology by detecting and quantifying multiple Human Immunodeficiency Virus (HIV) subtypes (A, B, C, D, E, G, and panel), Epstein-Barr Virus (EBV), and Kaposi's Sarcoma-associated Herpes Virus (KSHV) in a fingerprick volume (50 µL) of PBS, plasma, and artificial saliva samples for a broad range of virus concentrations between 10(2) copies/mL and 10(7) copies/mL. We have also evaluated the microchip platform with discarded, de-identified HIV-infected patient samples by comparing our microchip viral load measurement results with reverse transcriptase-quantitative polymerase chain reaction (RT-qPCR) as the gold standard method using Bland-Altman Analysis.

1000-fold sample focusing on paper-based microfluidic devices

We present an experimental and analytical study of a novel paper-based analytical device (μPAD) for isotachophoretic sample focusing. Guided by a simple heat transfer model, we further developed wax printing fabrication to enable the creation of shallow channels, which are critical in providing sufficient dissipation of Joule heat, and thus enable the use of high electric fields and short analysis time. This results in a device that is self-contained on a simple piece of filter paper and does not require any specialized enclosures or cooling devices to combat evaporation at high temperatures. Furthermore, we provide an analytical model for isotachophoretic sample accumulation in porous media, introduce a simple figure of merit for evaluating and comparing the efficiency of such devices, and present experimental validation in both paper and glass channels. Using this device we demonstrate the processing of 30 μL of sample achieving 1000-fold increase in peak concentration in 6 min. We believe that this method and device can serve as a guide to the design of low-cost, rapid and highly sensitive paper-based diagnostic platforms.

Amperometric measurements of ethanol on paper with a glucometer

Recent advances in electrochemical analysis on filter paper exemplify the versatility of this substrate for high performance testing. Its low-cost, light-weight, and environmentally friendly properties make it particularly attractive for applications in addressing health and environmental safety needs in low-resource settings and developing countries. However, the main drawback to sensitive electrochemical testing is the use of a potentiostat, a bench-top instrument that is extremely expensive, thereby negating the some of the benefits of paper-based devices. Hence there is a need to develop paper-devices for use with handheld, portable device readers that can extract quantitative readouts. In this study, we developed a method to use micro-paper electrochemical devices, or µPEDs, with a glucose meter, which are used for personal monitoring of blood glucose levels. Ethanol was chosen as a model target analyte due to its importance in the global issue of road safety. µPEDs were simple in design and could be tested with a potentiostat. We observed that inclusion of the stabilizer trehalose was critical to preparing µPEDs for later analysis. In addition, an NAD(+)-dependent enzyme was used to impart selectivity to the biosensor, which also represents a class of enzymes with targets relevant to the health and food industry.

A versatile PDMS/paper hybrid microfluidic platform for sensitive infectious disease diagnosis

Bacterial meningitis is a serious health concern worldwide. Given that meningitis can be fatal and many meningitis cases occurred in high-poverty areas, a simple, low-cost, highly sensitive method is in great need for immediate and early diagnosis of meningitis. Herein, we report a versatile and cost-effective polydimethylsiloxane (PDMS)/paper hybrid microfluidic device integrated with loop-mediated isothermal amplification (LAMP) for the rapid, sensitive, and instrument-free detection of the main meningitis-causing bacteria, Neisseria meningitidis (N. meningitidis). The introduction of paper into the microfluidic device for LAMP reactions enables stable test results over a much longer period of time than a paper-free microfluidic system. This hybrid system also offers versatile functions, by providing not only on-site qualitative diagnostic analysis (i.e., a yes or no answer), but also confirmatory testing and quantitative analysis in laboratory settings. The limit of detection of N. meningitidis is about 3 copies per LAMP zone within 45 min, close to single-bacterium detection sensitivity. In addition, we have achieved simple pathogenic microorganism detection without a laborious sample preparation process and without the use of centrifuges. This low-cost hybrid microfluidic system provides a simple and highly sensitive approach for fast instrument-free diagnosis of N. meningitidis in resource-limited settings. This versatile PDMS/paper microfluidic platform has great potential for the point of care (POC) diagnosis of a wide range of infectious diseases, especially for developing nations.

Inkjet printing of conductive inks with high lateral resolution on omniphobic "R(F) paper" for paper-based electronics and MEMS

The use of omniphobic "fluoroalkylated paper" as a substrate for inkjet printing of aqueous inks that are the precursors of electrically conductive patterns is described. By controlling the surface chemistry of the paper, it is possible to print high resolution, conductive patterns that remain conductive after folding and exposure to common solvents.

Absorbance enhancement in microplate wells for improved-sensitivity biosensors

A generic optical biosensing strategy was developed that relies on the absorbance enhancement phenomenon occurring in a multiple scattering matrix. Experimentally, inserts made of glass fiber membrane were placed into microplate wells in order to significantly lengthen the trajectory of the incident light through the sample and therefore increase the corresponding absorbance. Enhancement factor was calculated by comparing the absorbance values measured for a given amount of dye with and without the absorbance-enhancing inserts in the wells. Moreover, the dilution of dye in solutions with different refractive indices (RI) clearly revealed that the enhancement factor increased with the ΔRI between the membrane and the surrounding medium, reaching a maximum value (EF>25) when the membranes were dried. On this basis, two H2O2-biosensing systems were developed based on the biofunctionalization of the glass fiber inserts either with cytochrome c or horseradish peroxidase (HRP) and the analytical performances were systematically compared with the corresponding bioassay in solution. The efficiency of the absorbance-enhancement approach was particularly clear in the case of the cytochrome c-based biosensor with a sensitivity gain of 40 folds and wider dynamic range. Therefore, the developed strategy represents a promising way to convert standard colorimetric bioassays into optical biosensors with improved sensitivity.

Stability measurements of antibodies stored on paper

Reagent storage has been a long-standing challenge for diagnostics, especially those designed for low-resource settings and point-of-care applications. In general, the stability of a reagent relies on careful temperature control, often by refrigeration, which is costly and often unavailable in these remote settings. Poor reagent integrity can negatively affect the reproducibility and reliability of an assay. Given the recent interest in paper-based devices designed for quantitative analysis in point-of-care settings, a better understanding of reagent stability on filter paper is critical for proper device use and its longevity. In this article, we present an independent method to examine the stability of reconstituted antibodies that were stored on filter paper using flow cytometry. We validated the method by measuring the activity as measured by the mean fluorescence intensity (MFI) of antibodies stored with known stabilizers. Furthermore, we demonstrated the potential of our method to screen the influence of other paper treatments and storage processes on antibody stability, which may be applicable to the storage of reagents on paper in general.