Engineering a sustainable future for point-of-care diagnostics and single-use microfluidic devices

High-capacitance air-brushed electrodes for capacitive label-free bioassays

Non-invasive assays for protein biomarkers of cancer allow both its early diagnosis and continuous treatment monitoring. Yet, accurate point-of-care (POC) diagnostic devices for cancer diagnosis and monitoring, needed in point-of-care (POC) sites and places with limited resources, are scarce, not the least, due to their high current cost or bulky equipment necessary for analysis. Here, we show that the capacitive cellulase-linked electrochemical enzyme-linked aptamer-sorbent assay (e-ELASA) on magnetic beads (MBs) performed with airbrushed graphite (Gr) electrodes accurately and economically detects HER-2/neu, the protein biomarker of some aggressive forms of cancers and target of anticancer therapy. The disposable Gr electrodes were produced by airbrushing inexpensive graphite-powder/chitosan water inks onto polyester transparency films, producing high-capacitance electrodes, whose apparent specific capacitance ranged between 3.61 and 8.88 mF cm-2 as a function of the number of sprayed layers and graphite content in inks. The five-layer electrodes produced from 1.7 g of graphite powder (per 5 mL)/0.55 % chitosan water inks outperformed manually polished spectroscopic Gr electrodes earlier used in this label-free capacitive e-ELASA, as a result of the higher capacitive changes of the former, providing the same 0.1 fM limit of detection of HER-2/neu, in both buffer and 10 % serum, yet with a three-fold higher sensitivity. The portable and low cost airbrushed electrodes/e-ELASA set-up can be used for quick and accurate regular POC monitoring of HER-2/neu, particularly, in low and middle income settings, and, in perspective, the high-capacitance airbrushed electrodes can be adapted for other type label-free capacitive bioassays.

Mitigating the environmental effects of healthcare: the role of the endocrinologist

Human health depends on planetary health, and yet healthcare provision can have unintended consequences for the health of the planet. Emissions from the healthcare sector include greenhouse gases, air pollution and plastic pollution, alongside chemical contamination. Chemical pollution resulting in endocrine disruption has been associated with plastics, which are a source of concerning additives such as phthalates, bisphenols, perfluoroalkyl and polyfluoroalkyl substances, and flame retardants (all routinely found in healthcare products). Many endocrine-disrupting chemicals are persistent and ubiquitous in the environment (including water and food sources), with potential secondary harms for human health, including disrupting reproductive, metabolic and thyroid function. Here we review evidence-based strategies for mitigating environmental effects of healthcare delivery. We focus on what endocrinologists can do, including reducing demand for healthcare services through better preventative health, focusing on high-value care and improving sustainability of medical equipment and pharmaceuticals through adopting circular economy principles (including reduce, reuse and, as a last resort, recycle). The specific issue of endocrine-disrupting chemicals might be mitigated through responsible disposal and processing, alongside advocating for the use of alternative materials and replacing additive chemicals with those that have lower toxicity profiles, as well as tighter regulations. We must work to urgently transition to sustainable models of care provision, minimizing negative effects on human and planetary health.

Translation of COVID-19 Serology Test on Foil-Based Lateral Flow Chips: A Journey from Injection Molding to Scalable Roll-to-Roll Nanoimprint Lithography

Lateral flow tests (LFTs) had a pivotal role in combating the spread of the SARS-CoV-2 virus throughout the COVID-19 pandemic thanks to their affordability and ease of use. Most of LFT devices were based on nitrocellulose membrane strips whose industrial upscaling to billions of devices has already been extensively demonstrated. Nevertheless, the assay option in an LFT format is largely restricted to qualitative detection of the target antigens. In this research, we surveyed the potential of UV nanoimprint lithography (UV-NIL) and extrusion coating (EC) for the high-throughput production of disposable capillary-driven, foil-based tests that allow multistep assays to be implemented for quantitative readout to address the inherent lack of on-demand fluid control and sensitivity of paper-based devices. Both manufacturing technologies operate on the principle of imprinting that enables high-volume, continuous structuring of microfluidic patterns in a roll-to-roll (R2R) production scheme. To demonstrate the feasibility of R2R-fabricated foil chips in a point-of-care biosensing application, we adapted a commercial chemiluminescence multiplex test for COVID-19 antibody detection originally developed for a capillary-driven microfluidic chip manufactured with injection molding (IM). In an effort to build a complete ecosystem for the R2R manufacturing of foil chips, we also recruited additional processes to streamline chip production: R2R biofunctionalization and R2R lamination. Compared to conventional fabrication techniques for microfluidic devices, the R2R techniques highlighted in this work offer unparalleled advantages concerning improved scalability, dexterity of seamless handling, and significant cost reduction. Our preliminary evaluation indicated that the foil chips exhibited comparable performance characteristics to the original IM-fabricated devices. This early success in assay translation highlights the promise of implementing biochemical assays on R2R-manufactured foil chips. Most importantly, it underscores the potential utilization of UV-NIL and EC as an alternative to conventional technologies for the future development in vitro diagnostics (IVD) in response to emerging point-of-care testing demands.

The Impact of Antibiotic Therapy on Intestinal Microbiota: Dysbiosis, Antibiotic Resistance, and Restoration Strategies

The human gut microbiota-an intricate and dynamic ecosystem-plays a pivotal role in metabolic regulation, immune modulation, and the maintenance of intestinal barrier integrity. Although antibiotic therapy is indispensable for managing bacterial infections, it profoundly disrupts gut microbial communities. Such dysbiosis is typified by diminished diversity and shifts in community structure, especially among beneficial bacterial genera (e.g., Bifidobacterium and Eubacterium), and fosters antibiotic-resistant strains and the horizontal transfer of resistance genes. These alterations compromise colonization resistance, increase intestinal permeability, and amplify susceptibility to opportunistic pathogens like Clostridioides difficile. Beyond gastrointestinal disorders, emerging evidence associates dysbiosis with systemic conditions, including chronic inflammation, metabolic syndrome, and neurodegenerative diseases, underscoring the relevance of the microbiota-gut-brain axis. The recovery of pre-existing gut communities post-antibiotic therapy is highly variable, influenced by drug spectrum, dosage, and treatment duration. Innovative interventions-such as fecal microbiota transplantation (FMT), probiotics, synbiotics, and precision microbiome therapeutics-have shown promise in counteracting dysbiosis and mitigating its adverse effects. These therapies align closely with antibiotic stewardship programs aimed at minimizing unnecessary antibiotic use to preserve microbial diversity and curtail the spread of multidrug-resistant organisms. This review emphasizes the pressing need for microbiota-centered strategies to optimize antibiotic administration, promote long-term health resilience, and alleviate the disease burden associated with antibiotic-induced dysbiosis.

Eco-sustainable point-of-care devices: Progress in paper and fabric based electrochemical and colorimetric biosensors

Monitoring real-time health conditions is a rinsing demand in a pandemic prone era. Wearable Point-of-Care (POC) devices with paper and fabric-based sensors are emerging as simple, low-cost, portable, and disposable analytical tools for development of green POC devices (GPOCDs). Capabilities of passive fluid transportation, compatibility with biochemical analytes, disposability and high degree of tunability using vivid device fabrication strategies enables development of highly sensitive and economically feasible POC sensors in particularly post COVID-19 pandemic outbreak. Herein we focus mainly on development of biosensors for testing body fluids in the last 5 years using microfluidic technique through electrochemical and colorimetric principle which forms the two most competing sensing techniques providing quantitative and qualitative assessment modalities respectively and forms almost 80 % of the diagnostic platform worldwide. Present review highlights use of these popular substrates as well as various fabrication strategies for realization of GPOCDs ranging from costly and highly sophisticated photolithography to low cost, non conventional techniques like use of correction ink or marker based devices to even novel pop-up/origami induced patterning techniques. Insights into the advancements in colorimetric technique like distance, count or even text based semi-quantitative read-out modality as a on-hand diagnostic information has also been provided. Finally, future outlooks with other interdisciplinary modalities like use of novel materials, incorporation of digital tools like artificial intelligence (AI), machine learning (ML) and strategies for sensitivity and reliability improvement of future GPOCDs have also been discussed.

Green Electrochemical Point-of-Care Devices: Transient Materials and Sustainable Fabrication Methods

The spread of point-of-care (PoC) diagnostic tests using electrochemical sensors poses a significant environmental challenge, especially in limited-resource settings due to the lack of waste management infrastructure. This issue is expected to intensify with the emergence of the Internet of Medical Things (IoMT), necessitating eco-friendly solutions for disposable devices. This review discusses efforts to develop green and sustainable PoC diagnostic devices, clarifying terms like biodegradability and transient electronics. It explores potential transient and biodegradable materials and fabrication technologies, emphasizing sustainable electronics with low-energy consumption and low-carbon footprint techniques, particularly favoring printing methods. The review highlights examples of necessary electronic components containing biodegradable materials for electrochemical PoC devices and discusses their role in device sustainability. Finally, it examines the feasibility of integrating these components and technologies into comprehensive biodegradable PoC devices, addressing the imminent need for eco-friendly solutions in diagnostic testing. This comprehensive discussion serves as a guide for researchers and developers striving to mitigate the environmental impact of PoC testing in the era of IoMT and personalized medicine.

A life cycle assessment approach to minimize environmental impact for sustainable printed sensors

A printed hybrid sensor tag for applications in disposable healthcare and environmental monitoring optimized toward sustainability is presented. Following a systematic Life Cycle Assessment according to ISO 14040:2006 guidelines, the global warming potential associated with various substrate-, electrode-, and sensing materials, as well as manufacturing and end-of-life strategies, are evaluated. Results show that the utilization of bio-based polyethylene and copper inks can minimize the global warming potential most effectively by up to 39% from 42gCO2eq to 25.7gCO2eq per sensor tag. Among manufacturing methods, screen printing coupled with intense pulse light curing emerges as the most eco-efficient combination. Recycling is the most sustainable end-of-life option, although infrastructure challenges impede its full implementation. The silicon sensor chip needed for data communication has been identified as environmental hotspot. This study offers a comprehensive environmental evaluation of sustainable printed sensors and highlights critical challenges and opportunities for the electronics industry, particularly in relation to material selection, recycling strategies, and system-level considerations.

Sustainable biofabrication: from bioprinting to AI-driven predictive methods

Biofabrication is potentially an inherently sustainable manufacturing process of bio-hybrid systems based on biomaterials embedded with cell communities. These bio-hybrids promise to augment the sustainability of various human activities, ranging from tissue engineering and robotics to civil engineering and ecology. However, as routine biofabrication practices are laborious and energetically disadvantageous, our society must refine production and validation processes in biomanufacturing. This opinion highlights the research trends in sustainable material selection and biofabrication techniques. By modeling complex biosystems, the computational prediction will allow biofabrication to shift from an error-trial method to an efficient, target-optimized approach with minimized resource and energy consumption. We envision that implementing bionomic rationality in biofabrication will render bio-hybrid products fruitful for greening human activities.

Bibliometric study of plastics microfluidic chip from 1994 to 2022: A review

Microfluidic tools are widely used in research and manufacturing to manipulate fluids in micrometer channels. These tools are useful for detecting cell cultures, food pathogens, biomedical, energy, and disease. The affordability, versatility, biocompatibility, strength, and transparency of thermoplastics have contributed to its widespread use in the commercialization of microfluidic chips. A bibliometric study of plastic microfluidic chips was conducted using publications from the Scopus database between 1994 and 2022. The study analysed publications based on countries, journals, authorship, and keywords, while VOSviewer software was used for the visualization. Results showed that the United States and China were the most dominant article producers, accounting for almost 50 % of publications. Lab On a Chip was the most active journal, with 22.84 % of its publications involved in microfluidic chips. The network of keywords was coupled and concluded that Polydimethylsiloxane (PDMS), Polymethyl methacrylate (PMMA), Polystyrene (PS), and Cyclic olefin copolymer (COC) benefitted the researchers of microfluidic chips owing to their biocompatibility, durability, optically transparent, and inexpensiveness. By identifying global trends, key materials, and leading contributors in plastic microfluidic chip research, this study offers valuable insights into the most influential countries, leading journals, and primary materials. These insights are instrumental in guiding researchers, manufacturers, and academics in selecting future research directions and better material choices, particularly in the fields of biomedical diagnostics, food safety, and energy solutions.

Impact of Point-of-Care Testing on Diagnosis, Treatment, and Surveillance of Vaccine-Preventable Viral Infections

With the advent of a variety of vaccines against viral infections, there are multiple viruses that can be prevented via vaccination. However, breakthrough infections or uncovered strains can still cause vaccine-preventable viral infections (VPVIs). Therefore, timely diagnosis, treatment, and surveillance of these viruses is critical to patient care and public health. Point-of-care (POC) viral diagnostics tools have brought significant improvements in the detection and management of VPVIs. These cutting-edge technologies enable prompt and accurate results, enhancing patient care by facilitating timely treatment decisions. This review delves into the advancements in POC testing, including antigen/antibody detection and molecular assays, while focusing on their impact on the diagnosis, treatment, and surveillance of VPVIs such as mpox, viral hepatitis, influenza, flaviviruses (dengue, Zika, and yellow fever virus), and COVID-19. The role of POC tests in monitoring viral infection is crucial for tracking disease progression and managing outbreaks. Furthermore, the application of POC diagnostics has shown to be vital for public health strategies. In this review, we also highlight emerging POC technologies such as CRISPR-based diagnostics and smartphone-integrated POC devices, which have proven particularly beneficial in resource-limited settings. We underscore the importance of continued research to optimize these diagnostic tools for wider global use for mpox, viral hepatitis, influenza, dengue, and COVID-19, while also addressing current challenges related to their sensitivity, specificity, availability, efficiency, and more.

A drop dispenser for simplifying on-farm detection of foodborne pathogens

Nucleic-acid biosensors have emerged as useful tools for on-farm detection of foodborne pathogens on fresh produce. Such tools are specifically designed to be user-friendly so that a producer can operate them with minimal training and in a few simple steps. However, one challenge in the deployment of these biosensors is delivering precise sample volumes to the biosensor's reaction sites. To address this challenge, we developed an innovative drop dispenser using advanced 3D printing technology, combined with a hydrophilic surface chemistry treatment. This dispenser enables the generation of precise sample drops, containing DNA or bacterial samples, in volumes as small as a few micro-liters (∼20 to ∼33 μL). The drop generator was tested over an extended period to assess its durability and usability over time. The results indicated that the drop dispensers have a shelf life of approximately one month. In addition, the device was rigorously validated for nucleic acid testing, specifically by using loop-mediated isothermal amplification (LAMP) for the detection of Escherichia coli O157, a prevalent foodborne pathogen. To simulate real-world conditions, we tested the drop dispensers by integrating them into an on-farm sample collection system, ensuring they deliver samples accurately and consistently for nucleic acid testing in the field. Our results demonstrated similar performance to commercial pipettors in LAMP assays, with a limit of detection of 7.8×106 cells/mL for whole-cell detection. This combination of precision, ease of use, and durability make our drop dispenser a promising tool for enhancing the effectiveness of nucleic acid biosensors in the field.

Protists and protistology in the Anthropocene: challenges for a climate and ecological crisis

Eukaryotic microorganisms, or "protists," while often inconspicuous, play fundamental roles in the Earth ecosystem, ranging from primary production and nutrient cycling to interactions with human health and society. In the backdrop of accelerating climate dysregulation, alongside anthropogenic disruption of natural ecosystems, understanding changes to protist functional and ecological diversity is of critical importance. In this review, we outline why protists matter to our understanding of the global ecosystem and challenges of predicting protist species resilience and fragility to climate change. Finally, we reflect on how protistology may adapt and evolve in a present and future characterized by rapid ecological change.

Unlocking the potential of environmentally friendly adsorbent derived from industrial wastes: A review

With increasing urbanization and industrialization, growing amounts of industrial waste, such as red mud (RM), fly ash (FA), blast furnace slag (BFS), steel slag (SS), and sludge, are being produced, exposing substantial threats to the environment and human health. Given that numerous researchers associate with conventional adsorbents, developing and utilizing industrial wastes derived from adsorption technology still has received limited attention. Utilizing this waste contributes to developing alternative materials with superior performance and significantly reduces the volume of solid waste. The excellent physical and chemical characteristics of these wastes are also investigated in this paper. This review attempts to demonstrate a comprehensive overview of the application of industrial waste-based adsorbent in the adsorption process for removing organic pollutants, dyes, metallic ions, non-metallic ions, and radioactive substances. In addition, industrial waste-based adsorbents are among the most promising and applicable techniques for pollutant removal, offering remarkable adsorption efficiency, rich surface chemistries, reasonable cost, simple operation, and low energy consumption. This review summarizes state-of-the-art advancements in engineered adsorbents (including physical and chemical modifications). It provides a holistic view regarding a comprehensive understanding of the mechanism involved in adsorption for water remediation. The challenges and the prospects for future research in applying these adsorbents are also elucidated, contributing to sustainable waste management and environmental sustainability.

Revolutionizing biocatalysis: A review on innovative design and applications of enzyme-immobilized microfluidic devices

Integrating microfluidic devices and enzymatic processes in biocatalysis is a rapidly advancing field with promising applications. This review explores various facets, including applications, scalability, techno-commercial implications, and environmental consequences. Enzyme-embedded microfluidic devices offer advantages such as compact dimensions, rapid heat transfer, and minimal reagent consumption, especially in pharmaceutical optically pure compound synthesis. Addressing scalability challenges involves strategies for uniform flow distribution and consistent residence time. Incorporation with downstream processing and biocatalytic reactions makes the overall process environmentally friendly. The review navigates challenges related to reaction kinetics, cofactor recycling, and techno-commercial aspects, highlighting cost-effectiveness, safety enhancements, and reduced energy consumption. The potential for automation and commercial-grade infrastructure is discussed, considering initial investments and long-term savings. The incorporation of machine learning in enzyme-embedded microfluidic devices advocates a blend of experimental and in-silico methods for optimization. This comprehensive review examines the advancements and challenges associated with these devices, focusing on their integration with enzyme immobilization techniques, the optimization of process parameters, and the techno-commercial considerations crucial for their widespread implementation. Furthermore, this review offers novel insights into strategies for overcoming limitations such as design complexities, laminar flow challenges, enzyme loading optimization, catalyst fouling, and multi-enzyme immobilization, highlighting the potential for sustainable and efficient enzymatic processes in various industries.

BioTrojans: viscoelastic microvalve-based attacks in flow-based microfluidic biochips and their countermeasures

Flow-based microfluidic biochips (FMBs) are widely used in biomedical research and diagnostics. However, their security against potential material-level cyber-physical attacks remains inadequately explored, posing a significant future challenge. One of the main components, polydimethylsiloxane (PDMS) microvalves, is pivotal to FMBs' functionality. However, their fabrication, which involves thermal curing, makes them susceptible to chemical tampering-induced material degradation attacks. Here, we demonstrate one such material-based attack termed "BioTrojans," which are chemically tampered and optically stealthy microvalves that can be ruptured through low-frequency actuations. To chemically tamper with the microvalves, we altered the associated PDMS curing ratio. Attack demonstrations showed that BioTrojan valves with 30:1 and 50:1 curing ratios ruptured quickly under 2 Hz frequency actuations, while authentic microvalves with a 10:1 ratio remained intact even after being actuated at the same frequency for 2 days (345,600 cycles). Dynamic mechanical analyzer (DMA) results and associated finite element analysis revealed that a BioTrojan valve stores three orders of magnitude more mechanical energy than the authentic one, making it highly susceptible to low-frequency-induced ruptures. To counter BioTrojan attacks, we propose a security-by-design approach using smooth peripheral fillets to reduce stress concentration by over 50% and a spectral authentication method using fluorescent microvalves capable of effectively detecting BioTrojans.

Approaching sustainability in Laboratory Medicine

INTRODUCTION

Clinical laboratories and the total testing process are major consumers of energy, water, and hazardous chemicals, and produce significant amounts of biomedical waste. Since the processes in the clinical laboratory and the total testing process go hand in hand it mandates a holistic, and comprehensive approach towards sustainability.

CONTENT

This review article identifies the various sources and activities in Laboratory Medicine that challenge sustainability and also discusses the various approaches that can be implemented to achieve sustainability in laboratory operations to reduce the negative impact on the environment.

SUMMARY

The article highlights how the integration of technological advancements, efficient resource management, staff training and sensitization, protocol development towards sustainability, and other environmental considerations contributes significantly to a sustainable healthcare ecosystem.

OUTLOOK

Variables and resources that negatively impact the environment must be identified and addressed comprehensively to attain a long-lasting level of carbon neutrality.

The social lives of point-of-care tests in low- and middle-income countries: a meta-ethnography

Point-of-care tests (POCTs) have become technological solutions for many global health challenges. This meta-ethnography examines what has been learned about the 'social lives' of POCTs from in-depth qualitative research, highlighting key social considerations for policymakers, funders, developers and users in the design, development and deployment of POCTs. We screened qualitative research examining POCTs in low- and middle-income countries and selected 13 papers for synthesis. The findings illuminate five value-based logics-technological autonomy, care, scalability, rapidity and certainty-shaping global health innovation ecosystems and their entanglement with health systems. Our meta-ethnography suggests that POCTs never achieve the technological autonomy often anticipated during design and development processes. Instead, they are both embedded in and constitutive of the dynamic relationships that make up health systems in practice. POCTs are often imagined as caring commodities; however, in use, notions of care inscribed in these devices are constantly negotiated and transformed in relation to multiple understandings of care. POCTs promise to standardize care across scale, yet our analysis indicates nonstandard processes, diagnoses and treatment pathways as essential to 'fluid technologies' rather than dangerous aberrations. The rapidity of POCTs is constructed and negotiated within multiple distinct temporal registers, and POCTs operate as temporal objects that can either speed up or slow down experiences of diagnosis and innovation. Finally, while often valued as epistemic tools that can dispel diagnostic uncertainty, these papers demonstrate that POCTs contribute to new forms of uncertainty. Together, these papers point to knowledge practices as multiple, and POCTs as contributing to, rather than reducing, this multiplicity. The values embedded in POCTs are fluid and contested, with important implications for the kind of care these tools can deliver. These findings can contribute to more reflexive approaches to global health innovation, which take into account limitations of established global health logics, and recognize the socio-technical complexity of health systems.

Sample preparation and detection methods in point-of-care devices towards future at-home testing

Timely and accurate diagnosis is critical for effective healthcare, yet nearly half the global population lacks access to basic diagnostics. Point-of-care (POC) testing offers partial solutions by enabling low-cost, rapid diagnosis at the patient's location. At-home POC devices have the potential to advance preventive care and early disease detection. Nevertheless, effective sample preparation and detection methods are essential for accurate results. This review surveys recent advances in sample preparation and detection methods at POC. The goal is to provide an in-depth understanding of how these technologies can enhance at-home POC devices. Lateral flow assays, nucleic acid tests, and virus detection methods are at the forefront of POC diagnostic technology, offering rapid and sensitive tools for identifying and measuring pathogens, biomarkers, and viral infections. By illuminating cutting-edge research on assay development for POC diagnostics, this review aims to accelerate progress towards widely available, user-friendly, at-home health monitoring tools that empower individuals in personalized healthcare in the future.

Electrochemical detection of miRNA using commercial and hand-made screen-printed electrodes: liquid biopsy for cancer management as case of study

The growth of liquid biopsy, i. e., the possibility of obtaining health information by analysing circulating species (nucleic acids, cells, proteins, and vesicles) in peripheric biofluids, is pushing the field of sensors and biosensors beyond the limit to provide decentralised solutions for nonspecialists. In particular, among all the circulating species that can be adopted in managing cancer evolution, both for diagnostic and prognostic applications, microRNAs have been highly studied and detected. The development of electrochemical devices is particularly relevant for liquid biopsy purposes, and the screen-printed electrodes (SPEs) represent one of the building blocks for producing novel portable devices. In this work, we have taken miR-2115-3p as model target (it is related to lung cancer), and we have developed a biosensor by exploiting the use of a complementary DNA probe modified with methylene blue as redox mediator. In particular, the chosen sensing architecture was applied to serum measurements of the selected miRNA, obtaining a detection limit within the low nanomolar range; in addition, various platforms were interrogated, namely commercial and hand-made SPEs, with the aim of providing the reader with some insights about the optimal platform to be used by considering both the cost and the analytical performance.

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

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

Magnetically localized and wash-free fluorescent immuno-assay: From a research platform (MLFIA) to a multiplexed POC system (MagIA)

Sexually transmitted infections (STI) remain one of the world's public health priorities: Nearly 400 million people are infected not only in emerging, but also in western countries. HIV, HBV and HCV share common infection pathways; thus these 3 diseases are recommended to be tested at the same time. However, this combined approach is currently mainly available in laboratories, and seldomly at the Point-of-care (POC). Consequently, there is a need for a STI screening POC platform with laboratory-like performance. Such a platform should be autonomous and portable and enable multiplexed screening from capillary blood. The previously developed and introduced MLFIA (Magnetically Localized and wash-free Fluorescent Immuno-Assay) technology has the potential to address these needs, as the MLFIA 18-chamber microfluidic cartridge and the MLFIA Analyzer were previously characterized and evaluated with plasma and serum from patients infected with HIV, Hepatitis B (Hep B) or C (Hep C). Here, we present the efforts to transfer this research platform (MLFIA) to a fully integrated multi-analysis solution (MagIA). First, we present the design changes of the consumable enabling to perform multiple assays in parallel, a fast filling of the cartridge with patient samples, and a homogeneous reagent/sample incubation. Second, we describe the development a piezoelectric actuator integrated into the Analyzer: this mixing module allows for an automated, fully integrated and portable workflow, with homogeneous in-situ mixing capabilities. The obtained MagIA platform was further characterized and validated for immunoassays (LOD, cartridge stability over time), using various biological models including OVA and IgG. We discuss the performances of the MLFIA and MagIA platforms for the detection of HIV / Hep B / Hep C using results from 102 patient plasma samples. Lastly, we assessed the compatibility of the MagIA platform with veinous and capillary blood samples as a final step towards its POC validation.

Point-of-care devices engaging green graphene: an eco-conscious and sustainable paradigm

The healthcare landscape has experienced a profound and irreversible transformation, primarily driven by the emergence of nanomaterial-assisted point-of-care (POC) devices. The inclusion of nanomaterials in POC devices has revolutionized healthcare by enabling rapid, on-site diagnostics with minimal infrastructure requirements. Among the materials poised to lead this technological revolution, green graphene emerges as a compelling contender. It possesses a unique combination of exceptional material properties and environmentally conscious attributes. These attributes include its substantial surface area, unparalleled electrical conductivity, and inherent biocompatibility. This article embarks on an exploration of POC devices incorporating green graphene. It meticulously dissects the intricacies of their design, performance characteristics, and diverse applications. Throughout the exposition, the transformative impact of green graphene on the advancement of POC diagnostics takes centre stage. It underscores the material's potential to drive sustainable and effective healthcare solutions, marking a significant milestone in the evolution of healthcare technology.

Gradient Hydrogels Spatially Trapped Optical Cell Profiling for Quantitative Blood Cellular Osmotic Analysis

The quantitative exploration of cellular osmotic responses and a thorough analysis of osmotic pressure-responsive cellular behaviors are poised to offer novel clinical insights into current research. This underscores a paradigm shift in the long-standing approach of colorimetric measurements triggered by red cell lysis. In this study, we engineered a purpose-driven optofluidic platform to facilitate the goal. Specifically, creating photocurable hydrogel traps surmounts a persistent challenge─optical signal interference from fluid disturbances. This achievement ensures a stable spatial phase of cells and the acquisition of optical signals for accurate osmotic response analysis at the single-cell level. Leveraging a multigradient microfluidic system, we constructed gradient osmotic hydrogel traps and developed an imaging recognition algorithm, empowering comprehensive analysis of cellular behaviors. Notably, this system has successfully and precisely analyzed individual and clustered cellular responses within the osmotic dimension. Prospective clinical testing has further substantiated its feasibility and performance in that it demonstrates an accuracy of 92% in discriminating complete hemolysis values (n = 25) and 100% in identifying initial hemolysis values (n = 25). Foreseeably, this strategy should promise to advance osmotic pressure-related cellular response analysis, benefiting further investigation and diagnosis of related blood diseases, blood quality, drug development, etc.

Low-High-Low Rotationally Pulse-Actuated Serial Dissolvable Film Valves Applied to Solid Phase Extraction and LAMP Isothermal Amplification for Plant Pathogen Detection on a Lab-on-a-Disc

The ability of the centrifugal Lab-on-a-Disc (LoaD) platform to closely mimic the "on bench" liquid handling steps (laboratory unit operations (LUOs)) such as metering, mixing, and aliquoting supports on-disc automation of bioassay without the need for extensive biological optimization. Thus, well-established bioassays, normally conducted manually using pipettes or using liquid handling robots, can be relatively easily automated in self-contained microfluidic chips suitable for use in point-of-care or point-of-use settings. The LoaD's ease of automation is largely dependent on valves that can control liquid movement on the rotating disc. The optimum valving strategy for a true low-cost and portable device is rotationally actuated valves, which are actuated by changes in the disc spin-speed. However, due to tolerances in disc manufacturing and variations in reagent properties, most of these valving technologies have inherent variation in their actuation spin-speed. Most valves are actuated through stepped increases in disc spin-speed until the motor reaches its maximum speed (rarely more than 6000 rpm). These manufacturing tolerances combined with this "analogue" mechanism of valve actuation limits the number of LUOs that can be placed on-disc. In this work, we present a novel valving mechanism called low-high-low serial dissolvable film (DF) valves. In these valves, a DF membrane is placed in a dead-end pneumatic chamber. Below an actuation spin-speed, the trapped air prevents liquid wetting and dissolving the membrane. Above this spin-speed, the liquid will enter and wet the DF and open the valve. However, as DFs take ∼40 s to dissolve, the membrane can be wetted, and the disc spin-speed reduced before the film opens. Thus, by placing valves in a series, we can govern on which "digital pulse" in spin-speeding a reagent is released; a reservoir with one serial valve will open on the first pulse, a reservoir with two serial valves on the second, and so on. This "digital" flow control mechanism allows the automation of complex assays with high reliability. In this work, we first describe the operation of the valves, outline the theoretical basis for their operation, and support this analysis with an experiment. Next, we demonstrate how these valves can be used to automate the solid-phase extraction of DNA on on-disc LAMP amplification for applications in plant pathogen detection. The disc was successfully used to extract and detect, from a sample lysed off-disc, DNA indicating the presence of thermally inactivated Clavibacter michiganensis ssp. michiganensis (Cmm), a bacterial pathogen on tomato leaf samples.

Facile prepared microfluidic chip for multiplexed digital RT-qPCR test

The chip-based digital polymerase chain reaction (PCR) is an indispensable technique for amplifying and quantifying nucleic acids, which has been widely employed in molecular diagnostics at both fundamental and clinical levels. However, the previous designs have yet to achieve widespread application due to limitations in complex chip fabrication, pretreatment procedures, special surface properties, and low throughput. This study presents a facile digital microfluidic chip driven by centrifugal force for digital PCR analysis. Interestingly, regardless of the hydrophilicity or hydrophobicity of the inner chip surface, an efficient digitization process can be achieved. PCR reagents introduced into the inlet can be allocated to 9600 microchambers and subsequently isolated by the immiscible phase (silicone oil). The centrifugal priming approach offers a facile means to achieve high-throughput analysis. The design was further employed for the quantification of nucleic acids using digital PCR. The calculated result exhibited a strong correlation with the measured value at the concentrations from 1 copy/μL to 1000 copies/μL (R2  = 0.99). Additionally, the chip also allowed digital multiplexed analysis, thereby indicating its potential for multi-target detection applications.

Optical imaging for screening and early cancer diagnosis in low-resource settings

Low-cost optical imaging technologies have the potential to reduce inequalities in healthcare by improving the detection of pre-cancer or early cancer and enabling more effective and less invasive treatment. In this Review, we summarise technologies for in vivo widefield, multi-spectral, endoscopic, and high-resolution optical imaging that could offer affordable approaches to improve cancer screening and early detection at the point-of-care. Additionally, we discuss approaches to slide-free microscopy, including confocal imaging, lightsheet microscopy, and phase modulation techniques that can reduce the infrastructure and expertise needed for definitive cancer diagnosis. We also evaluate how machine learning-based algorithms can improve the accuracy and accessibility of optical imaging systems and provide real-time image analysis. To achieve the potential of optical technologies, developers must ensure that devices are easy to use; the optical technologies must be evaluated in multi-institutional, prospective clinical tests in the intended setting; and the barriers to commercial scale-up in under-resourced markets must be overcome. Therefore, test developers should view the production of simple and effective diagnostic tools that are accessible and affordable for all countries and settings as a central goal of their profession.

Emerging trends in nanomaterial design for the development of point-of-care platforms and practical applications

Nanomaterials and nanotechnology offer promising opportunities in point-of-care (POC) diagnostics and therapeutics due to their unique physical and chemical properties. POC platforms aim to provide rapid and portable diagnostic and therapeutic capabilities at the site of patient care, offering cost-effective solutions. Incorporating nanomaterials with distinct optical, electrical, and magnetic properties can revolutionize the POC industry, significantly enhancing the effectiveness and efficiency of diagnostic and theragnostic devices. By leveraging nanoparticles and nanofibers in POC devices, nanomaterials have the potential to improve the accuracy and speed of diagnostic tests, making them more practical for POC settings. Technological advancements, such as smartphone integration, imagery instruments, and attachments, complement and expand the application scope of POCs, reducing invasiveness by enabling analysis of various matrices like saliva and breath. These integrated testing platforms facilitate procedures without compromising diagnosis quality. This review provides a summary of recent trends in POC technologies utilizing nanomaterials and nanotechnologies for analyzing disease biomarkers. It highlights advances in device development, nanomaterial design, and their applications in POC. Additionally, complementary tools used in POC and nanomaterials are discussed, followed by critical analysis of challenges and future directions for these technologies.

Microfluidic paper-based colorimetric quantification of malondialdehyde using silver nanoprism toward on-site biomedical analysis: a new platform for the chemical sensing and biosensing of oxidative stress

Malondialdehyde (MDA) is a critical product of polyunsaturated adipose acid peroxidation and represents a common biomarker of oxidative stress. The effect of different MDA concentrations on human biofluids reflects pathological changes, which has been seen in diverse types of sickness, such as leukemia, diabetes, cancer, cardiovascular disease, and age-related macular degeneration and liver disease. In this study, different types of silver nanoparticles, including silver nanoprism (AgNPrs), silver nanowires (AgNWs), and silver nanospheres (AgNSs), were synthesized and used for the chemosensing of MDA by colorimetric and spectrophotometric methods. Colorimetric tests were performed to identify malondialdehyde in the solution as well as the one-droplet-based microfluidic paper substrate as a miniaturization device for the monitoring of analytes in human real samples. The analytical quantification of the MDA was done using the UV-Vis method. Also, the utilization of the designed chemosensor for the analysis of MDA in real sample was evaluated in human urine samples. Using the spectrophotometric method, MDA was deformed in the linear range of 0.01192 to 1.192 mM with a low limit of quantification of 0.12 μM. Essential significant features of this study include the first application of AgNPrs with high stability and great optical properties without any reagent as an optical sensing probe of MDA and optimized OD-μPCD toward on-site and on-demand MDA screening in real samples diagnosis and the innovative time/color semi-analytical recognition strategy. Moreover, the prepared OD-μPCD decorated by AgNPrs could be a prized candidate for commercialization due to the benefits of the low-cost materials used, like paper and paraffin, and portability. This innovative process led to uniform hydrophilic micro-channels on the surface of cellulose, without the use of a UV lamp, clean room, and organic solvents. This report could be a pioneering work, inspiring simple and effective on-site semi-analytical recognition devices for harmful substances or illegal drugs, which simply consist of a piece of lightweight paper and one drop of the required reagent.

Soft microfiber-based hollow microneedle array for stretchable microfluidic biosensing patch with negative pressure-driven sampling

Wearable point-of-care testing devices are essential for personalized and decentralized healthcare. They can collect biofluid samples from the human body and use an analyzer to detect biomolecules. However, creating an integrated system is challenging due to the difficulty of achieving conformality to the human body, regulating the collection and transport of biofluids, developing a biosensor patch capable of precise biomolecule detection, and establishing a simple operation protocol that requires minimal wearer attention. In this study, we propose using a hollow microneedle (HMN) based on soft hollow microfibers and a microneedle-integrated microfluidic biosensor patch (MIMBP) capable of integrated blood sampling and electrochemical biosensing of biomolecules. The soft MIMBP includes a stretchable microfluidic device, a flexible electrochemical biosensor, and a HMN array made from flexible hollow microfibers. The HMNs are fabricated by electroplating flexible and mechanically durable hollow microfibers made from a nanocomposite matrix of polyimide, a poly (vinylidene fluoride-co-trifluoroethylene) copolymer, and single-walled carbon nanotubes. The MIMBP uses the negative pressure generated by a single button push to collect blood and deliver it to a flexible electrochemical biosensor modified with a gold nanostructure and Pt nanoparticles. We have demonstrated that glucose can be accurately measured up to the molar range in whole human blood collected through the microneedle. The MIMBP platform with HMNs has great potential as a foundation for the future development of simple, wearable, self-testing systems for minimally invasive biomolecule detection. This platform capable of sequential blood collection and high sensitivity glucose detection, which are ideal for personalized and decentralized healthcare.

Material-level countermeasures for securing microfluidic biochips

Flow-based microfluidic biochips (FMBs) have been rapidly commercialized and deployed in recent years for biological computing, clinical diagnostics, and point-of-care-tests (POCTs). However, outsourcing FMBs makes them susceptible to material-level attacks by malicious actors for illegitimate monetary gain. The attacks involve deliberate material degradation of an FMB's polydimethylsiloxane (PDMS) components by either doping with reactive solvents or altering the PDMS curing ratio during fabrication. Such attacks are stealthy enough to evade detection and deteriorate the FMB's function. Furthermore, material-level attacks can become prevalent in attacks based on intellectual property (IP) theft, such as counterfeiting, overbuilding, etc., which involve unscrupulous third-party manufacturers. To address this problem, we present a dynamic material-level watermarking scheme for PDMS-based FMBs with microvalves using a perylene-labeled fluorescent dye. The dyed microvalves show a unique excimer intensity peak under 405 nm laser excitation. Moreover, when pneumatically actuated, the peak shows a predetermined downward shift in intensity as a function of mechanical strain. We validated this protection scheme experimentally using fluorescence microscopy, which showed a high correlation (R2 = 0.971) between the normalized excimer intensity change and the maximum principal strain of the actuated microvalves. To detect curing ratio-based attacks, we adapted machine learning (ML) models, which were trained on the force-displacement data obtained from a mechanical punch test method. Our ML models achieved more than 99% accuracy in detecting curing ratio anomalies. These countermeasures can be used to proactively safeguard FMBs against material-level attacks in the era of global pandemics and diagnostics based on POCTs.

Toward 70% cervical cancer screening coverage: Technical challenges and opportunities to increase access to human papillomavirus (HPV) testing

The World Health Organization (WHO) has called for the elimination of cervical cancer as a public health problem. Cervical cancer screening through human papillomavirus (HPV) testing is a core component of the strategy for elimination, with a set target of screening 70% of women twice in their lifetimes. In this review, we discuss technical barriers and opportunities to increase HPV screening globally.

Paper-based electrochemical biosensors for the diagnosis of viral diseases

Paper-based electrochemical analytical devices (ePADs) have gained significant interest as promising analytical units in recent years because they can be fabricated in simple ways, are low-cost, portable, and disposable platforms that can be applied in various fields. In this sense, paper-based electrochemical biosensors are attractive analytical devices since they can promote diagnose several diseases and potentially allow decentralized analysis. Electrochemical biosensors are versatile, as the measured signal can be improved by using mainly molecular technologies and nanomaterials to attach biomolecules, resulting in an increase in their sensitivity and selectivity. Additionally, they can be implemented in microfluidic devices that drive and control the flow without external pumping and store reagents, and improve the mass transport of analytes, increasing sensor sensitivity. In this review, we focus on the recent developments in electrochemical paper-based devices for viruses' detection, including COVID-19, Dengue, Zika, Hepatitis, Ebola, AIDS, and Influenza, among others, which have caused impacts on people's health, especially in places with scarce resources. Also, we discuss the advantages and disadvantages of the main electrode's fabrication methods, device designs, and biomolecule immobilization strategies. Finally, the perspectives and challenges that need to be overcome to further advance paper-based electrochemical biosensors' applications are critically presented.

Analyzing SDG interlinkages: identifying trade-offs and synergies for a responsible innovation

This paper responds to recent calls to address the indivisible nature of the Sustainable Development Goal (SDG) framework and the related knowledge gap on how SDG targets interlink with each other. It examines how SDG targets interact in the context of a specific technology, point of care (PoC) microfluidics, and how this relates to the concept of responsible innovation (RI). The novel SDG interlinkages methodology developed here involves several steps to filter the relevant interlinkages and a focus group of experts for discussing these interlinkages. The main findings indicate that several social synergies occur when deploying PoC microfluidics, but that the environmental trade-offs may jeopardize the total progress toward the SDGs. More specifically, the environmental sacrifices (use of plastics and lack of recyclability) resulted in the product being cheaper and, thus, better accessible. This work suggests that attention should be given (and prioritized) to the use of renewable and recyclable materials without jeopardizing the accessibility of the product. This should minimize the identified trade-offs. These findings inform how analyzing SDG interlinkages relates to the responsibilities and dimensions of RI in several ways. First, analyzing SDG interlinkages helps to execute the governance responsibility by using the RI dimensions (anticipation, reflexivity, inclusion and responsiveness). Second, analyzing SDG interlinkages gives insights into if and how a technology relates to the do-good and avoid-harm responsibility. This is important to assess the responsiveness of the technology to ensure that the technology can become truly sustainable and leaves no one behind.

Paper-based analytical devices for point-of-need applications

Paper-based analytical devices (PADs) are powerful platforms for point-of-need testing since they are inexpensive devices fabricated in different shapes and miniaturized sizes, ensuring better portability. Additionally, the readout and detection systems can be accomplished with portable devices, allying with the features of both systems. These devices have been introduced as promising analytical platforms to meet critical demands involving rapid, reliable, and simple testing. They have been applied to monitor species related to environmental, health, and food issues. Herein, an outline of chronological events involving PADs is first reported. This work also introduces insights into fundamental parameters to engineer new analytical platforms, including the paper type and device operation. The discussions involve the main analytical techniques used as detection systems, such as colorimetry, fluorescence, and electrochemistry. It also showed recent advances involving PADs, especially combining optical and electrochemical detection into a single device. Dual/combined detection systems can overcome individual barriers of the analytical techniques, making possible simultaneous determinations, or enhancing the devices' sensitivity and/or selectivity. In addition, this review reports on distance-based detection, which is also considered a trend in analytical chemistry. Distance-based detection offers instrument-free analyses and avoids user interpretation errors, which are outstanding features for analyses at the point of need, especially for resource-limited regions. Finally, this review provides a critical overview of the practical specifications of the recent analytical platforms involving PADs, demonstrating their challenges. Therefore, this work can be a highly useful reference for new research and innovation.

Digital transformation and sustainability in healthcare and clinical laboratories

Healthcare, and in particular, clinical laboratories, are major contributors to carbon emissions and waste. Sustainability in healthcare has shifted from an environmental concern towards a holistic definition that includes balancing socio-ecological and socio-technical systems, including health services effectiveness and cost efficiency. Digital transformation can reduce waste and the cost of services by enhancing effectiveness while maintaining quality. Digital health interventions can provide personalized patient-centered care on a global scale and include decision support systems that have the potential to improve the performance and quality of healthcare. The right interfaces must be used so that the advantages of going digital are felt throughout the health system: a successful and sustainable implementation of digital innovation depends on its integration into a functional health ecosystem. Telehealth has the potential to reduce carbon emissions due to the reduced daily commute of health professionals, although research is limited. Recently, economic models have changed from the linear "take-make-dispose" to circular models based on recycling and upcycling that have the goal of keeping products, components, and materials at their highest utility and value. The previous linear models threaten human health and well-being and harm natural ecosystems.

Lessons from COVID-19 for improving diagnostic access in future pandemics

Throughout the COVID-19 pandemic, we have witnessed the critical and expanding roles of testing. Despite the development of over a thousand brand of tests - with some close to fulfilling the 4As (accuracy, access, affordability, and actionability via quick time to result) of an ideal diagnostic test - gaps persisted in developing tests to fit public health needs, and in providing equitable access. Here, we review how the use cases for testing evolved over the course of the COVID-19 pandemic, with associated engineering challenges (and potential lessons) at each phase for test developers. We summarise lessons learnt from the recent epidemic and propose four areas for future cooperative effort among test developers, government regulators and policy makers, public health experts, and the public: 1) develop new models for public sector funding and research and development; 2) increase testing capacity by investing in adaptable open-platform technologies at every level of the healthcare system; 3) build data connectivity infrastructures to support a connected diagnostic system as a backbone for surveillance; and 4) facilitate the rapid translation of innovation into use through a coordinated framework for regulatory approval and policy development.

Plant pathogen detection on a lab-on-a-disc using solid-phase extraction and isothermal nucleic acid amplification enabled by digital pulse-actuated dissolvable film valves

By virtue of its ruggedness, portability, rapid processing times, and ease-of-use, academic and commercial interest in centrifugal microfluidic systems has soared over the last decade. A key advantage of the LoaD platform is the ability to automate laboratory unit operations (LUOs) (mixing, metering, washing etc.) to support direct translation of 'on-bench' assays to 'on-chip'. Additionally, the LoaD requires just a low-cost spindle motor rather than specialized and expensive microfluidic pumps. Furthermore, when flow control (valves) is implemented through purely rotational changes in this same spindle motor (rather than using additional support instrumentation), the LoaD offers the potential to be a truly portable, low-cost and accessible platform. Current rotationally controlled valves are typically opened by sequentially increasing the disc spin-rate to a specific opening frequency. However, due lack of manufacturing fidelity these specific opening frequencies are better described as spin frequency 'bands'. With low-cost motors typically having a maximum spin-rate of 6000 rpm (100 Hz), using this 'analogue' approach places a limitation on the number of valves, which can be serially actuated thus limiting the number of LUOs that can be automated. In this work, a novel flow control scheme is presented where the sequence of valve actuation is determined by architecture of the disc while its timing is governed by freely programmable 'digital' pulses in its spin profile. This paradigm shift to 'digital' flow control enables automation of multi-step assays with high reliability, with full temporal control, and with the number of LUOs theoretically only limited by available space on the disc. We first describe the operational principle of these valves followed by a demonstration of the capability of these valves to automate complex assays by screening tomato leaf samples against plant pathogens. Reagents and lysed sample are loaded on-disc and then, in a fully autonomous fashion using only spindle-motor control, the complete assay is automated. Amplification and fluorescent acquisition take place on a custom spin-stand enabling the generation of real-time LAMP amplification curves using custom software. To prevent environmental contamination, the entire discs are sealed from atmosphere following loading with internal venting channels permitting easy movement of liquids about the disc. The disc was successfully used to detect the presence of thermally inactivated Clavibacter michiganensis. Michiganensis (CMM) bacterial pathogen on tomato leaf samples.

Hand-Powered Point-of-Care: Centrifugal Microfluidic Platform for Urine Routine Examination (μCUREX)

Urinalysis is one of the simplest and most common medical tests in modern cities. With the assistance of professional technicians and equipment, people in metropolitan areas can effortlessly acquire information about their physiological conditions from traditional clinical laboratories. However, the threshold, including precise benchtop equipment and well-trained personnel, still remains a considerable dilemma for residents in healthcare-poor areas. Hence, it is a crucial and urgent topic to develop a smart and affordable widget to address this challenge. To improve the healthcare rights of residents, we proposed a disposable centrifugal microfluidic urine routine examination platform (named μCUREX) actuated with a modified hand-powered fan. Two parts of urinalysis (sediment test and chemical strip test) were integrated into the μCUREX disc. The influence on sedimentation by variant hand-powered manipulation was simulated using COMSOL. As a result, more than 70% of the sediment can be collected. Moreover, the color change of chemical strip papers (indicators for glucose, pH, protein, and occult blood) was recorded with a 3D-printed studio and analyzed after reaction with chemical-spiked and pH-adjusted artificial and human urine specimens. The whole process can be completed within 10 min, with only 200 μL of urine needed. In conclusion, we successfully constructed an ultra-low-cost point-of-care platform for urinalysis in extremely resource-poor settings. The handy size, high affordability, and user-friendliness of the μCUREX disc provide strong potential and feasibility in solving problems in resource-poor settings. Furthermore, we highly expect the μCUREX platform to improve the level of healthcare in resource-limited areas.

A microfluidic finger-actuated blood lysate preparation device enabled by rapid acoustofluidic mixing

For many blood-based diagnostic tests, including prophylactic drug analysis and malaria assays, red blood cells must be lysed effectively prior to their use in an analytical workflow. We report on a finger-actuated blood lysate preparation device, which utilises a previously reported acoustofluidic micromixer module. The integrated device includes a range of innovations from a sample interface, to the integration of blisters on a laser engraved surface and a large volume (130 μL) one-stroke manual pump which could be useful in other low-cost microfluidic-based point-of-care devices. The adaptability of the acoustic mixer is demonstrated on highly viscous fluids, including whole blood, with up to 65% percent volume fraction of red blood cells. Used in conjunction with a lysis buffer, the micromixer unit is also shown to lyse a finger-prick (approximately 20 μL) blood sample in 30 seconds and benchmarked across ten donor samples. Finally, we demonstrate the ease of use of the fully integrated device. Cheap, modular, but reliable, finger-actuated microfluidic functions could open up opportunities for the development of diagnostics with minimal resources.

A review of cardiac troponin I detection by surface enhanced Raman spectroscopy: Under the spotlight of point-of-care testing

Cardiac troponin I (cTnI) is a biomarker widely related to acute myocardial infarction (AMI), one of the leading causes of death around the world. Point-of-care testing (POCT) of cTnI not only demands a short turnaround time for its detection but the highest accuracy levels to set expeditious and adequate clinical decisions. The analytical technique Surface-enhanced Raman spectroscopy (SERS) possesses several properties that tailor to the POCT format, such as its flexibility to couple with rapid assay platforms like microfluidics and paper-based immunoassays. Here, we analyze the strategies used for the detection of cTnI by SERS considering POCT requirements. From the detection ranges reported in the reviewed literature, we suggest the diseases other than AMI that could be diagnosed with this technique. For this, a section with information about cardiac and non-cardiac diseases with cTnI release, including their release kinetics or cut-off values are presented. Likewise, POCT features, the use of SERS as a POCT technique, and the biochemistry of cTnI are discussed. The information provided in this review allowed the identification of strengths and lacks of the available SERS-based point-of-care tests for cTnI and the disclosing of requirements for future assays design.