Portable Point-of-care Testing Research Articles

Drip-Dry Strategy Assisted Blu-Ray Disc Biosensor for Fast Point of Care Testing.

Discs and numerous other consumer products have been developed for point of care testing (POCT) to replace traditional large and expensive biochemical devices in certain scenarios. Herein, we propose a drip-dry strategy (2D strategy) assisted Blu-ray disc (BD) biosensor, termed BDB, for rapid and portable POCT within 30 min with the cost of a single test < $1. The platform utilizes the covered area formed by the deposition of the substance to be measured on the activated BD surface after the evaporation of water and realizes the quantitative detection of the target through the error readout of free disc quality diagnosis software. As a proof of concept, we first demonstrated the feasibility of direct quantitative detection of substances in solution in a single system through the detection of pure proteins avoiding colorimetric reagent used in traditional optical detection. For the complex mixed systems, we then innovatively utilize the principle that soluble targets promote/inhibit the dissolution of insoluble precipitates to achieve specific detection of targets and successfully apply BDB to the indirect quantitative detection of glutathione (GSH) with LOD of 0.447 mM in the range of 2-16 mM and organophosphorus pesticides (OPs) with LOD of 2.122 × 10-7 M in the range of 1.289 × 10-7-1.289 × 10-4 M. The BDB is widely applicable, easy to operate, and less time-consuming, which is anticipated to provide an alternative method for early, on-site detection or screening.

Development of an immunochromatographic strip for the rapid detection of 11-dehydro-thromboxane B2 in human urine

Urinary 11-dehydro-thromboxane B2 (11-DH-TXB2) is a diagnostic marker for evaluating the effect of aspirin treatment in patients with cardiovascular disease. Therefore, it is of great clinical significance to develop a rapid detection method for 11-DH-TXB2 in urine. In this study, we prepared an ultrasensitive monoclonal antibody (mAb) against 11-DH-TXB2. The mAb belongs to the IgG1 subtype with kappa light chains. In an indirect competitive ELISA, it had a half-maximal inhibitory concentration of 3.63 ng/mL and a high affinity of 5.60 × 109 L/mol for 11-DH-TXB2. We then developed an immunochromatographic strip for point-of-care testing (POCT) of 11-DH-TXB2 in human urine. The strip provides a cut-off value and limit of detection of 500 ng/mL and 31.2 ng/mL, respectively. The result is obtained within 15 min. In summary, the proposed strip is a portable POCT tool for monitoring 11-DH-TXB2 in human urine.

Nanoengineered plasmonics-enhanced photothermal tags for sensitive detection of cardiac biomarker troponin I using lateral flow immunoassay

In recent years, photothermal lateral flow immunoassay (LFIA) has gained widespread use as a point-of-care testing (POCT) technique because of its cost-effective portable instrumentation and easy-to-handle procedures. However, developing a highly sensitive photothermal LFIA platform with high photothermal efficiency remains challenging. In this study, we developed a portable smartphone-based plasmonics-enhanced photothermal LFIA (PPh-LFIA) platform to improve the photothermal LFIA sensitivity by engineering plasmonic-active gold nanostars (GNS) having large-sized sharp branches. We investigated the photothermal effect using various GNS engineered to have different sizes and spike lengths of GNSs (GNS-1, GNS-2, GNS-3, and GNS-4) in order to exhibit optimal plasmonics properties. The results showed that the GNS-3 having a broad plasmon band with a plasmon maximum band at 995 nm exhibited the strongest photothermal efficiency (80 %). As a proof-of demonstration, we have employed GNS-3 for the detection of the cardiac biomarker, troponin I (cTnI), used as the model system. The results show high sensitivity with a detection limit (LOD) of 5.5 pg/mL, which was around 1000 times more sensitive than traditional colorimetric LFIA based on gold nanospheres (GNSP). To verify the applicability of the PPh-LFIA platform, cTnI was spiked into human blood serum samples, enabling the detection of cTnI with an LOD of 6.7 pg/mL. Overall, this study offers insights for nanoengineering and fine-tuning the GNS morphology to increase the photothermal efficiency, consequently improving the PPh-LFIA detection sensitivity, which makes it suitable for use as a sensitive and portable POCT tool.

CRISPR/Cas12a-Responsive Hydrogels for Conjugation-Free and Universal Indicator Release in Colorimetric Detection.

Recent advances have demonstrated the significant potential and advantages to repurpose existing point-of-care reactions/devices to realize portable detection of nonoriginal targets, e.g., pathogen genes. However, pursuing this aim usually requires protein indicator-nucleic acid conjugation via a covalent bond, which may bring drawbacks such as high cost, complicated procedure, and annoying component rebuilding. Herein, we developed a conjugation-free, effective, and universal detection platform called CRIs-gel (CRISPR/Cas12a-Responsive Indicators@RCA hydrogels). Various protein indicators are pre-encapsulated into the hydrogels made of effective and high-yield rolling circle amplification (RCA). Upon a targeting sequence binding with its antisense crRNA, CRISPR/Cas12a starts its trans-cleavage activity to crush the hydrogel, which may directly release the indicator for downstream readout. Two proteins, amylase (GA) and human chorionic gonadotropin (hCG), are successfully used as model indicators to trigger the downstream amylum-I2 color change and pregnancy test strip response. After coupling with upstream isothermal nucleic acid amplification, both portable readouts may detect as few as 2 copies/μL genetic sequences of influenza A virus (FluA), human papilloma virus (HPV), SARS-CoV-2, and influenza B virus (FluB). This conjugation-free CRIs-gel platform is thus simple, sensitive, and universal and can provide innovative insights for portable point-of-care testing (POCT) development.

A portable point-of-care testing device for forward blood typing with hemophilia diagnosis.

This paper presents a portable point-of-care testing (POCT) device to conduct simultaneous and on-site tests of ABO and Rh(D) forward blood typing and hemophilia diagnosis using only a small amount of human whole blood sample. The POCT device consisted of a spinning module, a measuring circuit, an interdigitated electrode (IDE) for hemophilia diagnosis, and three disposable microfluidic chips for bioassays with anti-A, anti-B, and anti-D, respectively, and measurement of the concentration of factor VIII. Agglutination will occur if red blood cells (RBCs) are exposed to the corresponding antibody. To evaluate the degree of RBC agglutination, a linear sweep voltage, ranging from - 0.5 to + 0.5V, was applied to the electrodes of the microfluidic chip and the resulting current was measured. For different levels of agglutination, the measured I-V curves were explicitly discriminated, providing five clinical levels from non-agglutination (level 0) to strong agglutination (level 4). The quantitative norm obtained from cubic fitting function of each I-V curve served as the criterion to represent this agglutination level. The ABO blood type was determined by both agglutination levels of the blood sample reacting with anti-A and anti-B. The degree of agglutination with anti-D gave the Rh(D) type. Moreover, the concentration of factor VIII was detected for the determination of hemophilia. Without requiring expensive equipment, this POCT device is especially suitable for usage in emergency or natural disasters to provide quantitative testing in rescue and relief operations.

Methods for detecting of cardiac troponin I biomarkers for myocardial infarction using biosensors: a narrative review of recent research.

In cardiovascular diseases (CVDs), acute myocardial infarction (AMI) is considered one of the leading causes of human death, and its diagnosis mainly relies on the detection of the cardiac biomarker troponin I. Traditional detection methods have certain limitations, which has prompted the development of methods with higher sensitivity and specificity. In recent years, biosensors, as an emerging technology, have been widely applied in the clinical medicine and biodetection fields. We retrieved and reviewed relevant articles published over the past 3 years and subsequently summarized the research progress of different types of biosensors in detecting cardiac troponin I and the challenges faced in achieving simple, specific, and portable point-of-care testing (POCT) technology for bedside rapid detection. The aim of this review is to serve as reference for the early diagnosis and treatment of CVDs. This study searched for relevant literature published from 2019 to 2022 in the PubMed database of the National Center for Biotechnology Information (NCBI). The keywords used were as follows: "cardiac troponin I", "biosensor", "point-of-care testing", "electrochemical detection", and "surface-enhanced Raman spectroscopy". The review found that biosensor technology has high specificity and sensitivity in the detection of cardiac troponin I and is simpler and more convenient than is traditional laboratory testing. Its vigorous development can facilitate the diagnosis of AMI earlier and faster. This study reviewed the progress of cardiac troponin I detection based on biosensing strategies. We found that cardiac troponin I detection methods based on biosensing strategies have their own advantages and disadvantages in clinical applications, and their sensitivity has been constantly improved. In the future, the detection of cardiac troponin I using biosensing technology will be simpler, faster, more sensitive, and portable.

Flexible Point-of-Care Electrodes for Ultrasensitive Detection of Bladder Tumor-Relevant miRNA in Urine.

Portable point-of-care testing (POCT) is currently drawing enormous attention owing to its great potential for disease diagnosis and personal health management. Electrochemical biosensors, with the intrinsic advantages of cost-effectiveness, fast response, ease of miniaturization, and integration, are considered as one of the most promising candidates for POCT application. However, the clinical application of electrochemical biosensors-based POCT is hindered by the decreased detection sensitivity due to the low abundance of disease-relevant biomolecules in extremely complex biological samples. Herein, we construct a flexible electrochemical biosensor based on single-stranded DNA functionalized single-walled carbon nanotubes (ssDNA-SWNTs) for high sensitivity and stability detection of miRNA-21 in human urine to achieve bladder cancer (BCa) diagnosis and classification. The ssDNA-SWNT electrodes with a 2D interconnected network structure exhibit a high electrical conductivity, thus enabling the ultrasensitive detection of miRNA-21 with a detection limit of 3.0 fM. Additionally, the intrinsic flexibility of ssDNA-SWNT electrodes endows the biosensors with the capability to achieve high stability detection of miRNA-21 even under large bending deformations. In a cohort of 40 BCa patients at stages I-III and 44 negative control samples, the constructed ssDNA-SWNT biosensors could detect BCa with a 92.5% sensitivity, an 88.6% specificity, and classify the cancer stages with an overall accuracy of 81.0%. Additionally, the flexible ssDNA-SWNT biosensors could also be utilized for treatment efficiency assessment and cancer recurrence monitoring. Owing to their excellent sensitivity and stability, the designed flexible ssDNA-SWNT biosensors in this work propose a strategy to realize point-of-care detection of complex clinical samples to achieve personalized healthcare.

Point of care testing (POCT) of cholesterol in blood serum via a moving reaction boundary electrophoresis titration chip.

Cholesterol (CHO) in human blood is one of the most frequently and crucially quantified substances in diagnostic laboratories. However, visual and portable point of care testing (POCT) methods have been rarely developed for the bioassay of CHO in blood samples. Here, we developed an electrophoresis titration (ET) model, a chip device of ∼60 grams, and a quantification method for the POCT of CHO in blood serum based on a moving reaction boundary (MRB). In this model, the selective enzymatic reaction is integrated with an ET chip for visual and portable quantification. At first, CHO reacted with cholesterol oxidase (CHOx) in the anode well, producing H2O2 and cholest-4-en-3-one in the solution. H2O2 further oxidized the colorless and chargeless leucocrystal violet (LCV) dye into violet colored positively charged crystal violet (CV+) and, under the influence of the electric field, the CV+ migrates in the ET channels and is titrated by the alkali of sodium hydroxide immobilized in the ET channels. The length covered by the MRB was measured as a function of the CHO content. The relevant experiments validated the feasibility of the model and method. Furthermore, the experiments revealed the high selectivity, portability, and visuality of the ET-MRB model, device, and method. Finally, the experiments showed a fair sensitivity of LOD of 5 μM, good linearity of 10-1000 μM (r2 = 0.9919), fair stability (intra-day RSD of less than 5.09% and an inter-day RSD of less than 6.36%), and high recovery (99.4-105%). All the data and results indicate the potential of the ET-MRB model, chip device, and method for POCT of CHO in human blood samples.

Weak light photodetector based on upconversion luminescence for glutathione detection

Through simple refitting, the weak light photodetector can be used for highly sensitive detection of upconversion luminescence (UCL) signal of NaYF4:Yb/Er upconversion nanoparticles (UCNPs). Here, based on UCL quenching mechanism of the inner-filter effect (IFE) between UCNPs and MnO2 nanosheet, a simple label-free biosensor is designed for selective detection of glutathione (GSH). Based on the merit of low background and high response, the photodetector shows excellent stability and sensitivity, with a linear range of 0.1–100 μM and a detection limit of 41 nM. Furthermore, the photodetector only requires low-dose UCNPs to be suitable for detection of the clinical samples. Through the miniaturization of the photodetector, it is expected that a portable point-of-care testing (POCT) device based on UCL will be built in the future to realize fast and highly sensitive liquid biopsy.

Tetrahedral DNA framework based CRISPR electrochemical biosensor for amplification-free miRNA detection

microRNA (miRNA) is a kind of small non-coding RNA that has been regarded as potential biomarkers for cancers. Sensitive and specific detection of miRNA at low expression levels is highly desirable but remains challenging, especially for amplification-free and portable point of care (POC) diagnostics. The clustered regularly interspaced short palindromic repeats (CRISPR)/Cas13a has been recently discovered and used in the field of RNA detection. Nonetheless, most CRISPR/Cas13a-based methods were burdened with expensive equipment, time-consuming procedures, and complicated operations which were not suitable for POC analysis. In this work, we constructed a three-dimensional tetrahedral DNA framework based CRISPR-electrochemical biosensor (CRISPR-E). By combining tetrahedral DNA framework, CRISPR, and electrochemical biosensor, the process of activation, cleavage of Cas13a, and signal readout were all finished on the chip, and a simple, amplification-free and sensitive detection of miRNA-19b was realized. Under the optimal experimental conditions, a linear range from 10 pM to 104 pM with detection limit of 10 pM for miRNA-19b in buffer solution was achieved. Selectivity analysis indicated that our CRISPR-E had good distinguishing ability between miRNA-19b and miRNA-197. The results of miRNA-19b detection in mimic serum samples were consistent with that of the buffer solution. This all-on-chip strategy of our CRISPR-E is very suitable for POC testing.

Lab-on-cloth integrated with a photoelectrochemical cell and ion imprinting for point-of-care testing of Hg(Ⅱ)

In this work, we successfully developed a cloth-based device integrated with a photoelectrochemical (PEC) cell and ion imprinting for point-of-care testing (POCT) of divalent mercury ions (Hg(Ⅱ)). PEC cells have increasingly emerged as promising power supply units in recent years. The CdS/ZnS core-shell quantum dots (QDs) are used in the PEC cell, because they improve the spatial separation and transfer of charge and broaden the absorption of visible light. Ion imprinting can identify a specific metal ion selectively in the presence of other interfering ions. To achieve noninterference identification, the QDs-based PEC cell region is isolated from the ion imprinting-based detection area. In addition, wax screen-printing can be used in conjunction with carbon ink screen-printing for economical and facile fabrication of cloth-based devices. Under optimized conditions, Hg(Ⅱ) can be determined over the range of 0.0005–5 mg/L, with a detection limit of 0.090 µg/L (i.e., 0.45 nM). The proposed cloth-based devices are also applied successfully for the detection of Hg(Ⅱ) in sweat, complex water and food samples, with recoveries of 98.2–116.1% and relative standard deviations (RSDs) of 1.2–13.9%. Additionally, cloth-based devices have acceptable storage stability and selectivity. Therefore, the presented method offers a sensitive, low-cost, portable POCT device and has the potential to be applied for human body, environmental and food monitoring in remote areas and developing or industrialized countries.

Aptamer-engineered extended-gate field-effect transistor device for point-of-care therapeutic drug monitoring.

Herein, we report a portable point-of-care testing (POCT) device based on an aptamer-engineered extended-gate field-effect transistor (EG-FET) for therapeutic monitoring of the drug methotrexate. This method was shown to be highly sensitive, efficient, and convenient to use, features contributing to its realizing a clinical detection of drugs in blood.

Clozapine point of care testing in acute psychiatry: A precision approach to treatment resistant psychosis

IntroductionClozapine, the antipsychotic of choice for treatment-resistant schizophrenia, has a narrow therapeutic range and high interpatient variability in the dose-response relationship. Serum clozapine levels are essential both for therapeutic dosing and to monitor adherence. Use of venepuncture and prolonged result turnaround times with standard laboratory based methods for drug monitoring together contribute to the suboptimal use of clozapine.ObjectivesA novel portable point-of-care (POC) device has been developed to measure whole blood clozapine concentrations using an automated homogenous immunoassay. It is as accurate and reliable as standard laboratory methods but only requires a drop of blood obtained by finger prick and can produce a result in minutes. We pioneered clozapine POC testing in the acute inpatient setting during the outbreak of the COVID-19 pandemic.MethodsWe report on the use of POC clozapine testing in the management of 4 acutely psychotic patients with treatment resistant schizophrenia.ResultsPOC testing offered a more practical, less invasive and quicker alternative to conventional methods for monitoring of clozapine levels. Near immediate availability of clozapine levels expedited clinical decisions and helped ensure safe clozapine prescribing to severely unwell patients in a time of crisis. By facilitating patients’ early safe discharge from hospital, clozapine point of care testing also reduced length of hospitalisation.ConclusionsPoint of care monitoring of other psychotropic medications in addition to clozapine brings about the prospect of personalised precision medicine for patients with severe mental illness, both in the acute setting and in the community.

Pressure-Based Bioassay Perceived by a Flexible Pressure Sensor with Synergistic Enhancement of the Photothermal Effect.

An effective signal amplification strategy based on temperature-amplification synergistic pressure was designed for the sensitive detection of carcinoembryonic antigen (CEA) by using a noncontact point-of-care testing (POCT) aptasensor with a flexible pressure sensor based on a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS)-modified sponge (PEDOT:PSS-sponge). In the biological recognition system, target analyte triggered the release of platinum nanoparticle-labeled complementary DNA (Pt-cDNA) from CEA aptamer-conjugated magnetic beads. On the basis of the unique characteristics of platinum nanoparticles (e.g., catalytic ability for H2O2 decomposition, peroxidase-like catalytic activity, and photothermal characteristics), the platinum nanoparticles (PtNPs) could not only catalyze hydrogen peroxide (H2O2) to produce a large amount of oxygen (O2) but could also assist the oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) to a photothermal agent ox-TMB with the increasing temperature. Under 808 nm near-infrared (NIR) laser irradiation, an increase in the pressure and temperature occurred simultaneously in the closed detection cell. Meanwhile, the increasing temperature could be helpful for further increasing the pressure. The flexible pressure sensor was compressed in a closed system to cause a decrease in contact resistance, thereby establishing a correlation between the concentration and the resistance-readable analysis. Under optimum conditions, the dynamic detection range of this detection strategy for target CEA was between 0.2 and 80 ng mL-1, and the limit of detection (LOD) was 0.15 ng mL-1. Overall, the signal amplification strategy of temperature coordination provides possibilities for the future development of sensitive and portable POCT protocols.

DNA Tetrahedra-Cross-linked Hydrogel Functionalized Paper for Onsite Analysis of DNA Methyltransferase Activity Using a Personal Glucose Meter.

Despite the recent developments on the construction of point-of-care testing (POCT) devices, it is still a big challenge to build portable POCT tools for simple, sensitive, selective, and quantitative determination of disease-related biomarkers. With this in mind, we developed a simple and user-friendly POCT tool for onsite analysis of DNA adenine methyltransferase (Dam) activity by using DNA tetrahedra-based hydrogel to trap glucose-producing enzymes for target recognition and signal transduction. The enzyme-encapsulated DNA hydrogel and the substrate of enzyme were separately modified on papers and then combined onto a commercial glucose test strip for the sensitive evaluation of Dam activity via using a personal glucose meter (PGM) for quantitative signal readout. Taking advantage of the great amount of enzyme entrapped in DNA hydrogel and the high signal amplification ability of enzyme, this POCT tool is capable of highly sensitive and selective determination of Dam activity with a direct detection limit down to 0.001 U/mL, which is superior to that of most previously reported biosensors. Furthermore, this device can also be applied to screen inhibitor and analyze Dam activity in spiked serum samples, indicating the great potential for clinical practice and diagnostic applications. Additionally, all the reactions for Dam assay are performed on paper, which is simple and deliverable to end-users for medical diagnostics at home or in-field.

Albuminuria detection using graphene oxide-mediated fluorescence quenching aptasensor

A simple and sensitive graphene oxide-mediated fluorescence quenching aptasensor is developed to quantify albuminuria in urine samples. The developed aptasensor used the specific target binding property of aptamer and fluorescence quenching property of graphene oxide to determine the concentration of human serum albumin in urine. The limit of detection of the developed platform is 0.05 µg.mL−1 and the detection range is 0.1–600 µg.mL−1, which covers the albuminuria concentration range present in normal human urine and the urine of the patient with chronic kidney disease. This approach can be modified to measure albuminuria using a high-throughput quantification platform and portable point of care testing. In addition, the production cost for one reaction is cheaper than those for the standard automated method. Therefore, this aptasensor has significant potential for commercialization and public use.•Our protocol is customized by using the fluorescence quenching property of graphene oxide and specific binding property of human serum albumin aptamer to detect human serum albumin in urine sample•The limit of detection of our developed platform is 0.05 µg.mL−1•The detection range of our aptasensor is 0.1–600 µg.mL−1

The Era of Digital Health: A Review of Portable and Wearable Affinity Biosensors

AbstractDigital health facilitated by wearable/portable electronics and big data analytics holds great potential in empowering patients with real‐time diagnostics tools and information. The detection of a majority of biomarkers at trace levels in body fluids using mobile health (mHealth) devices requires bioaffinity sensors that rely on “bioreceptors” for specific recognition. Portable point‐of‐care testing (POCT) bioaffinity sensors have demonstrated their broad utility for diverse applications ranging from health monitoring to disease diagnosis and management. In addition, flexible and stretchable electronics‐enabled wearable platforms have emerged in the past decade as an interesting approach in the ambulatory collection of real‐time data. Herein, the technological advancements of mHealth bioaffinity sensors evolved from laboratory assays to portable POCT devices, and to wearable electronics, are synthesized. The involved recognition events in the mHealth affinity biosensors enabled by bioreceptors (e.g., antibodies, DNAs, aptamers, and molecularly imprinted polymers) are discussed along with their transduction mechanisms (e.g., electrochemical and optical) and system‐level integration technologies. Finally, an outlook of the field is provided and key technological bottlenecks to overcome identified, in order to achieve a new sensing paradigm in wearable bioaffinity platforms.

A microfluidic colorimetric immunoassay for sensitive detection of altenariol monomethyl ether by UV spectroscopy and smart phone imaging

A novel microfluidic colorimetric immunoassay was developed using gold nanoparticles (GNPs) for indicating different concentrations of altenariol monomethyl ether (AME), and UV spectroscopy and smart phone imaging for monitoring color change of the GNPs. Norland Optical Adhesive 81 (NOA 81) was used for simple and rapid fabrication of the microfluidic chip. AME-BSA modified magnetic nanoparticles (MNPs-BSA-AME) were used as capture probe and the self-magnetism for rapid separation and purification. AME monoclonal antibodies modified gold nanoparticles (GNP-mAbs) which dried on conjugate pad were used as detection probe and the self-catalyst for signal amplification. Under the optimal conditions, the proposed microfluidic colorimetric immunoassay was able to detect AME as low as 12.5 pg/mL for UV spectroscopy (574 nm), and 200 pg/mL for smart phone imaging. The total analysis time is less than 15 min. The immunoassay also has a lower cross-reactivity to AME analogues. It was also evaluated by analyzing fruit samples spiked with AME. The recoveries ranged from 91.19% to 94.15% for UV spectroscopy, and from 90.63% to 93.9% for smart phone imaging. This method can be used for rapid, sensitive, low-cost and portable point-of care testing (POCT) of other mycotoxins or haptens in food samples.

Development of a "Dual Gates" Locked, Target-Triggered Nanodevice for Point-of-Care Testing with a Glucometer Readout.

Developing a facile and sensitive sensing platform is of importance for point-of-care testing (POCT). Herein, a sensitive and portable POCT platform based on "dual gates" aminated magnetic mesoporous silica nanocomposites (AMMS) bearing polydopamine (PDA)-aptamer (Apt) two-tier shells, as a novel nanodevice, is designed for target detection through a target-triggered glucose (GO) release from AMMS with personal glucometer (PGM) readout. In the absence of target, GO can be firmly captured in pores by the designed "dual gates", which would decrease the high background signal of this system and ensure the accuracy of the detection results. Upon the introduction of the target molecules under acidic conditions (pH 5.5), the subsequent PDA self-degradation and the specific Apt-target reaction can cause the departure of "dual gates" and the opening of pores to release the loaded GO molecules, which could be quantitatively monitored by a portable PGM. It has been demonstrated that such POCT platform shows high sensitivity and excellent selectivity for aflatoxin B1 (AFB1) detection, accompanied by the well-presented reproducibility and stability. Importantly, this sensing platform was further validated by assaying contaminated samples, where the obtained results were well matched with that by HPLC. Regarding the features of portability, high sensitivity, and high throughput detection, the developed platform might find wide applications in POCT.

Reliability of Point-of-Care Testing of INR in Acute Stroke

In the emergency department, portable point-of-care testing (POCT) coagulation devices may facilitate stroke patient care by providing rapid International Normalized Ratio (INR) measurement. The objective of this study was to evaluate the reliability, validity, and impact on clinical decision-making of a POCT device for INR testing in the setting of acute ischemic stroke (AIS). A total of 150 patients (50 healthy volunteers, 51 anticoagulated patients, 49 AIS patients) were assessed in a tertiary care facility. The INR's were measured using the Roche Coaguchek S and the standard laboratory technique. The interclass correlation coefficient and 95% confidence interval between overall POCT device and standard laboratory value INRs was high (0.932 (0.69 - 0.78). In the AIS group alone, the correlation coefficient and 95% CI was also high 0.937 (0.59 - 0.74) and diagnostic accuracy of the POCT device was 94%. When used by a trained health professional in the emergency department to assess INR in acute ischemic stroke patients, the CoaguChek S is reliable and provides rapid results. However, as concordance with laboratory INR values decreases with higher INR values, it is recommended that with CoaguChek S INRs in the > 1.5 range, a standard laboratory measurement be used to confirm the results.