Portable Biosensors and Point-of-Care Systems
Portable Biosensors and Point-of-Care Systems describes the principles, design and applications of a new generation of analytical and diagnostic biomedical devices, characterized by their very small size, ease of use, multi-analytical capabilities and speed to provide handheld and mobile point-of-care (POC) diagnostics. The book is divided in four Parts. Part I is an in-depth analysis of the various technologies upon which portable diagnostic devices and biosensors are built. In Part II, advances in the design and optimization of special components of biosensor systems and handheld devices are presented. In Part III, a wide scope of applications of portable biosensors and handheld POC devices is described, ranging from the support of primary healthcare to food and environmental safety screening. Diverse topics are covered, including counterterrorism, travel medicine and drug development. Finally, Part IV of the book is dedicated to the presentation of commercially available products including a review of the products of point-of-care in-vitro-diagnostics companies, a review of technologies which have achieved a high Technology Readiness Level, and a special market case study of POC infusion systems combined with intelligent patient monitoring. This book is essential reading for researchers and experts in the healthcare diagnostic and analytical sector, and for electronics and material engineers working on portable sensors.
Inspec keywords: proteins; cellular biophysics; portable instruments; nanomedicine; molecular biophysics; patient diagnosis; biosensors; optical sensors; patient monitoring; nanosensors; veterinary medicine; electrochemical sensors; biomedical equipment
Other keywords: point-of-care diagnostics; marine security monitoring; portable optical detectors; airport security monitoring; intelligent patient monitoring; point-of-care infusion management; nanosensors; defence applications; biowarfare detection; veterinary science; monolithically integrated optoelectronic biosensors; handheld cell-based biosensors; paper-based diagnostic devices; point-of-care electrochemical sensors; travel security monitoring; antibody detection; portable magnetoelastic biosensors
Subjects: General electrical engineering topics; Biomedical measurement and imaging; Cellular biophysics; Chemical sensors; Molecular biophysics; Bench and portable instruments; Optical instruments and techniques; Sensing devices and transducers; Nanotechnology applications in biomedicine; Biomedical engineering; Textbooks
- Book DOI: 10.1049/PBHE003E
- Chapter DOI: 10.1049/PBHE003E
- ISBN: 9781849199629
- e-ISBN: 9781849199636
- Page count: 381
- Format: PDF
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Front Matter
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Part I: Background science and technology
1 Portable optical detectors for point-of-care diagnostics
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Point-of-care testing (POCT), which is diagnostic testing performed on site, has the potential to improve healthcare and healthcare delivery. The motivation for POCT is to bring medical testing conveniently and immediately to the patient. Samples can be obtained and tested, and results are analyzed immediately at or near the location of the patient, thus enabling more rapid medical diagnostics and treatment. Early POCT research included the work of Clark and Lyons in the 1960s, which resulted in the “enzyme electrode”for glucose measurement using the enzyme glucose oxidase (GOD). This work was the first demonstration of a biosensor, as well as the first glucose monitor. More comprehensive portable POCT technology was developed in the early 1990s, with a portable simultaneous multiple analyte whole-blood analyzer for optical monitoring of chemical reactions at nine wavelengths. However, the most significant advance in POCT technology has been the emergence of modern consumer handheld devices, such as the smartphone, which enables POCT devices to be portable, and handheld instruments, such as lab-on-a-chip (LOC), leading to the proliferation of POCT, especially in resource-poor settings.
2 Paper-based diagnostic devices
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This chapter will provide an overview of existing diagnostic devices made primarily out of paper and then focus on paper-based microfluidic devices, the next generation of paper-based diagnostic devices that promises to extend the use of paper as a material for fabricating diagnostic devices well into the future.
3 Advanced lateral flow technology for point-of-care and field-based applications
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In this chapter, the key components of a lateral-flow system will be discussed and key advances described that facilitate higher performance in field-based applications in any market space, from veterinary infectious disease testing to hormone and biomarker testing in animals and equally to human diagnostic, environmental, and biodefense applications of the technology. Some key principles of designing these devices for ease of use in field environments using user-centric design principles will also be discussed.
4 Point-of-care electrochemical sensors for antibody detection
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Antibody assays are relevant to a wide range of clinical issues, although there remain large gaps in their availability in clinical laboratories and are rarely offered for patient or near-patient access. Specific antibody assays are useful for monitoring infectious, autoimmune, inflammatory, immune deficiency, and allergic diseases as well as for spontaneous responses to tumor antigens in cancer diagnosis, to alloantigens in organ transplantation, and to therapeutic macromolecules. However, antibody assays performed in centralized clinical laboratories can be prolonged, labor intensive, and costly, which slows the diagnostic process and may restrict its use for a large segment of the population. An alternative would be the availability of testing capability while the patient remains in a clinic or even a remote or possibly at-home setting. The general advantages, characteristics, and challenges of point-of-care (POC) testing have been well delineated.
5 Portable magnetoelastic biosensors
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In this chapter, an overview of the ME biosensor and the current state research on this platform is given. The origin of magnetostriction and ME coupling is reviewed. This is followed by a review of the fabrication processes for the ME resonator platform and the biorecognition element. Three common resonant frequency measurement techniques are discussed. This chapter is closed with some significant findings that have resulted from this investigation on ME biosensors.
6 Portable and handheld cell-based biosensors
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The present review is divided into two parts: First, novel approaches to improving the performance of cell-based sensors are presented. Second, an overview is provided of systems and assays already in use in toxicity testing, the most prominent application area for this particular group of biosensors.
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Part II: Sub-component design and optimization
7 Novel nanocomposite materials for miniaturized biosensor fabrication
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This chapter deals specifically with the nanocomposite materials that are or can be used in the biosensing technology, since they are highly controllable and custom fabricated. We will emphasize particularly the application of nanocomposite materials as a solution to miniaturization process. The need of miniature devices is becoming very important, as they are the main detection and monitoring components in implantable and point-of-care systems for real-time analysis and diagnosis. The ability to design biosensors at micro- or nanoscale allows for medical real-time continuous monitoring of certain vital health-related conditions.
8 Monolithically integrated optoelectronic biosensors for point-of-need applications
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In this chapter, the main categories of integrated optical sensors that is grating-couplers, interferometers, photonic crystals, microring resonators, slot waveguides or silicon wires will be discussed. Emphasis will be given to the analytical performance of these sensors upon their application in clinical diagnostics, food analysis schemes or environmental monitoring. Finally, the attempts to build up lab-on-chips or portable devices for application of these sensors at the point-of-need will be mentioned. The comparison of the various types of sensors will be performed using the detection sensitivity and in particular the limit of detection (LOD) as figures of merit. The LOD is referred to the lowest amount of analyte that the sensor can detect as a signal distinguishable from the measurement noise. Usually, the LOD is expressed as refractive index units (RIU) or as surface mass density (g mm-2). It can be also expressed as analyte concentration, although this value could complicate the comparison between different sensors which have been evaluated using different analytes or recognition molecules with different affinity constants. Therefore, whenever applicable, the first two expressions of LOD are preferable to be employed as a more objective performance criterion.
9 Time-series processing for portable biosensors and mobile platforms for automated pattern recognition
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In this chapter, techniques concerning processing of time-series produced by portable biosensors will be presented. A biosensor can be defined as a `compact analytical device or unit incorporating a biological or biologically derived sensitive recognition element integrated or associated with a physio-chemical transducer' [1,2]. There are three main parts of a biosensor: (i) the bio-receptor which is the sensitive biological element that reacts with a specific type of chemicals or biological agents, (ii) a transducer that converts the biorecognition reaction into a measurable signal, and (iii) a signal processing system that reads the measurement signal, providing the user with proper information or advice.
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Part III: Applications
10 Nanosensors in food safety
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Food safety is a critical and persistent public health issue. The concerns associated with food safety are further intensified by improper hygiene, poor food handling practices, and contaminated food supplies, leading to a financial burden of foodborne disease (FBD). The FBDs are often linked to consumer illness, which bears high medical costs and loss of productivity and sales. To combat the threat of FBDs, an increased and comprehensive awareness of food safety is of paramount importance. The safety of the food enormously influences consumer health. There are several factors that ensure the safety of processed and packaged food commodities from pathogenic microorganisms, such as Listeria monocytogenes, Escherichia coli O157:H7, Toxoplasma gondii, Campylobacter jejuni, Salmonella, Staphylococcus aureus, Campylobacter coli, Bacillus cereus, Norovirus, and numerous others that can deleteriously impact human health. Hence considering the roles that food safety plays in both health and development, relevant actions have been taken by various agencies in different nations to improve the safety of the food supplied to the consumers. In the United States, the US Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA) are key agencies providing food safety guidelines, standards, and policies to US entities and many other nations. The European Food Safety Authority and the Food Standards Agency in the United Kingdom were authorized to survey the quality and safety of foods sold in stores. In addition, they are also assigned the responsibility of performing research in food safety and, therefore, plays crucial roles in uplifting the food safety scenario in the EU, the UK, and across the globe. Various foodborne diseases cause significant morbidity and mortality worldwide. Historically, efforts to reduce the life-threatening consequences of food contamination have been made by innovation in food preservation. Sun drying and cooking were conceivably the first methods used; later more sophisticated technologies, such as fermentation and canning, came into existence. In recent times, advanced technologies in food preservation and packaging have made food safer. As the global population is increasing, scientists with innovative approaches towards science and technology are working efficiently to provide the best quality and safest foods to consumers. In between these approaches, nanotechnology provides an advanced and powerful platform utilizing unique properties of materials emerging from nanometric size (1-100 nm) that have the prospect of revolutionizing agriculture and food sectors, biomedicine, environment safety, energy conservation, and many other areas.
11 POC in biowarfare detection and defence applications: an update
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For bacteria and viruses as bioagents, various types of immunochemical devices are preferred for the early response and good sensitivity; the capability of continuous monitoring is also a quite attractive advantage. The detection occurs on the phenotype level, and no extraction of the genetic material from the bioagent is required, which is the necessary case for methods based on PCR and general detection of specific nucleic acid sequences. ELISA as a classic immunoanalytical format inspired various types of immunosensors. Here, the optical [10] and electrochemical [11] immunosensors will be addressed as the approach combining high sensitivity, simple construction and portability of the sensing part with the excellent specificity of antibodies and other affinity-based recognition systems.
12 POC in travel, marine, and airport security monitoring
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This review will focus on infectious diseases. A large series reviewing in-flight emergencies indicated that infectious diseases accounted for 2.8 percent of emergencies and no death. In this situation, physicians present aboard provided almost half of the initial in-flight medical care.In order to anticipate how modern technologies for medical laboratory and internet transmission of data may help reducing the medical deserts during travel, it is useful to briefly review the medical syndromes and situations most frequently encountered during travel, and then review how point-of-care (POC) laboratories may help resolving this issue. Indeed, POCs have been invented to provide patients and doctors with near-to patient, rapid diagnosis of some urgent diseases requiring some rapid medical decisions regarding the necessity for hospitalization, the necessity for isolating a contagious patient and the necessity to start a specific medical treatment such as an appropriate antimicrobial in the case of diagnosed infectious disease.
13 Biosensor applications in veterinary science
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The adoption of biosensor systems in the management of animal care, either at the farm or home is not new. Sensor approaches have been developed since the early 1990s, in parallel with the emergence of automated processes, such as automated milking systems in dairy farming aimed to reduce labor requirements and associated costs. On a different level, customized portable blood glucose meters (PBGM) for monitoring diabetic pets have been commercially available for more than 15 years. Nowadays, a rapid expansion in the number of point-of-care (POC) systems for veterinary science is observed, the scope of which exceeds by far the respective applications for human medicine. In the present chapter, the progress in this continuously evolving field during the last 5 years is briefly reviewed.
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Part IV: Commercialization
14 Commercialized point-of-care technologies
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In this work, we shall attempt to review the status of PoC IVD as can be seen through commercialized applications alone, with a focus on handheld and small benchtop systems. The specific viewpoint is based on the technological and diagnostic target decisions of 104 PoC manufacturers that were selected on the basis of site visits on international trade fairs [10], PoC conferences, and market reports [11] for the PoC industry. The selection process for trade fair participation was the inclusion of any company offering a PoC solution on settings ranging from clinic to what is referred to as extreme PoC [12]. The scope of the selection is to get a comprehensive image of the commercialized PoC landscape, while minimizing bias in the inclusion process. Subsequently, we proceed to categorize the technologies used by each of these companies. We identify five major groups: (1) lateral-flow assays, (2) centrifugal microfluidics systems, (3) electrochemical systems, (4) nucleic acid testing systems, and (5) blood gas analyzers. Those five technological categories encompass 97 out of 104 companies, whereas 14 systems cannot be grouped into these categories. The technological groups are not strictly related to the sensing approach or the fluidic manipulation approach, rather in key design similarities. However, PoC systems are at the epicenter of a very active research field with new principles being applied constantly [13,14] that may very well render this categorization obsolete in the near future. In this sense, this article can be viewed as a snapshot of the commercial PoC landscape at the time of writing that is sure to evolve in coming years. Using as a starting point the previously mentioned 104 PoC firms, this review outlines the most prevalent technologies in the field and provides some insight on their functions, attributes, and limitations. Furthermore, using the same starting point, we present a thorough list of biomarkers that are currently the diagnostic objective of systems reviewed in this work.
15 Consumer diagnostics
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An extensive overview of the progress in the commercialization of portable biosensors is given in the present chapter. The survey is focused on these systems and technologies that are either already incorporated in commercial products or are very close to be commercialized, being characterized with a Technology Readiness Level value of 7 or higher. Updated information is provided in the following sectors: (i) optimization and advances in conceptual approaches and operating principles, (ii) novel applications of commercial handheld/portable biosensors, and (iii) novel biomarkers that could be used as targets for emerging biosensor platforms.
16 A market case report: point-of-care infusion management and intelligent patient monitoring
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This paper discusses the following topics, infusion and infusion management at point-of-care today, infusion pump basics, infusion `smart pumps' and problems of infusion pumps at point of care.
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Back Matter
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