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To establish wider utility at the point of care, device validation should be carried out within the target population, and in the most appropriate environment and use conditions.
A portable multiplexed assay allows for the rapid detection, via plasmonic-gold-enhanced near-infrared fluorescence, of SARS-CoV-2 RNA at single-copy sensitivity and single-nucleotide specificity for the discrimination of variants of the virus.
A rapid one-pot isothermal assay that leverages rolling-circle amplification and the endonuclease Cas12a can accurately detect specific miRNAs in extracellular vesicles in patient plasma.
A low-cost probe for otoacoustic emissions made from off-the-shelf earbuds and microphones performs similarly to a clinical-grade device, as shown via a clinical study involving 201 paediatric ears screened for hearing loss.
The optical detection of two virulence factors of Mycobacterium tuberculosis on extracellular vesicles in blood allowed for the diagnosis of tuberculosis in paediatric cases that were missed by clinical microbiological assays.
A COVID-19 test implemented in an automated microfluidic device and leveraging isothermal RNA amplification followed by T7 transcription and Cas13-mediated cleavage of a quenched fluorophore rapidly detects SARS-CoV-2 RNA in saliva samples.
A 3D-printed lab-on-a-chip allows for the concurrent rapid electrochemical detection of SARS-CoV-2 RNA in saliva and of anti-SARS-CoV-2 antibodies in saliva spiked with blood plasma.
A paper-based assay leveraging nucleic acid strand-displacement reactions and the enzymatic amplification of the recognition of viral RNA at the single-nucleotide level allows for the rapid colorimetric detection of SARS-CoV-2 variants.
SARS-CoV-2 and its variants can be visually detected via easy-to-use Cas13-based nucleic acid tests leveraging lyophilised reagents and fast sample inactivation at ambient temperature.
A one-step fluorescence assay relying on suboptimal protospacer adjacent motifs for Cas12a detects SARS-CoV-2 RNA in nasopharyngeal samples in less than 20 minutes with a sensitivity comparable to that of RT–qPCR.
A portable prototype scanner for brain MRI that uses a compact and lightweight permanent rare-earth magnet with a built-in readout field gradient generates clinically relevant images of the brain, as shown in adult volunteers.
A portable device integrating reverse transcription, fast thermocycling and in situ fluorescence detection accurately detects SARS-CoV-2 RNA in patient samples in 17 min.
Analysis of physiological and activity data from consumer smartwatches enables real-time detection, often before symptom onset, of COVID-19, as well as other respiratory illnesses and stress inducers.
The specific high-sensitivity enzymatic reporter unlocking (SHERLOCK) assay detected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA with high sensitivity and specificity in hundreds of nasopharyngeal and throat swab samples collected at Siriraj Hospital in Thailand.
A custom-made fidget spinner rapidly concentrates pathogens in 1-ml samples of undiluted urine by more than 100-fold for the on-device colorimetric detection of bacterial load and pathogen identification.
A fast and inexpensive point-of-care assay based on CRISPR–Cas13 accurately detects the DNA of opportunistic viruses in blood and urine samples as well as an mRNA marker of renal transplant rejection in urine samples.
A ‘smart’ toilet that uses pressure and motion sensors, biometric identification, urinalysis strips, a computer-vision uroflowmeter and machine learning longitudinally tracks biomarkers of health and disease in the user’s urine and stool.
An optofluidic device rapidly detects, via surface-enhanced Raman scattering, picomolar concentrations of biomarkers for traumatic brain injury in finger-prick blood samples from patients.
An electrical biosensor combining CRISPR–Cas9 and a graphene field-effect transistor detects target genes in purified genomic samples at high sensitivity, within 15 minutes, and without the need for amplification.
This Perspective describes the current state of point-of-care sensors for the diagnosis and monitoring of sepsis, and outlines opportunities for their use in improving the care of sepsis patients.
An ultrasonic and stretchable device conformal to the skin that captures blood pressure waveforms at deeply embedded arterial and venous sites enables the continuous monitoring of cardiovascular events.
A point-of-care device that can run on a variety of power inputs enables isothermal nucleic acid quantification for the diagnosis of infectious diseases in resource-limited settings with unreliable electrical power supply.
A low-cost point-of-care device that uses contrast-enhanced microholography and deep learning accurately detects aggressive lymphomas in patients referred for aspiration and biopsy of enlarged lymph nodes.
A portable device enables the automated manufacturing of therapeutic-grade biologics in a few hours and under current good-manufacturing-practice conditions.
A microfluidic assay that identifies sepsis from a single droplet of diluted blood by measuring the spontaneous motility of neutrophils showed 97% sensitivity and 98% specificity in two independent patient cohorts.
A compact, self-contained device bearing an array of microneedles collects 100 μl of blood at the push of a button, and is more convenient and less painful than a fingerstick and venepuncture.
A hand-powered centrifuge made of two paper discs, string and wooden handles is shown to achieve rotational speeds of 125,000 r.p.m., separate pure plasma from whole blood in less than 1.5 minutes and isolate malaria parasites in 15 minutes.
Pooled testing for the diagnosis of COVID-19 via isothermal nucleic acid amplification and detection can be automated by using electromagnetically actuated swarms of millimetric magnets to handle droplets of magnetized samples on a microfluidic chip.
Off-the-shelf microphones and earbud components connected to a smartphone can be as effective as an expensive clinical-grade device at measuring otoacoustic emissions to screen for hearing loss.
An assay leveraging strand-displacement reactions and enzymatic amplification for the recognition of viral RNA and implemented on origami paper allows for the fast colorimetric detection of SARS-CoV-2 variants, with single-nucleotide specificity.
Assays leveraging the CRISPR-associated enzyme Cas13 and isothermal RNA amplification for the detection of viral RNA are being simplified for point-of-care use.
Freeze-dried genetic circuits can be integrated with textiles for the detection — colorimetric, or via fluorescence or luminescence — of small molecules and nucleic acids from SARS-CoV-2 and other pathogens.
To facilitate diagnostic radiology at the point of care, improvements in imaging hardware and processing software that raise the signal away from the noise floor are being leveraged toward improving device portability or accessibility.
A prototype device for performing magnetic-resonance-imaging scans of the brain that integrates a lightweight permanent magnet and low-power gradient coils is suitable for eventual use at the bedside.
Upcoming inexpensive assays for the detection of SARS-CoV-2 RNA in less than one hour at points of care or at home should help suppress the COVID-19 pandemic.
Data from consumer smartwatches can improve the detection of COVID-19 when combined with symptom self-reporting, and can also detect the disease in pre-symptomatic individuals.
An optofluidic chip incorporating a surface-enhanced Raman-scattering substrate rapidly detects picomolar concentrations of biomarkers of traumatic brain injury in finger-prick blood samples from patients.
Biomarkers of health and disease in urine and stool can be longitudinally tracked with a ‘smart’ toilet incorporating biometric identification, pressure and motion sensors, urinalysis strips and a uroflowmeter.
A custom fidget spinner that uses centrifugal forces to concentrate bacterial pathogens in urine samples enables the rapid on-device colorimetric detection of urinary tract infections and the testing of the pathogen’s susceptibility to antibiotics.
A lunchbox-sized device for nucleic acid quantification that can be powered by sunlight, a flame or electricity enables the diagnosis of disease in settings with unreliable power supply.
A holographic approach relying on small-molecule chromogens enables a rapid and inexpensive test for the accurate classification of aggressive lymphoma at the point of care.
A microfluidic device for assaying neutrophil motility in blood samples from sepsis patients and a machine-learning algorithm trained with the motility data enable a faster and accurate sepsis diagnosis.
A hand-spun centrifuge made of paper and string can separate plasma from whole blood in less than two minutes, and be used to diagnose malaria and other infectious diseases in areas without laboratory resources or electricity.