Clostridium difficile is a Gram-positive, spore-forming bacterium that continues to present a worldwide problem in healthcare settings. The bacterium causes disease, the symptoms of which include diarrhea, fever, nausea, abdominal pain and even death. Despite the prevalence of the disease, the diagnosis of C. difficile infection is still challenging, with a variety of methods available, each varying in their effectiveness. In this work we sought to identify a new biomarker for C. difficile, develop affinity reagents and design a diagnostic assay for C. difficile infection which could be used in a typical two-step testing algorithm. Initially a bioinformatics pipeline was developed that identified a surface associated biomarker "AKDGSTKEDQLVDALA" present in all C. difficile strains sequenced to-date and unique to the C. difficile species. Monoclonal antibodies were subsequently raised against peptides corresponding to the biomarker sequence. During characterization studies, monoclonal antibody 521 (mAb521) was shown to bind all known C. difficile surface layer types, but not closely related strains. Surface plasmon resonance measurements were used to calculate an apparent equilibrium dissociation constant of 36.5 nM between the purified protein target containing the biomarker (surface layer protein A) and mAb521. We demonstrate a limit of detection of 12.4 ng/mL against surface layer protein A and 1.7 × 106 cells/mL in minimally processed C. difficile cultures. The utility of this computational approach to antibody design for diagnostic tests is the ability to produce antibodies that can act as universal species identifiers while mitigating the likelihood of false-positive detection by intelligently screening potential biomarkers against RefSeq data for other nontarget bacteria.

Monolithic integration of nanophotonic sensors with CMOS detectors can transform the laboratory based nanophotonic sensors into practical devices with a range of applications in everyday life. In this work, by monolithically integrating an array of gold nanodiscs with the CMOS photodiode we have developed a compact and miniaturized nanophotonic sensor system having direct electrical read out. Doing so eliminates the need of expensive and bulky laboratory based optical spectrum analyzers used currently for measurements of nanophotonic sensor chips. The experimental optical sensitivity of the gold nanodiscs is measured to be 275 nm/RIU which translates to an electrical sensitivity of 5.4 V/RIU. This integration of nanophotonic sensors with the CMOS electronics has the potential to revolutionize personalized medical diagnostics similar to the way in which the CMOS technology has revolutionized the electronics industry.

Sensitive, specific, rapid, inexpensive and easy-to-use nucleic acid tests for use at the point-of-need are critical for the emerging field of personalised medicine for which companion diagnostics are essential, as well as for application in low resource settings. Here we report on the development of a point-of-care nucleic acid lateral flow test for the direct detection of isothermally amplified DNA. The recombinase polymerase amplification method is modified slightly to use tailed primers, resulting in an amplicon with a duplex flanked by two single stranded DNA tails. This tailed amplicon facilitates detection via hybridisation to a surface immobilised oligonucleotide capture probe and a gold nanoparticle labelled reporter probe. A detection limit of 1 × 10−11 M (190 amol), equivalent to 8.67 × 105 copies of DNA was achieved, with the entire assay, both amplification and detection, being completed in less than 15 minutes at a constant temperature of 37 °C. The use of the tailed primers obviates the need for hapten labelling and consequent use of capture and reporter antibodies, whilst also avoiding the need for any post-amplification processing for the generation of single stranded DNA, thus presenting an assay that can facilely find application at the point of need.

Complementary metal oxide semiconductor (CMOS) technology has made personal mobile computing and communications an everyday part of life. In this paper we present a nanophotonic integrated CMOS-based biosensor that will pave the way for future personalized medical diagnostics. To achieve our aim, we have monolithically integrated plasmonic nanostructures with a CMOS photodiode. Following this approach of monolithic nanophotonics microelectronics integration, we have successfully developed a miniaturized nanophotonic sensor system with direct electrical readout, which eliminates the need of bulky and costly equipment that is presently used for interrogation of nanophotonic sensors. The optical sensitivity of the plasmonic nanostructures is measured to be 275 nm/refractive index unit (RIU), which translates to an electrical sensitivity of 5.8 V/RIU in our integrated sensor system. This advance is the first demonstration of monolithic integration of nanophotonic structures with CMOS detectors and is a crucial step toward translating laboratory based nanophotonic sensing systems to portable, low-cost, and digital formats.

The interface between the sample and the transducer surface is critical to the performance of a biosensor. In this work, we compared different strategies for covalent self-assembly of antibodies onto bare gold substrates by introducing disulfide groups into the immunoglobulin structure, which acted as anchor molecules able to chemisorb spontaneously onto clean gold surfaces. The disulfide moieties were chemically introduced to the antibody via the primary amines, carboxylic acids, and carbohydrates present in its structure. The site-directed modification via the carbohydrate chains exhibited the best performance in terms of analyte response using a model system for the detection of the stroke marker neuron-specific enolase. SPR measurements clearly showed the potential for creating biologically active densely packed self-assembled monolayers (SAMs) in a one-step protocol compared to both mixed SAMs of alkanethiol compounds and commercial immobilization layers. The ability of the carbohydrate strategy to construct an electrochemical immunosensor was investigated using electrochemical impedance spectroscopy (EIS) and differential pulse voltammetry (DPV) transduction. Graphical Abstract Left: Functionalization strategies of bare gold substrates via direct bio-SAM using disulfide-containing antibody chemically modified via their primary amines (A), carbohydrates (B) and carboxylic acids (C). Right: Dependence of the peak height with NSE concentration at NSE21-CHO modified electrochemical immunosensor. Inset: Logarithmic calibration plot.

In this work, different methodologies were evaluated in search of robust, simple, rapid, ultrasensitive, and user-friendly lateral flow aptamer assays. In one approach, we developed a competitive based lateral flow aptamer assay, in which β-conglutin immobilized on the test line of a nitrocellulose membrane and β-conglutin in the test sample compete for binding to AuNP labeled aptamer. The control line exploits an immobilized DNA probe complementary to the labeled aptamer, forcing displacement of the aptamer from the β-conglutin-aptamer complex. In a second approach, the competition for aptamer binding takes place off-strip, and following competition, aptamer bound to the immobilized β-conglutin is eluted and used as a template for isothermal recombinase polymerase amplification, exploiting tailed primers, resulting in an amplicon of a duplex flanked by single stranded DNA tails. The amplicon is rapidly and quantitatively detected using a nucleic acid lateral flow with an immobilized capture probe and a gold nanoparticle labeled reporter probe. The competitive lateral flow is completed in just 5 min, achieving a detection limit of 55 pM (1.1 fmol), and the combined competitive-amplification lateral flow requires just 30 min, with a detection limit of 9 fM (0.17 amol).

This paper describes a one-port mechanical resonance detection scheme utilized on a piezoelectric thin film driven silicon circular diaphragm resonator and discusses the limitations to such an approach in degenerate mode mass detection sensors. The sensor utilizes degenerated vibration modes of a radial symmetrical microstructure thereby providing both a sense and reference mode allowing for minimization of environmental effects on performance. The circular diaphragm resonator was fabricated with thickness of 4.5 µm and diameter of 140 µm. A PZT thin film of 0.75 µm was patterned on the top surface for the purposes of excitation and vibration sensing. The device showed a resonant frequency of 5.8 MHz for the (1, 1) mode. An electronic interface circuit was designed to cancel out the large static and parasitic capacitance allowing for electrical detection of the mechanical vibration thereby enabling the frequency split between the sense and reference mode to be measured accurately. The extracted motional current, proportional to the vibration velocity, was fed back to the drive to effectively increase the Q factor, and therefore device sensitivity, by more than a factor of 8. A software phase-locked loop was implemented to automatically track the resonant frequencies to allow for faster and accurate resonance detection. Results showed that by utilizing the absolute mode frequencies as an indication of sensor temperature, the variation in sensor temperature due to the heating from the drive electronics was accounted for and led to an ultimate measurement sensitivity of 2.3 Hz.

Cirrhosis has a long natural history with considerable symptomatic impacts, particularly in advancing disease. Measuring health related quality of life (HRQOL) in liver disease provides detail about the nature and extent of its effects on individuals. Understanding the drivers of impaired HRQOL can help identify targets for improvement through new treatments or health systems service delivery. Evaluation of novel therapies which target symptomatic improvement, should be done with suitable outcome measures, including HRQOL assessment. In this article, we provide an overview of HRQOL in advanced liver disease for the clinician. A clear description of the important HRQOL tools is given alongside a discussion of the factors, which are known to contribute to impaired HRQOL in advanced liver disease.

This work reports on the design, fabrication and characterization of a piezoelectrically actuated mass sensor. The sensor utilizes degenerate resonant modes in which one mode is used as a reference to compensate for environmental effects. The project builds on a capacitively driven version of the sensor allowing improvements and challenges surrounding the new design to be assessed in relation to modeling and fabrication. The operational mode of interest showed an average resonant frequency of 7.8 MHz (quality factor of 490), at atmospheric pressure with an electrically recovered signal to noise ratio of 2400:1. The lead zirconate titanate performance yielded a central displacement sensitivity of 1.50 nm V-1, which is in good agreement with the levels predicted in modeling. A small initial split in the degenerate modes was recorded due to fabrication tolerances; however, the devices still exhibited good environmental stability, with a temperature sensitivity of only 11 Hz degrees C-1. Electroplating of gold onto the sensor surface demonstrated a device mass sensitivity of 12.0 Hz pg(-1).

Glutamate mediates most of the excitatory synaptic transmission in the brain, and its abnormal regulation is considered a key factor underlying the appearance and progression of many neurodegenerative and psychiatric diseases. In this work, a microdisc-based amperometric biosensor for glutamate detection with highly enhanced selectivity and good stability is proposed. The biosensor utilizes the enzyme glutamate oxidase which was dip-coated onto 125μm diameter platinum discs. To improve selectivity, phosphatidylethanolamine was pre-coated prior to enzyme deposition, and electropolymerization of o-phenylenediamine was performed to entrap the enzyme within a polymer matrix. A variety of coating configurations were tested in order to optimize biosensor performance. For stability measurements, biosensors were biased continuously and calibration curves calculated each day for a period of 5–6 days. The optimized biosensors exhibited very high sensitivity (71±1mAM−1cm−2), low detection limit of ∼2.5μM glutamate, selectivity (over 87% against ascorbic acid), very good temporal stability during continuous use, and a response time of <5s. These biosensors are therefore good candidates for further development as devices for continuous monitoring during traumatic brain injury or neurosurgery.

This work reports a piezoelectrically driven and sensed Circular Diaphragm Resonator (CDR) mass sensor. The work is a development of an electrostatically-activated version and aims to simplify the microfabrication process and signal recovery electronics. A range of device geometries were fabricated and both optical and electrical testing performed to assess performance. Electrical sensing, using a charge amplifier, achieved a signal to noise ratio of 10:1 at 6 MHz and a preliminary sensitivity of 55 fg Hz -1 . The devices are nano-enabled as biosensors using a high resolution bio-molecule patterning technique and preliminary results are introduced in this regard.

This work reports on the development of a lab demonstrated resonant mass sensor towards mid-size production. The issues associated with scaling-up production of the microfabricated chip are discussed with particular focus on yield and device reproducibility, as well as the constraints imposed on the design and manufacturing of the device when packaging and integration must be taken into account. Issues of modal alignment and ambient operational pressure are discussed. Fabricated devices show a 4.81 Hz pg(-1) mass sensitivity with a temperature sensitivity of typically 10 Hz degrees C-1.

The potential neurotoxin 1-trichloromethyl-1,2,3,4-tetrahydro-beta-carboline (TaClo) has recently been suggested to be a causative factor in the clinical development of Parkinsonian symptoms after long-term exposure to precursor compounds such as the hypnotic chloral hydrate. TaClo is known to cause cell death in dopaminergic neuronal cells, however, the pathway and mechanisms remain undefined. This study reports for the first time that TaClo promotes cytotoxicity in SH-SY5Y neuroblastoma cells within 2 hours of initial exposure. TaClo also caused superoxide production from isolated mitochondria, which was comparable in response time and magnitude to production elicited by more established respiratory inhibitors such as rotenone and antimycin A. These findings present new evidence in support of TaClo-induced neuronal death via superoxide signalling and oxidative stress.

This work reports on the development of control electronics for a resonant mode biosensor. The laboratory demonstrated sensor initially showed a signal-to-noise ratio of -100 dB. With the application of half-frequency drive, frequency down conversion, appropriate filtering, and digital signal processing, a cost-effective electronic solution demonstrated a signal-to-noise ratio of +30 dB. This paper highlights important aspects in the design of integrated solutions to microelectromechanical systems-based sensors.

It has been reported that the introduction of a dielectric barrier between adjacent digits of an interdigitated electrode array can improve the sensitivity of the array as an electrochemical impedance biosensor. Here we present an in-depth analysis of the impedance in planar interdigitated electrodes and 3-D interdigitated electrodes (with dielectric barriers). The analysis indicates that the planar geometry not only provides lower impedance but also a higher change impedance as a result of molecular immobilization on the electrode array surface.