Laser-based engineering of paper for manufacturing fluidic sensors: (Lab-flo)

In 2013 we started work on an 18-month EPSRC feasibility grant entitled 'Laser-printable point-of-care sensors for low-cost medical diagnosis and disease monitoring', which explored laser-based printing of biological materials for applications in the healthcare sector. Our results have attracted the attention of several major international healthcare manufacturers who see the potential of laser-patterning of porous materials like paper for their future product range and who want to work with us to further develop this technology. We are submitting this follow-on proposal to (1) develop a laboratory-standard process for laser-based paper-patterning for fluidic devices, (2) use our technology in trials for a point-of-care diagnostics demonstrator sensor that allows detection of specific diseases such as tuberculosis, as well as dramatically reducing detection limits, (3) extend the technique to incorporate methodologies for fluid delay, multiplexing, and patterning of 3-D devices, and (4) explore applications beyond planar devices in paper, including 'Light-Up Paper' and functionalised fabrics for 'Smart Plasters'.

With the continuously increasing strains on already over-burdened public health systems of a developed nation such as U.K, and developing countries with the low-resource settings, the role of diagnostics is proving to be crucial. On-site detection and point-of-care (POC) diagnostic testing is a trend that is emerging as one of the popular choices for such non-invasive clinical diagnostics. The reason central to the increasing approval of POC diagnostic testing at a patient's bed-side in a near-patient environment of a hospital emergency ward, or an intensive care or simply in a general practitioners clinic, is because it presents an effective modus-operandi which eliminates unnecessary communication delays between the clinical care team and external testing laboratories.

Economic Impact:
In common with most other countries, the U.K. continues to experience an economic downturn, where austerity cuts on the one hand and ever-increasing demands for increased provision in the healthcare sector on the other make for a very unhappy and unbalanced scenario. One favourable and hence a much preferred route that will enable crucial savings to the NHS (in terms of costs and staff) is the need to enable early-stage testing for disease/condition at the POC (homes, care-homes, nursing home and GP practices) thus reducing the burden on the NHS-hospitals via reduced patient trips to A&E units, emergency call outs and hospital admissions that then improves hospital bed-shortages and unnecessary occupation of these beds - all of this translates into huge financial savings for UK public health system and the economy .
The total POC diagnostics market, which comprises products outside the laboratory, used by healthcare professionals in hospital emergency, critical care, out-patient and GP surgeries, as well as consumers, to test for disease, infection, fertility, drug and alcohol abuse, was worth $13.8 billion in 2011 and is predicted to grow due to increasing interest in the adoption of these technologies to $16.5 billion in 2016. Currently, the United States accounts for almost 50% of the total POC market, however, this is followed by regions, that include Europe and Japan.
The motivation of the proposed research is the underpinning need to enable such potentially life-saving diagnostics, and hence the end-goal is to develop a methodology that will truly make possible the fabrication of such POC diagnostics devices on a paper-platform on a large-scale, which most importantly will make such devices affordable in cost, and thus allow for their wide-scale use at the POC. The UK stands to make considerable gains therefore from the economic benefits that would ensue.

Societal Impact:
POC diagnostics also facilitate prompt exchange of invaluable clinical information between healthcare professionals and their patients from the convenient comforts of their homes, which in some probabilities could be in inaccessible locations. Since a timely exchange of clinical data could potentially be very useful in early detection and prevention of life-threatening infectious diseases (such as TB, which is the focus of this research) diseases or conditions, the wide societal benefits would be not just be in the form of saving lives and but also improving the quality of life for a patient suffering from terminal illness.
For the aging population, incapacitated patients or for those suffering from illnesses such as AIDS or cancer, the possibility to remotely test themselves and send their information to the doctor, could help them from contracting possible life-threating infections from trips to the hospitals. Furthermore, the applicability of low-cost, disposable paper-based testing, the technology developed through this project, could also be extended to include testing for screening of food pathogens and environmental toxins, all of which unarguably have massive societal benefits.