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Paper 1
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Abstract— Since the beginning of the pandemic caused by with the bat SARS-like coronavirus strain BatCov RaTG13. The
SARS-CoV-2 virus, the demand for diagnostic kits as well as infectious disease is known to be caused by severe acute respiratory
devices used to treat the patient has increased drastically. One of syndrome coronavirus 2 (SARS-CoV-2). The disease quickly spread
the diagnostic tools that are desperately needed in these times is in other countries, causing a pandemic. [1]
thermal cycler, a tool needed to perform polymerase chain
reaction (PCR). (Real time) PCR method is the standard of the The most common symptoms of the disease are fever, dry cough, and
diagnosis to check the presence of SARS-CoV-2 virus. In other tiredness. There are less common symptoms, such as aches and pains,
words, RT-PCR is the most effective way of diagnosis during this sore throat, diarrhea, conjunctivitis (inflammation of the conjunctiva
pandemic. However, the access to this method is limited, and only of the eye), headache, loss of taste or smell, a rash on skin, or
several laboratories or hospitals can perform this method; yet the discolouration of fingers or toes. Serious symptoms, which are a sign
virus is spread all around the world. That is why, this paper will that the patient needs immediate help, include difficulty in breathing
discuss the development of a fabric-based PCR microfluidic or shortness of breath, chest pain or pressure, and loss of speech and
chamber for DNA amplification and electrochemical detection inability to move. [3]
Index Terms— PCR, fabric-based, microfluidic, DNA The Chinese CDC (Center for Disease Control) reported that the case
amplification, electrochemical detection fatality ratio varies, depending on age, and whether a person has
hereditary diseases or not. It is reported that the case fatality ratio
increases with age. The case fatality ratio for people who are aged
I. INTRODUCTION between 11 to 19 years old is 0.2%, while for people who are aged
In the end of year 2019 -- on 30th December 2019 to be exact -- above 80 years, it is 14.8%. The case fatality ratio increases when a
person has hereditary disease as well. This hereditary disease can
China reported its first case of infectious disease in Wuhan, which is cause the presence of comorbid conditions. For people who have
now known as the coronavirus disease (2019) or COVID-19. In cardiovascular disease, the case fatality ratio reaches 10.5%. While
Wuhan Jinyintan Hospital, three bronchoalveolar lavage samples for people who have diabetes, the case fatality ratio is 7.3%, for
were collected from a patient who had pneumonia with unknown people who have hypertension, it is 6.0%. For people who have
etiology (or cause). Real time polymerase chain reaction (PCR) was chronic respiratory disease, the case fatality ratio is 6.3%, and for
performed on these three samples, and the assays showed positive people who have cancer, the case fatality ratio is 5.6%. The table for
results for pan-Betacoronavirus. Then, the whole genome sequences the variation of case fatality ratio can be seen in Table 1. [2] [4]
of the virus were acquired using Illumina and nanopore sequencing.
Bioinformatic analyses were then performed, and the results showed TABLE 1. Variation of Case Fatality Ratio Between Patients
that the virus had similar features with the coronavirus family and
that the virus belonged to the Betacoronavirus 2B lineage. [2]
Factor Type Case Fatality Ratio
It was then revealed using the alignment of the full-length genome
sequence of the COVID-19 virus and other available genomes of Age 11-19 years old 0.2%
Betacoronavirus that the closest relationship between the virus was
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tube can bind onto the target sequence on the single stranded DNA.
>80 years old 14.8% The primers are binded through complementary base pairings [12].
Because of the bond, polymerisation begins. However in order for the
Hereditary disease Cardiovascular 10.5% primer to successfully (and specifically) bind to the target DNA
disease sequence, the temperature must be precisely fit. It has to be low
enough so that hybridization of the primer to the strand is allowed,
Diabetes 7.3% but it also needs to be high enough so that the hybridization is
specific.
Hypertension 6.0%
If the temperature is too low, the primer might not bind perfectly. But
Chronic respiratory 6.3% if the temperature is too high, the primer might not bind at all.
disease Usually, the temperature during annealing is set to 3-5 °C below the
melting temperature of the primers. Next, after annealing is the last
Cancer 5.6% step, which is extension.
The final extension step requires free nucleotides and the temperature
Because of the high risk of fatality, people began to do more research
is raised again that allows the TAQ (Thermus aquaticus) Polymerase
on COVID-19 disease, from how to detect the disease in effective
to extend the primers, synthesizing new strands of DNA. The
and efficient ways, how to prevent the spread of the virus, and to its
temperature required for TAQ Polymerase to work properly is
treatment. We believe that detection of the disease plays an important
between 75-80 °C , however 72 °C is usually used. The result of the
role in restraining the spread of the virus. Despite having to rely on
extension step is two double-stranded sequences of target DNA, each
people’s honesty to tell the doctors when they are feeling ill, it is also
containing one newly made strand and one original strand.
an important thing to verify the disease, in order to convince patients
[7][8][9][10] The steps of polymerase chain reaction can be seen in
to be treated with specific treatment, and also to reduce panic that is
Figure 1.
spread around the country.
PCR reactions are commonly used for a wide variety of applications
The main way of detecting the presence of coronavirus
in the medical field, that includes genotyping, forensic science, and
(SARS-CoV-2) is by using the real time polymerase chain reaction
primarily in disease diagnostics. PCR is a valuable method in
method. There was a study that compared the usage of ELISA
diagnosing infections and infectious disease, where it can amplify a
(enzyme-linked immunosorbent assays) method and quantitative real
given DNA to determine whether a patient is positively or negatively
time polymerase chain reaction method in detecting the SARS-CoV
infected without the need to take large amounts of blood samples
virus, the cause of epidemic of SARS (severe acute respiratory
from the patient.
syndrome) back in 2003. The result showed that quantitative real
time polymerase chain reaction (qRT-PCR) was the method of
choice, as it could detect the SARS-CoV earlier in fecal specimens.
The sensitivity of qRT-PCR is higher than ELISA. [5] Moreover,
qRT-PCR is able to detect viral infection in early stages. [16][17] We
believe that real time polymerase chain reaction is still the method of
choice now, as the cause of the disease comes from the same family.
[6]
The temperature required for denaturation is usually between 95-98 As technology develops, portable devices have gained interest. This
℃, and the time needed is between 20-30 seconds. The next step after includes devices for polymerase chain reaction. The device that can
denaturation is annealing. To allow annealing, the temperature is perform polymerase chain reaction is called a thermal cycler.
lowered to 50–65 °C for 20–40 seconds. Annealing is done by Currently, the type of thermal cycler that is widely used in the
lowering the temperature in order so that the primers within the PCR hospitals is the common one. The current widely used thermal cycler
3
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typically has a dimension of around 27.5 × 43 × 33 cm , total weight time divided by density multiplied by volume and specific heat
of around 11.5 kg, using AC power supply, temperature range capacity.
between room temperature (37℃) up to 110℃, sample using either
96 well plate/384 well plate/0.1 ml tube/0.2 ml tube, with either silver Q = m.C.∆T (1)
or aluminium thermoblock. [13] This type of thermal cycler is not
portable, as it has a relatively large dimension, is pretty heavy to be Q = P. t (2)
carried around, and needs to be connected to an AC power source.
Recently, a smaller thermal cycler device has been developed. The m = ρ.V (3)
device is said to be portable, because of the small dimension of only
5.08 × 12.7 × 10.16 cm, and weight of around 0.45 kg. This device Looking at (4), assuming that the current remains the same, then if
uses 0.2 ml PCR tube for the sample container, and it has a capacity the volume that is used is large, then the change of temperature
of 8 0.2 ml PCR tubes. It can be connected with a computer or laptop difference will decrease. But if the volume that is used is small, then
using the USB cord, or to Android phones and tablets using micro the change of temperature difference will increase. In other words, if
USB OTG adapters. Because it can be connected to laptops, it can be we use a small amount of volume, then we won’t need a large current
programmed using the application made specifically for the device. to increase or decrease the temperature.
However, even though the device is said to be portable, it still needs
to be connected to an AC source. [14] Meanwhile, not every place ∆T = P .t
(1)
where someone needs to conduct a polymerase chain reaction has an ρ.V .C
AC source. To solve this problem, a low cost portable thermal cycler
with smaller dimension and lighter weight can be developed. In this paper, we propose the development of a fabric-based PCR
microfluidic chamber for DNA amplification and electrochemical
detection. Our fabric-based PCR microfluidic chamber for DNA
II. CURRENT CONDITION AND PROPOSED SOLUTION
amplification and electrochemical detection will hopefully help
provide an alternative of thermal cycler for Polymerase Chain
As mentioned before, the recommended method of detecting Reaction (PCR).
COVID-19 is using quantitative real time Polymerase chain reaction.
However, conducting qRT-PCR method for diagnostics often There are two main parts of our fabric-based PCR microfluidic
depends on access to centralized laboratory facilities. That is why, chamber for DNA amplification and electrochemical detection, which
people began to do more research on compact PCR-based methods are: (1) the heater and temperature sensor, and (2) electrochemical
and devices for point of care (POC) settings. The examples of mini detection.
PCR are given in the previous part.[18][19][20]
Meanwhile, in Indonesia, there are three approved ways of detecting A. Heater and Temperature Sensor
the presence of SARS-Cov-2 to detect the COVID-19 disease: (1) In our fabric-based PCR microfluidic chamber DNA amplification
Real Time Polymerase Chain Reaction (RT-PCR), or more and electrochemical detection, we use nichrome wire as the heater
commonly known as swab test, (2) Rapid Molecular Assay, and (3) and Carbon Nanotube as the temperature sensor. However,
Rapid Diagnostic Test, or more commonly known as rapid test. The experiments were also conducted to assess whether carbon nanotube
real time polymerase chain reaction (RT-PCR), as explained can be used as a heater.
previously, is the most effective approved way of detecting
SARS-CoV-2. Rapid Molecular Assays/rapid molecular testing is Theoretically, carbon nanotubes (CNT) can be used as heaters and
known to be the alternative of real time polymerase chain reaction. sensors because of their unique electrical, structural, mechanical
The rapid molecular assay uses the Xpert MTB/RIF diagnostic test. It properties, and thermal conductivities. [27] We can control the
was previously used mainly for patients with tuberculosis. With this resistivity of CNT by changing the numbers of layers or by changing
method, the diagnosis can be done faster, which is around 45 the reagents used in the densification process. The thermal
minutes. [21][22][23][24][25] The Rapid Diagnostic Test is the conductivity of CNT is known to be 3500 W m−1 K −1 [28] and as a
simplest way of detecting SARS-CoV-2. Rapid diagnostic test is not heater, it can reach temperatures up to 750 ℃ [29].
only used for COVID-19, but also for other diseases. Even though it
As for the sensor, there are many ways of assembling technique,
is really quick (typically only 20 minutes) and assumed to be sensing material, substrate which produce different ranges of
inaccurate, the false positive rate of rapid diagnostic tests is less than temperature and sensitivity. We decided to use printing and dip
10%, and the invalid tests are less than 5%. Rapid diagnostic tests coating as the assembly technique, using multi walled carbon
play the role as the first test that is taken by people who are suspected nanotubes (MWCNTs), with PVDF mono- filament fiber as the
to have COVID-19. It checks the presence of the antibody (mainly substrate. [30] The proposed design of our CNT based temperature
Immunoglobulin G and M/ IgG and IgM). [26] sensor and heater can be seen in Figure 2. The CNT thread is put
based on Figure 2 to maximize the performance of the CNT on the
In this study, temperature plays a major role towards the succession microliter chamber as the heater.
of the PCR reaction. Energy is defined as mass multiplied with
specific heat capacity multiplied with the difference of temperature The design for the heater and the sensor can be seen in Figure 2. It
(1). Energy can also be defined as power multiplied with time (2). is designed to be multiple meanders to maximize the performance of
Mass can be expressed as density multiplied with the volume (3). both the nichrome wire as the heating element and the CNT-thread as
Substituting and rearranging (1), (2), and (3), we can obtain (4), the temperature sensor. The design of the CNT-thread as a heater also
where temperature difference is defined as power multiplied with takes the meander shape.
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Fig. 2. Design of CNT based temperature sensor (left) and nichrome wire
heater (right)
Fig. 3. Concept Design for the Fabric-Based Microfluidic Electrochemical
B. Microliter Chamber Design and Layers DNA Detection
The use of pyrrolidinyl peptide nucleic acids (acpcPNA) can be used It can be seen from Fig. 3. That the hydrophobic area encapsulates
as a probe for the detection of complementary DNA targets. This is the hydrophilic area for the chambers. The electrodes for detection
because acpcPNA shows that it has low chances of self-hybridization will be developed further in the future so in this case, the focus of this
and it has great selectivity, binding affinity for complementary short research is on the chamber itself. The bottom part of the chamber will
DNA or RNA molecules [31][32]. The main method of detection is be made hydrophobic with another layer full of epoxy resin wax to
by the use of electrochemical impedance spectroscopy (EIS). In prevent any leaks downwards. Both these layers will be stacked together
general, to obtain a diagnosis of the target DNA sequence, probes can and clipped.
be electrostatically immobilized [32] or covalently immobilized [31]
on the surface of the electrode, and these probes will exert an The layers of the device would entail Figure 4 below. The first two
electrochemical response due to the hybridization of the target DNA. layers on the top are shown in Figure 3, the rest of the layers below
Hybridization of DNA can be monitored indirectly with EIS because are the heating elements as well as the temperature sensor placed
labels or indicators, such as methylene blue [33] or anthraquinone underneath the denaturation region or chamber.
[32], are not required. Based on the work of P. Teengam, et al. in
2018, the electrochemical device was created to be paper-based. This
was due to the need to covalently immobilize the probe with
generated aldehyde groups from the cellulose-based paper. Cellulose
is usually modified chemically with various functional groups and is
suitable with biological samples [34]. Fabric electrochemical devices
(FED) has also been proven to be easily accessible, cheap, light,
biocompatible, flexible, and measurement can be done with only a
small volume of sample [35]. Besides the utilization of acpcPNA,
DNA sequence that complements the target DNA can also be used if
immobilized to the surface of the electrode for detection.
Various designs of the FED chamber for the sample solution have
been implemented, from two layers being folded [31] to layers being
stacked to form a 3D electrode [9]. For the simplicity of the design, a
folding technique will be implemented. As seen from Fig. 3, there are Fig. 4. Concept Design for the Whole Cloth-based PCR Device
4 areas. The sample area is indicated by the number 1, the
denaturation area indicated by the number 2, the chamber for the
insertion of PBS solution after PCR is finished indicated by the
‘PBS’ label and lastly the electrode area for EIS detection. The
sample will be dropped onto the denaturation chamber (2) and the
sample chamber (1) will be folded onto 2. To prevent evaporation
and to reduce costs, the folding will decrease the likelihood of
evaporation. Clipping can be done for 1 and 2 to achieve this. After
the PCR cycle has been completed, PBS solution will be dropped
onto the PBS chamber and overflowed to reach 2 or the PCR
solution. 1 can be opened again and the electrode can then be folded
onto the denaturation area for measurement.
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Fig. 5. Top View of PCR Chamber and DNA Detection Design in Silhouette
Studio
Fig. 7. Hydrophobic Layer Construction with Epoxy Resin (a) Resin solution
and hardener were measured 1 gram each and mixed in the same container for
2-3 minutes with remains on the side scraped. (b) Mixed solution was rested
for 30 minutes at room temperature and the thickening of the solution was
constantly monitored for if some mixing is required to be done. Once the
solution is thick enough, it can be scooped. (c) Solution was distributed to the
fabric with the help of the stencil, thinly and not with too much power, and let
dried.
Fig. 6. Bottom View of PCR Chamber and DNA Detection Design in
Silhouette Studio
cycles and high temperatures, the fabric coated epoxy resin has also
been tested inside an oven at a temperature of around 95°C for 2
minutes, the denaturation temperature. It was proven that the fabric
layers could withstand the high temperatures of PCR.
B. Electric Circuit to Control Temperature
After the fabrication of the microliter chamber, the next step is to
design the circuit schematics. The circuit consists of a relay that
drives the nichrome wire heater, powered by the battery. The
nichrome wire heater will be clipped using an alligator clip.
The (+) side of the battery is first connected to the relay. From the
relay, one end of the nichrome wire heater which is then put on the
fabric based on Figure 2. The other end of the nichrome wire heater is
then connected to the ground. The relay is then also connected to the
Arduino Mini microcontroller. Afterwards, the connections are then
all covered by electrical tape to avoid any interference or disruptions.
To set up the cooling system, the heater source input will be cut off.
One leg of CNT coated thread is connected directly to the analog
input in the Arduino Mini board. The resistor that is used has the
value of 10k Ohm. The circuit design can be seen in Figure 9 below.
Fig. 9. Circuit design for fabric-based PCR microfluidic chamber for DNA
amplification and electrochemical detection
The program code for the Arduino Mini will be as shown below
which was adapted from [42-50].
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program. Thus, the Steinhart and Hart equation, shown in (1), is used
since it is the mathematical expression best suited to picture the
resistance and temperature relationship [54].
1
T= A + Bln(R) + C[ln(R)]3
(1)
1
T1 = A + Bln( R1 ) + C[ln( R1 )]3 (2)
1
T2 = A + Bln( R2 ) + C[ln( R2 )]3 (3)
1
T3 = A + Bln( R3 ) + C[ln( R3 )]3 (4)
1 60 15270
2 80 14560
3 100 14280
The Arduino Mini program needs a conversion of the analog input of C. Verification for PCR Test
the voltage from the sensor to be converted to temperature in the The proposed materials needed for verification of PCR include a
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learning kit from miniPCR called the miniPCRTM Crime Lab: Missy
Baker Gone Missing. This learning kit has all the reagents needed for Fig. 11. CNT thread, alligator clip, pin header and PCB placement in the CNT
the verification of PCR from the PCR Master Mix including the as heater experiment
dNTPs, PCR buffer with Mg2+, gel loading dye, and the Taq DNA
polymerase, as well as the primers needed, a 100 bp DNA Ladder and To set up the experiment, 2 multimeters, 9V batteries (4), jumper
the template DNAs as samples. Results or expectations of the PCR cables, crocodile clips, parallel CNT-coated thread connection,
have also been provided in the guide to ensure that comparisons can Arduino UNO, MLX90614 IR Temperature sensor. The circuit for
be done quickly with the real life trial to see if PCR has been verified the experiment can be seen in Figure. below. The IR sensor is placed
or not. A free demonstration of electrophoresis will also be provided above the Paralleled CNT-coated to measure the temperature of the
by miniPCR. If the device has proven to be functional, this CNT coated thread.
demonstration for verification is ready.
The method in which the final DNA sample, after going through
PCR, can be transferred from the fabric to the electrophoresis gel
would be with the use of dilution. The chamber will be washed off by
either PBS buffer or PCR buffer. The washed off solution with the
DNA sample will be the one placed at the wells of the gel for the
verification with electrophoresis. The total dilution volume should be
that required for the electrophoresis.
The results of this experiment were then put as an Excel data and the
graph of resistance versus temperature was produced from the data.
This experiment showed that the CNT thread has characteristics of a
NTC thermistor, where the resistance decreases as temperature
increases. This can be seen in Figure 15 below.
Fig. 14. CNT thread, alligator clip, thermometer, and copper plate placement
in the CNT as temperature sensor experiment
G. Assembly
Using the acrylic casing fabricated, nichrome wire as the heater,
carbon nanotube thread as the temperature sensor, and the
fabric-based chamber fabricated, the project is then assembled. The
circuit is built based on Figure 9 explained previously. The
assembled project can be seen in Figure 20 below. The temperature
of the heating element is monitored using an infrared camera, and the
temperature sensed from the CNT-thread temperature sensor is also
monitored using the serial monitor from Arduino IDE.
beforehand, which hinders the verification of PCR. The verification As a heating element, the CNT in the lab is found to be unsuitable
of this device to do PCR with DNA samples cannot be done yet. due to combustion at around 75˚C. Further research and
characterization is also needed. However, the potential for CNT to
perform as a heating element is present. Therefore, the alternate
nichrome wire was used in this experiment. There are still problems
due to melting jumper cables that disrupted the circuitry. Therefore,
improvements for the circuit needs to be made.
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