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Background and Purpose: Patient-Reported Measured Outcomes (PROMs) are essential to gain a full understanding of a patient's condition, and in spine surgery, these questionnaires are of help when tailoring a surgical strategy. Electronic registries allow for a systematic collection and storage of PROMs, making them readily available for clinical and research purposes. This study aimed to investigate the reliability between the electronic and paper form of ODI (Oswestry Disability Index), SF-36 (Short Form Health Survey 36) and COMI-back (Core Outcome Measures Index for the back) questionnaires., Methods: A prospective analysis was performed of ODI, SF-36 and COMI-back questionnaires collected in paper and electronic format in two patients' groups: Pre-Operatively (PO) or at follow-up (FU). All patients, in both groups, completed the three questionnaires in paper and electronic form. The correlation between both methods was assessed with the Intraclass Correlation Coefficients (ICC)., Results: The data from 100 non-consecutive, volunteer patients with a mean age of 55.6 ± 15.0 years were analysed. For all of the three PROMs, the reliability between paper and electronic questionnaires results was excellent (ICC: ODI = 0.96; COMI = 0.98; SF36-MCS = 0.98; SF36-PCS = 0.98. For all p < 0.001)., Conclusions: This study proved an excellent reliability between the electronic and paper versions of ODI, SF-36 and COMI-back questionnaires collected using a spine registry. This validation paves the way for stronger widespread use of electronic PROMs. They offer numerous advantages in terms of accessibility, storage, and data analysis compared to paper questionnaires., (© 2021. The Author(s).)

A combination of thin-film microextaction based on an aptamer immobilized on modified Whatman cellulose paper followed by electrospray ionization ion mobility spectrometry has been developed for the analysis of codeine in urine samples. The immobilization is based on the covalent linking of an amino-modified anticodeine aptamer to aldehyde groups of the oxidized cellulose paper. The covalent bonds were examined by infrared spectroscopy and elemental analysis. The effect of the extraction parameters, including the elution conditions (solvent type and volume), extraction time, and extraction temperature, on the extraction efficiency were investigated. Under the optimized conditions, the linear dynamic range was found to be 10-300 ng/mL with a detection limit of 3.4 ng/mL for codeine in urine. The relative standard deviation was 6.8% for three replicate measurements of codeine at 100 ng/mL in urine. Furthermore, the samples were analyzed with a standard method for the analysis of codeine using high-performance liquid chromatography with ultraviolet detection. The comparison of the results validates the accuracy of the proposed method as an alternative method for the analysis of codeine in urine samples.

Paper-based devices serve to address many analytical questions both inside and outside of the laboratory setting. For the first time, yeast is used to construct a whole-cell, paper-based biosensor device. This biologically based paper analytical device (BioPAD) is sensitive to antibiotics in the tetracycline family, and it could potentially address questions of pharmaceutical quality as well as antibiotic contamination in liquids. Our BioPAD can qualitatively discriminate the presence/absence of doxycycline over a range of 30-10,000 μg/mL. In an analysis of a doxycycline dosage form (tablet) commonly used for malaria prophylaxis, BioPADs identified the presence of antibiotic with 92 and 95 % sensitivity, evaluated by eye and computer-assisted image analysis, respectively, with no false positives by either method. BioPADs were found to remain viable for at least 415 days when stored at 4 °C. This research demonstrates the utility of whole yeast cells in paper-based pharmaceutical testing, and it highlights the potential for the development of yeast-based BioPADs to address a range of qualitative analytical questions, especially in low resource settings.

The incidence of flavivirus infections has increased dramatically in recent decades in tropical and sub-tropical areas worldwide, affecting hundreds of millions of people each year. Dengue viruses are typically transmitted by mosquitoes and can cause a wide range of symptoms from flu-like fever to organ impairment and death. Although conventional diagnostic tests can provide early diagnosis of acute dengue infections, access to these tests is often limited in developing countries. Consequently, there is an urgent need to develop affordable, simple, rapid, and robust diagnostic tools that can be used at 'Point of Care' settings. Early diagnosis is crucial to improve patient management and reduce the risk of complications. In the present study, a novel laser-cut device made of glass-fiber paper was designed and tested for the detection of the dengue Non Structural 1 (NS1) viral protein and specific IgM in blood and plasma. The device, called PAD, was able to detect around 25 ng/mL of NS1 protein in various sample types in 8 minutes, following a few simple steps. The PAD was also able to detect specific IgM in human plasmas in less than 10 minutes. The PAD appears to have all the potential to assist health workers in early diagnosis of dengue fever or other tropical fevers caused by flaviviruses.

A field paper-based heavy metal strip was designed and implemented for simultaneous detection of the heavy metals Zn, Cr, Cu, Pb and Mn in wastewater samples. The colorimetric paper strip was fabricated by drop-casting of chromogenic reagents onto detection zones. When the fabricated paper strip was exposed to Zn, Cr, Cu, Pb and Mn, multiple colors appeared that were then recorded with a smartphone followed by processing in the Color Picker application. After optimizing the analytical parameters, such as the chromogenic concentration, pH and reaction time, the paper strip achieved detection limits of 0.63, 0.07, 0.17, 0.03 and 0.11 mg/L for Zn, Cr, Cu, Pb and Mn, respectively. Five heavy metals analyses were able to be performed within 1 min on one paper strip. This paper strip is accurate with recoveries from 87 to 107%. The results of the proposed paper strip correlated well with those determined by inductively coupled plasma-optical emission spectrometry of wastewater samples. The use of a single paper strip integrated with a smartphone for the detection of five heavy metals in wastewater represents an all-in-one device with on-site detection, leading to cost-effective and rapid assays that show a great application potential for on-site environmental monitoring. Graphical abstract.

The use of electrospun nanofibers as functional material in paper-based lateral flow assays (LFAs) was studied. Specific chemical features of the nanofibers were achieved by doping the base polymer, poly(lactic acid) (PLA), with poly(ethylene glycol) (PEG) and polystyrene8K-block-poly(ethylene-ran-butylene)25K-block-polyisoprene10K-Brij76 (K3-Brij76) (KB). The LFAs were assembled such that the sample flowed through the nanofiber mat via capillary action. Initial investigations focused on the sustainable spinning and assembly of different polymer structures to allow the LFA format. Here, it was found that the base polymer poly(vinyl alcohol) (PVA), which was shown to function well in microfluidic biosensors, did not work in the LFA format. In contrast, PLA-based nanofibers enabled easy assembly. Three relevant features were chosen to study nanofiber-based functionalities in the LFA format: adsorption of antibodies, quantification of results, and nonspecific binding. In particular, streptavidin-conjugated sulforhodamine B (SRB)-encapsulating liposomes were captured by anti-streptavidin antibodies adsorbed on the nanofibers. Varying the functional polymer concentration within the PLA base enabled the creation of distinct capture zones. Also, a sandwich assay for the detection of Escherichia coli O157:H7 was developed using anti-E. coli antibodies as capture and reporter species with horseradish peroxidase for signal generation. A dose-response curve for E. coli with a detection limit of 1.9 × 10(4) cells was achieved. Finally, functional polymers were used to demonstrate that nonspecific binding could be eliminated using antifouling block copolymers. The enhancement of paper-based devices using functionalized nanofibers provides the opportunity to develop a broad spectrum of sensitive and specific bioassays with significant advantages over their traditional counterparts.

We report the use of bioactive paper for typing of secondary human blood groups. Our recent work on using bioactive paper for human blood typing has led to the discovery of a new method for identifying haemagglutination of red blood cells. The primary human blood groups, i.e., ABO and RhD groups, have been successfully typed with this method. Clinically, however, many secondary blood groups can also cause fatal blood transfusion accidents, despite the fact that the haemagglutination reactions of secondary blood groups are generally weaker than those of the primary blood groups. We describe the design of a user-friendly sensor for rapid typing of secondary blood groups using bioactive paper. We also present mechanistic insights into interactions between secondary blood group antibodies and red blood cells obtained using confocal microscopy. Haemagglutination patterns under different conditions are revealed for optimization of the assay conditions.

Xylanases are widely used enzymes in the food, textile, and paper industries. Most efficient xylanases have been identified from lignocellulose-degrading microbiota, such as the microbiota of the cow rumen and the termite hindgut. Xylanase genes from efficient pulp and paper wastewater treatment (PPWT) microbiota have been previously recovered by metagenomics, assigning most of the xylanase genes to the GH10 family. In this study, a total of 40 GH10 family xylanase genes derived from a certain PPWT microbiota were cloned and expressed in Escherichia coli BL21 (DE3). Among these xylanase genes, 14 showed xylanase activity on beechwood substrate. Two of these, PW-xyl9 and PW-xyl37, showed high activities, and were purified to evaluate their xylanase properties. Values of optimal pH and temperature for PW-xyl9 were pH 7 and 60 ℃, respectively, while those for PW-xyl37 were pH 7 and 55 ℃, respectively; their specific xylanase activities under optimal conditions were 470.1 U/mg protein and 113.7 U/mg protein, respectively. Furthermore, the Km values of PW-xyl9 and PW-xyl37 were determined as 8.02 and 18.8 g/L, respectively. The characterization of these two xylanases paves the way for potential application in future pulp and paper production and other industries, indicating that PPWT microbiota has been an undiscovered reservoir of efficient lignocellulase genes. This study demonstrates that a metagenomic approach has the potential to screen efficient xylanases of uncultured microorganisms from lignocellulose-degrading microbiota. In a similar way, other efficient lignocellulase genes might be identified from PPWT treatment microbiota in the future.

A novel cytorhabdovirus, tentatively named "paper mulberry mosaic-associated virus" (PMuMaV), was discovered and identified by transcriptome sequencing (RNA-seq), small RNA sequencing (sRNA-seq), and RT-PCR amplification. The whole-genome sequence of PMuMaV is 13,736 nucleotides (nt) in length and contains six open reading frames (ORFs) encoding a nucleocapsid protein (N), a phosphoprotein (P), a putative movement protein (P3), a matrix protein (M), a glycoprotein (G), and an RNA-dependent RNA polymerase (L). The coding sequences are flanked by a 194-nt leader and a 370-nt trailer sequence at the 3' terminus and 5' terminus, respectively. Pairwise sequence comparisons showed that PMuMaV is related to northern cereal mosaic virus (NCMV, 38.97%), barley yellow striate mosaic virus (BYSMV, 38.86%), and maize yellow striate virus (MYSV, 38.76%), and phylogenetic analysis also placed these viruses together into the same branch, thus suggesting that PMuMaV is a member of a new species in the genus Cytorhabdovirus.

Paper spray (PS) is an ambient ionization technique applicable to ionizing analytes from untreated dried biofluid samples. In-field sample analysis could benefit from the capability to use a finger prick of blood to measure drugs in whole blood at low cost and in a short time. Some studies may require specialized blood collection devices that can be used in remote areas. In this study, four different dried blood spot (DBS) devices are used with PS sources and tested for rapid quantification of imatinib and N-desmethyl-imatinib. A triple quadrupole mass spectrometer allows analyte detection with high sensitivity. Analytical figures of merit for the four devices are compared, and it is concluded that several of the novel devices successfully deploy DBS with PS and yield similar results to traditional manual PS methods. Clinical samples collected in a remote location were analyzed as a proof of concept for in-field blood collection and subsequent rapid laboratory analysis. Graphical abstract Dried blood spot analyis by paper spray ionization MS/MS for in field sample collection.

Despite a large body of evidence, the implementation of guidelines on hemodynamic optimization and goal-directed therapy remains limited in daily routine practice. To facilitate/accelerate this implementation, a panel of experts in the field proposes an approach based on six relevant questions/answers that are frequently mentioned by clinicians, using a critical appraisal of the literature and a modified Delphi process. The mean arterial pressure is a major determinant of organ perfusion, so that the authors unanimously recommend not to tolerate absolute values below 65 mmHg during surgery to reduce the risk of postoperative organ dysfunction. Despite well-identified limitations, the authors unanimously propose the use of dynamic indices to rationalize fluid therapy in a large number of patients undergoing non-cardiac surgery, pending the implementation of a "validity criteria checklist" before applying volume expansion. The authors recommend with a good agreement mini- or non-invasive stroke volume/cardiac output monitoring in moderate to high-risk surgical patients to optimize fluid therapy on an individual basis and avoid volume overload. The authors propose to use fluids and vasoconstrictors in combination to achieve optimal blood flow and maintain perfusion pressure above the thresholds considered at risk. Although purchase of disposable sensors and stand-alone monitors will result in additional costs, the authors unanimously acknowledge that there are data strongly suggesting this may be counterbalanced by a sustained reduction in postoperative morbidity and hospital lengths of stay. Beside existing guidelines, knowledge and explicit clinical reasoning tools followed by decision algorithms are mandatory to implement individualized hemodynamic optimization strategies and reduce postoperative morbidity and duration of hospital stay in high-risk surgical patients.

Radiofrequency denervation has been established for many years as an important minimally invasive procedure for the treatment of chronic pain conditions. Positive experiences of many users for various indications are contrasted by a nonuniform evidence. With meticulous patient selection and correct assessment of the indications a longer term reduction of pain, a reduced need for analgesics and an improvement in the quality of life can be achieved. The aim of this interdisciplinary position paper is to present the value of radiofrequency denervation in the treatment of chronic pain. The summarized recommendations of the expert group are based on the available evidence and on the clinical experiences of Austrian centers that frequently implement the procedure. The position paper contains recommendations on patient selection and proven indications. We discribe safety aspects, complications, side effects and contraindications.

This consensus paper summarizes the expert consensus and recommendations of the working group "Heart and Kidney" of the German Cardiac Society (DGK) and the German Society of Nephrology (DGfN) on contrast medium-induced acute kidney injury. Potentially nephrotoxic contrast agents containing iodine are frequently used in interventional medicine and for computer tomography diagnostics. Acute kidney injury occurs in approximately 8-17% of patients exposed to contrast media. The risk factors and underlying pathophysiology are discussed and recommendations for the prophylaxis and treatment of contrast medium-induced acute nephropathy are presented.

Unlike in developed countries, most public toilets in China do not provide toilet paper onsite and users must bring their toilet paper. Moreover, an open waste bin is placed in each user's cubicle to collect used toilet paper and tissues. Such practices, which are common in East Asia and central America, have induced a dilemma of toilet paper disposal because some municipalities have removed waste bins from public toilets to prevent virus transmission by fecal matter. As a consequence, users were forced to flush down their used toilet paper and tissues. Yet, it is unknown whether standard toilet paper can be flushed easily without causing issues in sewer operations. Here, we surveyed the conditions of toilets in university campus and other public facilities in different regions across China. We also evaluated the disintegration characteristics of toilet paper products both by conducting online surveys and by physical disintegration experiments. We found that only 15% of toilets provided toilet paper, while open waste bins occurred at nearly all sites. Further, our survey indicated that 82% of toilet paper products sold in China did not give any indication on their flushability, whereas 77% of US products did. Disintegration results showed that none of the five popular, best-selling toilet paper products passed the flushability standard. We propose strategies to solve the current toilet paper dilemma in developing communities., Competing Interests: Conflict of interestAuthors declare no conflict of interest in this work., (© Springer Nature Switzerland AG 2020.)

Non-radiologist point-of-care ultrasonography (US) is increasingly implemented in paediatric care because it is believed to facilitate a timely diagnosis, such as in ascites or dilated renal pelvicalyceal systems, and can be used to guide interventional procedures. To date, all policy statements have been published by non-radiologic societies. The European Society of Paediatric Radiology hereby issues a position statement on paediatric non-radiologist point-of-care US from the point of view of those leading on children's imaging, i.e. paediatric radiologists. In this position statement, we will address the boundaries, education, credentialing, quality control, reporting and storage of images in paediatric practice.

A paper-based visual fluorescence immunoassay is presented for the detection of matrix metalloproteinase-7 (MMP7) that is related to renal cancer. The method is based on the distance-dependent fluorescence quenching of CdTe quantum dots (QDs) on a nitrocellulose membrane by Ag + following a sandwich-type immunoreaction on microtiter wells using silver nanoparticle (AgNP)-labeled secondary antibody- and primary antibody-coated microtiter wells. The silver nanoparticles captured in the well are dissolved with HNO 3 , while the quenching effect of QDs is based on silver ion-exchange reaction under 365-nm excitation light irradiation. Increasing concentration of released Ag + , thus higher concentration of the protein, leads to an increased distance of quenching on the nitrocellulose membrane. The paper-based immunoassay by combination of AgNP-assisted ion-exchange reaction with QD gives good distance-dependent responses and allows the detection of MMP7 at a concentration as low as 7.3 pg mL -1 . The coefficients of variation are less than 6.9% and 12.4% for intra-assay and inter-assay, respectively. High specificity and long-term stability are achieved during the assay. Importantly, the testing of human serum samples using our strategy shows well-matched results with commercial human MMP7 ELISA kits. Graphical abstract A distance-dependent visual immunoassay is developed for the determination of serum matrix metalloproteinase-7 on CdTe quantum dot-impregnated paper with silver ion-exchange reaction.

A rapid and sensitive colorimetric assay is described for Salmonella typhimurium (S. typhimurium) detection using urea/phenol red impregnated test paper. Aptamer-modified Fe 3 O 4 @Ag multifunctional hybrid nanoprobes (apt-Fe 3 O 4 @Ag NPs) were used to specifically captured S. typhimurium; the nanoprobes were quickly etched by H 2 O 2 to form Ag + . The generated Ag + can inhibit the urease-catalyzed hydrolysis reaction of urea to produce NH 4 . Consequently, the as-prepared test paper displayed a yellow color. In the presence of S. typhimurium, the target bacteria can cause aggregation of apt-Fe + . Consequently, the as-prepared test paper displayed a yellow color. In the presence of S. typhimurium, the target bacteria can cause aggregation of apt-Fe 3 O 4 @Ag NPs, and the deposited Ag on the nanoprobe's surface is shielded against H 2 O 2 -induced oxidative decomposition leading to reduced Ag + . An obvious color change from yellow to pink can be monitored directly using our test paper as a result of increased NH + . An obvious color change from yellow to pink can be monitored directly using our test paper as a result of increased NH 4 + . The entire assay procedure could be completed within 1 h. A limit of detection of 48 cfu/mL is achieved with a linear range of 1 × 10 2 to 1 × 10 6  cfu/mL. The recoveries of S. typhimurium spiked in pure milk samples were 92.48-94.05%. Graphical abstract Schematic diagram of the proposed colorimetric assay for S. typhimurium detection based on etching of bifunctional apt-Fe 3 O 4 @Ag NPs and inhibiting catalytic activity of urease by Ag + . A color change from yellow to pink can be observed and correlated to the concentration of S. typhimurium.

The diagnosis of dengue infection is still a critical factor determining success in the clinical management and treatment of patients. Here, the development of microfluidic paper-based analytical devices (μPADs) utilizing a sandwich immunoassay on wax patterned paper functionalized with anti-dengue NS1 monoclonal antibodies for point-of-care detection of dengue NS1 (DEN-NS1-PAD) is reported. Various assay conditions, including the length of the channel and diluent, were optimized, and the response detected by the naked eye and digitized images within 20-30 min. The DEN-NS1-PAD was successfully tested in the field for detecting dengue NS1 in buffer, cell culture media, and human serum. The limit of detection (LoD) of the DEN-NS1-PAD obtained with the naked eye, scanner, and a smartphone camera was 200, 46.7, and 74.8 ng mL -1 , respectively. The repeatability, reproducibility, and stability of the DEN-NS1-PAD were also evaluated. High true specificity and sensitivity in the serum of pediatric patients were observed. These evaluation results confirm that the DEN-NS1-PAD can potentially be used in point-of-care dengue diagnostics, which can significantly impact on the spreading of mosquito-borne diseases, which are likely to become more prevalent with the effects of global warming. Graphical Abstract.

Paper-based devices have been very much in the foreground of analytical science recently. This work innovatively proposed a fluorescent paper-based sensor (FPS) constructed on a hybrid polydimethylsiloxane (PDMS)/paper platform where cellulose papers functionalized with carbon dots (CDs) as fluorophores by Schiff base chemistry were loaded on the grooves array of a designed PDMS plate. As a proof of concept, the performance of FPS was investigated with folic acid (FA) as the target analyte. Under optimal conditions, FPS enabled a rapid fluorescence quenching response to FA via inner filter effect in a wide range of 1-300 μmol L -1 with the limit of detection of 0.28 μmol L -1 . The feasibility of FPS was further verified by the detection of FA in orange juice and urine samples with satisfactory results. The covalent modification of CDs on paper endowed the FPS with good assay reproducibility and stability. Interestingly, FPS achieved a more sensitive assay of FA than the conventional strategy, by which the same CDs were directly used to detect FA in a solution-based system. The FPS illuminated a novel strategy for construction of reliable and sensitive assays based on paper-based devices. It is of paramount importance for its practical application in biosensing and clinical diagnosis. Graphical abstract.

This work presents a portable microfluidic paper-based analytical device (micro-PAD) card for the quantification of total ammonia nitrogen in human saliva. The amount of total ammonia nitrogen in saliva can be an indicator of the status of the oral microbiome with potential correlation to kidney health problems. The developed micro-PAD card comprises twenty units consisting of three stacked layers of circular discs: the sample layer, paper discs impregnated with sodium hydroxide solution, the PTFE membrane layer, and the detection layer, paper discs impregnated with bromothymol blue. The twenty units were aligned on transparent laminating pouches laminated to form the micro-PAD card (7.5 cm × 10.5 cm). Saliva samples can be directly dispensed onto the micro-PAD card and the detection was achieved by the BTB indicator color change, from yellow to blue, after conversion of ammonium into ammonia and diffusion of the ammonia gas through a hydrophobic layer. The determination of total ammonia nitrogen in saliva using the developed micro-PAD card intended to be very simple method and operated without the need of laboratory equipment. A quantification limit of 11.3 NH 4 + mg L -1 and linear application range from up to 150 NH 4 + mg L -1 were obtained making it suitable for the expected concentrations of total ammonia nitrogen in human saliva. It was successfully applied to saliva samples and its validation obtained by comparison against a potentiometric method. The card is stable for at least 1 month making it ideal as a portable device for point-of-care diagnosis. Graphical Abstract.

This work presents an affordable distance-based microfluidic paper-based device (μPAD), using polydiacetylene (PDA) liposome as a chromogenic substance with a smartphone-based photo editor, for rapid and in-field analysis of quaternary ammonium compounds (QACs) (e.g., didecyldimethylammonium chloride (DDAC), benzyldimethyltetradecyl ammonium chloride (BAC), and cetylpyridinium chloride (CPC)). In-field analysis of these compounds is important to ensure their antimicrobial activity and user safety since they are widely utilized as disinfectants in households and hospitals. The μPAD featured a thermometer-like shape consisting of a sample reservoir and a microchannel as the detection zone, which was pre-deposited with PDA liposome. The color change from blue to red appeared in the presence of QACs and the color bar lengths were proportional to the QAC concentrations. Reactions of QACs with the PDA required a specific pH range (from pH 4.0 to 10.0) and a readout time of 7 min. Analytical performance characteristics of the device were tested with DDAC, BAC, and CPC showing acceptable specificity, accuracy (96.1-109.4%), and precision (%RSDs ≤ 9.3%). Limits of detection and quantitation were in the ranges of 20 to 80 and 70 to 250 μM, respectively. Feasibility of the newly developed device was demonstrated for in-field analysis of QACs in fumigation solution providing comparable results with those obtained from a colorimetric assay (P > 0.05). The proposed device shows potentials for further applications of other analytes since it offers speed, simplicity, and affordability for in-field analysis, especially in remote areas where expertise, resources, and infrastructures are limited. Graphical abstract.

A challenge for paper-based cation sensors relying on classical carrier-based ion-selective optodes (ISOs) is their pH-cross response caused by the use of H + -sensitive chromoionophores as optical signal transducers. This work demonstrates fully pH-independent fluorescence-based calcium detection with a paper-based plasticizer-free ISO. To achieve a pH-independent assay, a solvatochromic dye (SD) instead of a traditional H + -sensitive chromoionophore has been applied to the paper-based ISO by means of inkjet printing technology. The detection principle depends on an ionophore-driven phase-transfer ion-exchange reaction between target cations and the positively charged SD, which no longer involves H + in the optical signal transduction process. The developed paper-based ISOs with the SD resulted in Ca 2+ concentration-dependent response curves not affected by the sample pH (pH 6.0, 7.0, and 8.0). The dynamic range obtained for Ca 2+ detection was from 10 -5 to 1 mol L -1 with a detection limit of 19.3 μmol L -1 . Additionally, excellent selectivity derived from the used ionophore has been confirmed. As a simple practical application, the determination of Ca 2+ in mineral water has been achieved without the pH-buffering process required for conventional cation-exchange ISOs.

A simple probe pair was designed for the detection of hemoglobin E (HbE) genotype, a single-point mutation that leads to abnormal red blood cells commonly found in South East Asia. The key to differentiation is the use of a conformationally constrained peptide nucleic acid (PNA) that was immobilized on carboxymethylcellulose-modified paper. This was then used for target DNA binding and visualization by an enzyme-catalyzed pigmentation. The biotinylated target DNA bound to the immobilized probe was visually detected via alkaline phosphatase-linked streptavidin. This enzyme conjugate catalyzed the dephosphorylation of the substrate 5-bromo-4-chloro-3-indolyl phosphate, leading to a series of reactions that generate an intense, dark blue pigment. The test was validated with 100 DNA samples, which shows good discrimination among different genotypes (normal, HbE, and heterozygous) with 100% accuracy when optimal conditions of analysis were applied. The method does not require temperature control and can be performed at ambient temperature. This is an attractive feature for diagnosis in primary care, which accounts for a large part of affected population. Graphical abstract Schematic representation of a paper-based sensor for the detection of the gene Hemoglobin E. The interaction between an immobilized peptide nucleic acid and a DNA target leads to enzymatic pigmentation, allowing simple visual readout with up to 100% accuracy.

Mushroom cultivation is an economically feasible bio-technological process for conversion of various lignocellulosic wastes. The aim of this study was to evaluate the suitability of waste paper supplemented with corn stalk and wheat bran for oyster mushroom cultivation. Pure culture of Oyster mushroom (Pleurotus ostreatus (Jacq.: Fr.) Kummer) was purchased from YB Plant Micropropagation Plc; Mekelle, Ethiopia. Then, the pure culture was used as inoculum for spawn preparation using sorghum prepared in Microbiology laboratory, Department of Biology, Aksum University. Waste paper supplemented with corn stalk and wheat bran with 0%, 25% and 50% were prepared. The substrates were mixed with the spawn that has been inoculated with pure culture of oyster mushroom aseptically for their productivity and biological efficiency (BE) for cultivation of P. ostreatus mushroom. Data were analyzed using SPSS version 20. Higher (26.20 ± 19.36) mean weight, pileus diameter (7.90 ± 2.66 cm), total yield (646.4 ± 273.1 g) and BE (64.64 ± 273%) were obtained from waste paper (50%) supplemented with cornstalk (25%) and wheat bran (25%). And lower (17.92 ± 81.95%) BE were obtained from waste paper (100%). Moreover, the highest (3.88 ± 0.32 cm) mean stalk length was obtained from waste paper (50%) supplemented with corn stalk (50%). This study revealed that waste paper supplemented with corn stalk and wheat bran resulted in high BE and total yield. Thus, utilization of waste paper appears to be a promising alternative for the cultivation of oyster mushroom when supplemented with other substrates.

Process-monitoring laboratories in the pulp and paper industry generally use a combination of wet chemical analyses and physical measurements to certify the fitness of a production pulp for a specific end-use. These laboratory tests require time and the effort of trained personnel, limiting their utility for real-time process control. Here we show that Raman probes of unrefined cellulosic pulps, well-suited to the online measurement of in-process materials, can predict the quality attributes of manufactured papers. The accuracy of prediction improves when the covariance is modelled in a reduced measurement space selected by a data-driven, feature-selection technique referred to as a Template Oriented Genetic Algorithm (TOGA). TOGA, combined with discrete wavelet transform (DWT), isolates functional-group features that correlate best with mechanical properties paper derived from refined pulp. Paper makers refine market pulps to build sheet strength using a beating process that decreases freeness as it increases fibre-fibre bonding. Methods demonstrated here predict manufactured sheet properties obtainable after any specified degree of refining from the Raman spectrum of an unrefined pulp. This analysis capacity will enable both vendors of market pulp and makers of sheet paper to specify in advance the amount of beating required to produce a desired product, thereby saving cost and conserving resources.

Bioprocessing of pulp requires lignolytic as well as hemicellulolytic enzymes. The present study is the first report of a cocktail of laccase (L), xylanase (X), and mannanase (M), from a single bacterium for pulp biobleaching. A novel strain Bacillus tequilensis LXM 55 produced thermo-alkali stable L + X + M. On optimization higher enzyme yield (IUml -1 /fold increase) of laccase (396.35/24.16), xylanase (212.95/81.90) and mannanase (153.33/102.90) were achieved in the cocktail. Treatment of pulp with cocktail of enzymes led to 49.35% reduction in kappa number and considerable enhancement in the brightness (11.59%), whiteness (4.11%), and other pulp properties. Most importantly, no mediator system was required for the application of laccase. 40% less chlorine consumption was required to obtain the paper of the same quality as that of pulp treated without enzyme but with 100% chlorine. Therefore, this cocktail of enzymes is highly suitable for pulp biobleaching in the paper mill.

Purpose: Associations between various malignancies and work in the pulp and paper industry have been reported but mostly in analyses of mortality rather than incidence. We aimed to study cancer incidence by main mill pulping process, department and gender in a Swedish cohort of pulp and paper mill workers., Methods: The cohort (18,113 males and 2,292 females, enrolled from 1939 to 1999 with >1 year of employment) was followed up for cancer incidence from 1958 to 2001. Information on the workers' department and employment was obtained from the mills' personnel files, and standardized incidence ratios (SIRs) were calculated using the Swedish population as reference., Results: Overall cancer incidence, in total 2,488 cases, was not increased by work in any department. However, risks of pleural mesothelioma were increased among males employed in sulphate pulping (SIR, 8.38; 95 % CI, 3.37-17) and maintenance (SIR, 6.35; 95 % CI, 3.47-11), with no corresponding increase of lung cancer. Testicular cancer risks were increased among males employed in sulphate pulping (SIR, 4.14; 95 % CI, 1.99-7.61) and sulphite pulping (SIR, 2.59; 95 % CI, 0.95-5.64). Female paper production workers showed increased risk of skin tumours other than malignant melanoma (SIR, 2.92; 95 % CI, 1.18-6.02)., Conclusions: Incidence of pleural mesothelioma was increased in the cohort, showing that asbestos exposure still has severe health consequences, and highlighting the exigency of strict asbestos regulations and elimination. Testicular cancer was increased among pulping department workers. Shift work and endocrine disruptors could be of interest in this context.

The molecular imaging of paper cross sections containing the wet-strength additive poly(amidoamine)-epichlorohydrin (PAE) was effected by Fourier transform infrared (FT-IR) spectroscopic imaging. Thin cross sections of laboratory sheet samples were prepared and transferred onto CaF2 substrates. A laboratory sheet sample without PAE acted as a reference. Principal component analysis (PCA) was applied to identify and to reveal the distribution of PAE across the section. Differences in the loading plots of the fourth and fifth principal components for the sheets with and without PAE were found in the region of the amide I, amide II, and amine bands within a variance of 0.4-0.8%. The score images of the PCA reveal inhomogeneous distribution of PAE. Small areas of higher concentration of PAE occur across the cross section. The aim of this study was to demonstrate that FT-IR spectroscopic imaging provides spatially resolved quantitative information about the chemical composition of paper, which was successfully achieved.

A novel washing technique for microfluidic paper-based analytical devices (μPADs) that is based on the spontaneous capillary action of paper and eliminates unbound antigen and antibody in a sandwich immunoassay is reported. Liquids can flow through a porous medium (such as paper) in the absence of external pressure as a result of capillary action. Uniform results were achieved when washing a paper substrate in a PDMS holder which was integrated with a cartridge absorber acting as a porous medium. Our study demonstrated that applying this washing technique would allow μPADs to become the least expensive microfluidic device platform with high reproducibility and sensitivity. In a model μPAD assay that utilized this novel washing technique, C-reactive protein (CRP) was detected with a limit of detection (LOD) of 5 μg mL -1 . Graphical Abstract A novel washing technique for microfluidic paper-based analytical devices (μPADs) that is based on the spontaneous capillary action of paper and eliminates unbound antigen and antibody in a sandwich immunoassay is reported.

Paper-based artworks are among the most valuable assets for transmission of knowledge. Historical paper is composed of different polysaccharides (e.g. cellulose), binders, and glues. During aging all of these components undergo several degradation processes, as a result of external and intrinsic causes, and these can compromise the state of conservation of the document. In this work, application of a new biotechnological strategy for paper artefact preservation is reported. By making use of innovative and non-invasive materials, for example appropriate hydrogels, in combination with selective electrochemical biosensors, it is possible to simultaneously verify the degradation condition of the paper artwork and then to efficiently clean it, while monitoring the process of removal of both pollution and degradation products. In this paper, we focus on specific examples in which such techniques have been applied to paper artworks and that illustrate the advantages and potential of this biotechnology compared with the traditional paper-cleaning methods currently in use.

Rapid, sensitive, on-site detection of bacteria without a need for sophisticated equipment or skilled personnel is extremely important in clinical settings and rapid response scenarios, as well as in resource-limited settings. Here, we report a novel approach for selective and ultra-sensitive multiplexed detection of Escherichia coli (non-pathogenic or pathogenic) using a lab-on-paper test strip (bioactive paper) based on intracellular enzyme (β-galactosidase (B-GAL) or β-glucuronidase (GUS)) activity. The test strip is composed of a paper support (0.5 × 8 cm), onto which either 5-bromo-4-chloro-3-indolyl-β-D: -glucuronide sodium salt (XG), chlorophenol red β-galactopyranoside (CPRG) or both and FeCl(3) were entrapped using sol-gel-derived silica inks in different zones via an ink-jet printing technique. The sample was lysed and assayed via lateral flow through the FeCl(3) zone to the substrate area to initiate rapid enzyme hydrolysis of the substrate, causing a change from colorless-to-blue (XG hydrolyzed by GUS, indication of nonpathogenic E. coli) and/or yellow to red-magenta (CPRG hydrolyzed by B-GAL, indication of total coliforms). Using immunomagnetic nanoparticles for selective preconcentration, the limit of detection was ~5 colony-forming units (cfu) per milliliter for E. coli O157:H7 and ~20 cfu/mL for E. coli BL21, within 30 min without cell culturing. Thus, these paper test strips could be suitable for detection of viable total coliforms and pathogens in bathing water samples. Moreover, inclusion of a culturing step allows detection of less than 1 cfu in 100 mL within 8 h, making the paper tests strips relevant for detection of multiple pathogens and total coliform bacteria in beverage and food samples.

Research into paper-based sensors or functional materials that can perform analytical functions with active recognition capabilities is rapidly expanding, and significant research effort has been made into the design and fabrication of bioactive paper at the biosensor level to detect potential health hazards. A key step in the fabrication of bioactive paper is the design of the experimental and operational procedures for the immobilization of biomolecules such as antibodies, enzymes, phages, cells, proteins, synthetic polymers and DNA aptamers on a suitably prepared paper membrane. The immobilization methods are concisely categorized into physical absorption, bioactive ink entrapment, bioaffinity attachment and covalent chemical bonding immobilization. Each method has individual immobilization characteristics. Although every biomolecule-paper combination has to be optimized before use, the bioactive ink entrapment method is the most commonly used approach owing to its general applicability and biocompatibility. Currently, there are four common applications of bioactive paper: (1) paper-based bioassay or paper-based analytical devices for sample conditioning; (2) counterfeiting and countertempering in the packaging and construction industries; (3) pathogen detection for food and water quality monitoring; and (4) deactivation of pathogenic bacteria using antimicrobial paper. This article reviews and compares the different biomolecule immobilization techniques and discusses current trends. Current, emerging and future applications of bioactive paper are also discussed.

Paper is a widely used support for use in devices for point-of-care testing (POCT) in clinical diagnosis, food safety monitoring and environmental pollution. Paper is inexpensive, biocompatible, biodegradable and allows a sample fluid to flow by capillary force. Numerous method have been developed recently for chemical modification of papers in order to introduce different functionalities. This review (with 148 refs.) summarizes the recent progress in paper-based POCT devices. The introduction summarizes the state of the art of paper-based POCT devices and the physicochemical properties of existing unmodified materials (including cellulose, cellulose-based composites, cotton fibers, glass fibers, nitrocellulose, thread). Methods for paper modification for sample pretreatment are summarized next, with subsections on sample storage and collection, sample separation, nucleic acid extraction and sample preconcentration. Another main section covers approaches for paper modification for improving POCTs, with subsections on assays for proteins, nucleic acids, drugs, ion and organic molecules. The advantages and disadvantages of these approaches are compared. Several tables are presented that summarize the various modification techniques. A concluding section summarizes the current status, addresses challenges and gives an outlook on future perspectives of POCTs. Graphical abstract This review summarizes the progress that has been made in paper based point-of-care testing (POCT) and lateral flow assays (LFAs), quite often by using advanced nanomaterials for paper modification.

Ethanol production from the steam-exploded mixture of 75% cotton gin waste and 25% recycled paper sludge in various conditions was investigated by semi-simultaneous saccharification and fermentation (SSSF) consisting of a pre-hydrolysis and a simultaneous saccharification and fermentation (SSF). Four cases were studied: 24-h pre-hydrolysis + 48-h SSF (SSSF 24), 12-h pre-hydrolysis + 60-h SSF (SSSF 12), 72-h SSF, and 48-h hydrolysis + 24-h fermentation (SHF). The ethanol concentration, yield, and productivity of SSSF 24 were higher than those of the other operations. A model of SSF was used to simulate the data for four components in SSF. The analysis of the reaction rates of cellobiose, glucose, cell, and ethanol using the model and the parameters from the experiments showed that there was a transition point of the rate-controlling step at which the cell growth control in the initial 2 h was changed to the cellobiose reaction control in later period during ethanol production of SSF from the mixture.

The potential hazards associated with industrial effluents, coupled with increasing awareness of environment problems, have prompted many countries to limit the indiscriminate discharge of untreated wastewaters. The pulp and paper industry has been among the most significant of industrial polluters of the waterways, and therefore has been one of the industries of concern. The pulp and paper industry produces large quantities of brown/black effluent that primarily result from pulping, bleaching, and paper-making production stages. The dark color and toxicity of pulp-paper mill effluent comes primarily from lignin and its chlorinated derivatives (e.g., lignosulphonic acid, resins, phenols, and hydrocarbons) that are released during various processing steps of lignocellulosic materials. The color originates from pulping and pulp bleaching stages, while adsorbable organic halides (AOX) originates exclusively from chlorine bleaching. Discharge of untreated effluent results in increased BOD/COD, slime growth, thermal problems, scum formation, discoloration, loss of aesthetic quality and toxicity to the aquatic life, in the receiving waterbodies. The dark brow color of pulp-paper effluent is not only responsible for aesthetic unacceptability, but also prevents the passage of sunlight through colored waterbodies. This reduces the photosynthetic activity of aquatic flora, ultimately causing depletion of dissolved oxygen. The pulp-paper organic waste, coupled with the presence of chlorine, results in the generation of highly chlorinated organic compounds. These toxic constituents of wastewater pose a human health risk through long term exposure. via drinking water and\or through consumption of fish that can bioaccumulate certain pollutants from the food chain. Therefore, considerable attention has been focused by many countries on decolorization of paper mill effluents , along with reduction in the contaminants that pose human health or other environmental hazards. Various physicochemical remediation treatments in the pulp-paper industry are now used, or have been suggested, but often are not implemented, because of the high cost involved. More recently, the paper and pulp industry has been investigating the use of biological remediation steps to replace or augment current treatment strategies. Certain biological treatments offer opportunities to reduce cost (both capital and operating), reduce energy consumption, and minimize environmental impact. Two primary approaches may be effective to curtail release of toxic effluents: first, development of pulping and bleaching processes that emphasize improved oxygen delignification or biopulping, plus partial or complete replacement of chlorine treatment with hydrogen peroxide or with biobleaching; second, implementation of biological processing that involves sequential two-step anaerobic-aerobic or three-step aerobic-anaerobic treatment technologies at end of pipe. The selection of the specific process will depend upon the type of pollutants/toxicants/mutagens present in the effluent. The use of environmental-friendly technologies in the pulp and paper industry is becoming more popular, partly because of increasing regulation, and partly because of the availability of new techniques that can be used to economically deal with pollutants in the effluents. Moreover, biotechnology research methods are offering promise for even greater improvements in the future. The obvious ultimate goal of the industry and the regulators should be zero emission through recycling of industrial wastewater, or discharge of the bare minimum amount of toxicants or color.

The present study investigated the impact of the dominant hand on performance in two paper-and-pencil tests of visual selective attention (d2-R; FAIR-2). We hypothesized that preview benefits (i.e., preprocessing of stimuli located to the right of the currently fixated item) could improve test performance of left-handers as compared to right-handers because using the right hand could prevent preview benefits simply by covering subsequent stimuli. A group of left-handed students (n = 86) and a group of right-handed students (n = 90) completed both the test d2-R and the test FAIR-2 with their dominant (writing) hand. Results showed that left-handed participants outperformed right-handers in both tests. Hence, when the results of left-handers are to be compared to right-handers or to normative data (which are dominated by right-handers), the impact of preview benefits on left-hander performance should be taken into account.

Despite recent advancements in the field of microfluidic paper-based analytical devices (μPADs), a key challenge remains in developing a simple and efficient μPAD with customized imaging capabilities for antioxidant assays. In the present study, we report a facile approach for μPAD fabrication through the application of transparent nail paint leading to creation of hydrophobic barriers and well-defined channels. The resultant μPADs were then characterized through scanning electron microscopy and contact angle measurements. The resolution and functional features of the fabricated μPAD were amenable to the intended assay. The μPAD's impregnated poly(methacrylic acid) (PMAA)-coated cerium oxide (CeO 2 ) nanoparticles oxidized the 3,3',5,5'-tetramethylbenzidine (TMB) leading to the formation of a blue-colored charge-transfer complex. The addition of different antioxidant standard solutions resulted in a reduction in the blue color in a dose-dependent manner which could be observed visually. The color intensity of the PMAA-CeO 2 nanoparticle@TMB oxidation product was inversely proportional to the antioxidant concentration and was measured using customized in-house MATLAB-based image processing software. Importantly, PMAA-CeO 2 nanoparticle-based μPADs demonstrated good analytical characteristics and were able to be stored for long periods without any loss of activity. Moreover, potential interferents did not pose any threat to the colorimetric signal read-out for determination of antioxidant activity. The developed method was further applied for the assessment of antioxidant activity in a variety of tea samples and performed satisfactorily in comparison with a commonly used antioxidant detection method. Collectively, the developed μPAD-based platform holds great potential as a low-cost, convenient, portable and reliable method for pursuing various on-site antioxidant assays. Graphical Abstract.

A colorimetric assay was developed which has the capability of determining urea in biological samples. It is an origami paper-based sensor consisting of silver nanoparticles that were synthesized by using two different capping agents: thiomalic acid and maltol. The function of the assay relied on hydrolysis of urea to ammonia and carbon dioxide in the presence of urease. The products interacted with nanoparticles which caused aggregation. Interestingly, thiomalic acid capped with silver nanoparticles were selective to ammonia, and the other nanoparticles synthesized by maltol responded to carbon dioxide. These interactions turned the color of nanoparticles from yellow to brown and red, respectively. The resulting colorations were captured by a floatable scanner. A routine image analysis software was utilized to provide the response of the assays. The method was applied to individually determine ammonia, carbon dioxide, and urea. The linear range was 0.06 mg.dL -1 -170.0 mg.dL -1 for ammonia, 0.08 mg.dL -1 -220.0 mg.dL -1 for carbon dioxide, and 0.5 mg.dL -1 -200.0 mg.dL -1 for urea. The respective limits of detection were 0.03 mg.dL -1 , 0.06 mg.dL -1 , and 0.18 mg.dL -1 . No interferences were found in the detremination of urea. The method demonstrates a reliable performance for determination of urea in both saliva and blood samples. Graphical Abstract Schematic representation of paper based colorimetric sensor based on silver nanoparticles for both qualitative and quantitative analyses of urea in biological samples.

A ratiometric fluorescent test pen filled with a mixing ink of blue carbon dots (CDs) and red CdTe quantum dots (CdTe QDs) is introduced for portable assay of silver ion (Ag(I)) on paper. The mixing ink was tuned with ratiometric fluorescent intensity of 1:5, and then filled into a vacant commercial fluorescent pen core. Writing/painting a random word/figure on a blank paper can make the most portable nanoprobe determining Ag(I) by visualization. Ag(I) can adsorb onto the surface of CdTe QDs, which leads to the formation of surficial Ag 2 Te layer by an ion-exchanging reaction. This enables the red fluorescence of CdTe QDs (with excitation/emission maxima at 360/628 nm) to be quenched. Due to the unchanged blue fluorescence of CDs (with excitation/emission maxima at 360/440 nm) as internal standard, the solution color evolves gradually from red to blue with the increase of Ag(I) concentration with a detection limit of 3.48 nM. This is at least 2 orders of magnitude lower than the limit defined by World Health Organization (WHO) in drinkable water. The fluorescent test pen has also been used for the determination of Ag(I) in wastewater. Graphical abstract Ag(I) can adsorb on the surface of CdTe QDs to quench their fluorescence, while the fluorescent intensity of CDs keep constant, accompanying color change with the increase of Ag(I) concentration. The method offers a visual assay of Ag(I) in water.

A disposable surface-enhanced Raman scattering (SERS) substrate was prepared by successively spraying silver nanoparticles (AgNPs) and gold nanoparticles (AuNPs) onto commercial filter paper using an inexpensive consumer sprayer. The strong surface enhancement of AgNPs and chemical stability of AuNPs can be advantageously combined. The substrate exhibited excellent SERS activity for malachite green (MG), methylene blue (MB), and crystal violet (CV) under 785-nm excitation, with limits of detection (LODs) of 4.3 × 10 -9 , 2.0 × 10 -8 , and 8.1 × 10 -8  M, respectively. The substrate exhibited long-term stability, and it can be stored under ambient conditions for 4 weeks with a relative standard deviation of less than 3% among peak intensities. The substrate also showed good reproducibility with a relative standard deviation of 7.1% among different substrate peak intensities. The substrates enable on-site determination of residual fishery drugs and distinguish MG, MB, and CV mixtures in spiked fish within 5 min, and the average recoveries in fish scales and fish meat were better 90.1% and 76.9%, respectively. The method exhibited rapidity, simplicity, and high sensitivity and is expected to be used for the screening of additives in food.

Of 13 thermal printing papers analyzed, 11 contained 8-17 g/kg bisphenol A (BPA). When taking hold of a receipt consisting of thermal printing paper for 5 s, roughly 1 microg BPA (0.2-6 microg) was transferred to the forefinger and the middle finger if the skin was rather dry and about ten times more if these fingers were wet or very greasy. This amount transferred to dry skin was neither significantly increased when taking hold of the paper at up to 10 sites, nor reduced when BPA-free paper was contacted afterwards. After 60-90 min, BPA applied to the skin as a solution in ethanol was only partially or no longer at all extractable with ethanol, whereas BPA transferred to the skin by holding thermal printer paper remained largely extractable after 2 h. This suggests that penetration of the skin depends on the conditions. Extractability experiments did not enable us to conclude whether BPA passes through the skin, but indicated that it can enter the skin to such a depth that it can no longer be washed off. If this BPA ends up in the human metabolism, exposure of a person repeatedly touching thermal printer paper for 10 h/day, such as at a cash register, could reach 71 microg/day, which is 42 times less than the present tolerable daily intake (TDI). However, if more than just the finger pads contact the BPA-containing paper or a hand cream enhances permeability of the skin, this margin might be smaller.

This article describes the use of microfluidic paper-based analytical devices (muPADs) to perform quantitative chemical assays with internal standards. MicroPADs are well-suited for colorimetric biochemical assays; however, errors can be introduced from the background color of the paper due to batch difference and age, and from color measurement devices. To reduce errors from these sources, a series of standard analyte solutions and the sample solution are assayed on a single device with multiple detection zones simultaneously; an analyte concentration calibration curve can thus be established from the standards. Since the muPAD design allows the colorimetric measurements of the standards and the sample to be conducted simultaneously and under the same condition, errors from the above sources can be minimized. The analytical approach reported in this work shows that muPADs can perform quantitative chemical analysis at very low cost.

This paper deals with the study of the kinetic migration of a series of organic compounds representative of potential contaminants in packaging materials and used as surrogates (o-xylene, acetophenone, dodecane, naphthalene, 2,3,4-trichloroanisole, benzophenone, isomeric mix of diisopropylnaphthalene, diisobutyl phthalate and methyl stearate). Migration to one side of a solid simulant, Tenax, also referred to as MPPO (modified polyphenylene oxide), was investigated in this study. One spiked sample of multilayer material was used to optimise the extraction procedures for the multilayer paper-based material and the Tenax as well as to perform kinetic migration studies. Three sequential extractions using ethanol were necessary for the strips of the multilayer material but only one extraction was necessary for the solid simulant to obtain >70% recovery of the surrogates. These results enabled us to specify the extraction requirements of the multilayer sample and the solid simulant and as well as those of the migration tests at high temperature using Tenax as solid simulant. The matrix effect associated with the extraction of the contaminants from the multilayer sample is also discussed.