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Fibrinogen (FIB) plays a key role in blood coagulation and thrombosis and its concentration in blood can directly reflect health conditions, thus efficient detection of FIB would benefit the treatments of certain diseases such as liver and heart diseases. However, there is a lack of sensitive, simple, rapid and cheap FIB detection device currently, in lieu of expensive and sophisticated approaches in laboratories. Here, we propose a novel plasma separation and FIB detection platform based on a microfluidic paper-based analytical device (μPAD). It is the first time that dielectrophoretic (DEP) force is combined with capillary force on paper for plasma separation, and the separation efficiency of plasma reaches about 95%, ensuring reliable downstream FIB detection, for which we also propose a new method called the resistance-fibrinogen detection (RFD) method. It not only avoids the use of large-scale instruments for detection, but also possesses high precision and simplicity. The method is found to be reliable in FIB detection for various concentrations ranging from 127.0 to 508.0 mg dL -1 . Moreover, the results obtained from the proposed μPAD show an excellent agreement (R 2 = 0.9985) with those obtained from an automatic coagulation analyzer with natural human blood samples. Overall, the proposed platform provides a low-cost and reliable approach for FIB detection, especially for clinical use in resource-limited areas.

Globally, rapid development of antibiotic resistance amongst pathogens has led to limited treatment options and high indirect costs to health management. There is a need to avoid misuse of available antibiotics and to develop rapid, affordable and accessible diagnostic technologies to detect drug resistance even in resource limited settings. This study reports the development of instrument-free point-of-care devices for detection of antibiotic resistance for rapid diagnosis of drug resistance in the penicillin, cephalosporin and carbapenem groups of antibiotics. The simple paper-based devices for flow through assay determine the presence of resistant bacteria in a sample by a visible colour change within 30 minutes. At the center of this technology is the unique sensing nanomaterial comprising of core-shell nanoparticles layered with specific antibiotics. The core is comprised of chitosan nanoparticles of size ∼15 nm coated with the starch-iodine indicator to form a shell increasing the size to ∼47 nm. The test strip is coated with the nanoparticles, air-dried and overlayed with the required antibiotic. In the presence of penicillin, cephalosporin and carbapenem resistant bacteria, the core-shell nanoparticles undergo a visible colour change from blue to white. The core-shell nanoparticles were deposited on paper to form a point-of-care device. Devices were developed to screen for three main classes of antibiotics namely penicillins, cephalosporins and carbapenems. The devices were validated using standard resistant and susceptible ATCC strains in three different sample types, pure colony, broth culture and saline suspensions. The change of colour from blue to white was considered a positive test. The time of detection was found to be 30 min, while the limit of detection was 10 5 cfu ml -1 . The device exhibited 100% sensitivity and specificity with known resistant and susceptible cultures not only from pure colonies but also from direct samples of spiked saline suspensions with graded confounding factors of albumin, glucose, and urea. The inter-device reproducibility and storage stability of the devices was established. The developed point-of-care devices have potential as screening devices for antimicrobial resistance.

We report for the first time a highly sensitive and rapid quantitative method for the detection of Salmonella Typhimurium (S. Typhimurium) using a conductive immunosensor on a paper-based device (PAD). S. Typhimurium monoclonal antibodies (MA) were first immobilized on a paper-based device and then captured by S. Typhimurium. After an immunoreaction on the device, the polyclonal antibody-colloidal gold conjugate (PA-AuNPs) was dropped to bind with S. Typhimurium. After a complete sandwich reaction, a dark red color appeared on the paper-based device, which can be observed by the naked eye for a rapid screening test. The electrical conductivity of PA-AuNPs between the screen-printed electrodes on the paper-based device was also measured for an accurate quantitative analysis. The electrical conductivity correlated well with the concentration of S. Typhimurium, which was controlled by the amount of S. Typhimurium attached to the polyclonal antibody-colloidal gold conjugate. The device showed a linear correlation for the concentration of the S. Typhimurium in the range of 10-10 8 CFU mL -1 in a logarithmic plot, with an R 2 value of 0.9882 and a limit of detection (LOD) as low as 10 CFU mL -1 . This simple, highly sensitive, and rapid method for the S. Typhimurium detection was successfully performed within 30 min, and it can be developed into small portable measuring devices in order to facilitate preliminary screening tests.

An increasing number of patients are living with Alzheimer's disease (AD); thus, the need for a method to detect AD early and sensitively has become urgent, and the demand for an intelligent analytical platform is growing year by year. Abnormal levels of acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) are known to be indicative of AD. In this work, a novel conjugated polythiophene (CP) compound was successfully combined with CdTe quantum dots (QDs) to improve their selectivity and sensitivity. The QDs successfully enabled the detection of low concentrations of AChE by turning on the fluorescence of the CdTe/CP via the interaction between CP and thiocholine produced by ATCh hydrolysis and aggregation induced emission enhancement (AIEE). Under optimal conditions, we reached a low detection limit of 0.14 U L -1 , which is 7.9 times lower than that of pristine QDs. More importantly, an efficient, inexpensive, and disposable paper-based platform, which allows the efficient visual detection of AChE activity via the color variation of CdTe/CP, was designed. Moreover, the accuracy of the method was demonstrated by conducting a recovery test in human serum, in which the recoveries reached 107% and 110%, proving that CdTe/CP has considerable potential to be used for analyzing real biological samples. The advantages of this method are its simplicity, fast detection capability, affordability, and the fact that it can be used for on-site detection of AChE activity. Furthermore, it has certain guiding significance for detecting AD.

In this paper, a paper-supported analytical device based on a sandwich immunoreaction and luminescence resonance energy transfer (LRET) was reported for the visual and quantitative determination of a cancer biomarker, in which upconversion nanoparticles (UCNPs) were located on the surface of the paper as energy donors and gold nanoparticles (AuNPs) were used as energy acceptors. Upon the recognition of the cancer biomarker by two rationally selected antibodies, the upconversion luminescence was quenched by the AuNPs in a biomarker concentration-dependent manner. As a model target, CEA was detected using this immunosensor, and a linear relationship within 0.5-30 ng mL-1 was obtained in buffer solution, with a detection limit of 0.21 ng mL-1. The immunosensor was also applicable in 20-fold diluted human serum with a linear range of 0.5-30 ng mL-1 and a detection limit of 0.36 ng mL-1. This technique also realized the qualitative judgment of the critical concentration of CEA in serum samples by the naked eye. This approach displays great application potential for point-of-care testing in clinical applications, as well as the potentiality to be extended to other kinds of disease-related biomolecules.

Paracetamol overdose is a leading cause of acute liver failure that can prove fatal. Establishing paracetamol concentration accurately and quickly is critical. Current detection methods are invasive, time-consuming and/or expensive. Non-invasive, rapid and cost-effective techniques are urgently required. To address this challenge, a novel approach, called Paper-Arrow Mass Spectrometry (PA-MS) has been developed. This technique combines sample collection, extraction, enrichment, separation and ionisation onto a single paper strip, and the entire analysis process, from sample to result, can be carried out in less than 10 min requiring only 2 μL of raw human saliva. PA-MS achieved a LOQ of 185 ng mL−1, mean recovery of 107 ± 7%, mean accuracy of 11 ± 8% and precision ≤5% using four concentrations, and had excellent linearity (r2 = 0.9988) in the range of 0.2–200 μg mL−1 covering the treatment concentration range, surpassing the best-in-class methods currently available for paracetamol analysis. Furthermore, from a panel of human saliva samples, inter-individual variability was found to be <10% using this approach. This technique represents a promising tool for rapid and accurate emergency diagnosis. [ABSTRACT FROM AUTHOR]

Illicit drug trafficking and abuse is a significant public safety and health concern. Color tests are commonly used for drug screening, but their poor specificity results in false positives. This study demonstrates the combination of drug residue collection using pressure-sensitive adhesive paper, on-paper color testing, and post-reaction analysis by paper spray mass spectrometry (PS-MS) on both portable and benchtop ion trap MS. All steps, including residue collection, color testing, and paper spray analysis, were performed on the same piece of paper. Three common color tests were investigated: the cobalt thiocyanate test for cocaine, the Simon test for methamphetamine, and the Marquis test for phenethylamine stimulants and opiates. The detection threshold for color tests ranged from 1.25 to 10 μg on paper. Drug residues were successfully confirmed by paper spray MS at the color test threshold in all cases, except for heroin after reaction with the Marquis reagent, when using the portable MS. In this case, the MS detection threshold was 4-fold higher than the color test threshold. The stability of the color test products was assessed through a time study. Drug residues could be detected by MS at least 24 hours after reaction. A series of realistic samples, including false positives, were analyzed to demonstrate the technique's utility in real-world scenarios. Overall, combining color tests with PS-MS offers a rapid, low-cost method for the collection and analysis of illicit drugs. [ABSTRACT FROM AUTHOR]

We report a strategy that tunes the CO2 and proton concentrations near the electrode–electrolyte interface using surfactant modification with various amounts (0.05, 0.8, 1.6, and 3.2 mg) of hexadecyl trimethyl ammonium bromide (CTAB). The positively charged group of CTAB favors CO2 surface diffusion and inhibits excessive proton accumulation on Zn nanosheets on carbon paper. A CO faradaic efficiency of 95.6% and a total ampere density of −13.1 mA cm−2 were obtained over the optimal CTAB-modified Zn electrode at −1.1 V with stability over 12 hours. [ABSTRACT FROM AUTHOR]

In this study, the rational preparation of Kevlar fiber (KF)-reinforced eco-friendly paper based on ultralong hydroxyapatite nanowires (HAPNWs) is reported. The ultralong HAPNWs were used to constitute the paper skeleton, and KF was used to further enhance the mechanical properties of the paper. The KF and ultralong HAPNWs interweaved with each other to form a three-dimensional porous structure and immobilize TiO2 nanoparticles, resulting in high flexibility and mechanical strength of the paper; in particular, the writable paper exhibited superhydrophobic, anti-fouling, self-cleaning and oil/water separation properties after being modified with fluorine-free stearic acid (STA). Owing to the photo-induced hydrophilicity and photocatalysis of TiO2, the surface wettability could be tuned by UV light. Moreover, the as-prepared paper possessed promising thermal stability, and the weight percentage was maintained above 90% even when it was heated to 800 °C. Unlike traditional paper, the as-prepared paper manifested favorable fire-retardant properties even when it was directly exposed to fire for 5 minutes. Furthermore, the soft paper was utilized to efficiently separate an oil/water mixed solution; moreover, it was used to transport water and various organic liquids when lubricant oil was infused into the porous structure. The present study is propitious for the fabrication of multifunctional inorganic paper, which will find practical applications in the fields of paper making, liquid transportation, oil–water separation, fire-retardants, and waterproofing. [ABSTRACT FROM AUTHOR]

The water-soluble bromophenoxy-substituted naphthalimide derivative 1 and its copolymer P1 with acrylamide were synthesized and the photophysical properties of their host–guest complexes with cucurbit[8]uril (CB[8]) were studied. Notably, the host–guest complex CB[8]·1 showed long-lived RTP on filter paper and demonstrated a humidity response, making it suitable for use as an encryption ink. Furthermore, the solid powder of the host–guest complex between P1 and CB[8] exhibited a 4 s afterglow emission. [ABSTRACT FROM AUTHOR]

The first discrete bimetallic europium(iii)/copper(ii) complex for the fast, sensitive and selective luminescent detection of both aqueous and gaseous hydrogen sulfide has been developed. The chemosensor displayed an impressive response time of 30 seconds and a low theoretical limit of detection (100 ppb) for gaseous hydrogen sulfide.

In the present article we report a new hybrid microfluidic device (hyFlow) comprising a disposable paper electrode and a three-dimensional (3D) printed plastic chip for the electrochemical detection of a magnetic bead-silver nanoparticle (MB-AgNP) bioconjugate. This hybrid device evolved due to the difficulty of incorporating micron-scale MBs into paper-only fluidic devices. Specifically, paper fluidic devices can entrap MB-containing conjugates within their cellulose or nitrocellulose fiber matrix. The hyFlow system was designed to minimize such issues and transport MB conjugates more efficiently to the electrochemical detection zone of the device. The hyFlow system retains the benefit of fluid transport by pressure-driven flow, however, no pump is required for its operation. The hyFlow device is capable of detecting either pre-formed MB-AgNP conjugates or conjugates formed in situ. The detection limit of AgNPs using this device is 12 pM, which represents just 22 AgNPs per MB.

Atherosclerosis (AS) is the most common factor causing many cardiovascular and cerebrovascular diseases and has received considerable attention. The occurrence mechanism of AS is uncertain because it is a choronically pathological process that is influenced by multi-aspects, among which cytokines play the key roles in regulating the processes of the immune system. For example, two key cytokines, namely, IL-10 and MCP-1 (chemokine), which are involved in AS progression with varied levels, can be used for AS status monitoring and early diagnosis of AS-associated diseases. Hence, a new paper-based, surface-enhanced Raman spectroscopy (SERS) sensing platform was established for the detection of these two key cytokines. By combining a nanoporous networking membrane as the substrate and SERS nanotags as the probe for signal reading, together with a sandwich design, sensitive and specific identification and quantification of cytokine targets in human serum were achieved with excellent sensing characteristics. The lowest detectable concentration was determined to be 0.1 pg mL-1 for both IL-10 and MCP-1 in human serum. The assay also exhibits high specificity towards target cytokine detection, with low-nonspecific binding and acceptable cross-reactivity in the presence of other structurally similar targets. Finally, the practicability was validated by performing duplex detection in human serum, which further demonstrates the high specificity of the assay for the detection of target cytokines. Taken together, these promising results illustrate that this developed sensing assay is a candidate for clinical multi-target analysis in real environments.

Recently, portable sensing devices with point of care testing (POCT) capability have attracted great attention due to their inherent affordability and accessibility in low resource areas. Paper sensors possess excellent potential as POCT platforms because of low cost, ease of operation, disposability and high-volume manufacturing. Paper sensors that incorporate functional nucleic acids (FNAs) as recognition elements are particularly attractive given that FNAs can be isolated from random-sequence nucleic acid pools to recognize, or respond to, virtually any target of interest. In this review, the advantages of FNAs, particularly DNA aptamers and DNAzymes, as recognition elements for the design of paper sensors are first discussed. This is followed by reviewing three specific types of FNA based paper sensors: dot blots, lateral flow assays, and microfluidic paper-based analytical devices. Furthermore, advances in the signal reporting methods used by FNA based paper sensors are summarized. Finally, limitations of current FNA based paper sensors are discussed along with considerations of future research directions.

Escherichia coli O157:H7 is a severe foodborne pathogen that causes lots of life-threatening diseases. In the search for a rapid, sensitive, portable and low-cost method to detect this pathogen, we developed a wax-printed paper-based enzyme-linked immunosorbent assay (P-ELISA) based on microfluidic paper-based analytical devices (μPADs), with the whole operation time being less than 3 h and only needing 5 μl samples for detection. The limit of detection (LOD) of E. coli O157:H7 reached 104 CFU ml-1, which is an order of magnitude higher than that of conventional ELISA (C-ELISA). The LOD in artificially contaminated beef samples is 1 CFU per 25 g after enriching the culture for 8 h. This method is superior to the molecular biology method in detection sensitivity and superior to C-ELISA and the national standard method in detection time and cost. Thus, the established P-ELISA method has good sensitivity, specificity and repeatability. It can be suitable for point-of-care testing without expensive and bulky instruments and can also provide a platform for detecting other pathogens, especially in areas that lack advanced clinical equipment.

Binding protein scaffolds, such as rcSso7d, have been investigated for use in diagnostic tests; however, the functional performance of rcSso7d has not yet been studied in comparison to antibodies. Here, we assessed the analyte-binding capabilities of rcSso7d and antibodies on cellulose with samples in buffer and 100% human serum.

Nearly 7% of the world's population live with a hemoglobin variant. Hemoglobins S, C, and E are the most common and significant hemoglobin variants worldwide. Sickle cell disease, caused by hemoglobin S, is highly prevalent in sub-Saharan Africa and in tribal populations of Central India. Hemoglobin C is common in West Africa, and hemoglobin E is common in Southeast Asia. Screening for significant hemoglobin disorders is not currently feasible in many low-income countries with the high disease burden. Lack of early diagnosis leads to preventable high morbidity and mortality in children born with hemoglobin variants in low-resource settings. Here, we describe HemeChip, the first miniaturized, paper-based, microchip electrophoresis platform for identifying the most common hemoglobin variants easily and affordably at the point-of-care in low-resource settings. HemeChip test works with a drop of blood. HemeChip system guides the user step-by-step through the test procedure with animated on-screen instructions. Hemoglobin identification and quantification is automatically performed, and hemoglobin types and percentages are displayed in an easily understandable, objective way. We show the feasibility and high accuracy of HemeChip via testing 768 subjects by clinical sites in the United States, Central India, sub-Saharan Africa, and Southeast Asia. Validation studies include hemoglobin E testing in Bangkok, Thailand, and hemoglobin S testing in Chhattisgarh, India, and in Kano, Nigeria, where the sickle cell disease burden is the highest in the world. Tests were performed by local users, including healthcare workers and clinical laboratory personnel. Study design, methods, and results are presented according to the Standards for Reporting Diagnostic Accuracy (STARD). HemeChip correctly identified all subjects with hemoglobin S, C, and E variants with 100% sensitivity, and displayed an overall diagnostic accuracy of 98.4% in comparison to reference standard methods. HemeChip is a versatile, mass-producible microchip electrophoresis platform that addresses a major unmet need of decentralized hemoglobin analysis in resource-limited settings.

Cobalt(ii) phthalocyanine (CoPc) was suspended in aqueous medium and the colloidal system was used as catalyst for the electrochemical determination of hydrogen peroxide on paper-based electrodes modified with carbon nanomaterials. H 2 O 2 was oxidised at 0.275 V vs. Ag pseudoreference electrode. This system was adapted to develop a glucose sensor with glucose oxidase immobilized on the cellulose electrode. CoPc suspended nanoparticles acted as nanoenzyme mimicking peroxidase activity and were combined with different carbon nanomaterials to form hybrids with optimised catalytic performance. GO-CoPc paper-based electrodes yielded the best results with a linear range of ∼12 μM to 49 mM for H 2 O 2 and 0.1 mM to 1 mM for glucose. Glucose was determined in physiological serum and juice samples with recoveries of 93.3 and 94.2% respectively. CoPc could replace HRP for the catalytic sensing of H 2 O 2 , without the need to be dissolved. This material can be used in situ in a simple protocol with other nanomaterials for electrode modification. The sensor described has the advantage of easy preparation, using the catalyst in colloidal form, long term stability, and versatility to be adapted to other low cost and disposable enzymatic systems.

A novel silica coated paper substrate is developed through a facile vacuum filtration method by using the commercially available silica particles as the coating material and corn starch as the adhesive agent. Unlike the commercial silica coated paper (namely grade SG81 paper), the resulting paper substrate was covered by a layer of silica particles on the top side of the paper, and no cellulosic fibers were exposed at its surface. After loading a solution sample on its surface, the coated silica particles allowed the target analytes to remain at the top side rather than penetration through the substrate. Owing to this effect and the special interactions with analytes, the as-prepared silica coated paper demonstrated superior performance in the analysis of different pesticides in milk using paper spray mass spectrometry to the uncoated filter paper and grade SG81 paper. Compared to the other two papers, paper spray analysis using the as-prepared paper improved the estimated lower limit of quantitation of seven pesticides (alachlor, acetochlor, pretilachlor, butachlor, metolachlor, napropamid and benzeneacetamide) in milk by a factor of 2 to 19-fold depending on the pesticide. This study offers a novel paper substrate for paper spray in high sensitivity analysis of target analytes in a complex foodstuff matrix without any pretreatment. [ABSTRACT FROM AUTHOR]

The increasing prevalence of antibiotic-resistant bacteria needs rapid identification and efficient destruction routes. This study proposes testing paper derived from electrospun fibrous mats and aggregation-induced emission (AIE) probes for trace sensing and simultaneous destruction of antibiotic-resistant E. coli. Aptamers are conjugated on fibers for selective capture of E. coli, and the capture capability can be regenerated via rinsing with salt solution. Hydroxyl tetraphenylethene (TPE) is linked with two cephalosporin molecules to construct TPE-Cep probes, and the fluorescence emission is turned on specifically in the presence of β-lactamase, which is a critical marker for screening resistant bacteria. Fibrous mats are lit up only in the presence of antibiotic-resistant bacteria, and the fluorescence intensity changes could be statistically fitted into an equation for quantitative analysis. Fibrous strips display apparent color changes from blue to green for a visual readout of bacterial levels, and the limit of detection (LOD) is much lower than those of previous paper substrates. In addition, the TPE-Cep probes could produce reactive oxygen species (ROS) under room light illumination to kill the captured bacteria. Thus, the integration of aptamer-grafted electrospun fibers and functional AIE probes provides potential for selective capture, trace imaging and photodynamic destruction of antibiotic-resistant bacteria.

Rapid analysis of metabolites in biofluids is of great importance for disease diagnosis or new-born disease screening. Herein, we introduce an agarose hydrogel conditioning method to enhance the performance of paper spray ionization mass spectrometry. With facile and fast hydrogel conditioning, the signal intensity of therapeutic drugs spiked in urine was 5 to 15 fold higher than that in direct paper spray ionization mass spectrometry analysis. Consequently, the sensitivity of metabolites in urine was improved via hydrogel conditioning, resulting in 9 to 15 fold decrease in the possibility of detection (POD) levels. These results show that agarose hydrogel conditioning coupled with paper spray ionization mass spectrometry could serve as a facile ionization method for ambient mass spectrometry, which might be useful in fast screening of metabolites and therapeutic drugs in raw biofluids.

A paper-based platform was developed and tested for studies on basic cell culture, material biocompatibility, and activity of pharmaceuticals in order to provide a reliable, robust and low-cost cell study platform. It is based upon a paper or paperboard support, with a nanostructured latex coating to provide an enhanced cell growth and sufficient barrier properties. Wetting is limited to regions of interest using a flexographically printed hydrophobic polydimethylsiloxane layer with circular non-print areas. The nanostructured coating can be substituted for another coating of interest, or the regions of interest functionalized with a material to be studied. The platform is fully up-scalable, being produced with roll-to-roll rod coating, flexographic and inkjet printing methods. Results show that the platform efficiency is comparable to multi-well plates in colorimetric assays in three separate studies: a cell culture study, a biocompatibility study, and a drug screening study. The color intensity is quantified by using a common office scanner or an imaging device and the data is analyzed by a custom computer software without the need for expensive screening or analysis equipment.

The development of viable point-of-care diagnostic formats is integral to achieving better patient care and improved outcomes. The need for robust and low-cost tests is especially important in under-resourced and rural settings. Perhaps the greatest challenge is ensuring that an untrained individual is capable of operating and interpreting the test, out with a care facility. Here we present a paper-based diagnostic device capable of sensing miR-29a using both colorimetric and surface enhanced Raman scattering (SERS) analysis. Rather, than carry out the two types of analyses in tandem, we envisage that the colorimetric output is easy enough to be interpreted by the untrained-individual administering the test to provide them with qualitative feedback. If deemed positive, the test can be further validated at a centralized care facility using a handheld-Raman spectrometer to provide a semi-quantitative result. Detection of miR-29a, a microRNA associated with myocardial infarction, was achieved at a level of pg μL-1 through the combination of three-dimensional paper-based microfluidics, colorimetric detection, and surface enhanced Raman scattering (SERS) analysis. RGB analysis of the colorimetric output generated from samples containing miR-29a at different concentrations (18-360 pg μL-1) showed differentiation from the control sample, however significant repeat variability indicated that it could not be used for quantifying miR-29a levels. However, the SERS analysis exhibited greater reproducibility at varying concentrations, achieving an LoD of 47 pg μL-1. The union of the paper-based device and the two analysis methods resulted in the production of a sensitive, reproducible and facile, point of care test (POCT), which paves the way for future implementation in the diagnosis of a range of diseases.

More than 60% newborns experience hyperbilirubinemia and jaundice within the initial week after birth due to the accumulation of total bilirubin in blood. Left untreated high levels of bilirubin may result in brain impairment. Simple, fast, accurate, low-cost and timely point-of-care (POC) analysis of total bilirubin is an unmet need especially in resource-limited areas. This work introduces a novel sensing device, named a "tape-paper sensor", capable of separating plasma from whole blood and measuring total bilirubin by a colorimetric diazotization method. The tape-paper sensing method overcomes non-homogeneous color distribution caused by the "coffee stain" effect, which improves the accuracy of colorimetric evaluation on paper-based analytical devices. The level of hemolysis in the plasma extracted by the device is evaluated, confirming no interference in the detection of total bilirubin. The accuracy of the tape-paper sensing approach for neonatal blood sample measurement is verified by comparison with the hospital pathology laboratory method. The small volume of samples and reagents, minimal equipment (an office scanner), fast detection (<10 min) and low fabrication cost (∼A$ 0.6) reveal the suitability of the device for POC use and in resource-limited settings. The tape-paper sensor is a low-cost, fast, and user-friendly device for measurement of blood total bilirubin levels in neonatal jaundice diagnostics.

Paper-based sensors offer an affordable yet powerful platform for field and point-of-care (POC) testing due to their self-pumping ability and utility for many different analytical measurements. When combined with electrochemical detection using small and portable electronics, sensitivity and selectivity of the paper devices can be improved over naked eye detection without sacrificing portability. Herein, we review how the field of electrochemical paper-based analytical devices (ePADs) has grown since it was introduced a decade ago. We start by reviewing fabrication methods relevant to ePADs with more focus given to the electrode fabrication, which is fundamental for electrochemical sensing. Multiple sensing approaches applicable to ePADs are then discussed and evaluated to present applicability, advantages and challenges associated with each approach. Recent applications of ePADs in the fields of clinical diagnostics, environmental testing, and food analysis are also presented. Finally, we discuss how the current ePAD technologies have progressed to meet the analytical and practical specifications required for field and/or POC applications, as well as challenges and outlook.

Based on surface biomolecular imprinting technology, a rotary microfluidic electrochemical paper-based chip (MIP-ePADs) was proposed for sensitive and selective detection of human interleukin 6 (IL-6) and procalcitonin (PCT). Compared with the traditional method, the sample can be added directly on the MIP-ePAD by rotating the working electrode, which avoids the loss of the liquid to be tested and greatly simplifies the process of electropolymerization imprinting and template elution. Our experimental results show that linear concentration ranges of IL-6 and PCT in the electrochemical molecularly imprinted microfluidic paper-based chip ranged from 0.01 to 5 ng mL -1 , with their detection limits being 3.5 and 2.1 pg mL -1 , respectively. For the detection of actual serum samples, there was no significant difference between the results of MIP-ePADs and the traditional electrochemiluminescence method used in hospitals, indicating that the paper-based chip can be used for stable and accurate analysis and detection. The chip greatly reduces the cost of clinical trials due to its advantages of easy preparation and low cost. The chip can be used for the analysis of non-antibody inflammation markers and can be widely used in home and hospital treatment detection. This method will not only play an important role in rapid detection, but also provide new ideas for the improvement of rapid detection technology.

Multienzyme systems are essential for utilizing di-, oligo-, and polysaccharides as fuels in enzymatic fuel cells effectively. However, the transfer of electrons generated by one enzymatic reaction in a multienzyme cascade at the electrode may be impeded by other enzymes, potentially hindering the overall efficiency. In this study, carbon paper was first modified by incorporating single-walled carbon nanotubes (SWCNTs) and gold nanoparticles (AuNPs) sequentially. Subsequently, glucose oxidase (GOx) and a trehalase-gelatin mixture were immobilized separately on the nanostructured carbon paper via layer-by-layer adsorption to mitigate the electron transfer hindrance caused by trehalase. The anode was first fabricated by immobilizing GOx and trehalase on the modified carbon paper, and the cathode was then fabricated by immobilizing bilirubin oxidase on the nanostructured electrode. The SWCNTs and AuNPs were distributed adequately on the electrode surface, which improved the electrode performance, as demonstrated by electrochemical and morphological analyses. An enzymatic fuel cell was assembled and tested using trehalose as the fuel, and a maximum power density of 23 μW cm -2 was obtained at a discharge current density of 60 μA cm -2 . The anode exhibited remarkable reusability and stability., Competing Interests: There are no conflicts of interest to declare., (This journal is © The Royal Society of Chemistry.)

Conductive papers made from carbon nanotubes and wood fibers exhibit a p-type character. N 2 plasma treatment converts paper into n-type and conversion is verified by elemental analyses, work function and Hall-effect measurements. By screening one face of p-type paper in plasma, the p-n junctions are successfully created along the thickness direction and electrical rectification is evident by current-voltage measurement., Competing Interests: The authors declare no conflict of interest., (This journal is © The Royal Society of Chemistry.)

In experiments, printing paper is imprinted with three different ink micropatterns (square, grid, and stripe). The wetting contact angle of water droplets on a heterogeneous surface is then investigated using a proportionate scaling molecular dynamics (MD) simulation, where the water droplets and the ink-patterned printing paper are both shrunk by a factor of 200 000 collectively. The errors from the theoretical values are always less than 1°, which is much less than the bias of experimental measurement data, according to the modeling contact angles. It has been demonstrated that this proportionate scaling approach works well to appropriately explain the interaction between micro-/nanostructures and liquids., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

A simple and portable paper-based analytical device was developed for visual and semiquantitative detection of ferric ion in real samples using green emitting carbon dots (CDs), which were prepared via microwave method using sodium citrate, urea and sodium hydroxide as raw materials and then loaded on the surface of paper substrate. When Fe 3+ exists, the green fluorescence of CDs was quenched and significant color change from green to dark blue were observed, resulting the visual detection of Fe 3+ with a minimum distinguishable concentration of 100 μM. By analyzing the intensity changes of green channels of test paper with the help of smartphone, the semiquantitative detection was realized within the range of 100 μM to 1200 μM. The proposed paper-based analytical devices have great application prospects in on site detection of Fe 3+ in real samples., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Malondialdehyde (MDA) is a critical product of polyunsaturated adipose acid peroxidation and represents a common biomarker of oxidative stress. The effect of different MDA concentrations on human biofluids reflects pathological changes, which has been seen in diverse types of sickness, such as leukemia, diabetes, cancer, cardiovascular disease, and age-related macular degeneration and liver disease. In this study, different types of silver nanoparticles, including silver nanoprism (AgNPrs), silver nanowires (AgNWs), and silver nanospheres (AgNSs), were synthesized and used for the chemosensing of MDA by colorimetric and spectrophotometric methods. Colorimetric tests were performed to identify malondialdehyde in the solution as well as the one-droplet-based microfluidic paper substrate as a miniaturization device for the monitoring of analytes in human real samples. The analytical quantification of the MDA was done using the UV-Vis method. Also, the utilization of the designed chemosensor for the analysis of MDA in real sample was evaluated in human urine samples. Using the spectrophotometric method, MDA was deformed in the linear range of 0.01192 to 1.192 mM with a low limit of quantification of 0.12 μM. Essential significant features of this study include the first application of AgNPrs with high stability and great optical properties without any reagent as an optical sensing probe of MDA and optimized OD-μPCD toward on-site and on-demand MDA screening in real samples diagnosis and the innovative time/color semi-analytical recognition strategy. Moreover, the prepared OD-μPCD decorated by AgNPrs could be a prized candidate for commercialization due to the benefits of the low-cost materials used, like paper and paraffin, and portability. This innovative process led to uniform hydrophilic micro-channels on the surface of cellulose, without the use of a UV lamp, clean room, and organic solvents. This report could be a pioneering work, inspiring simple and effective on-site semi-analytical recognition devices for harmful substances or illegal drugs, which simply consist of a piece of lightweight paper and one drop of the required reagent., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

We created novel Pd/CB-Ni@rGO nanomaterials for glucose detection. The as-synthesized nanomaterials were dropped on the electrode surface using the drop casting technique. The prepared electrode was then attached to a paper-based device containing the sample zone and the reaction zone, enabling plasma isolation and an enzymatic reaction for glucose detection in whole blood. The nanomaterials and surfaces of electrodes were characterized by FTIR, TEM, and SEM. The proposed approach is a disposable glucose detection method that is unaffected by protein fouling on the electrode, and it requires only one drop of human blood. Therefore, there is no need for extensive sample preparation, and there is less sample consumption. Under optimal conditions, Pd/CB-Ni@rGO can accurately measure blood glucose levels with a linear range of 7 to 7140 μM ( R 2 = 0.9986) and a low detection limit of 0.82 μM. Besides, the developed sensor shows excellent anti-interference capacity, stability, and satisfactory reproducibility and repeatability. Importantly, Pd/CB-Ni@rGO was successfully applied for glucose in whole blood from 4 volunteers, with results that correlated well with those obtained using an Accucheck glucometer at a 95% confidence level. Given its low cost, high accuracy, and ease of use, the blood glucose sensor holds significant potential for clinical use and broadens the area of future noninvasive sensor development.

Ascorbic acid (AA) or vitamin C plays multiple crucial roles, particularly as an antioxidant. This essentially biologically active molecule was selectively detected over other reductants by the synthesized profluorescent nitroxide probe ProN6 via a switch-on method. After either a hydrogen atom or single electron transfer from AA to nitroxide, the resulting diamagnetic hydroxylamine was rapidly cyclized to form a fluorescent O -acylalkoxyamine. This cyclization prevented the reoxidation of the corresponding hydroxylamine to the nitroxide, leading to a high precision of detection. A kinetic fluorescence study indicated that ProN6 exhibited higher reactivity than ProN7. Density functional theory (DFT) calculations indicated that the Gibbs free energy of the AA-induced cascade reductive lactonization of ProN6 was lower than that of ProN5 and ProN7. The designed probe achieved the sensitive and specific detection of AA with detection limits of 77.9 nM and 195.9 μM in solution and on paper, respectively. The utilization of the probe as a paper-based fluorescent sensor demonstrated the good accuracy of the quantitative analysis of AA in commercial supplements., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Heavy metals emanate from natural and man-made sources, such as agricultural chemicals including fertilisers and pesticides, medical waste, and chemicals released from industries. Detection and monitoring toxic metal ions is one of the challenges confronting scientists in biological, environmental, and chemical systems. This study describes the design and synthesis of a new imidazole-based fluorescent and colourimetric chemosensor (DPICDT) for highly selective sensing of Hg 2+ and Cu 2+ ions in aqueous acetonitrile medium. The probe was synthesised by coupling benzil and substituted aldehyde using ethanolic ammonium acetate. The structure of DPICDT was confirmed via IR spectra, NMR, and HR-MS spectra. The DPICDT probe displayed a rapid naked-eye response towards Cu 2+ ions from colourless to red-purple and significant fluorescence quenching response towards Hg 2+ over other competitive metal ions in both solution and solid support. The binding modes of DPICDT with Cu 2+ and Hg 2+ ions were found to be at a 1 : 1 ratio as determined using Job plot, ESI HR-MS, and the sensing mechanism was evolved by 1 H NMR titrations, HR-MS spectra, and DFT calculations. The lower detection limit was 15.1 nM for Cu 2+ , eventually far less than the World Health Organization guideline for drinking water (Cu 2+ - 31.5 μM) and 1.17 μM for Hg 2+ (permissible concentration 2 ppb). Promisingly, the tissue paper-based DPICDT test strips and silica-supported DPICDT were developed and demonstrated for on-site application without resorting to expensive instruments., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

EVs/exosomes are considered as the next generation of biomarkers, including for liquid biopsies. Consequently, the quantification of EVs/exosomes is crucial for facilitating EV/exosome research and applications. Paper-based enzyme-linked immunosorbent assay (p-ELISA) is a portable diagnostic system with low cost that is simple and easy to use; however, it shows low sensitivity and linearity. In this study, we develop p-ELISA for targeting EVs/exosomes by using streptavidin agarose resin-based immobilization (SARBI). This method reduces assay preparation times, provides strong binding, and retains good sensitivity and linearity. The time required for the total assay, including preparation steps and surface immobilization, was shortened to ∼2 h. We evaluated SARBI p-ELISA systems with/without CD63 capture Ab and then with fetal bovine serum (FBS) and EVs/exosome-depleted fetal bovine serum (dFBS). The results provide evidence supporting the selective capture ability of SARBI p-ELISA. We obtain semiquantitative p-ELISA results using an exosome standard (ES) and human serum (HS), with R2 values of 0.95 and 0.92, respectively.

This communication describes the rational design of a transparent paper-based chemosensing platform for multi-target detection by wavelength-dependent absorbance/transmittance. The platform was successfully applied in the examination of bovine serum albumin (BSA) and cholesterol in serum with a low detection limit of 0.1 μM and 0.1 mM, respectively. With low cost and high sensitivity, the paper-based platform shows great promise for multiplexed bioassays.

Fluid manipulation in microfluidic systems is often controlled by active pumps that are relatively large in size and require external power sources which limit their portability and use in limited-resource settings. In this work, portable, detachable, low-cost, and power-free paper pumps with engineered capillary tubes (referred to as "grooves") that can passively drive viscous fluids based on capillary action are presented. The proposed grooved paper pumps are capable of generating a controllable flow of complex biofluids within microfluidic devices with minimal user intervention and no external power sources. The pumping performance of grooved paper pumps in this study is tested with undiluted, unseparated whole blood samples - demonstrating successful transport of approximately 150 μL of blood within an average time of 5 minutes to 50 minutes, depending on their design parameters. Results for the flow rate of grooved paper pumps indicate that the number of grooves created within the porous paper determines the profile of the generated flow rate. The experimental data also show that as the number of grooves in the pumps is increased, the flow rate approaches a constant value for the entire duration of pumping before the pump becomes saturated. The promising performance of grooved paper pumps with whole blood offers potential applications of these small, disposable pumps in point-of-care diagnostics in which time is crucial and access to external power is limited.

Microvesicles and exosomes are promising liquid biopsy biomarkers. However, conventional isolation techniques damage and contaminate the biomarkers. We developed an origami-paper-based device for effective isolation of biomarkers with less damage and in fewer steps. The multi-folded device enables the preconcentration of the microvesicles/exosomes on specific layers (∼5-fold) by the ion concentration polarization technique and they were simply isolated from the rest of the sample by unfolding the device.

A chemosensor containing an o-hydroxyaniline unit as the reaction site was developed for colorimetric and fluorimetric detection of phosgene, which showed fast response (15 s), high specificity, and an extremely low detection limit. The chemosensor was incorporated into paper strips for visual detection of phosgene vapor.

In the emergency diagnosis of patients, acute myocardial infarction (AMI) is always time-consuming to diagnose, and the process requires multiple laboratory procedures, expensive equipment and skilled workers. Herein, we developed an easy-to-use, low-cost and portable fluorescent lateral flow immunoassay based on paper microfluidics for the point-of-care diagnostics of non-communicable diseases. The fluorescent lateral flow immunoassay can produce results in less than 10 minutes, and the limit of detection (LOD) is 0.019 ng ml -1 . The slope was linear from 0 to 100 ng ml -1 ; the equation is y = 0.0342e 2.1181x and R 2 = 0.9618, which are distinctive features that ensure maximum amplification of the signal and recording of quantitative values by an analyser. The detection sensitivity showed an exceptional increase to 0.01 ng ml -1 . Compared with conventional bioassay readers, our analyser shows some advantages to easily, clearly and effectively read data. The present point-of-care test for cardiac troponin I decreases the turnaround time and has a high coefficient of variation even at lower concentrations of troponin. So, the development of lateral flow assay-based point-of-care assays with higher analytical performance for real world samples can decrease the rule-out time for AMI in emergency departments and other fields.

The rapid development of and the large market for medical diagnostics necessitate point-of-care testing (POCT) with superior sensitivity, miniaturization, multiple functionalities and high integration. Thus, flexible substrates with complex structures that provide multiple functions are in demand. Herein, we present multistructured pseudo-papers (MSPs) as a platform for building flexible microfluidics. Flexible and freestanding MSPs are generated by the self-assembly of colloidal silica crystals or core-shell copolymer elastic colloidal crystals on microcavity PDMS molds to form photonic crystals (PCs). Nitrocellulose (NC) multistructured pseudo-papers (NC MSPs) were obtained by etching SiO 2 PCs after NC precursor infiltration, while elastic copolymer (EC) multistructured pseudo-papers (EC MSPs) were directly peeled off the mold; both types of freestanding MSPs have ordered micropillars and nanocrystal structures and presented unique properties such as pumpless liquid transport and fluorescence and chemiluminescence (CL) enhancement. MSPs with designed patterns were fabricated by patterned PDMS molds, and complicated microfluidic chips were used to generate MSPs by utilizing these patterns as liquid channels. The MSPs were used for fabricating microfluidic sensors for human cardiac marker and cancer marker sensing; the features of these bioinspired MSPs indicate their potential for sensitive sensing, which will enable them to find broader applications in many fields.

An accurate quantification method with a wide linearity range is paramount for the development of low-cost, portable and point-of-care sensors. This work reports a new approach to analyze the colorimetric assays on paper-based sensors using the quantification from a light transmission method. Compared to the commonly-developed color intensity measurement on scanned digital images, a portable transmission densitometer is capable of directly quantifying the optical density of colorimetric results. The detection of heavy metals in an aqueous system, including Fe(ii), Cu(ii), and Ni(ii), was carried out to demonstrate the good performance and reliability of this method. Our measurements show that the linear quantification range spans from 0.5-500 mg L -1 for the assays of Cu(ii) and Fe(ii) and from 2-500 mg L -1 for Ni(ii) based on the reading of transmitted light through the assay spot. As a comparison, the linear range is restricted to 0.5-50 mg L -1 for the same assays when analysed by the common reflection method, suggesting a significant improvement in the accuracy and sensitivity of high analyte concentrations from the light transmission method. By expanding the linearity range, this method further streamlines the sampling procedure during analysis and will greatly advance the future development of paper-based analytical sensors.

A fully enclosed paper microfluidic device has been fabricated using pentafluoroethane (PFE) plasma deposition followed by O 2 plasma etching. Structures with one and two non-interacting, fully enclosed hydrophilic channels were generated in a single paper sheet using metal masks. Furthermore, by performing an additional O 2 plasma step with a secondary mask, pinholes were created at the reaction zones for reagent loading. Finally, to demonstrate the functionality of the device, a glucose assay was performed. Quantitative analysis of glucose assays showed that the device can be used for the clinically relevant range of glucose. To our knowledge, this is the first time that such structures have been fabricated without paper stacking. Multi-layer devices have enhanced functionality relative to a single channel device, because the design space for creating networks of channels within the paper substrate is greatly expanded. The fluid-filled channels in the fabricated device are isolated, thereby preventing contamination due to handling and environmental exposure. Fluid evaporation can be inhibited by sealing the device with adhesive tape without contaminating the enclosed channels. The method described is a dry process and compatible with roll-to-roll technology, thus facilitating large scale production. The novel method to fabricate enclosed μ-PADs overcomes many of the limitations experienced with current approaches and thus offers an alternative means to develop low-cost point-of-care diagnostics for resource-limited settings.

A cellulose paper-based biosensor was developed for the equipment-free and naked-eye detection of a transcription factor (TF) using dopamine as the signal-responsive material based on exonuclease III-assisted cycling amplification. Compared with other TF biosensors, the proposed biosensor demonstrates low-cost, portable, disposable, and naked-eye detection features.