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Monitoring various biomarkers in saliva samples emerges as a dynamic and non-invasive method. However, the high viscosity of saliva presents a distinct challenge when integrating paper-based platforms for on-site analysis. In addressing this challenge, we introduced the capillary-driven microfluidic paper-based analytical devices (μCD-PAD) designed for user-friendly and simultaneous detection of ethanol and tetrahydrocannabinol (THC) in saliva without a sample preparation step. Employing a colorimetric approach, we quantified both analytes. Synthetic salivas of varying viscosity flowed seamlessly to the detection zone without needing a sample preparation step, and no impact on colorimetric detection due to viscosity was observed (RSD <5 %). Within 10 min after the solution reached the detection zone, the device produced a homogeneous color signal, easily analyzed by a smartphone camera. To extend the application for determination to cover a legal limit concentration of ethanol and concentration of salivary THC even 24 h after marijuana consumption, the detection time of 30 min was optimized. Moreover, a saliva sample containing both analytes was used to demonstrate the capability of the developed device to detect ethanol and THC simultaneously. No cross-talk between ethanol and THC occurred and showed recovery in the 98–102 % for ethanol and 95–105 % for THC with acceptable accuracy. This developed device exhibits excellent potential for forensic applications, providing a user-friendly, cost-effective, and real-time screening tool for detecting ethanol and THC in saliva. [Display omitted] • The μCD-PAD is developed for salivary analysis without sample preparation. • The μCD channel gives a perfect flow of the high-viscosity sample. • A colorimetric on PAD provides a user-friendly and simple detecting platform. • A smartphone-enabled device offers real-time decision-making for on-site analysis. • The device can detect ethanol and THC simultaneously without cross-talking. [ABSTRACT FROM AUTHOR]

Schematic diagram depicting the synthesis process of the intelligent paper-based biosensor and its colorimetric detection application for biomarkers in urine. (FP: filter paper; CPBA: Carboxyphenylboric acid; HRP: horseradish peroxidase; TMB: 3,3′,5,5′-tetramethylbenzidine; GLU: glusose; UA: uric acid; SAR: sarcosine; GOx: glucose oxidase; UOx: urate oxidase; SOx: urate oxidase.) [Display omitted] • A green, low-cost, portable and visual intelligent paper-based biosensor was created. • This sensor immobilized HRP in horseradish by a borate-modified filter paper. • This sensor can detect many substances simultaneously and improve detection efficiency. • This sensor boasts the advantages of superior sensitivity, stability and selectivity. In the increasing demand for real-time testing, the imperative for a straightforward, rapid, portable, and effective biosensor is evident. In this study, an intelligent paper-based biosensor was developed, employing cost-effective and readily available filter paper as a matrix to prepare boronate affinity paper-based materials. The immobilization of horseradish peroxidase (HRP) from crude horseradish extract onto the material surface was realized. Ultimately, a cold assembly technique was employed to construct this intelligent paper-based biosensor, which combined with a smartphone APP, facilitated the easy, accurate, and simultaneous detection of the content of glucose (GLU), uric acid (UA), and sarcosine (SAR) in urine, significantly enhancing the convenience and practicality of real-time monitoring. Additionally, UV spectroscopy served as an auxiliary method to affirm the reliability of the detection outcomes. For the detection of GLU, UA, and SAR, the biosensor exhibited linear ranges of 2–200, 2–500, and 2–500 µmol L–1, respectively, with detection limits (LODs) of 1 µmol L–1 for all analytes. In practical urine sample analysis, the recovery rates of GLU, UA, and SAR detected by the intelligent paper-based biosensors were within a reasonable range, with relative standard deviations below 3.5 %. This fully demonstrates the high accuracy and reliability of the intelligent paper-based biosensor. The development of this low-cost, portable biosensor provides a new method for the detection of biomarkers related to H 2 O 2. [ABSTRACT FROM AUTHOR]

Human sweat can be collected non-invasively with low infectivity; however, its application as a determination method has been challenged due to the presence of trace amounts of chiral metabolites. Moreover, its application as a biological fluid for disease diagnosis has not been previously reported. In this study, the human dried sweat spot paper (DSSP) method was proposed for the derivatization of a novel mass spectrometric chiral probe, N -[1-Oxo-5-(triphenylphosphonium) pentyl]-(S)-3-aminopyrrolidine (OTPA), determination and resolution of DL-lactic acid (DL-LA) enantiomers in human elbow sweat. The methodological validation revealed the resolution (Rs) as 1.78, the limit of detection (S/N = 3) as 20.83 fmol, good linearity (R2 ≥ 0.9996), and the intra-day and intra-day stability with RSD ranging from 0.53 to 10.85 %, while the average recovery rate of D-LA and L-LA were 104.00 % ± 4.68 % and 107.41 % ± 8.34 %, respectively, with high accuracy. In addition, the method was applied for the determination of DL-LA in the sweat on elbow of 10 healthy volunteers and 30 diabetic patients. The results demonstrated that the D/L ratio and L/D ratio were significantly different (p < 0.0001). In addition, a moderate positive linear correlation between the D/L-LA ratio in human sweat and fasting blood glucose level (r = 0.7744, p < 0.0001) was observed, thereby suggesting that the D/L ratio of lactate in human sweat correlate the glucose level in human fasting blood. The D/L lactate ratio in human sweat could be used as a potential biomarker for diabetes screening. The method can be used to screen for diabetes by providing a dry sweat paper to test equipment and has the potential to be a non-invasive early-warning diagnostic tool for diabetes. [Display omitted] • A dried sweat spot paper method for estimating DL-LA enantiomers in human sweat. • The D/L and L/D ratios of LA in diabetic patient sweat are significantly different. • The D/L-LA ratio in human sweat is positively correlated with fasting blood glucose levels. • DSSP combined with UHPLC-MS/MS accurately quantified D/L-LA ratio is a non-invasive preventive method for screening for diabetes. [ABSTRACT FROM AUTHOR]

After the COVID-19 pandemic, the demand for highly sensitive, miniaturized, non-destructive sensing of disease biomarkers has received significant attention. Nanomaterial-coated paper-based electrochemical biosensors were utilized to diagnose various disease biomarkers. Nanomaterials have contributed significantly to electrochemical biosensors advancements because they improve biosensing properties such as specificity, sensitivity, robustness, and reproducibility. Moreover, the viability of environmentally friendly paper-based electrochemical biosensors for the highly sensitive detection of target analytes in complicated samples has improved. Paper-based electrode (PE) substrates are desirable for lab-scale and large-scale manufacturing applications because they are inexpensive, do not require microfluidic pumps because electrolyte migration can be achieved through capillary action, can be stacked with reagents for reagent-less applications, and can achieve multiphase detection via origami-based approaches. Therefore, this review considers the properties of functional nanomaterials, such as the active surface area available for interactions, attachment of biorecognition species to the electrode via microporous capillary action, cellulose conductivity, and photochemical functional properties, and electrochemical properties of carbon-based conductive pastes that are widely used to print sensors onto paper substrates. The conclusions can be used to improve PE biosensors for biomedical research. Recent paper-based electrodes modified with different nanomaterials for detecting various biomarkers are discussed. [Display omitted] • Innovative miniaturized point of care devices for emerging disease biomarkers. • Development of paper-based electrochemical biosensors for risk assessment of different diseases. • Application of hybrid nanocomposites to improve sensitivity of devices. • Rapid guide for constructing sustainable paper based devices as biosensor platform. [ABSTRACT FROM AUTHOR]

Carcinoembryonic Antigen (CEA) and 4-nitroquinoline-N-oxide (4-NQO) are cancer markers that play a crucial role in tumor risk assessment and early cancer diagnosis. Therefore, it is in demand to develop a fast, accurate, simple, and cost-effective method to detect these cancer markers for quick and early stage-cancer diagnosis and treatment. Herein, we report a dual signaling approach for direct and indirect signal transduction of cancer biomarker binding on molecularly imprinted-electrodes integrated on an ePAD, enabling sensitive and selective quantitative analysis of 4-NQO and CEA. Multiple test zones on a single device based on artificial recognition sites using core-shell Cu-MOF@MIP were developed to create a selective "Dual-signal-ePAD". An effective and facile imprinting method on a Cu-MOF surface based on the synthesized of 4-VPBA/MAA/TRIM polymer. It resulted in a novel MIP useable as a high-performance sensing tool for the ultrasensitive and specific quantification of the target cancer biomarkers. Multiple tests consisted of voltammetric analysis of 4-NQO via oxidation of the analyte on a WE 1 , and impedance analysis of CEA via the molecular interaction with the imprinted WE 2. The proposed device provides enhanced electrochemical signal amplification due to its high conductivity, electrocatalytic activity, and the target-specific recognition sites for accurate determination of 4-NQO and CEA targets. The Dual-signal-ePAD exhibits good voltammetric and EIS response, oxidation currents of 4-NQO at −0.06 V and R CT of CEA, resulting in high selectivity and sensitivity with a linear response range covering the concentration range of clinical interest for both analytes. Dual-signal ePAD is a good candidate for clinical screening and POCT. [Display omitted] • Multiplex testing of voltammetric and impedance analysis on the target-specific imprinted electrodes was proposed. • Analysis relying via oxidation of 4-NQO and impedance analysis of CEA on the target-specific imprinted electrodes. • Specific recognition sites on Cu-MOF surfaces was formed on a 4-VPBA/MAA/TRIM polymer integrated into ePAD. • Dual-signal-ePAD provides outstanding detection performance. • It can serve as a device for simple, fast, and cost-effective sensor in POCT applications. [ABSTRACT FROM AUTHOR]

As a crucial biomarker for some diseases, the determination of cholesterol in human serum is of great significance for the diagnosis and prevention of these diseases. Hence, a portable cholesterol detection method is necessary for clinical and domestic applications. Here, a portable paper sensor was designed for cholesterol detection by modifying screen-printed electrode (SPE) with nanoporous gold (NPG). To achieve the reliable cholesterol detection, a synergistic strategy was proposed based on the oxidation of cholesterol by cholesterol oxidase (ChOx) and the reduction of oxidation product (H 2 O 2) by NPG. Compared to existing electrochemical sensors, the resulting paper sensor exhibited a wider linear response in a range from 50 μM to 6 mM as well as a higher sensitivity of 32.68 μA mM−1 cm−2 with a lower detection limit of 8.36 μM. Moreover, the portable paper sensor presented strong anti-interference capability and stability in the detection of cholesterol in human serum, and the data detected by the portable paper sensor were consistent with that obtained by an automatic biochemical analyzer. These unique performances confirmed that the proposed paper sensor was a sensitive, reliable, and portable cholesterol detection method, making it a good choice for cholesterol detection. [ABSTRACT FROM AUTHOR]

• IFCC position paper about CDT outlining caveats, key points, and recommendations. • Alcohol intake versus CDT is discussed as well as the cut-off and expected range. • Comparison studies using inadequate study populations will lead to wrong outcome. • Standardisation has led to test accuracy improvements in national EQAS. Carbohydrate deficient transferrin (CDT) is a biomarker for excessive alcohol consumption utilized in clinical and forensic medicine and workplace testing. Previously, many different analytical methods for CDT were used and the measurand varied considerably, making direct comparison of test results difficult. To end this confusion, the IFCC established a working group on CDT standardisation (WG-CDT) which completed its tasks in 2017. This IFCC position paper by the WG-CDT summarizes state of the art information about the measurand and the analytical methods and gives concise recommendations for its utilization. The results achieved by the CDT standardisation process led to accuracy improvements in national external quality assessment schemes over the years. A brief review of ROC based comparison studies with the traditional biomarkers (GGT, MCV, ALT and AST) discusses the bias resulting from inadequate study populations. In large groups of the general population the superior diagnostic performance of CDT is confirmed. The relationship between alcohol intake versus resulting CDT is discussed as well as the cutoff and measurement uncertainty. Concerning the application in practice, potential pitfalls are considered and recommendations handling both analytical and preanalytical caveats are given. Finally, some examples of serious misunderstandings in publications about CDT are addressed. [ABSTRACT FROM AUTHOR]

A novel CuS grafted PEDOT:PSS conducting paper-based electrochemical immunosensor has been successfully fabricated for the detection of EpCAM antigen. Electrical conductivity is further improved by doping the CuS@PEDOT:PSS/WP electrode with different organic solvents such as N,N-dimethyl formamide (DMF), N,N-dimethyl acetamide (DMA), ethylene glycol (EG) and dimetyl sulfoxide (DMSO). It is observed that DMSO doped conducting paper shows the highest conductivity (6.1 × 10−2 S/cm) among all these solvents. This low cost, biodegradable electrochemical paper-based immunosensor (BSA/anti-EpCAM/EP) possesses a broad linear range from 0.01 pg/mL to 1000 ng/mL for EpCAM antigen detection. The immunosensor is found to have high sensitivity of 104.31 μA pg−1 mL. This conducting paper based immunosensor is further used to detect EpCAM antigen in human serum samples, thereby confirming a cost effective clinical tool over other costly conventional techniques. • An electrochemical paper-based immunosensor has been designed using CuS and PEDOT:PSS. • This low cost and flexible platform may be a promising candidate over other costly conventional electrodes. • It exhibits high sensitivity of 104.31 μA pg−1 mL in broad range of 0.01 pg/mL to 1000 ng/mL, for EpCAM detection. • The clinical applicability and validity has been checked with human serum sample. [ABSTRACT FROM AUTHOR]

Development of the portable device is significant for sensitive and rapid detection of an anthrax biomarker dipicolinic acid (DPA), existing in the B. anthracis. In this work, a novel HAp:Tb-EDTA paper-based ratiometric fluorescent sensor was obtained by a simple one-pot method for rapid and sensitive DPA detection. With the increased DPA concentration, the luminescence intensity of HAp (hydroxyapatite) remained constant, and thus applied as the stable reference signal, while the luminescence signal of Tb3+-EDTA was significantly enhanced due to the antenna effect. Therefore, the HAp:Tb-EDTA paper-based sensor was endowed with self-calibrated and ratiometric fluorescent detection performance for DPA. The proposed sensor showed excellent detection performance with a detection limit as low as 10.8 nM in the linear range of 0.5–30 μM. After combination with a smartphone, rapid visual and fluorescent detection of DPA was achieved. The proposed sensor was successfully applied to detect DPA from B. subtilis spore real samples, showing the application prospects of the paper-based sensors and opening a new horizon to develop novel paper-based point-of-care testing (POCT) devices. A sensing platform was constructed by a HAp:Tb-EDTA paper-based ratiometric fluorescent probe prepared by a one-pot method and combined with a smartphone. The sensing platform has good stability and can be used for sensitive detection of DPA released from Bacillus subtilis spores. [Display omitted] • A novel HAp:Tb-EDTA paper-based ratiometric fluorescent probe was facilely constructed. • The Tb3+-EDTA recognition unit uniformly distributed on HAp with a paper-like structure, making it superior to that based on commercial test papers. • A portable platform was constructed through combining with smartphones for real samples detection, showing widespread application prospects. • Opening a new horizon to develop novel paper-based point-of-care testing (POCT) devices. [ABSTRACT FROM AUTHOR]

Paper-based analytical devices (PADs), thanks to the versatility, cheapness, availability, biodegradability, and porosity of paper, have emerged as flexible sensing platforms for determining various analytes. However, lack of selectivity can be a problem in complex analysis conditions and samples. To improve the selectivity and specificity of PADs, they can be integrated with molecularly imprinted polymers (MIPs). The high selectivity of the sensor is the essential feature for biomarker analysis because the reliable and accurate determination of biomarkers provides valuable information about various diseases, especially cancer. Therefore, MIP-PAD systems offer a good option for biomarker analysis. This way, it is possible to achieve point-of-care tests, early diagnosis, and affordability. This review points out the significant processes of MIP-PAD fabrication and characterization (paper selection and fabrication, synthesis of MIP). The most recent applications of MIP-PADs for biological samples are explained and discussed in detail. Lastly, the commercialization of MIP-PADs is evaluated. This study is the first in the literature to assess MIP-PADs for biomarkers analysis. • The evaluation of MIP-PADs for biomarker detection. • Comprehensive research for fabrication and characterization of MIP-PADs. • The successful sensor applications of MIP-PADs for biological samples. • The place of MIP-PADs in commercial applications. [ABSTRACT FROM AUTHOR]

Abstract We present a QR code paper microfluidic colorimetric assay that can exploit the hardware and software on mobile devices, and circumvent sample preparation by directly targeting volatile biomarkers. Our platform is a printable microarray of well-defined reaction regions, which outputs an instant diagnosis by directing the user to a URL containing their test result, while simultaneously storing epidemiological data for remote access and bioinformatics. To assist in the rapid identification of Escherichia coli in bloodstream infections, we employed an existing colorimetric reagent (p -dimethylaminocinnamaldehyde) and adapted its use to detect volatile indole, a biomarker produced by E. coli. Our assay was able to quantitatively detect indole in the headspace of E. coli culture after 12 h of growth (27.0 ± 3.1 ppm), assisting in species-level identification hours earlier than existing methods. Results were confirmed with headspace solid-phase microextraction (HS-SPME) two-dimensional gas chromatography time-of-flight mass spectrometry (GC×GC-ToFMS), which estimated indole concentration in E. coli culture to average 32.3 ± 5.2 ppm after 12 h of growth. This QR paper microfluidic platform represents a novel development in both telemedicine and diagnostics using volatile biomarkers. We envision that our QR code platform can be extended to other colorimetric assays for real-time diagnostics in low-resource environments. Highlights • Volatile indole can be detected on a paper substrate with a colorimetric reagent. • Colorimetric signal correlates linearly with volatile indole concentration. • Indole can be colorimetrically detected in the headspace of E. coli culture. • Benchmarking with GCxGC-TOFMS showed that paper sensor measurements were accurate. • Digital QR code paper-based microfluidic sensors are feasible diagnostic platforms. [ABSTRACT FROM AUTHOR]

A novel washing scheme following antigen–antibody reactions with analyte was used during construction of a fluorescent immunosensor to resolve the background problem in the lateral flow assay with human serum. An immuno-membrane strip was devised to simultaneously measure cardiac troponin I (cTnI), creatinine kinase-MB isoform (CK-MB), and myoglobin to diagnose acute myocardial infarction. This strip was then installed within a cartridge containing a built-in washing solution tank, which was used to supply the solution across the signal generation pad of the strip after the immune reactions. Such cross-flow washing was initiated by onset-signaling from the internal control and began to run automatically upon sample addition. Under optimal conditions, the immunosensor displayed a stably suppressed background baseline, enabling us to attain a low detection limit for cTnI (0.05 ng/mL) as well as favorable reproducibility for repetitive measurements (relative standard deviation <10%). No interference was observed among the different complex formations at the respective analyte sites, and no artifacts were caused by sample matrices. We tested the performance relationship with the Pathfast reference system for positive serum samples (36 for cTnI, 58 for CK-MB, and 17 for myoglobin), and the correlation coefficients were >0.98. This result suggests that the new immunosensor system based on two-dimensional chromatography can be used for clinical testing [ABSTRACT FROM AUTHOR]

[Display omitted] • PEDOT:PSS and Borophene nanosheets modified conducting paper. • Cost efficient and flexible biosensor for protein biomarker detection. • Environment friendly biosensing platform with smoke free degradation. • Ultralow LOD (0.49 ng ml−1) and wider LDR (1 ng ml−1 - 60 µg ml−1) for swine flu detection. Here, we report results of the studies related to the fabrication of nanomaterial modified paper [Whatman paper modified with poly(3,4-ethylenedioxythiophene):poly(4-styrene sulfonate) (PEDOT:PSS) and Borophene nanosheets] based biosensor for proteinaceous Serum Amyloid A (SAA) biomarker detection. For the fabrication of stable and cost-efficient nanomaterial modified conducting paper, we used simple dip coating method followed by solvent treatment. The incorporation of Borophene nanosheets onto the conducting paper resulted in enhance electrochemical performance, flexibility and signal stability. The flexibility of fabricated electrode is validated via bending and folding studies; it continues to maintain conductivity even after being folded 40 times. Furthermore, this paper sensor may be quickly and properly disposed of by simple burning method without emitting smoke. It was also observed that no any harmful/heavy element was present after disposal of the paper sensor. During fabrication of paper based sensor, anti-SAA was physically immobilized and further bovine serum albumin (BSA) was used to block the non-specific binding sites. To examine structural and morphological features of the synthesized material and the fabricated paper electrodes; X-ray diffraction, transmission electron microscopy, scanning electron microscopy, contact angle, and Fourier-transform infrared spectroscopy were used. The fabricated immunoelectrode (BSA/anti-SAA/Borophene/CP) is highly efficient to detect SAA with ultralow limit of detection of 0.49 ng mL−1, wider linear detection range in between 1 ng mL−1 - 60 µg mL−1 and high durability of 42 days. Finally, SAA protein in spiked serum samples was analyzed using the fabricated immunosensor, and the obtained results show good correlation with the standard SAA protein samples. [ABSTRACT FROM AUTHOR]

Pathogens cause various infectious diseases and high morbidity and mortality which is a global public health threat. The highly sensitive and specific detection is of significant importance for the effective treatment and intervention to minimise the impact. However, conventional detection methods including culture and molecular method gravely depend on expensive equipment and well-trained skilled personnel, limiting in the laboratory. It remains challenging to adapt in resource-limiting areas, e.g., low and middle-income countries (LMICs). To this end, low-cost, rapid, and sensitive detection tools with the capability of field testing e.g., a portable device for identification and quantification of pathogens, has attracted increasing attentions. Recently, paper-based microfluidic analytical devices (μPADs) have shown a promising tool for rapid and on-site diagnosis, providing a cost-effective and sensitive analytical approach for pathogens detection. The fast turn-round data collection may also contribute to better understanding of the risks and insights on mitigation method. In this paper, critical developments of μPADs for in-field detection of pathogens both for clinical diagnostics and environmental surveillance are reviewed. The future development, and challenges of μPADs for rapid and onsite detection of pathogens are discussed, including using the cross-disciplinary development with, emerging techniques such as deep learning and Internet of Things (IoT). [Display omitted] • The state-of-the-art on μPAD is critically reviewed. • μPAD enables onsite detections of biochemical markers from molecules to organisms. • Insights is provided highlighting on multidisciplinary aspects. [ABSTRACT FROM AUTHOR]

Abstract Citrate is currently considered a preferred biomarker for the early stage detection of prostate cancer. In the present work, based on the highly efficient catalytic properties of gold nanoclusters, a novel system for optical determination of citrate was successfully established under optimized conditions. Cysteine-capped gold nanoclusters (Cys-AuNCs) are shown to have an intrinsic peroxidase-mimetic activity. In the presence of H 2 O 2, Cys-AuNCs nanostructures are able to catalyse the oxidation of 3,3′,5,5′-tetramethylbenzidine (TMB) with high efficiency to produce a blue dye (with an absorbance maximum at 650 nm). Citrate has carboxylic and hydroxyl groups that can bind with free amino and free carboxyl cysteine groups via hydrogen bonds, thus creating a coating on the surface of the gold nanocluster and inhibiting the cluster oxidation activity. Accordingly, a visual, sensitive and simple colorimetric method using Cys-AuNCs as peroxidase mimetic was developed for detecting citrate. A suitable linear relationship for citrate was obtained for the range of 0.5 to 1000 μM. The limit of detection (LOD) of the proposed method was calculated as 0.1 μM and the relative standard deviation (RSD) was obtained to be less than 4.0%. Moreover, the biosensor was used to perform a paper assay on a Y-shaped microfluidic device and make use of the distinctive features of microchannels such as short response time, very low reagent volume required, low fabrication cost etc. A detection limit of 0.4 μM was achieved through the paper test and a good linear range was observed between 1.0 μM–10 mM. The proposed method was further applied to citrate detection in the human urine sample. Graphical Abstract Unlabelled Image Highlights • The first approach for colorimetric detection of citrate as biomarker was investigated. • The method was used to perform a paper assay on a Y-shaped microfluidic device. • A detection limit of 0.4 µM was achieved through the paper test • The assay was applied to citrate detection in the human urine sample. [ABSTRACT FROM AUTHOR]

The use of microfluidic paper-based analytical devices (μPADs) for aiding medical diagnosis is a growing trend in the literature mainly due to their low cost, easy use, simple manufacturing, and great potential for application in low-resource settings. Many important biomarkers (proteins, ions, lipids, hormones, DNA, RNA, drugs, whole cells, and more) and biofluids are available for precise detection and diagnosis. We have reviewed the advances μPADs in medical diagnostics have achieved in the last few years, focusing on the most common human biofluids (whole blood/plasma, sweat, urine, tears, and saliva). The challenges of detecting specific biomarkers in each sample are discussed, along with innovative techniques that overcome such limitations. Finally, the difficulties of commercializing μPADs are considered, and future trends are presented, including wearable devices and integrating multiple steps in a single platform. • μPADs can be applied for simple and low-cost diagnosis in low-resource settings. • The challenges of applying μPADs to human biofluids are analyzed. • Recent advancements to overcome specific drawbacks for each fluid are discussed. • Difficulties in commercializing μPADs and future tendencies are presented. [ABSTRACT FROM AUTHOR]

The accurate detection of glucose and cholesterol plays a pivotal role in disease diagnosis and home care. To this end, biochemical analyzers have become extensively utilized tools for measuring disease biomarkers. Nonetheless, their poor portability and high cost have restricted their accessibility, limiting their use to laboratory settings and hindering the adoption of point-of-care testing (POCT). In contrast, the emergence of portable and affordable paper-based testing platform has revolutionized diagnostic testing by providing distance signals, enhancing intuitiveness and visual accessibility. Consequently, these platforms have become increasingly suitable for POCT. We have developed a POCT platform that integrated AuNS@Ag, stimulus-responsive hydrogel and test strips, enabling visual distance reading of glucose. The silver-coated AuNS and enzyme were encapsulated within a temperature-responsive N-isopropylacrylamide-acrylamide (NIPAM-AcAm) hydrogel to act as target recognition and reaction units respectively. Glucose can diffuse freely within the hydrogel porous matrix, thereby instigating enzyme-catalyzed reaction that induce alterations in the photothermal effect of the system. This dynamic process ensures efficient and responsive modulation of the system's photothermal properties. By ingeniously capturing distance signals induced by the photothermal effect-mediated water release the visualization and quantification of target substances are achieved, with a linear range spanning from 0 to 30 mM. The consistency between distance-based POCT platform and commercial blood glucose meter demonstrates that the platform provides a portable, affordable and reliable method for visual reading biomarkers. The proposed strategy enables direct, visual quantitative analysis of the target without the need for additional analytical instruments. Particularly, this method holds significant promise as an efficient platform for cholesterol and other disease markers measurement. [Display omitted] • A POCT platform was constructed for visible distance-readout of disease marker. • AuNS@Ag was employed as target recognition unit for photothermal signal output. • Temperature-responsive hydrogel as carrier and framework for the platform. [ABSTRACT FROM AUTHOR]

Abstract The early detection of acute myocardial infarction (AMI) upon the onset of chest pain symptoms is crucial for patient survival. However, this detection is challenging, particularly without a persistent elevation of ST-segment reflected in an electrocardiogram or in blood tests. A majority of the available point-of-care testing devices allow accurate and rapid diagnosis of AMI. However, AMI diagnosis is reliable only at intermediate and later stages, with myocardial injury (> 6 h) and MI, based on the expression of specific cardiac biomarkers including troponin I or T (cTnI or cTnT), creatine kinase-MB (CK−MB), and myoglobin. Diagnosis at the early myocardial ischemia stage is not possible. To overcome this limitation, a sensitive and rapid microfluidic paper-based device (µPAD) was developed for the simultaneous detection of multiple cardiac biomarkers for the early and late diagnosis of AMI. The glycogen phosphorylase isoenzyme BB (GPBB) was detected during early (within first 4 h) ischemic myocardial injury. On the same µPAD platform, detection of prolonged elevation of levels of cTnT and CK-MB, which are only produced 6 h after the onset of chest pain in human serum, was possible. Sandwich immunoassay performed on the µPAD achieved reproducibility (RSD approximately 10% and intra-and inter-day precision (CV 10–20%, 99th percentile), as well as consistently stable test results for 28 days, with strong correlation (r2 = 0.962), using the standard Siemens Centaur XPT Immunoassay system. The present findings indicate the potential of the µPAD platform as a point-of-care device for the early diagnosis and prognosis of AMI. Graphical abstract fx1 Highlights • The first POC device developed for early diagnosis and prognosis of AMI. • Wax printed µPAD allows rapid multiplex detection of GPBB, CK-MB and cTnT. • Developed µPAD has potential use in clinical testing. • Results obtained are well correlated with Siemens Centaur XPT Immunoassay system. [ABSTRACT FROM AUTHOR]

In this paper, we describe a validated paper-based microfluidic analytical device for the simultaneous quantification of two important biomarkers of renal function in urine. This paper platform provides an inexpensive, simple, and easy to use colorimetric method for the quantification of creatinine (CRN) and uric acid (UA) in urine samples. The microfluidic paper-based analytical device (μPAD) consists of a main channel with three identical arms, each containing a circular testing zone and a circular uptake zone. Creatinine detection is based on the Jaffé reaction, in which CRN reacts with picrate to form an orange-red product. Uric acid quantification is based on the reduction of Fe 3+ to Fe 2+ by UA, which is detected in a colorimetric reaction using 1,10-phenanthroline. Under optimum conditions, obtained through chemometrics, the concentrations of the analytes showed good linear correlations with the effective intensities, and the method presented satisfactory repeatability. The limits of detection and the linear ranges, respectively, were 15.7 mg L −1 and 50–600 mg L −1 for CRN and 16.5 mg L −1 and 50–500 mg L −1 for UA. There were no statistically significant differences between the results obtained using the μPAD and a chromatographic comparative method (Student's t -test at 95% confidence level). [ABSTRACT FROM AUTHOR]

Total joint arthroplasty (TJA) has significantly improved the quality of life for millions suffering from end-stage arthritis. However, periprosthetic joint infections (PJI) remain a serious complication, necessitating extensive interventions and prolonged antimicrobial treatments. The aging population is expected to lead to a rise in TJA cases, subsequently increasing the incidence of PJI, particularly in the elderly who face higher mortality rates. Current diagnostic methods for suspected PJI, such as radiographs and biochemical markers like CRP and ESR, exhibit limited sensitivity. Therefore, there is a critical need for a specific synovial fluid biomarker assay to enhance PJI diagnosis using specific SF-based assay. This study introduces a novel microfluidic chip with a paper-based aptamer-sandwich assay for the quantitative detection of HNP 1, a crucial PJI biomarker, in synovial fluid. The assay leverages the advantages of aptamers over antibodies, demonstrating high selectivity and affinity for target molecules. The integration of a nitrocellulose (NC) membrane onto the microfluidic platform represents a significant advancement, reducing background signals and simplifying the assay procedure without intricate procedure and pre-treatment. The NC membrane-based microfluidic device offers rapid, cost-effective, and highly sensitive detection of HNP 1, with a limit of detection of 0.5 mg L−1. The microfluidic device demonstrates exceptional performance, detecting up to four clinical samples in approximately 42 min on a single chip with 100 % accuracy, as confirmed by analysis of 12 clinical samples and comparison with "gold-standard". Moreover, the assay exhibits a wide dynamic range of 0.5–100 mg L-1, underscoring its potential as a powerful tool for PJI diagnosis in clinical settings. This work introduces a paper-based microfluidic system tailored for rapid HNP 1 detection using synovial fluid near joint region (and not serum via blood) for better diagnosis. The innovative paper-based aptamer-sandwich assay yields results within 42-min. Significantly, it boasts a wide dynamic range, detecting levels from an impressive 0.5 mg L-1, crucial in the 2.6 mg L-1 threshold region. This heightened sensitivity and expansive detection capability establish our assay as a leader in PJI diagnostics, promising unmatched precision and efficiency in clinical applications. Schematic representation of the automated paper-based aptamer sandwich assay for periprosthetic joint infection (PJI) detection. The microfluidic chip features a reaction zone utilizing an NC membrane as the paper substrate, along with a dual aptamer assay for efficient aptamer-sandwich formation. Detection is achieved via the PMT module and subsequent analysis using fluorescent microscopy to differentiate PJI-positive and negative synovial fluid (SF) samples. [Display omitted] • We devised a novel paper-based aptamer-sandwich assay integrated into an automated microfluidic platform to detect HNP 1. • 42-minute swift operated assay, streamlined pretreatment steps, no extra quenching methods needed. • Clinical samples assessed on chip; results compared to gold standard ELISA (designed for serum, adjusted for SF). [ABSTRACT FROM AUTHOR]

Functionalized manganese-doped carbon dots (FMn-CDs) were prepared by integration of pyrolysis-derived Mn-CDs with ethylene diamine, ethylenediamine tetraacetic acid and Eu(III) ions. The FMn-CDs emitted intense blue fluorescence with high photostability, excellent water-solubility and favorable biocompatibility. 2, 6-dipicolinic acid (DPA) is an important biomarker of Bacillus anthracis spore . It serves as an antenna suction light group and can sensitize the Eu(III) combined on the FMn-CDs to produce bright red fluorescence. Benefitting from the absorbance energy transfer emission effect from DPA to the sensitized Eu(III), a ratiometric biosensor towards DPA detection was developed. The approach exhibited a linearity range from 0.1 to 750 nM and a detection limit of 0.1 nM. Moreover, visual FMn-CDs test paper was produced for the DPA detection using a smartphone under a portable UV lamp, with a lowest detection limit of 1 μM. This work revealed the potential of a convenient smart phone diagnostics for DPA detection using visual FMn-CDs test paper. [ABSTRACT FROM AUTHOR]

Abstract Background Our current understanding of the pathophysiology and management of sepsis is associated with a lack of progress in clinical trials, which partly reflects insufficient appreciation of the heterogeneity of this syndrome. Consequently, more patient-specific approaches to treatment should be explored. Aims To summarize the current evidence on precision medicine in sepsis, with an emphasis on translation from theory to clinical practice. A secondary objective is to develop a framework enclosing recommendations on management and priorities for further research. Sources A global search strategy was performed in the MEDLINE database through the PubMed search engine (last search December 2017). No restrictions of study design, time, or language were imposed. Content The focus of this Position Paper is on the interplay between therapies, pathogens, and the host. Regarding the pathogen, microbiologic diagnostic approaches (such as blood cultures (BCs) and rapid diagnostic tests (RDTs)) are discussed, as well as targeted antibiotic treatment. Other topics include the disruption of host immune system and the use of biomarkers in sepsis management, patient stratification, and future clinical trial design. Lastly, personalized antibiotic treatment and stewardship are addressed (Fig. 1). Implications A road map provides recommendations and future perspectives. RDTs and identifying drug-response phenotypes are clear challenges. The next step will be the implementation of precision medicine to sepsis management, based on theranostic methodology. This highly individualized approach will be essential for the design of novel clinical trials and improvement of care pathways. [ABSTRACT FROM AUTHOR]

Acute kidney injury (AKI) is a serious renal emergency that is often underdiagnosed and associated with high mortality rates. Early diagnosis of AKI is crucial to improve patient prognosis and reduce healthcare costs. In this study, a paper-based colloidal gold multiplex vertical flow assay was developed for rapid detection of three AKI biomarkers, namely, NGAL, CysC, and RBP4, in a single test kit. In this system, specific capture antibodies were pre-immobilized on the sensing membrane at four spatially isolated immunoreactive sites. Gold nanoparticles were conjugated with detection antibodies as the colorimetrical labels. The resultant images could be read out qualitatively by the naked eyes or quantitatively by a smartphone-based readout device. Three AKI biomarkers could be simultaneously detected in 10–15 min. The detection sensitivity and specificity for clinical serum samples collected from 25 patients with AKI and 25 healthy individuals were determined as 92% and 88%. This vertical flow assay platform is easy to use, rapid, and low cost. It is a promising diagnostic tool for multiplex detection of disease biomarkers at point of care. [Display omitted] • A multiplex colorimetric vertical flow assay was developed by using wax-printed sensing membrane. • Three acute kidney injury biomarkers could be simultaneously detected in 10–15 min. • A miniaturized smartphone-based readout device was developed for result imaging. • Clinical samples were tested by this system with a good accuracy. [ABSTRACT FROM AUTHOR]

Personalized health care (PHC) is being appreciated globally to combat clinical complexities underlying various metabolic or infectious disorders including diabetes, cardiovascular, communicable diseases etc. Effective diagnoses majorly depend on initial identification of the causes which are nowadays being practiced in disease-oriented approach, where personal health profile is often overlooked. The adoption of PHC has shown significantly improved diagnoses in various conditions including emergency, ambulatory, and remote area. PHC includes personalized health monitoring (PHM), which is its integral part and may provide valuable information's on various clinical conditions. In PHC, bio-fluids are analyzed using various diagnostic devices including lab based equipment and biosensors. Among all types of biosensing systems, paper based biosensors are commercially attracted due to its portability, easy availability, cheaper manufacturing cost, and transportability. Not only these, various intrinsic properties of paper has facilitated the development of paper based miniaturized sensors, which has recently gained ASSURED (Affordable, Sensitive, Specific, User-friendly, Rapid and Robust, Equipment free, Deliverable to all end-users) status for point of care diagnosis in miniaturized settings. In this review, importance of paper based biosensors and their compatibility for affordable and low cost diagnostics has been elaborated with various examples. Limitations and strategies to overcome the challenges of paper biosensor have also been discussed. We have provided elaborated tables which describe the types, model specifications, sensing mechanisms, target biomarkers, and analytical performance of the paper biosensors with their respective applications in real sample matrices. Different commercial aspects of paper biosensor have also been explained using SWOT (Strength, Weakness, Opportunities, Threats) analysis. [ABSTRACT FROM AUTHOR]

In this work, a novel time-resolved ratiometric fluorescent probe based on dual lanthanide (Tb: terbium, and Eu: europium)-doped complexes (Tb/DPA@SiO 2 -Eu/GMP) has been designed for detecting anthrax biomarker (dipicolinic acid, DPA), a unique and major component of anthrax spores. In such complexes-based probe, Tb/DPA@SiO 2 can serve as a stable reference signal with green fluorescence and Eu/GMP act as a sensitive response signal with red fluorescence for ratiometric fluorescent sensing DPA. Additionally, the probe exhibits long fluorescence lifetime, which can significantly reduce the autofluorescence interferences from biological samples by using time-resolved fluorescence measurement. More significantly, a paper-based visual sensor for DPA has been devised by using filter paper embedded with Tb/DPA@SiO 2 -Eu/GMP, and we have proved its utility for fluorescent detection of DPA, in which only a handheld UV lamp is used. In the presence of DPA, the paper-based visual sensor, illuminated by a handheld UV lamp, would result in an obvious fluorescence color change from green to red, which can be easily observed with naked eyes. The paper-based visual sensor is stable, portable, disposable, cost-effective and easy-to-use. The feasibility of using a smartphone with easy-to-access color-scanning APP as the detection platform for quantitative scanometric assays has been also demonstrated by coupled with our proposed paper-based visual sensor. This work unveils an effective method for accurate, sensitive and selective monitoring anthrax biomarker with backgroud-free and self-calibrating properties. [ABSTRACT FROM AUTHOR]

This manuscript describes the development and clinical testing of a paper-based, metabolic assay designed for rapid, semi-quantitative measurement of organophosphate poisoning. Paper-based platforms, including point-of-care devices and 96-well plates, provided semi-quantitative information regarding the concentration of AchE (a biomarker for organophosphate poisoning). The paper-based 96-well-plate developed and implemented in this study was used to measure the level of organophosphate poisoning in three different clinical patients. Results were comparable to those obtained using conventional hospital methods currently considered the “gold standard”. This diagnostic device offers several advantages over conventional methods, including short operating time (twice as fast as conventional methods), procedure simplicity, and reduced fabrication cost. With further commercialization efforts, the methods described in this manuscript could be applied to a wide range of potential diagnostic applications in the field. [ABSTRACT FROM AUTHOR]

Food-borne pathogens have been recognized as a major cause of human infections worldwide. Their identification needs to be simpler, cheaper and more reliable than the traditional methods. Here, we constructed a low-cost paper platform for viable pathogenic bacteria detection with the naked eye. In this study, an effective isothermal amplification method was used to amplify the hlyA mRNA gene, a specific RNA marker in Listeria monocytogenes. The amplification products were applied to the paper-based platform to perform a visual test using sandwich hybridization assays. When the RNA products migrated along the platform by capillary action, the gold nanoparticles accumulated at the designated area. Under optimized experimental conditions, as little as 0.5pg/μL genomic RNA from L. monocytogenes could be detected. It could also be used to specifically detect 20CFU/mL L. monocytogenes from actual samples. The whole assay process, including RNA extraction, amplification, and visualization, can be completed within several hours. This method is suitable for point-of-care applications to detect food-borne pathogens, as it can overcome the false-positive results caused by amplifying nonviable L. monocytogenes. Furthermore, the results can be imaged and transformed into a two-dimensional bar code through an Android-based smart phone for further analysis or in-field food safety tracking. [ABSTRACT FROM AUTHOR]

[Display omitted] • Fabrication of paper disc interfaced immunodevice for detecting diverse biomarker. • Highly sensitive and affordable disease detection tool. • Validated with range of spiked and real samples. • Universal sensing ability was accessed using C-reactive protein and potato viruses. The detection of specific biomarkers is used in various phases of the diagnosis of plant and human diseases, from prognosis to monitoring. Herein, we report a Prussian blue nanocube-modified immunodevice interfaced with a paper disc for the detection of plant biomarkers via streptavidin-biotin recognition. The detection ability of the immunodevice was assessed using Potato virus X as a model biomarker and analyzed using cyclic voltammetry, differential pulse voltammetry, and electrochemical impedance spectroscopy. The immunodevice displayed excellent performance for Potato virus X detection with a detection limit of 0.92 nM (3S/N). The selectivity of the fabricated Potato virus X immunodevice was investigated using closely associated antigens, such as potato aucuba mosaic virus, Potato virus Y, and Potato virus A. The Potato virus X immunodevice exhibited ∼ 90 % recovery in spiked complex plant samples with a relative error of ∼ 9 %. Furthermore, the immunodevice was used to screen for Potato virus X in 10 samples from potato tubers and leaves. The paper-disc-interfaced immunodevice was also evaluated by detecting other biomarkers, such as potato aucuba mosaic virus in plant diseases and C-reactive protein in human ones. This immunodevice may allow the on-site monitoring of diverse biomarkers by simplifying the current point of care diagnostic tools. [ABSTRACT FROM AUTHOR]

Abstract: Dried blood spot samples (DBSS) on filter paper offer several advantages compared to conventional serum/plasma samples: they do not require any phlebotomy or separation of blood by centrifugation; they are less invasive; they allow sample stability and shipment at room temperature; and they pose a negligible risk of infection with blood-borne viruses, such as HIV, HBV and HCV, to those who handle them. Therefore dried blood spot samples (DBSS) on filter paper can be a quick, convenient and inexpensive means of obtaining blood samples for biomarker discovery, disease screening, diagnosis and treatment monitoring in non-hospitalized, public health settings. In this study, we investigated for the first time the potential application of dried blood spot samples (DBSS) in protein expression profiling using antibody array technology. First, optimal conditions for array assay performance using dried blood spot samples (DBSS) was established, including sample elution buffer, elution time, elution temperature and assay blocking buffer. Second, we analyzed dried blood spot samples (DBSS) using three distinct antibody array platforms, including sandwich-based antibody arrays, quantitative antibody arrays and biotin-label-based antibody arrays. In comparison with paired serum samples, detection of circulating proteins in dried blood spot samples (DBSS) correlated well for both low- and high-abundance proteins on all three antibody array platforms. In conclusion, our study strongly indicates the novel application of multiplex antibody array platforms to analyze dried blood spot samples (DBSS) on filter paper represents a viable, cost-effective method for protein profiling, biomarker discovery and disease screening in a large, population-based survey. [Copyright &y& Elsevier]

This work describes a fast and simple assay for in situ detection of thiocyanate, i.e., a biomarker of tobacco smoke exposure, in human saliva. The assay is based on the formation of an iron(III)-thiocyanate colored complex in a paper-based sensing platform and subsequent image analysis using a scanner as detection device. Experimental parameters influencing the color intensity of the complex were fully evaluated, including the selection of detection conditions, type of paper substrate, test zone dimensions and composition as well as the stability of the paper-based device. Under optimal conditions, the detection limit was 0.06 mM of thiocyanate, and the repeatability, expressed as relative standard deviation, was 3%. The proposed method, characterized by its simplicity, portability and low sample consumption, was applied to the detection of thiocyanate in a series of human saliva samples. Average thiocyanate levels in the ranges 0.28–0.87 mM and 0.78–4.28 mM were found for non-smokers and smokers, respectively. Recovery studies were carried out at two concentration levels, showing recovery values in the range of 96.1–103.6%. [ABSTRACT FROM AUTHOR]

Objective Attention-deficit/hyperactivity disorder (AD/HD) is a common developmental disorder. Many reports have suggested that symptoms of AD/HD are related to frontal lobe dysfunctions, particularly disinhibition. However, measuring neurological findings with biomarkers during frontal functional tasks has sometimes been difficult in children with AD/HD. This study aimed to investigate frontal inhibitory function objectively in children with AD/HD during "rock, paper, scissors" (RPS) tasks, as a familiar game for Japanese children, using near-infrared spectroscopy (NIRS). Subjects and methods Eighteen children with AD/HD were compared with 27 typically developing children (TDC). Children from each group were divided into two age groups: younger, 6-10 years; and older, 11-16 years. Changes in oxygenated hemoglobin [oxy-Hb] were measured in the prefrontal region using NIRS during a 'to lose' RPS task, in which subjects were asked to present the RPS signal that would lose in response to one of the three signals displayed randomly on a computer screen every 2.0 s. Results The rate of correct performance with both TDC and AD/HD increased with age. Only in the older group, the rate of correct performance was significantly higher with TDC than with AD/HD. However, children with AD/HD in both age groups showed significantly lower [oxy-Hb] activity in the prefrontal region during the 'to lose' RPS task, particularly in the dorsolateral area. Conclusions Our results suggest that prefrontal region activation during the 'to lose' RPS task could offer a biomarker for diagnosing AD/HD, and may help in the early treatment of AD/HD. [ABSTRACT FROM AUTHOR]

At present, most countries or regions use commercial centrifuges for centrifugation, but this is out of reaching for limited-resource areas. To overcome this problem, a portable electric yo-yo as centrifuge was firstly proposed to obtain serum, and this device can be combined with paper-based analytical devices for enzyme-linked immunosorbent assay (ELISA) analysis from human whole blood. In this study, inflammatory biomarkers C-reactive protein (CRP) and serum amyloid A (SAA) were used as target biomarker to verify the performance of the proposed method. The results shows good performance and their detection limits were determined to be 580 pg/mL for CRP and 800 pg/mL for SAA, respectively. We believe this method provides a new platform of low cost and fast detection for inflammatory biomarkers in the limited-resource settings. Using electric yo-yo device to implement inflammatory biomarkers detection in whole blood paper-based microfluidic immunoassay chip. [Display omitted] • A low-cost, portable and effective electric yo-yo centrifugal device is firstly proposed for blood centrifugation. • Paper-based microfluidic immunoassay chip used for inflammatory biomarkers analysis in whole blood. • The method shows good potential to on-site/limited-resource testing. [ABSTRACT FROM AUTHOR]

This manuscript describes the development and clinical testing of a paper-based, metabolic assay designed for rapid, semi-quantitative measurement of organophosphate poisoning. Paper-based platforms, including point-of-care devices and 96-well plates, provided semi-quantitative information regarding the concentration of AchE (a biomarker for organophosphate poisoning). The paper-based 96-well-plate developed and implemented in this study was used to measure the level of organophosphate poisoning in three different clinical patients. Results were comparable to those obtained using conventional hospital methods currently considered the “gold standard”. This diagnostic device offers several advantages over conventional methods, including short operating time (twice as fast as conventional methods), procedure simplicity, and reduced fabrication cost. With further commercialization efforts, the methods described in this manuscript could be applied to a wide range of potential diagnostic applications in the field. [ABSTRACT FROM AUTHOR]

Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is>70 years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living and social support. Comorbidity scoring and geriatric assessment tools are helpful in achieving such multidimensional evaluation in a systematic manner. The introduction of new drugs including novel monoclonal antibodies and kinase inhibitors offers enhanced opportunities for the treatment of elderly patients with CLL. This position paper of a Task Force of the International Society of Geriatric Oncology (SIOG) reviews currently available evidence relevant to such patients. All types of elderly patient (i.e. chronological age>65-70 years) are considered, from robust (fit) to vulnerable (unfit) to the terminally ill. Among the topics covered are the following: (i) the relationship between chronological age, prognosis and survival, (ii) assessment of biological aging, (iii) biological age as a determinant of treatment feasibility and tolerance and (iv) tailoring of both first and further-line treatment to the circumstances of the individual patient. [ABSTRACT FROM AUTHOR]

Paper-based point-of-care (POC) devices exhibit the advantages of simplicity, rapidity, trim sizes, and low cost, which are of particular importance for food safety, biological analysis, and medical diagnosis. However, the materials utilized to make paper-based POC rarely produce multiple signals, hampering further applications in diverse situations. Herein, we present an appealing approach, namely Colorimetric-Temperature Dual-Signal Output Sensor (CTDSS), and construct a CTDSS based on coordinative self-assembly biomimetic nanozymes Fe-GMP-L-His CPNs as a proof of concept. These CPNs mimic the structure of horseradish peroxidase (HRP), in which Fe (II) is the center, nucleotide GMP and histidine are chosen as ligands to simulate metal coordination of the pyrrole ring and protein function in HRP, respectively. This strategy allows CPNs to show an excellent peroxidase-like activity, efficiently converting H 2 O 2 into •OH and oxidizing TMB to generate colorimetric-temperature dual-signal. As a proof-of-concept application, we exploited cholesterol as the target and successfully applied this CTDSS to detect cholesterol, displaying extraordinary features of rapidity, dramatic specificity, and high sensitivity. By utilizing the colorimetric test strip and temperature discoloration sticker, the paper-based POC tools were constructed to visualize the target. Meanwhile, two proposed test strip POC devices generating different signal outputs exhibited remarkable feasibility and were further employed to detect cholesterol in human serum. We anticipate that this CTDSS platform will inspire innovative concepts for future portable detection tools. [ABSTRACT FROM AUTHOR]

Paper is a promising platform for the development of decentralized diagnostic assays owing to the low cost and ease of use of paper-based analytical devices (PADs). It can be challenging to detect on PADs very low concentrations of nucleic acid biomarkers of lengths as used in clinical assays. Herein we report the use of thermophilic helicase-dependent amplification (tHDA) in combination with a paper-based platform for fluorescence detection of probe-target hybridization. Paper substrates were patterned using wax printing. The cellulosic fibers were chemically derivatized with imidazole groups for the assembly of the transduction interface that consisted of immobilized quantum dot (QD)–probe oligonucleotide conjugates. Green-emitting QDs (gQDs) served as donors with Cy3 as the acceptor dye in a fluorescence resonance energy transfer (FRET)-based transduction method. After probe-target hybridization, a further hybridization event with a reporter sequence brought the Cy3 acceptor dye in close proximity to the surface of immobilized gQDs, triggering a FRET sensitized emission that served as an analytical signal. Ratiometric detection was evaluated using both an epifluorescence microscope and a low-cost iPad camera as detectors. Addition of the tHDA method for target amplification to produce sequences of ∼100 base length allowed for the detection of zmol quantities of nucleic acid targets using the two detection platforms. The ratiometric QD-FRET transduction method not only offered improved assay precision, but also lowered the limit of detection of the assay when compared with the non-ratiometric QD-FRET transduction method. The selectivity of the hybridization assays was demonstrated by the detection of single nucleotide polymorphism. [ABSTRACT FROM AUTHOR]

In this work, we developed a cascade signal amplification strategy for detection of IgG antigen by combining the rolling circle amplification (RCA) technique with oligonucleotide functionalized carbon dots (CDs), based on a paper-based electrochemiluminescence (ECL) origami device (PECLOD) for the first time. In this PECLOD, three-dimensional (3D) macroporous Au-paper electrode was fabricated and employed as the working electrode for specific and efficient antibodies capture. The RCA product containing tandem-repeat sequences could serve as an excellent template for periodic assembly of CDs, which presented per protein recognition event to numerous CDs tags for ECL readout. Under the optimal conditions, the proposed strategy showed remarkable amplification efficiency, very little nonspecific adsorption with good stability, reproducibility, and accuracy. Using human IgG (H-IgG) as a model protein, the designed strategy was successfully demonstrated for the ultrasensitive detection of protein target. The results revealed that the strategy exhibited a dynamic response to H-IgG range from 1.0 fM to 25 pM with a limit of detection as low as 0.15 fM. Importantly, the methodology can be further extended to the detection of other proteins or biomarkers. [ABSTRACT FROM AUTHOR]

Paper, a cheap and ubiquitous material, has great potential to be used as low-cost, portable and biodegradable platform for chemical and biological sensing application. In this paper, we are exploring a low-cost, flexible and reliable method to effectively pattern paper for capturing optical dyes and for flow-based delivery of target samples for colorimetric chemical sensing. In this paper, we target the detection of ammonia (NH 3 ) and carbon dioxide (CO 2 ), two of the important environmental and health biomarkers. By functionalizing the paper platform with diverse cross-reactive dyes sensitive to NH 3 and CO 2 , their selective sensing within a certain pH range, as well as their detection at different concentrations can be achieved. The images of paper based device were captured by a flatbed scanner and processed in MATLAB ® using a RGB model and PCA for quantitative analysis. Paper based devices with readout using ubiquitous consumer electronic devices (e.g. smartphones, flatbed scanner) are considered promising approaches for disease screening in developing countries with limited resources. [ABSTRACT FROM AUTHOR]

We present a novel dual-imprinted electrochemical paper-based analytical device (Di-ePAD) to simultaneously determine 8-hydroxy-2′-deoxyguanosine (8-OHdG) and 3-nitrotyrosine (3-NT) and assess oxidative and nitrative biomarkers in urine and plasma samples. The Di-ePAD was designed with hydrophobic barrier layers formed on filter paper to provide three-dimensional circular reservoirs and assembled electrodes. The molecularly imprinted polymer (MIP) was synthesized using a silica nanosphere decorated with silver nanoparticles (SiO 2 @AgNPs) as a core covered with dual-analyte imprinted sites on the polymer to recognize selectively and bind the target biomarkers. This strategy drives monodispersity and enhances the conductivity of the resulting MIP core-shell products. 3-NT-MIP and 8-OHdG-MIP were synthesized by successively coating the surface of SiO 2 @AgNPs with l -Cysteine via the thiol group, then terminating with MIP shells. The dual imprinted core-shell composites possess attractive properties for the target biomarkers' sensing, including catalytic activity, selectivity, and good conductivity. The Di-ePAD revealed excellent linear dynamic ranges of 0.01–500 μM for 3-NT and 0.05–500 μM for 8-OHdG, with detection limits of 0.0027 μM for 3-NT and 0.0138 μM for 8-OHdG. This newly developed method based on the synergistic effects of SiO 2 @AgNPs combined with promising properties of MIP offers outstanding selectivity, sensitivity, reproducibility, simplicity, and low cost for quantitative analysis of 3-NT and 8-OHdG. The proposed Di-ePAD showed good accuracy and precision when applied to actual samples, including urine and serum samples validated by a conventional HPLC method. [Display omitted] • A novel dual-imprinted electrochemical paper-based analytical device (Di-ePAD) was fabricated. • Dual-MIP was synthesized covered on the SiO 2 @AgNPs core. • Di-ePAD shows high sensitivity, selectivity and accuracy for simultaneous determination of 8-OHdG and 3-NT. [ABSTRACT FROM AUTHOR]

Lake Baikal, a unique habitat for a great number of endemic species, is the largest freshwater reservoir in the world which is still largely unaffected by anthropogenic pollution, except for some shore regions with industrial activity. The expressions of a biomarker of exposure (heat shock protein Hsp70) and a biomarker of effect (DNA single-strand breaks) were measured for the first time in endemic Baikalian sponge species (Baikalospongia intermedia, Lubomirskia fusifera, and Lubomirskia abietina). Tissue cubes of B. intermedia and dissociated cells of L. fusifera and L. abietina reacted to temperature stress (10–16 °C above ambient temperature) with a time-dependent increase in expression of Hsp70. In B. intermedia, the effects of model pollutants (lead, copper, and zinc, and the organochlorines tetrachloroguaiacol, TCG, and pentachlorophenol, PCP) and of the wastewater from the final refinement and aeration reservoirs of the Baikalsk Pulp and Paper Plant (BPPP), located at the shore of the southern basin of Lake Baikal, on the expression of Hsp70 and the extent of DNA damage were investigated. It was found that lead and zinc but not copper cause a strong induction of Hsp70 in this sponge, while the frequency of DNA single-strand breaks increased after exposure to all these heavy metals tested. Induction of DNA single-strand breaks was also observed after exposure to TCG and PCP, but these compounds did not (consistently) enhance Hsp70 expression. Wastewater taken from the final water aeration pond of BPPP caused a concentration-dependent increase in Hsp70 expression in B. intermedia. However, there was no difference in the basal levels of Hsp70 between sponges collected in the shallow water at an unpolluted site near Baikalsk City and at a polluted site where the wastewaters of BPPP are discharged into the lake. There was also no clear difference in the wastewater concentration-dependent induction of Hsp70 expression between sponges collected at these sites, indicating no adaptation to continuous stress exposure. [Copyright &y& Elsevier]

Although the early diagnosis and treatment for acute myocardial infarction have improved over the past decades, the morbidity and mortality from coronary artery disease (CAD) remain significant in Europe and worldwide. It is estimated that the majority of people in the developed countries who die suddenly from CAD, have no prior manifestation of disease, and the majority of these individuals are not considered to be at high risk. Accurate identification of individuals at risk of such events before the clinical manifestations is therefore required. This “State-of-Art” paper of the Italian Working Group on Atherosclerosis aims to i. provide an overview of both the traditional and emerging non-invasive imaging techniques used to detect early atherosclerosis in the general population with moderate cardiovascular risk; ii. identify the rationale for screening asymptomatic patients with preclinical atherosclerotic lesions and the optimal algorithm that should be used to detect them; iii. discuss the future directions of atherosclerosis research, with special focus on nanotechnology, aimed at early identification and treatment of low- and intermediate-risk patients. [ABSTRACT FROM AUTHOR]

The lateral-flow immunoassay (LFA) is an inexpensive and rapid paper-based assay that can potentially detect infectious disease biomarkers in resource-poor settings. Despite its many advantages that make it suitable for point-of-care diagnosis, LFA is limited by its inferior sensitivity relative to sophisticated laboratory-based assays. Our group previously introduced the use of a micellar aqueous two-phase system (ATPS), comprised of the nonionic Triton X-114 surfactant, to concentrate biomarkers in a sample and enhance their detection with LFA. However, achieving complete phase separation and target concentration using the Triton X-114 system required many hours, and the concentrated sample needed to be manually extracted and applied to LFA. Here, we successfully integrated the concentration and detection steps into a single step that occurs entirely within a portable paper-based diagnostic strip. In a novel approach, we applied the micellar ATPS to a 3-D paper design and effectively reduced the macroscopic phase separation time from 8 h to approximately 3 min. The 3-D design was integrated with LFA to simultaneously concentrate and detect Plasmodium lactate dehydrogenase (pLDH), a malaria biomarker, in both phosphate-buffered saline and fetal bovine serum within 20 min at room temperature. Compared to a conventional LFA setup with a pLDH detection limit of 10 ng μL −1 , our single-step diagnostic successfully detected pLDH at 1.0 ng μL −1 , demonstrating a 10-fold detection limit improvement and resulting in a sensitive and user-friendly assay that can be used at the point-of-care. The integration of a micellar ATPS and LFA represents a new platform that can improve and promote the use of paper-based diagnostic assays for malaria and other diseases within resource-poor settings. [ABSTRACT FROM AUTHOR]

Abstract: Paper based colorimetric biosensing platform utilizing cross-linked siloxane 3-aminopropyltriethoxysilane (APTMS) as probe was developed for the detection of a broad range of targets including H2O2, glucose and protein biomarker. APTMS was extensively used for the modification of filter papers to develop paper based analytical devices. We discovered when APTMS was cross-linked with glutaraldehyde (GA), the resulting complex (APTMS–GA) displays brick-red color, and a visual color change was observed when the complex reacted with H2O2. By integrating the APTMS–GA complex with filter paper, the modified paper enables quantitative detection of H2O2 through the monitoring of the color intensity change of the paper via software Image J. Then, with the immobilization of glucose oxidase (GOx) onto the modified paper, glucose can be detected through the detection of enzymatically generated H2O2. For protein biomarker prostate specific antigen (PSA) assay, we immobilized capture, not captured anti-PSA antibody (Ab1) onto the paper surface and using GOx modified gold nanorod (GNR) as detection anti-PSA antibody (Ab2) label. The detection of PSA was also achieved via the liberated H2O2 when the GOx label reacted with glucose. The results demonstrated the possibility of this paper based sensor for the detection of different analytes with wide linear range. The low cost and simplicity of this paper based sensor could be developed for “point-of-care” analysis and find wide application in different areas. [Copyright &y& Elsevier]

Abstract: In this work, electrochemiluminescence (ECL) immunoassay was introduced into the recently proposed microfluidic paper-based analytical device (μPADs) based on directly screen-printed electrodes on paper for the very first time. The screen-printed paper-electrodes will be more important for further development of this paper-based ECL device in simple, low-cost and disposable application than commercialized ones. To further perform high-performance, high-throughput, simple and inexpensive ECL immunoassay on μPAD for point-of-care testing, a wax-patterned three-dimensional (3D) paper-based ECL device was demonstrated for the very first time. In this 3D paper-based ECL device, eight carbon working electrodes including their conductive pads were screen-printed on a piece of square paper and shared the same Ag/AgCl reference and carbon counter electrodes on another piece of square paper after stacking. Using typical tris-(bipyridine)-ruthenium (Ⅱ) - tri-n-propylamine ECL system, the application test of this 3D paper-based ECL device was performed through the diagnosis of four tumor markers in real clinical serum samples. With the aid of a facile device-holder and a section-switch assembled on the analyzer, eight working electrodes were sequentially placed into the circuit to trigger the ECL reaction in the sweeping range from 0.5 to 1.1 V at room temperature. In addition, this 3D paper-based ECL device can be easily integrated and combined with the recently emerging paper electronics to further develop simple, sensitive, low-cost, disposable and portable μPAD for point-of-care testing, public health and environmental monitoring in remote regions, developing or developed countries. [Copyright &y& Elsevier]

L-tyrosine hydroxylase (TH) is a critical enzyme and involved in the conversion of L-tyrosine to L-3,4-dihydroxyphenylalanine (L-DOPA) in the human body. TH deficiency is a rare autosomal recessive disorder which results in cerebral catecholamine deficiency and causes symptoms of depression, movement disorders, and impaired development. L-DOPA is the common precursor of catecholamine neurotransmitters, therefore how to rapidly and precisely determine the ratio of L-DOPA to L-tyrosine in the bio-matrix is important to the clinical diagnosis of disorder. To response the demand, a low-cost, user-friendly, and on-site detection system is developed herein, which includes a wax-printing paper microfluidics as reaction platform, surface modification with sodium periodate for improving detection performance, an additive manufactured enclosed case for maintaining identical detection environment, and an IOS application (APP) to drive smartphone's imaging to facilitate high-throughput quantification of multiple biomarkers simultaneously. Multiple experiments were conducted to understand the detection limit, detection range, shelf-life, and specificity of this quantification system even with a complex bio-matrix such as artificial urine or Fetal Bovine Sera (FBS). The experiment results showed that L-DOPA, L-tyrosine, and creatinine can be easily and rapidly quantified with high reliability and repeatability, demonstrating an efficient tool for routine checkup of patients with TH deficiency. [Display omitted] • A portable system is developed using a periodate-modified paper platform to determine biomarkers for TH deficiency. • DOPA 4, 5-dioxygenase was used to specifically recognize L-DOPA and has no interference from tyrosine. • An enclosed case was used for sensing environment control and an IOS APP was created to facilitate high-throughput quantification of biomarkers. • The proposed system proved highly effective in the simultaneous analysis of L-DOPA, tyrosine, and creatinine. [ABSTRACT FROM AUTHOR]

Abstract: An active biomonitoring study was performed in the vicinity of two pulp and paper mill effluents (PPMEs) released in two different streams in northeastern France. Freshwater gastropods, Radix peregra (=Lymnaea peregra or Lymnaea pereger), were transplanted for 0, 3, 14 and 21 days at two to three sites located upstream and downstream from the mill discharge points in both rivers. Lysosomal and peroxisomal systems, as well as lipofuscin and neutral lipids, were tested using histochemical methods on cryostat sections of digestive gland tissues, and stereological data were obtained by image analysis. Evidence of structural changes in the lysosomal system was found in animals exposed to both effluents, comprising general stress responses such as enlarged and more numerous lysosomes; and also possible specific pluri-phasic effects. Modifications of the lysosomal and cytoplasmic contents of lipid-related materials were also described, namely enhanced lipofuscin deposit and neutral lipid depletion. The peroxisomal proliferation in exposed snails seems to show its implication in oxidative stress detoxication, without preventing higher lipoperoxidation, as indicated by the increased amounts of digestive lipofuscin. Structural changes of the lysosomal and peroxisomal systems, digestive lipofuscin and neutral lipid contents have potential for use as early cellular biomarkers in Radix peregra exposed to environmental stressors, which deserve further investigations. [Copyright &y& Elsevier]

Demand on the quick screening of gastric cancer (GC) has significantly stimulated the development of biomarker sensing techniques. Herein, we report the novel fluorescent paper-based analytical devices (PADs) for detections of GC-related microRNA-21 (miRNA-21) and circular RNA from Hippocampus Abundant Transcript 1 gene (circRNA-HIAT1) with prominent reliability and sensitivity. The PADs, constructed by in-situ synthesis of blue-emissive carbon dots (CDs) and conjugations of probe DNAs, exhibit the superior uniformity and stability. In the presence of targets, rolling circle amplifications (RCA) are triggered to generate long DNA strands for the assemblies of green-/red-emissive labels. Consequently, remarkable blue-to-green and blue-to-red emission color transitions of the PADs are achieved, implementing the color-analysis of miRNA-21 and circRNA-HIAT1, respectively. Benefited from the efficient RCA, coupled with the drastic ratiometric fluorescent changes, the limit of detections (LODs) of PADs are found to be several fM with the upper limit of the linear detection range at 1 nM. More importantly, the fluorescent PADs possess excellent specificity, as well as anti-interference capability in biological settings, enabling their applications in accurate GC screening with plasma samples. Overall, the proposed fluorescent PADs are featured with robust sensing platform, facile signal readout, and exceptional dual-type RNA sensing performance, holding high potential in point-of-care testing (POCT). [Display omitted] • In-situ synthesis of carbon dots on carboxylated cellulose paper is accomplished. • Fluorescent PADs are constructed by conjugating probe DNAs on fluorescent paper. • Dual-type RNA detection with ultra-sensitivity is realized with the PADs. • Emission color engineering of fluorescent labels enables the color-analysis of RNA. • Accurate gastric cancer screening by comparing abundances of dual-type RNA. [ABSTRACT FROM AUTHOR]

We first reported a novel visualized instrument-free signal conversion method on paper for cardiovascular biomarker detection based on the coffee-ring effect (CRE). Our strategy was based on the principle that cTnI was captured by DNA probe decorated detection antibody to form sandwich complex, which could hybridize with H1 probes to form G-quadruplex DNAzyme. As a peroxidase mimic, G-quadruplex DNAzyme could catalyze colorimetric reaction and generate colored products, which were converted to the end edge of the paper by evaporation-driven flow, forming a visible colored band. Hence, the resulted colored signals were converted to distance signal by CRE, so that the quantification of cTnI could be measured easily only by a ruler. Our results demonstrated that the length of the colored bands was proportional to the concentration of cTnI, with a limit of detection of 1.0 pg/mL. Furthermore, this strategy not only showed advanced performance to discriminate cTnI from complex samples but also exhibited high accuracy with standard method in real sample. Hence, these results demonstrated that this method established a promising equipment-free and visualized platform for detecting various kinds of genetic diseases and biomarkers, further promoting the development of point-of-care testing (POCT) in biomedicine. • A visual Cardiovascular Biomarker detection strategy was developed. • The resulted colored signals were converted to distance signal by CRE. • This method developed equipment-free and visualized platform. [ABSTRACT FROM AUTHOR]

Electrochemical paper-based analytical devices (ePADs) are useful analytical devices that serve as point-of-care testing (POCT) devices for various clinical biomarkers in view of their simplicity, portability, and low-cost format. However, multistep reagent manipulation usually restricts the performance of the device for end users. Herein, we developed a sequential ePAD for sequential immunosensing fluid delivery by integrating dual flow behaviors (fast-flow/delayed) within a single paper platform for the simultaneous detection of hepatitis B surface antigen (HBsAg) and hepatitis C core antigen (HCVcAg). In the present work, a fast-flow channel was used for the automated washing of unbound antigens, while a delayed channel was created to store a redox reagent for further electrochemical analysis with a single buffer loading (the analysis time can be completed within 500 s). Hence, the undesirable complex procedure of multi-step reagent manipulation is scarcely needed by the user. The detection limit of the proposed ePAD was as low as 18.2 pg mL−1 for HBsAg and 1.19 pg mL−1 for HCVcAg. In addition, this proposed ePAD was also proven to be effective in real clinical sera from patients to verify its biological applicability. The ePAD sensor shows high promise as an easy-to-use, portable, and extendable sensor for other multiplex biological assays. [Display omitted] • ePAD for simultaneous HBsAg and HCVcAg was created. • First time employment of dual flow behaviors on ePAD for hepatitis markers sensing. • ePAD shows an easy to use, portability, and broad sensing applicability. • The sensor was applied to detect hepatitis markers in real clinical sera. [ABSTRACT FROM AUTHOR]