Paper-Based Microfluidic Devices by Plasma Treatment

T-shirt ink for one-step screen-printing of hydrophobic barriers for 2D- and 3D-microfluidic paper-based analytical devices

This work presents the use of polyvinyl chloride (PVC) fabric ink, commonly employed for screening t-shirts, as new and versatile material for printing hydrophobic barrier on paper substrate for microfluidic paper-based analytical devices (μPADs). Low-cost, screen-printing apparatus (e.g., screen mesh, squeegee, and printing table) and materials (e.g. PVC ink and solvent) were employed to print the PVC ink solution onto Whatman filter paper No. 4. This provides a one-step strategy to print flow barriers without the need of further processing except evaporation for 3-5 min in a fume hood to remove the solvent. The production of the single layer μPADs is reasonably high with up to 77 devices per screening with 100% success rate. This method produces very narrow fluidic channel 486 ± 14 μm in width and hydrophobic barrier of 642 ± 25 μm thickness. Reproducibility of the production of fluidic channels and zones is satisfactory with RSDs of 2.9% (for 486-μm channel, n = 10), 3.7% (for 2-mm channel, n = 50) and 1.5% (for 6-mm diameter circular zone, n = 80). A design of a 2D-μPAD produced by this method was employed for the colorimetric dual-measurements of thiocyanate and nitrite in saliva. A 3D-μPADs with multiple layers of ink-screened paper was designed and constructed to demonstrate the method's versatility. These 3D-μPADs were designed for gas-liquid separation with in-situ colorimetric detection of ethanol vapor on the μPADs. The 3D-μPADs were applied for direct quantification of ethanol in beverages and highly colored pharmaceutical products. The printed barrier was resistant up to 8% (v/v) ethanol without liquid creeping out of the barrier.

Fabrication of laser printed microfluidic paper-based analytical devices (LP-µPADs) for point-of-care applications

Microfluidic paper-based analytical devices (µPADs) have provided a breakthrough in portable and low-cost point-of-care diagnostics. Despite their significant scope, the complexity of fabrication and reliance on expensive and sophisticated tools, have limited their outreach and possibility of commercialization. Herein, we report for the first time, a facile method to fabricate µPADs using a commonly available laser printer which drastically reduces the cost and complexity of fabrication. Toner ink is used to pattern the µPADs by printing, without modifying any factory configuration of the laser printer. Hydrophobic barriers are created by heating the patterned paper which melts the toner ink, facilitating its wicking into the cross-section of the substrate. Further, we demonstrate the utilization of the fabricated device by performing two assays. The proposed technique provides a versatile platform for rapid prototyping of µPADs with significant prospect in both developed and resource constrained region.

Nanoplasmonics in Paper-Based Analytical Devices

Chemical and biological sensing are crucial tools in science and technology. Plasmonic nanoparticles offer a virtually limitless number of photons for sensing applications, which can be available for visual detection over long periods. Moreover, cellulosic materials, such as paper, represent a versatile building block for implementation of simple, yet valuable, microfluidic analytical devices. This mini review outlines the basic theory of nanoplasmonics and the usability of paper as a nanoplasmonic substrate exploiting its features as a (bio)sensing platform based on different mechanisms depending on localized surface plasmon resonance response. Progress, current trends, challenges and opportunities are also underscored. It is intended for general researchers and technologists who are new to the topic as well as specialist/experts in the field.

Wax-Printed Fluidic Time Delays for Automating Multi-Step Assays in Paper-Based Microfluidic Devices (MicroPADs)

Microfluidic paper-based analytical devices (microPADs) have emerged as a promising platform for point-of-care diagnostic devices. While the inherent wicking properties of microPADs allow for fluid flow without supporting equipment, this also presents a major challenge in achieving robust fluid control, which becomes especially important when performing complex multi-step assays. Herein, we describe an ideal method of fluid control mediated by wax-printed fluidic time delays. This method relies on a simple fabrication technique, does not utilize chemicals/reagents that could affect downstream assays, is readily scalable, and has a wide temporal range of tunable fluid control. The delays are wax printed on both the top and bottom of pre-fabricated microPAD channels, without subsequent heating, to create hemi-/fully-enclosed channels. With these wax printed delays, we were able to tune the time it took aqueous solutions to wick across a 25 mm-long channel between 3.6 min and 13.4 min. We then employed these fluid delays in the sequential delivery of four dyes to a test zone. Additionally, we demonstrated the automation of two simple enzymatic assays with this fluid control modality. This method of fluid control may allow future researchers to automate more complex assays, thereby further advancing microPADs toward real-world applications.

Flow controllable three-dimensional paper-based microfluidic analytical devices fabricated by 3D printing technology

In most cases, three-dimensional paper-based microfluidic analytical devices (3D-μPADs) were fabricated manually by stacking or folding methods. For the first time, digital light processing stereolithography (DLP-SLA) 3D printing technology was adopted to automatically make 3D-μPADs. In the fabrication process, a printing pause was set between two layers to allow paper to be placed in the resin tank. The resin on the fresh paper spontaneously bonded to the former cured paper layer during curing, thus realizing the automatic bonding and alignment between different layers of paper and avoiding the human participation and errors as in stacking and folding methods. There was a gap between two vertical aligned flow paths, therefore the liquid did not flow spontaneously from the upper layer to the lower layer. Most of the fluid flow in 3D-μPADs was spontaneous or manually activated, which was not conducive to complex assays that require different regents to be delivered sequentially. Herein, we used an electric field or airflow to trigger the fluid flow and demonstrated the flow controllability by a proof-of-concept colorimetric assay. The limits of detection of glucose and albumin were 0.8 mM and 3.5 μM, respectively, which were sufficient for clinical requirements. Given the characteristic of flow controllability, we believe that the proposed 3D-μPADs have great potential to make paper-based complex assays automated and programmable.

Fabricating Paper Based Devices Using Correction Pens

We present a rapid (<10 s), cost-effective, unique single-step method for fabricating paper-based devices without necessitating any expensive instrumentation, simply by deploying correction pens that are otherwise commonly used for masking typos in printed or written matters. The marked regions formed by deposits from the correction pen demonstrate ubiquitous flow resistances to typical aqueous solutions and organic solvents in the transverse direction, resulting in a preferential bulk flow along the axial direction of the paper channels ‘fabricated’ in the process. Considering the simplicity and cost-effectiveness of this platform, it is deemed to be ideal for (bio) chemical sensing and point-of-care diagnostics in resource-limited settings.

Paper-based nucleic acid amplification tests for point-of-care diagnostics

There has been a recent resurgence in the use of paper as a substrate for developing point-of-care medical diagnostic tests, possibly triggered by expiring patents published in the 1990s. A hallmark of this resurgence has been the development of advanced shapes and structures made from paper to conduct multi-step fluidic operations using the wicking action of porous materials. Such devices indicate a distinct improvement over lateral flow immunoassays, which are restricted to conducting one-step operations. New developments in paper-based diagnostic devices have triggered interest in the development of paper-based point-of-care nucleic acid amplification tests (NAATs). NAATs can identify extremely low levels of specific nucleic acid sequences from clinical samples and are the most sensitive of all available tests for infectious disease diagnosis. Because traditional PCR-based NAATs require expensive instruments, the development of portable paper-based NAAT's has become an exciting field of research. This article aims to review and analyse the current state of development of paper-based NAATs. We project paper-based NAATs as miniaturized chemical processes and shed light on various schemes of operation used for converting the multiple steps of the chemical processes into paper microfluidic devices. We conclude by elaborating on the challenges that must be overcome in the near future so that progress can be made towards the development of fully functional and commercial paper-based NAATs.

Two-Dimensional Antifouling Fluidic Channels on Nanopapers for Biosensing

Two-dimensional (hydrophilic) channels were patterned on films prepared from cellulose nanofibrils (CNF) using photolithography and inkjet printing. Such processes included UV-activated thiol-yne click coupling and inkjet-printed designs with polystyrene. The microfluidic channels were characterized (SEM, wetting, and fluid flow) and applied as platforms for biosensing. Compared to results from the click method, a better feature fidelity and flow properties were achieved with the simpler inkjet-printed channels. Human immunoglobulin G (hIgG) was used as target protein after surface modification with either bovine serum albumin (BSA), fibrinogen, or block copolymers of poly(2-(dimethylamino)ethyl methacrylate) (PDMAEMA) and poly(oligo(ethylene glycol) methyl ether methacrylate) (POEGMA) (PDMAEMA- block-POEGMA copolymers). Surface plasmon resonance (SPR) and AFM imaging were used to determine their antifouling effect to prevent nonspecific hIgG binding. Confocal laser scanning microscopy revealed diffusion and adsorption traces in the channels. The results confirm an effective surface passivation of the microfluidic channels (95% reduction of hIgG adsorption and binding). The inexpensive and disposable systems proposed here allow designs with space-resolved blocking efficiency that offer a great potential in biosensing.

A paper-based microfluidic platform with shape-memory-polymer-actuated fluid valves for automated multi-step immunoassays

Smart fluid manipulation with automatically controlled paper valves will enable automated and multi-step immunoassays on paper-based microfluidic devices. In this work, we present an integrated paper-based microfluidic platform with shape-memory polymer (SMP)-actuated fluid valves capable of automated colorimetric enzyme-linked immunosorbent assays (ELISAs). A single-layer microfluidic paper-based analytical device (μPAD) was designed to store all the reagents on the chip, and sequentially transfer reagents to a paper test zone following a specific ELISA protocol through automatic fluidic flow control by the multiple SMP-actuated valves. The actuation of a paper valve was based on the thermally responsive, duel-state shape transformation of a SMP sheet attached to the root of a paper cantilever beam for driving a hydrophilic paper bridge to connect and disconnect two paper channels. A portable colorimetric reader was developed to control the on-chip valve operations, quantify the colorimetric signal output, display the assay result, and wirelessly transmit the data to a smart phone for the application of telemedicine. Reliable operations of the paper valve and the entire μPAD were demonstrated with success rates of 97% and 93%, respectively. A detection mechanism for valve malfunction was designed and confirmed effective to identify any mal-operation of individual valves, thus rendering our platform reliable in real assays. For device calibration, we conducted direct ELISAs of rabbit IgG in phosphate-buffered saline (PBS), and achieved a low limit of detection (LOD) of 27 pM (comparable to that of standard and paper-based ELISAs). In order to demonstrate the clinical application of our multi-step immunoassay platform, we also conducted sandwich ELISAs to quantify the protein level of an inflammatory cytokine, namely tumor necrosis factor (TNF)-α, in surgically injured laryngeal tissues of rats. The protein levels of TNF-α were shown similar between the conventional and μPAD ELISAs.

A novel colorimetric paper sensor based on the layer-by-layer assembled multilayers of surfactants for the sensitive and selective determination of total antioxidant capacity

A new colorimetric paper sensor, (TBABr/SDS)₃/PAD, was successfully fabricated to detect TAC. Good selectivity and sensitivity toward TAC were achieved. The (TBABr/SDS)₃/PAD sensor has been applied for TAC detection in food samples.

Paper Microfluidics for Cell Analysis

Paper microfluidics has attracted much attention since its first introduction around one decade ago due to the merits such as low cost, ease of fabrication and operation, portability, and facile integration with other devices. The dominant application for paper microfluidics still lies in point-of-care testing (POCT), which holds great promise to provide diagnostic tools to meet the ASSURED criteria. With micro/nanostructures inside, paper substrates provide a natural 3D scaffold to mimic native cellular microenvironments and create excellent biointerfaces for cell analysis applications, such as long-term 3D cell culture, cell capture/phenotyping, and cell-related biochemical analysis (small molecules, protein DNA, etc.). This review summarizes cell-related applications based on various engineered paper microdevices and provides some perspectives for paper microfluidics-based cell analysis.

Low-cost fabrication of a paper-based microfluidic using a folded pattern paper

Despite that microfluidic paper-based analytical devices (μPADs) provide effective analytical platforms for point-of-care diagnosis in resource-limited areas, it remains challenging to achieve simple and low-cost fabrication of μPADs. A novel method for fabrication of μPADs is developed in this study using a folded polydimethylsiloxane (PDMS)-coated paper mask with a specific pattern to form a sandwich structure with inserted chromatographic paper. PDMS penetrates the target paper from the front and the back sides, and then is cured in the target paper to form legible channels. This method for prototyping μPADs has many favorable merits including simple operation without the need of trained personnel, fast fabrication and low cost. We further investigated colorimetric detection of melamine in the μPADs, and it showed a remarkable measurement with a detection limit of 0.1 ppm in aqueous solutions and liquid milk discriminated by the naked eye, which meets the detection limit required by USA and China. The fabricating strategy developed in this study is very promising and attractive for the development of simple μPADs for point-of-care applications, including diagnostic testing, food safety control and environmental monitoring.

Reinventing (Bio)chemical Analysis with Paper

This paper focuses on one of the most commonly encountered materials in our society, namely paper. Paper is an inherently complex material, yet its use provides for chemical analysis approaches that are elegant in their simplicity of execution. In the first half of the previous century, paper in scientific research was used mainly for filtration and chromatographic separation. While its use decreased with the rise of modern elution chromatography, paper remains a versatile substrate for low-cost analytical tests. Recently, we have seen renewed interest to work with paper in (bio)analytical science, a result of the growing demand for inexpensive, portable analysis. Dried blood spotting, paper microfluidics, and paper spray ionization are areas in which paper is (re)establishing itself as an important material. These research areas all exploit several properties of paper, including stable sample storage, passive fluid movement and manipulation, chromatographic separation/extraction, modifiable surface and/or volume, easily altered shape, easy transport, and low cost. We propose that the real, and to date underexploited, potential of paper lies in utilizing its combined characteristics to add new dimensions to paper-based (bio)chemical analysis, expanding its applicability. This article provides the reader with a short historical perspective on the scientific use of paper and the developments that led to the establishment of the aforementioned research areas. We review important characteristics of paper and place them in a scientific context in this descriptive, yet critical, assessment of the achieved and the achievable in paper-based analysis. The ultimate goal is the exploration of integrative approaches at the interface between the different fields in which paper is or can be used.

Single step and mask-free 3D wax printing of microfluidic paper-based analytical devices for glucose and nitrite assays

Microfluidic paper-based analytical devices (μPADs) have recently emerged as a simple, portable, user-friendly, and affordable alternative to more instrument-intensive analytical approaches for point-of-care testing (POCT), food safety analysis, and environmental monitoring. However, most of the existing methods for the fabrication of μPADs still face a great challenge because of different trade-offs among cost, convenience, and the pattern resolution. In this work, we report a facile one-step approach to prepare a μPAD using an affordable, easy-to-build 3D printer to generate patterns of solid wax on laboratory filter paper. The presented wax printing method did not require the use of predesigned masks and an external heat source to form complete hydrophobic wax barrier through the use of a custom-made extruder. The results revealed a strong linear relationship (R² = 0.985) between the nominal and the printed widths of the wax barriers. The achievable resolution of the wax barrier printed on filter paper was 468 ± 72 µm, which was lower than previously reported minimum barrier feature sizes achieved by wax printing and other wax patterning techniques, such as stamping and screen-printing. The analytical utility of the fabricated μPADs was evaluated for colorimetric nitrite and glucose detection in artificial solutions. It was found that the fabricated μPADs provided adequate accuracy and reproducibility for quantitative determination of nitrite and glucose within concentration ranges relevant to the disease detection in human saliva and urine. The wax printing approach reported here provides a simple, rapid, and cost-effective fabrication method for paper-based microfluidics and may bring benefits to medical diagnostics in the developing world.

Paper-based biodetection using luminescent nanoparticles

Point-of-care and in-field technologies for rapid, sensitive and selective detection of molecular biomarkers have attracted much interest. Rugged bioassay technology capable of fast detection of markers for pathogens and genetic diseases would in particular impact the quality of health care in the developing world, but would also make possible more extensive screening in developed countries to tackle problems such as those associated with water and food quality, and tracking of infectious organisms in hospitals and clinics. Literature trends indicate an increasing interest in the use of nanomaterials, and in particular luminescent nanoparticles, for assay development. These materials may offer attributes for development of assays and sensors that could achieve improvements in analytical figures of merit, and provide practical advantages in sensitivity and stability. There is opportunity for cost-efficiency and technical simplicity by implementation of luminescent nanomaterials as the basis for transduction technology, when combined with the use of paper substrates, and the ubiquitous availability of cell phone cameras and associated infrastructure for optical detection and transmission of results. Luminescent nanoparticles have been described for a broad range of bioanalytical targets including small molecules, oligonucleotides, peptides, proteins, saccharides and whole cells (e.g., cancer diagnostics). The luminescent nanomaterials that are described herein for paper-based bioassays include metal nanoparticles, quantum dots and lanthanide-doped nanocrystals. These nanomaterials often have broad and strong absorption and narrow emission bands that improve opportunity for multiplexed analysis, and can be designed to provide emission at wavelengths that are efficiently processed by conventional digital cameras. Luminescent nanoparticles can be embedded in paper substrates that are designed to direct fluid flow, and the resulting combination of technologies can offer competitive analytical performance at relatively low cost.

Hydrophobic Covalent Patterns on Cellulose Paper through Photothiol-X Ligations

In the current study, we introduce photothiol-X chemistry as a powerful method to create hydrophobic patterns covalently grafted to the surface of cellulose paper. The general strategy builds on the use of a cellulose-based molecular printboard featuring disulfide functions which upon spatiocontrolled light irradiation at 365 nm allows robust photothiol-X ligations with hydrophobic moieties. A screening of structurally diverse molecular architectures as hydrophobic coating was conducted, and the most impressive result obtained with cholesterol moieties allows the creation of spatially well-resolved hydrophobic patterns with a contact angle of 140.8°. Our discoveries are supported by in-depth characterization studies using Fourier transform infrared spectroscopy, X-ray photoelectron spectrometry, and scanning electron microscopy analyses.

Creating compact and microscale features in paper-based devices by laser cutting

In this work we describe a fabrication method to create compact and microscale features in paper-based microfluidic devices using a CO₂ laser cutting/engraving machine. Using this method we are able to produce the smallest features with the narrowest barriers yet reported for paper-based microfluidic devices. The method uses foil backed paper as the base material and yields inexpensive paper-based devices capable of using small fluid sample volumes and thus small reagent volumes, which is also suitable for mass production. The laser parameters (power and laser head speed) were adjusted to minimize the width of hydrophobic barriers and we were able to create barriers with a width of 39 ± 15 μm that were capable of preventing cross-barrier bleeding. We generated channels with a width of 128 ± 30 μm, which we found to be the physical limit for small features in the chromatography paper we used. We demonstrate how miniaturizing of paper-based microfluidic devices enables eight tests on a single bioassay device using only 2 μL of sample fluid volume.

From functional structure to packaging: full-printing fabrication of a microfluidic chip

This paper presents a concept of a full-printing methodology aiming at convenient and fast fabrication of microfluidic devices. For the first time, we achieved a microfluidic biochemical sensor with all functional structures fabricated by inkjet printing, including electrodes, immobilized enzymes, microfluidic components and packaging. With the cost-effective and rapid process, this method provides the possibility of quick model validation of a novel lab-on-chip system. In this study, a three-electrode electrochemical system was integrated successfully with glucose oxidase immobilization gel and sealed in an ice channel, forming a disposable microfluidic sensor for glucose detection. This fully-printed chip was characterized and showed good sensitivity and a linear section at a low-level concentration of glucose (0-10 mM). With the aid of automatic equipment, the fully-printed sensor can be massively produced with low cost.

Improved sensitivity and limit-of-detection of lateral flow devices using spatial constrictions of the flow-path

We report on the use of a laser-direct write (LDW) technique that allows the fabrication of lateral flow devices with enhanced sensitivity and limit of detection. This manufacturing technique comprises the dispensing of a liquid photopolymer at specific regions of a nitrocellulose membrane and its subsequent photopolymerisation to create impermeable walls inside the volume of the membrane. These polymerised structures are intentionally designed to create fluidic channels which are constricted over a specific length that spans the test zone within which the sample interacts with pre-deposited reagents. Experiments were conducted to show how these constrictions alter the fluid flow rate and the test zone area within the constricted channel geometries. The slower flow rate and smaller test zone area result in the increased sensitivity and lowered limit of detection for these devices. We have quantified these via the improved performance of a C-Reactive Protein (CRP) sandwich assay on our lateral flow devices with constricted flow paths which demonstrate an improvement in its sensitivity by 62x and in its limit of detection by 30x when compared to a standard lateral flow CRP device.

Non-invasive paper-based microfluidic device for ultra-low detection of urea through enzyme catalysis

This work describes the design, fabrication and characterization of a paper-based microfluidic device for ultra-low detection of urea through enzyme catalysis. The microfluidic system comprises an entry port, a fluidic channel, a reaction zone and two electrodes (contacts). Wax printing was used to create fluidic channels on the surface of a chromatography paper. Pre-conceptualized designs of the fluidic channel are wax-printed on the paper substrate while the electrodes are screen-printed. The paper printed with wax is heated to cause the wax reflow along the thickness of the paper that selectively creates hydrophilic and hydrophobic zones inside the paper. Urease immobilized in the reaction zone catalyses urea into releasing ions and, thereby, generating a current flow between the electrodes. A measure of current with respect to time at a fixed potential enables the detection of urea. The methodology enabled urea concentration down to 1 pM to be detected. The significance of this work lies in the use of simple and inexpensive paper-based substrates to achieve detection of ultra-low concentrations of analytes such as urea. The process is non-invasive and employs a less cumbersome two-electrode assembly.

Anisotropic, Mesoporous Microfluidic Frameworks with Scalable, Aligned Cellulose Nanofibers

Cellulose paper has been extensively used in microfluidic analytical devices because of its hydrophilic nature. However, cellulose is randomly packed in paper without any particular orientation or channels within the bulk of the material, necessitating a complicated design of hydrophilic microchannels to guide the liquid flow. Herein, we develop an anisotropic mesoporous microfluidic framework (named as white wood) with aligned cellulose nanofibers and inherent microchannels via a facile one-step delignification process from natural wood. The hydrophilic nature of the innate microchannels in white wood makes it ideal for application as a pump-free microfluidic chip, exhibiting a fast and anisotropic liquid and large solid particle (as demonstrated with carbon nanotubes) mass transport, with a high transport speed along the channel direction approximately five times faster than that perpendicular to the channel direction. The anisotropic mass transport is further exemplified in the fabrication of chitosan films with aligned microstructures and birefringence, formed by virtue of unidirectional capillary forces exerted by the microchannels. We envision that our anisotropic mesoporous framework can have great applications to pump-free microfluidics, and the simple preparation process will pave a new way for the development of microfluidic devices based on chemically modified wood.

Solenoid Driven Pressure Valve System: Toward Versatile Fluidic Control in Paper Microfluidics

As paper-based diagnostics has become predominantly driven by more advanced microfluidic technology, many of the research efforts are still focused on developing reliable and versatile fluidic control devices, apart from improving sensitivity and reproducibility. In this work, we introduce a novel and robust paper fluidic control system enabling versatile fluidic control. The system comprises a linear push-pull solenoid and an Arduino Uno microcontroller. The precisely controlled pressure exerted on the paper stops the flow. We first determined the stroke distance of the solenoid to obtain a constant pressure while examining the fluidic time delay as a function of the pressure. Results showed that strips of grade 1 chromatography paper had superior reproducibility in fluid transport. Next, we characterized the reproducibility of the fluidic velocity which depends on the type and grade of paper used. As such, we were able to control the flow velocity on the paper and also achieve a complete stop of flow with a pressure over 2.0 MPa. Notably, after the actuation of the pressure driven valve (PDV), the previously pressed area regained its original flow properties. This means that, even on a previously pressed area, multiple valve operations can be successfully conducted. To the best of our knowledge, this is the first demonstration of an active and repetitive valve operation in paper microfluidics. As a proof of concept, we have chosen to perform a multistep detection system in the form of an enzyme-linked immunosorbent assay with mouse IgG as the target analyte.

3,3',5,5'-Tetramethylbenzidine Oxidation on Paper Devices for Horseradish Peroxidase-based Assays

We report on the colorimetric oxidation of 3,3',5,5'-tetramethylbenzidine (TMB) by hydrogen peroxide using horseradish peroxidase on photolithography-fabricated (P-PAD) and wax-printed (W-PAD) paper-based analytical devices. Fabricating PADs via photolithography exposes the hydrophilic areas to polymers (photoresists) and solvents, not only reducing the hydrophilicity, but also affecting the TMB-H2O2 assay system with an unavoidable incomplete elimination of photoresist during fabrication. Detection signals are then observed in the presence of photoresist residues on the P-PAD, even at a blank HRP concentration.

Low-cost Paper Analytical Devices for Environmental and Biomedical Sensing Applications

Over the last decade, the fabrication of analytical devices utilizing microfluidic structures and lab-on-a-chip platforms has shown breakthrough advancements, both for environmental and biological applications. The ASSURED criteria (affordable, sensitive, specific, user-friendly, robust, equipment-free, delivered), developed by the WHO for diagnostics devices, point towards the need of paper-based analytical devices (PAD) for diagnostics. On the other hand, cost-effective PADs owing the great advantage of affordable applicability in both resource-rich and -limited settings are recently employed for on-site environmental monitoring. In this book chapter, we will discuss about the brief history of paper analytical devices, fabrications, need, and its environmental and biomedical applications.

Water-based alkyl ketene dimer ink for user-friendly patterning in paper microfluidics

We propose the use of water-based alkyl ketene dimer (AKD) ink for fast and user-friendly patterning of paper microfluidic devices either manually or using an inexpensive XY-plotter. The ink was produced by dissolving hydrophobic AKD in chloroform and emulsifying the solution in water. The emulsification was performed in a warm water bath, which led to an increased rate of the evaporation of chloroform. Subsequent cooling led to the final product, an aqueous suspension of fine AKD particles. The effects of surfactant and AKD concentrations, emulsification procedure, and cooling approach on final ink properties are presented, along with an optimized protocol for its formulation. This hydrophobic agent was applied onto paper using a plotter pen, after which the paper was heated to allow spreading of AKD molecules and chemical bonding with cellulose. A paper surface patterned with the ink (10 g L^-1 AKD) yielded a contact angle of 135.6° for water. Unlike organic solvent-based solutions of AKD, this AKD ink does not require a fume hood for its use. Moreover, it is compatible with plastic patterning tools, due to the effective removal of chloroform in the production process to less than 2% of the total volume. Furthermore, this water-based ink is easy to prepare and use. Finally, the AKD ink can also be used for the fabrication of so-called selectively permeable barriers for use in paper microfluidic networks. These are barriers that stop the flow of water through paper, but are permeable to solvents with lower surface energies. We applied the AKD ink to confine and preconcentrate sample on paper, and demonstrated the use of this approach to achieve higher detection sensitivities in paper spray ionization-mass spectrometry (PSI-MS). Our patterning approach can be employed outside of the analytical lab or machine workshop for fast prototyping and small-scale production of paper-based analytical tools, for use in limited-resource labs or in the field.

Countercurrent liquid-liquid extraction on paper

Proof-of-concept is shown for two-phase countercurrent flow on paper. The device consists of two paper layers, one of which has been modified with a sizing agent to be hydrophobic. The layers exhibit different wetting behavior for water and octanol. Both phases dominate wetting in one of the layers and can be made to move in different directions along the interface to achieve liquid-liquid extraction.

Paper-based assays for urine analysis

A transformation of the healthcare industry is necessary and imminent: hospital-centered, reactive care will soon give way to proactive, person-centered care which focuses on individuals' well-being. However, this transition will only be made possible through scientific innovation. Next-generation technologies will be the key to developing affordable and accessible care, while also lowering the costs of healthcare. A promising solution to this challenge is low-cost continuous health monitoring; this approach allows for effective screening, analysis, and diagnosis and facilitates proactive medical intervention. Urine has great promise for being a key resource for health monitoring; unlike blood, it can be collected effortlessly on a daily basis without pain or the need for special equipment. Unfortunately, the commercial rapid urine analysis tests that exist today can only go so far-this is where the promise of microfluidic devices lies. Microfluidic devices have a proven record of being effective analytical devices, capable of controlling the flow of fluid samples, containing reaction and detection zones, and displaying results, all within a compact footprint. Moving past traditional glass- and polymer-based microfluidics, paper-based microfluidic devices possess the same diagnostic ability, with the added benefits of facile manufacturing, low-cost implementation, and disposability. Hence, we review the recent progress in the application of paper-based microfluidics to urine analysis as a solution to providing continuous health monitoring for proactive care. First, we present important considerations for point-of-care diagnostic devices. We then discuss what urine is and how paper functions as the substrate for urine analysis. Next, we cover the current commercial rapid tests that exist and thereby demonstrate where paper-based microfluidic urine analysis devices may fit into the commercial market in the future. Afterward, we discuss various fabrication techniques that have been recently developed for paper-based microfluidic devices. Transitioning from fabrication to implementation, we present some of the clinically implemented urine assays and their importance in healthcare and clinical diagnosis, with a focus on paper-based microfluidic assays. We then conclude by providing an overview of select biomarker research tailored towards urine diagnostics. This review will demonstrate the applicability of paper-based assays for urine analysis and where they may fit into the commercial healthcare market.

Patterned polycaprolactone-filled glass microfiber microfluidic devices for total protein content analysis

Membrane based microfluidic devices have gained much popularity in recent years, as they make possible rapid, inexpensive analytical techniques that can be applied to a wide variety of areas. The ability to modify device hydrophilicity and hydrophobicity is critically important in fabricating membrane based microfluidic devices. Polar hydrophilic membranes, such as glass microfiber (GMF) membranes, hold great potential as they are inexpensive, chemically inert, and stable. Filling of these membranes with non-polar polymers such as polycaprolactone (PCL) converts the hydrophilic GMF into a hydrophobic medium. Controlled alteration of the surface chemistry of PCL/GMF substrates allows for the fabrication of microfluidic patterns on the surface. Using this approach, we have developed a simple and rapid technique for fabrication of highly adaptable complex multidimensional (2D and 3D) microfluidic pathways on a single membrane. PCL-filled GMF media were masked and selectively exposed to oxygen radicals so that the exposed surface became permanently superhydrophilic in its behavior. The desired microfluidic pattern was cut into the mask prior to assembly and exposure, and the mask was removed after exposure to reveal the ready-to-use microfluidic device. To verify and demonstrate the performance of this novel fabrication method, a colorimetric total protein assay was applied to the determination of protein concentrations in real samples.

Sliding-strip microfluidic device enables ELISA on paper

This article describes a 3D microfluidic paper-based analytical device that can be used to conduct an enzyme-linked immunosorbent assay (ELISA). The device comprises two parts: a sliding strip (which contains the active sensing area) and a structure surrounding the sliding strip (which holds stored reagents—buffers, antibodies, and enzymatic substrate—and distributes fluid). Running an ELISA involves adding sample (e.g. blood) and water, moving the sliding strip at scheduled times, and analyzing the resulting color in the sensing area visually or using a flatbed scanner. We demonstrate that this device can be used to detect C-reactive protein (CRP)—a biomarker for neonatal sepsis, pelvic inflammatory disease, and inflammatory bowel diseases—at a concentration range of 1–100 ng/mL in 1000-fold diluted blood (1–100 µg/mL in undiluted blood). The accuracy of the device (as characterized by the area under the receiver operator characteristics curve) is 89% and 83% for cut-offs of 10 ng/mL (for neonatal sepsis and pelvic inflammatory disease) and 30 ng/mL (for inflammatory bowel diseases) CRP in 1000-fold diluted blood respectively. In resource-limited settings, the device can be used as a part of a kit (containing the device, a fixed-volume capillary, a pre-filled tube, a syringe, and a dropper); this kit would cost ~ $0.50 when produced in large scale (>100,000 devices/week). This kit has the technical characteristics to be employed as a pre-screening tool, when combined with other data such as patient history and clinical signs.

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3D microfluidic paper-based analytical device performs ELISA with colorimetric results.

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Two components enable separation of reagents in the device: a sliding-strip and a functional dock.

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All required reagents (antibodies, enzyme, substrate, buffers) are stored in the device.

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User only needs to add sample and water using the provided kit.

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Device can detect C-reactive protein for possible pre-screening of neonatal sepsis, pelvic inflammatory disease, or inflammatory bowel diseases.

Paper microfluidics for nucleic acid amplification testing (NAAT) of infectious diseases

The diagnosis of infectious diseases is entering a new and interesting phase. Technologies based on paper microfluidics, coupled to developments in isothermal amplification of Nucleic Acids (NAs) raise opportunities for bringing the methods of molecular biology in the field, in a low setting environment. A lot of work has been performed in the domain over the last few years and the landscape of contributions is rich and diverse. Most often, the level of sample preparation differs, along with the sample nature, the amplification and detection methods, and the design of the device, among other features. In this review, we attempt to offer a structured description of the state of the art. The domain is not mature and there exist bottlenecks that hamper the realization of Nucleic Acid Amplification Tests (NAATs) complying with the constraints of the field in low and middle income countries. In this domain however, the pace of progress is impressively fast. This review is written for a broad Lab on a Chip audience.

A review on wax printed microfluidic paper-based devices for international health

Paper-based microfluidics has attracted attention for the last ten years due to its advantages such as low sample volume requirement, ease of use, portability, high sensitivity, and no necessity to well-equipped laboratory equipment and well-trained manpower. These characteristics have made paper platforms a promising alternative for a variety of applications such as clinical diagnosis and quantitative analysis of chemical and biological substances. Among the wide range of fabrication methods for microfluidic paper-based analytical devices (μPADs), the wax printing method is suitable for high throughput production and requires only a commercial printer and a heating source to fabricate complex two or three-dimensional structures for multipurpose systems. μPADs can be used by anyone for in situ diagnosis and analysis; therefore, wax printed μPADs are promising especially in resource limited environments where people cannot get sensitive and fast diagnosis of their serious health problems and where food, water, and related products are not able to be screened for toxic elements. This review paper is focused on the applications of paper-based microfluidic devices fabricated by the wax printing technique and used for international health. Besides presenting the current limitations and advantages, the future directions of this technology including the commercial aspects are discussed. As a conclusion, the wax printing technology continues to overcome the current limitations and to be one of the promising fabrication techniques. In the near future, with the increase of the current interest of the industrial companies on the paper-based technology, the wax-printed paper-based platforms are expected to take place especially in the healthcare industry.

Microfluidic paper-based analytical devices for potential use in quantitative and direct detection of disease biomarkers in clinical analysis

Clinicians, working in the health-care diagnostic systems of developing countries, currently face the challenges of rising costs, increased number of patient visits, and limited resources. A significant trend is using low-cost substrates to develop microfluidic devices for diagnostic purposes. Various fabrication techniques, materials, and detection methods have been explored to develop these devices. Microfluidic paper-based analytical devices (μPADs) have gained attention for sensing multiplex analytes, confirming diagnostic test results, rapid sample analysis, and reducing the volume of samples and analytical reagents. μPADs, which can provide accurate and reliable direct measurement without sample pretreatment, can reduce patient medical burden and yield rapid test results, aiding physicians in choosing appropriate treatment. The objectives of this review are to provide an overview of the strategies used for developing paper-based sensors with enhanced analytical performances and to discuss the current challenges, limitations, advantages, disadvantages, and future prospects of paper-based microfluidic platforms in clinical diagnostics. μPADs, with validated and justified analytical performances, can potentially improve the quality of life by providing inexpensive, rapid, portable, biodegradable, and reliable diagnostics.

Turning the Page: Advancing Paper-Based Microfluidics for Broad Diagnostic Application

Infectious diseases are a major global health issue. Diagnosis is a critical first step in effectively managing their spread. Paper-based microfluidic diagnostics first emerged in 2007 as a low-cost alternative to conventional laboratory testing, with the goal of improving accessibility to medical diagnostics in developing countries. In this review, we examine the advances in paper-based microfluidic diagnostics for medical diagnosis in the context of global health from 2007 to 2016. The theory of fluid transport in paper is first presented. The next section examines the strategies that have been employed to control fluid and analyte transport in paper-based assays. Tasks such as mixing, timing, and sequential fluid delivery have been achieved in paper and have enabled analytical capabilities comparable to those of conventional laboratory methods. The following section examines paper-based sample processing and analysis. The most impactful advancement here has been the translation of nucleic acid analysis to a paper-based format. Smartphone-based analysis is another exciting development with potential for wide dissemination. The last core section of the review highlights emerging health applications, such as male fertility testing and wearable diagnostics. We conclude the review with the future outlook, remaining challenges, and emerging opportunities.

High-throughput rapid-prototyping of low-cost paper-based microfluidics

Paper-based micro analytical devices offer significant advantages compared to the conventional microfluidic chips including cost-effectiveness, ease of fabrication, and ease of use while preserving critical features including strong capillary action and biological compatibility. In this work, we demonstrate an inexpensive, rapid method for high-throughput fabrication of paper-based microfluidics by patterning hydrophobic barriers using a desktop pen plotter integrated with a custom-made, low-cost paper feeder. We tested various types of commercial permanent markers and compared their water-resistant capabilities for creating hydrophobic barriers. Additionally, we studied the performance of markers with different types of paper, plotting speeds, and pattern dimensions. To verify the effectiveness of the presented fabrication method, colorimetric analysis was performed on the results of a glucose assay.