# Paper and Fiber-Based Bio-Diagnostic Platforms: Current Challenges and Future Needs
## 1 Introduction
\begin{table}
\begin{tabular}{|p{113.8 pt}|p{113.8 pt}|p{113.8 pt}|p{113.8 pt}|p{113.8 pt}|} \hline
**Paper/Fiber** & **Strategies** & **Advantages** & **Disadvantages** & **Ref.** \\ \hline
**Whatman \# 903** & **Paper segments were fabricated in the circular shape by a dispersion/immersion technique for dense/detecting** & Improved analytical response, 26-fold enhanced sensitivity with 700-fold greater LOD than traditional **E103**, acceptable accuracy for small sample detection & Conducted assay in this study is lengthy & [53] \\ \hline \multirow{5}{*}{**Whatman CHR \# 1**} & Chitosan modified paper microarray with hydrophobic barriers was fabricated by wax scores printing for detection of different antigens & Easy translation to other signal reporting mechanisms, and other biomolecules in point-of-care devices, with sensitivity and linearity of calibration required & Neighboring cellulose zones may interfere with each other, a spaced-detection strategy is required & [55] \\ \cline{2-5}  & Electrodes integrated aPAD was fabricated by photolithography for electrochemical detection of antibody & Higher sensitivity than combometrics assay, highly quantitative, fast and efficient, dose not require sophisticated expensive equipment & The method was only used for a model protein to prove the concept & [56] \\ \cline{2-5}  & Paper assembly in lamination sheets for laptop depletion detection & Cost-effective compared to the conventional platform (85\% reduction in cost) and 93\% time reduction in assay performance & Commendedly available ELISA kit can achieve one order of magnitude lower LOD & [65] \\ \hline \multirow{5}{*}{**[PERSON] \# 1**} & Paper-based disk for protein detection & Non-foxicity of the applied fabrication materials with wide applications in industry & Almost 40\% of antibody molecules desorbed method/material require further optimization & [57] \\ \cline{2-5}  & Minkicked 96-well plate for detection of cardiac biomarker through colorimetric recognition & The high aspect ratio and high surface coverage of nanorods provide a large area for drug binding biomolecules crystallinity of cellulose supports growth of nanorods & Biomolecular penetration into the highly porous structure of cellulose can cause non-specific binding and induce errors in the assay & [58] \\ \cline{2-5}  & Minkicked 96-well plate for extracellular vesicles detection & Compatible with downstream analyses, such as scanning electron microscopy (SEM), enzyme-linked measurement analyses & Extracellular vesicles were captured on the paper device in a non-specific manner, therefore, the specificity was somewhat compromise & [59] \\ \cline{2-5}  & & Rapid and cost-effective analysis in comparison to conventional ELISA, with similar level of sensitivity and specificity while utilizing simple equipment and small sample volumes & Medium range sensitivity and specificity were reported & [60] \\ \cline{2-5}  & Was printing technique was applied for fabrication of paper-based 96-well plate aimed for biorecognition & High sensitivity and specificity: low sample volume, short operating time & Fabrication process is relatively complex. & [61] \\ \cline{2-5}  & It allows the user to print plates “on-demand” and opens opportunities for a wide range of nonstandard formats of customized assays & The method requires specialty software for image analysis and quantitation & [62] \\ \cline{2-5}  & Great multiplexing capacity, improved quantitative outputs, simplified data readout, performed assay at room temperature that dispenses the need for refrigeration & Limited to tests with a low number of false negative outputs & [63] \\ \cline{2-5}  & Reduced sample volume, higher sensitivity, shorter assay time, and lower fabrication cost & Low stability and short shelf life, which are typical drawbacks of the wax printing technique & [64] \\ \hline \end{tabular}
\end{table} 
Table 3: Paper and fiber-based bio-analytical platforms along with advantages and disadvantages of applied strategies.