The end user sensor tree: An end-user friendly sensor database

Detailed knowledge regarding sensor based technologies for the detection of food contamination often remains concealed within scientific journals or divided between numerous commercial kits which prevents optimal connectivity between companies and end-users. To overcome this barrier The End user Sensor Tree (TEST) has been developed. TEST is a comprehensive, interactive platform including over 900 sensor based methods, retrieved from the scientific literature and commercial market, for aquatic-toxins, mycotoxins, pesticides and microorganism detection. Key analytical parameters are recorded in excel files while a novel classification system is used which provides, tailor-made, experts' feedback using an online decision tree and database introduced here. Additionally, a critical comparison of reviewed sensors is presented alongside a global perspective on research pioneers and commercially available products. The lack of commercial uptake of the academically popular electrochemical and nanomaterial based sensors, as well as multiplexing platforms became very apparent and reasons for this anomaly are discussed.

Utility of Probiotics for Maintenance or Improvement of Health Status in Older People - A Scoping Review

OBJECTIVE

To evaluate the available evidence on probiotic use in older adults from human studies.

DESIGN

systematic review.

METHODS

The databases Embase, CINAHL and Medline were searched in December of 2017 for studies in humans where probiotics were used to modify a health outcome in older people. The quality of studies was evaluated using the Critical Appraisal Skills Program (CASP) assessment tool and the Cochrane Risk of Bias Assessment tool.

PARTICIPANTS

Subjects aged over sixty years either through specified selection criteria or where the mean participant age was greater than sixty.

INTERVENTIONS

Probiotic supplements.

MEASUREMENTS

Pre-specified clinically measurable health outcomes in age related conditions.

RESULTS

1210 articles were identified. After quality assessment and selection criteria were applied, 33 articles were identified to be included for review. As these studies cover a variety of applications and used customised protocols accordingly, meta-analysis was not possible and synthesis is in narrative form.

CONCLUSIONS

A growing body of research has applied commercially available probiotic preparations across care settings for age related conditions including gut dysmotility, osteoporosis, common infectious diseases and cognitive impairment. Although methodologies vary, randomised controlled trials have reproduced results in these areas, and so warrant consideration of probiotics as a low risk adjuvant treatment for specific indications in the elderly.

Pacemaker programming in patients with first-degree AV-block: Programming pattern and possible consequences

BACKGROUND

The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)-block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization.

METHODS

The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed.

RESULTS

A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/-R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P < .001).

CONCLUSIONS

There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.

Abstract P4-12-07: Cost-minimization of chemotherapy-induced (febrile) neutropenia prophylaxis with biosimilar ZARXIO® over NEUPOGEN®, NEULASTA®, and NEULASTA/ONPRO®: Breast cancer case study

RATIONALE & OBJECTIVES: Biosimilar filgrastim may offer significant cost advantages over originator filgrastim and pegfilgrastim. The objectives were (1) to evaluate for the US the comparative cost-minimization of chemotherapy-induced (febrile) neutropenia (CIN/FN) prophylaxis with biosimilar filgrastim ZARZIO® over originator filgrastim NEUPOGEN®, and originator pegfilgrastim NEULASTA® and NEULASTA/ONPRO® injection device with the health-care provider (HP) providing full administration, using 3Q2016 average selling price (ASP); and (2) to apply the different savings estimates to a breast cancer case study.

METHODS: Cost-minimization analysis of [1] acquisition costs for one patient for one chemotherapy cycle for 1 to 14 days (d) using per unit dose, and [2] administration costs using Current Procedural Terminology (CPT) codes. We calculated [1] the general cost of prophylaxis for one cycle with each agent, with standard filgrastim administrations ranging from 1-14 days and pegfilgrastim limited to single administration; and [2] the cost-savings that could be accrued from 1-14d prophylaxis with ZARXIO® over the three originator options. The case study concerns a 43 y/o Caucasian female, newly diagnosed with stage 2 HER2-negative breast cancer being started on TAC (FN risk &gt;20%); unremarkable medical history; no comorbidities; with primary prophylaxis initiated in cycle 1 and continued through 6 cycles per local protocol (single NEULASTA® or NEULASTA/ONPRO® or 11d NEUPOGEN® or ZARXIO®).

RESULTS: Using ASP+CPT, prophylaxis cost per dose (rounded) was $260 for ZARXIO®, $326 for NEUPOGEN®, $3,926 for NEULASTA®; $3,910 for NEULASTA®. In general, cost-savings per cycle from ZARXIO® over NEUPOGEN® ranged from $65 (1d) to $916 (14d); over Neulasta®, from $3,666 (1d) to $284 (14d); and over NEULASTA/ONPRO®, from $3,649 (1d) to $267 (14d). In the breast cancer case study, cost of prophylaxis per one cycle was $2,862 for ZARXIO® (11d), $3,582 for NEUPOGEN® (11d) vs. $3926 for NEULASTA® and $3910 for NEULASTA/ONPRO® single-injection. Cost-savings per cycle from ZARXIO® use were $719 vs. NEUPOGEN®, $1,064 vs. NEULASTA®, and $1,047 vs. NEULASTA/ONPRO®. Total savings from ZARXIO® use over all 6 TAC cycles were $4,316 vs. NEUPOGEN®, $6,385 vs. NEULASTA®, and $6,284 vs. NEULASTA/ONPRO®.

CONCLUSIONS: In general, CIN/FN prophylaxis with ZARXIO® for 1-14d generates significant cost savings over NEUPOGEN®, NEULASTA® and NEULASTA/ONPRO generating significant cost-savings. In the case study of the 43 y/o HER-negative breast cancer patient treated with TAC and prescribed 6 cycles of primary prophylaxis with 11d standard or single-administration pegfilgrastim, savings reached as high as $6,385 for the full course of chemotherapy. Given the trial evidence of non-inferiority of pegfilgrastim over filgrastim, the clinical trend for &lt;14d of filgrastim prophylaxis, and payer trends to authorize filgrastim vs. pegfilgrastim prophylaxis, using biosimilar Zarxio® is rational from both a economic perspective; as illustrated also in the breast cancer case study.

Citation Format: McBride A, Campbell K, Bikkina M, MacDonald K, Abraham I, Balu S. Cost-minimization of chemotherapy-induced (febrile) neutropenia prophylaxis with biosimilar ZARXIO® over NEUPOGEN®, NEULASTA®, and NEULASTA/ONPRO®: Breast cancer case study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-12-07.

Abstract P4-21-40: In vitro and in vivo activity of HER2-targeted antibody-liposomal doxorubicin conjugate MM-302 in HER2-intermediate tumors

This abstract was withdrawn by the authors.

Foxo1 is a downstream effector of Isl1 in direct pathway striatal projection neuron development within the embryonic mouse telencephalon

Recent studies have shown that the LIM-homeodomain transcription factor Isl1 is required for the survival and differentiation of direct pathway striatonigral neurons during embryonic development. The downstream effectors of Isl1 in these processes are presently unknown. We show here that Foxo1, a transcription factor that has been implicated in cell survival, is expressed in striatal projection neurons (SPNs) that derive from the Isl1 lineage (i.e. direct pathway SPNs). Moreover, Isl1 conditional knockouts (cKOs) show a severe loss of Foxo1 expression at E15.5 with a modest recovery by E18.5. Although Foxo1 is enriched in the direct pathway SPNs at embryonic stages, it is expressed in both direct and indirect pathway SPNs at postnatal time points as evidenced by co-localization with EGFP in both Drd1-EGFP and Drd2-EGFP BAC transgenic mice. Foxo1 was not detected in striatal interneurons as marked by the transcription factor Nkx2.1. Conditional knockout of Foxo1 using Dlx5/6-CIE mice results in reduced expression of the SPN marker Darpp-32, as well as in the direct pathway SPN markers Ebf1 and Zfp521 within the embryonic striatum at E15.5. However, this phenotype improves in the conditional mutants by E18.5. Interestingly, the Foxo family members, Foxo3 and Foxo6, remain expressed at late embryonic stages in the Foxo1 cKOs unlike the Isl1 cKOs where Foxo1/3/6 as well as the Foxo1/3 target Bach2 are all reduced. Taken together, these findings suggest that Foxo-regulated pathways are downstream of Isl1 in the survival and/or differentiation of direct pathway SPNs.

Novel porcine model of cutaneous myiasis: a training tool for healthcare workers

Cutaneous myiasis is a well-described problem in travellers to endemic regions including military personnel. Realistic training is important to ensure that healthcare workers have the confidence and expertise to recognise cutaneous myiasis and safely remove larvae if required. A model is described here that is simple, reproducible and realistic, and will allow for training of military healthcare workers in safe surgical removal of larvae when required.

Management of venous malformations in Klippel–Trenaunay syndrome with ultrasound-guided foam sclerotherapy

Objective: To study the clinical profile of Klippel–Trenaunay syndrome (KTS) and the management of venous malformations (VMs) with ultrasound-guided foam sclerotherapy using the compass technique.

Methods: In this open prospective series, 11 consecutive patients with KTS seeking therapy at a phlebology group practice were included. Seven (64%) of them were post-surgical recurrences.

Results: Pain was the commonest presenting complaint (100%), accompanied with VMs/ varicose veins in all except one (91%). Chronic venous insufficiency (CVI) was seen in seven (64%). Soft tissue and bone deformity was present in all (100%). Limb lengthening was frequent and detected in eight (73%), thickening in six (54%); unusually, one patient (9%) presented with severe thinning and shortening of the leg. Venous malformation was the primary vascular problem in nine patients (82%), with capillary malformation (CM)/port wine stain in seven (64%) and isolated lymphatic malformation (LM) in two (18%). The lateral embryonic/Klippel–Trenaunay (KT) vein was detected in 10 patients (91%). Deep vein deformity was not detected in any of them. All the deformities were of the lower limb (100%), while two (18%) had deformities of the thorax and one (9%) had gastrointestinal (GI) malformation. None of the patients gave family history of KTS, while five (45%) had history of varicosities in the family. Eight patients (73%) completed the therapeutic plan with a mean follow-up of 5±3.9 years. An excellent to good type result could be documented in six of the eight cases (75%). These patients had an event-free, good quality of life. Follow-up duplex studies revealed the evolving refluxing tracts requiring sequential therapies.

Conclusions: The results in this series demonstrate the utility of foam sclerotherapy using the compass technique in the management of KTS. Chronicity of the VMs in KTS necessitates strict clinical monitoring and sequential therapies.

Surface plasmon resonance biosensing: Approaches for screening and characterising antibodies for food diagnostics

Research in biosensing approaches as alternative techniques for food diagnostics for the detection of chemical contaminants and foodborne pathogens has increased over the last twenty years. The key component of such tests is the biorecognition element whereby polyclonal or monoclonal antibodies still dominate the market. Traditionally the screening of sera or cell culture media for the selection of polyclonal or monoclonal candidate antibodies respectively has been performed by enzyme immunoassays. For niche toxin compounds, enzyme immunoassays can be expensive and/or prohibitive methodologies for antibody production due to limitations in toxin supply for conjugate production. Automated, self-regenerating, chip-based biosensors proven in food diagnostics may be utilised as rapid screening tools for antibody candidate selection. This work describes the use of both single channel and multi-channel surface plasmon resonance (SPR) biosensors for the selection and characterisation of antibodies, and their evaluation in shellfish tissue as standard techniques for the detection of domoic acid, as a model toxin compound. The key advantages in the use of these biosensor techniques for screening hybridomas in monoclonal antibody production were the real time observation of molecular interaction and rapid turnaround time in analysis compared to enzyme immunoassays. The multichannel prototype instrument was superior with 96 analyses completed in 2h compared to 12h for the single channel and over 24h for the ELISA immunoassay. Antibodies of high sensitivity, IC50's ranging from 4.8 to 6.9ng/mL for monoclonal and 2.3-6.0ng/mL for polyclonal, for the detection of domoic acid in a 1min analysis time were selected. Although there is a progression for biosensor technology towards low cost, multiplexed portable diagnostics for the food industry, there remains a place for laboratory-based SPR instrumentation for antibody development for food diagnostics as shown herein.