A smart device for label-free and real-time detection of gene point mutations based on the high dark phase contrast of vapor condensation

Rolling Circle Amplification as an Efficient Analytical Tool for Rapid Detection of Contaminants in Aqueous Environments

Environmental contaminants are a global concern, and an effective strategy for remediation is to develop a rapid, on-site, and affordable monitoring method. However, this remains challenging, especially with regard to the detection of various contaminants in complex water environments. The application of molecular methods has recently attracted increasing attention; for example, rolling circle amplification (RCA) is an isothermal enzymatic process in which a short nucleic acid primer is amplified to form a long single-stranded nucleic acid using a circular template and special nucleic acid polymerases. Furthermore, this approach can be further engineered into a device for point-of-need monitoring of environmental pollutants. In this paper, we describe the fundamental principles of RCA and the advantages and disadvantages of RCA assays. Then, we discuss the recently developed RCA-based tools for environmental analysis to determine various targets, including heavy metals, organic small molecules, nucleic acids, peptides, proteins, and even microorganisms in aqueous environments. Finally, we summarize the challenges and outline strategies for the advancement of this technique for application in contaminant monitoring.

Advancing Mental Health and Psychological Support for Health Care Workers Using Digital Technologies and Platforms

BACKGROUND

The COVID-19 pandemic is a global public health crisis that has not only endangered the lives of patients but also resulted in increased psychological issues among medical professionals, especially frontline health care workers. As the crisis caused by the pandemic shifts from acute to protracted, attention should be paid to the devastating impacts on health care workers' mental health and social well-being. Digital technologies are being harnessed to support the responses to the pandemic, which provide opportunities to advance mental health and psychological support for health care workers.

OBJECTIVE

The aim of this study is to develop a framework to describe and organize the psychological and mental health issues that health care workers are facing during the COVID-19 pandemic. Based on the framework, this study also proposes interventions from digital health perspectives that health care workers can leverage during and after the pandemic.

METHODS

The psychological problems and mental health issues that health care workers have encountered during the COVID-19 pandemic were reviewed and analyzed based on the proposed MEET (Mental Health, Environment, Event, and Technology) framework, which also demonstrated the interactions among mental health, digital interventions, and social support.

RESULTS

Health care workers are facing increased risk of experiencing mental health issues due to the COVID-19 pandemic, including burnout, fear, worry, distress, pressure, anxiety, and depression. These negative emotional stressors may cause psychological problems for health care workers and affect their physical and mental health. Digital technologies and platforms are playing pivotal roles in mitigating psychological issues and providing effective support. The proposed framework enabled a better understanding of how to mitigate the psychological effects during the pandemic, recover from associated experiences, and provide comprehensive institutional and societal infrastructures for the well-being of health care workers.

CONCLUSIONS

The COVID-19 pandemic presents unprecedented challenges due to its prolonged uncertainty, immediate threat to patient safety, and evolving professional demands. It is urgent to protect the mental health and strengthen the psychological resilience of health care workers. Given that the pandemic is expected to exist for a long time, caring for mental health has become a "new normal" that needs a strengthened multisector collaboration to facilitate support and reduce health disparities. The proposed MEET framework could provide structured guidelines for further studies on how technology interacts with mental and psychological health for different populations.

Label-Free and Quantitative Dry Mass Monitoring for Single Cells during In Situ Culture

Quantitative measurement of single cells can provide in-depth information about cell morphology and metabolism. However, current live-cell imaging techniques have a lack of quantitative detection ability. Herein, we proposed a label-free and quantitative multichannel wide-field interferometric imaging (MWII) technique with femtogram dry mass sensitivity to monitor single-cell metabolism long-term in situ culture. We demonstrated that MWII could reveal the intrinsic status of cells despite fluctuating culture conditions with 3.48 nm optical path difference sensitivity, 0.97 fg dry mass sensitivity and 2.4% average maximum relative change (maximum change/average) in dry mass. Utilizing the MWII system, different intrinsic cell growth characteristics of dry mass between HeLa cells and Human Cervical Epithelial Cells (HCerEpiC) were studied. The dry mass of HeLa cells consistently increased before the M phase, whereas that of HCerEpiC increased and then decreased. The maximum growth rate of HeLa cells was 11.7% higher than that of HCerEpiC. Furthermore, HeLa cells were treated with Gemcitabine to reveal the relationship between single-cell heterogeneity and chemotherapeutic efficacy. The results show that cells with higher nuclear dry mass and nuclear density standard deviations were more likely to survive the chemotherapy. In conclusion, MWII was presented as a technique for single-cell dry mass quantitative measurement, which had significant potential applications for cell growth dynamics research, cell subtype analysis, cell health characterization, medication guidance and adjuvant drug development.

The impact of electronic health record-integrated patient-generated health data on clinician burnout

Patient-generated health data (PGHD), such as patient-reported outcomes and mobile health data, have been increasingly used to improve health care delivery and outcomes. Integrating PGHD into electronic health records (EHRs) further expands the capacities to monitor patients' health status without requiring office visits or hospitalizations. By reviewing and discussing PGHD with patients remotely, clinicians could address the clinical issues efficiently outside of clinical settings. However, EHR-integrated PGHD may create a burden for clinicians, leading to burnout. This study aims to investigate how interactions with EHR-integrated PGHD may result in clinician burnout. We identify the potential contributing factors to clinician burnout using a modified FITT (Fit between Individuals, Task and Technology) framework. We found that technostress, time pressure, and workflow-related issues need to be addressed to accelerate the integration of PGHD into clinical care. The roles of artificial intelligence, algorithm-based clinical decision support, visualization format, human-computer interaction mechanism, workflow optimization, and financial reimbursement in reducing burnout are highlighted.

Single cell capture, isolation, and long-term in-situ imaging using quantitative self-interference spectroscopy

Single cell research with microfluidic chip is of vital importance in biomedical studies and clinical medicine. Simultaneous microfluidic cell manipulations and long-term cell monitoring needs further investigations due to the lack of label-free quantitative imaging techniques and systems. In this work, single cell capture, isolation and long-term in-situ monitoring was realized with a microfluidic cell chip, compact cell incubator and quantitative self-interference spectroscopy. The proposed imaging method could obtain quantitative and dynamic refractive index distribution in living cells. And the designed microfluidic chip could capture and isolate single cells. The customized incubator could support cell growth conditions when single cell was captured in microfluidic chip. According to the results, single cells could be trapped, transferred and pushed into the culture chamber with the microfluidic chip. The incubator could culture single cells in the chip for 120 h. The refractive index sensitivity of the proposed quantitative imaging method was 0.0282 and the relative error was merely 0.04%.

Health Information System's Responses to COVID-19 Pandemic in China: A National Cross-sectional Study

OBJECTIVE

After the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Chinese hospitals and health information technology (HIT) vendors collaborated to provide comprehensive information technology support for pandemic prevention and control. This study aims to describe the responses from the health information systems (HIS) to the COVID-19 pandemic and provide empirical evidence in the application of emerging health technologies in China.

METHODS

This observational descriptive study utilized a nationally representative, cross-sectional survey of hospitals in China (N = 1,014) from 30 provincial administrative regions across the country. Participants include hospital managers, hospital information workers, and health care providers.

RESULTS

Among all the responses, the most popular interventions and applications include expert question-and-answer sessions and science popularization (61.74%) in online medical consultation, online appointment registration (58.97%) in online medical service, and remote consultation (75.15%) in telehealth service. A total of 63.71% of the participating hospitals expanded their fever clinics during the pandemic, 15.38% hospitals used new or upgraded mobile ward rounds systems, and 44.68% hospitals applied online self-service systems. Challenges and barriers include protecting network information security (57.00%) since some hospitals experienced cybersecurity incidents. 71.79% participants hope to shorten wait time and optimize the treatment process. Health care workers experienced increased amount of work during the pandemic, while hospital information departments did not experience significant changes in their workload.

CONCLUSION

In the process of fighting against the COVID-19, hospitals have widely used traditional and emerging novel HITs. These technologies have strengthened the capacity of prevention and control of the pandemic and provided comprehensive information technology support while also improving accessibility and efficiency of health care delivery.

Predicting mortality in critically ill patients with diabetes using machine learning and clinical notes

BACKGROUND

Diabetes mellitus is a prevalent metabolic disease characterized by chronic hyperglycemia. The avalanche of healthcare data is accelerating precision and personalized medicine. Artificial intelligence and algorithm-based approaches are becoming more and more vital to support clinical decision-making. These methods are able to augment health care providers by taking away some of their routine work and enabling them to focus on critical issues. However, few studies have used predictive modeling to uncover associations between comorbidities in ICU patients and diabetes. This study aimed to use Unified Medical Language System (UMLS) resources, involving machine learning and natural language processing (NLP) approaches to predict the risk of mortality.

METHODS

We conducted a secondary analysis of Medical Information Mart for Intensive Care III (MIMIC-III) data. Different machine learning modeling and NLP approaches were applied. Domain knowledge in health care is built on the dictionaries created by experts who defined the clinical terminologies such as medications or clinical symptoms. This knowledge is valuable to identify information from text notes that assert a certain disease. Knowledge-guided models can automatically extract knowledge from clinical notes or biomedical literature that contains conceptual entities and relationships among these various concepts. Mortality classification was based on the combination of knowledge-guided features and rules. UMLS entity embedding and convolutional neural network (CNN) with word embeddings were applied. Concept Unique Identifiers (CUIs) with entity embeddings were utilized to build clinical text representations.

RESULTS

The best configuration of the employed machine learning models yielded a competitive AUC of 0.97. Machine learning models along with NLP of clinical notes are promising to assist health care providers to predict the risk of mortality of critically ill patients.

CONCLUSION

UMLS resources and clinical notes are powerful and important tools to predict mortality in diabetic patients in the critical care setting. The knowledge-guided CNN model is effective (AUC = 0.97) for learning hidden features.

Pediatric Mental and Behavioral Health in the Period of Quarantine and Social Distancing With COVID-19

The coronavirus disease (COVID-19) pandemic has spread rapidly throughout the world and has had a long-term impact. The pandemic has caused great harm to society and caused serious psychological trauma to many people. Children are a vulnerable group in this global public health emergency, as their nervous systems, endocrine systems, and hypothalamic-pituitary-adrenal axes are not well developed. Psychological crises often cause children to produce feelings of abandonment, despair, incapacity, and exhaustion, and even raise the risk of suicide. Children with mental illnesses are especially vulnerable during the quarantine and social distancing period. The inclusion of psychosocial support for children and their families are part of the health responses to disaster and disaster recovery. Based on the biopsychosocial model, some children may have catastrophic thoughts and be prone to experience despair, numbness, flashbacks, and other serious emotional and behavioral reactions. In severe cases, there may be symptoms of psychosis or posttraumatic stress disorder. Timely and appropriate protections are needed to prevent the occurrence of psychological and behavioral problems. The emerging digital applications and health services such as telehealth, social media, mobile health, and remote interactive online education are able to bridge the social distance and support mental and behavioral health for children. Based on the psychological development characteristics of children, this study also illustrates interventions on the psychological impact from the COVID-19 pandemic. Even though the world has been struggling to curb the influences of the pandemic, the quarantine and social distancing policies will have long-term impacts on children. Innovative digital solutions and informatics tools are needed more than ever to mitigate the negative consequences on children. Health care delivery and services should envision and implement innovative paradigms to meet broad well-being needs and child health as the quarantine and social distancing over a longer term becomes a new reality. Future research on children's mental and behavioral health should pay more attention to novel solutions that incorporate cutting edge interactive technologies and digital approaches, leveraging considerable advances in pervasive and ubiquitous computing, human-computer interaction, and health informatics among many others. Digital approaches, health technologies, and informatics are supposed to be designed and implemented to support public health surveillance and critical responses to children's growth and development. For instance, human-computer interactions, augmented reality, and virtual reality could be incorporated to remote psychological supporting service for children's health; mobile technologies could be used to monitor children's mental and behavioral health while protecting their individual privacy; big data and artificial intelligence could be used to support decision making on whether children should go out for physical activities and whether schools should be reopened. Implications to clinical practices, psychological therapeutic practices, and future research directions to address current effort gaps are highlighted in this study.

The Role of Health Technology and Informatics in a Global Public Health Emergency: Practices and Implications From the COVID-19 Pandemic

At present, the coronavirus disease (COVID-19) is spreading around the world. It is a critical and important task to take thorough efforts to prevent and control the pandemic. Compared with severe acute respiratory syndrome and Middle East Respiratory Syndrome, COVID-19 spreads more rapidly owing to increased globalization, a longer incubation period, and unobvious symptoms. As the coronavirus has the characteristics of strong transmission and weak lethality, and since the large-scale increase of infected people may overwhelm health care systems, efforts are needed to treat critical patients, track and manage the health status of residents, and isolate suspected patients. The application of emerging health technologies and digital practices in health care, such as artificial intelligence, telemedicine or telehealth, mobile health, big data, 5G, and the Internet of Things, have become powerful "weapons" to fight against the pandemic and provide strong support in pandemic prevention and control. Applications and evaluations of all of these technologies, practices, and health delivery services are highlighted in this study.

Label-free tomography of living cellular nanoarchitecture using hyperspectral self-interference microscopy

Quantitative phase imaging (QPI) is the most ideal method for achieving long-term cellular tomography because it is label free and quantitative. However, for current QPI instruments, interference signals from different layers overlay with each other and impede nanoscale optical sectioning. Integrated incubators and improved configurations also require further investigation for QPI instruments. In this work, hyperspectral self-reflectance microscopy is proposed to achieve label-free tomography of living cellular nanoarchitecture. The optical description and tomography reconstruction algorithm were proposed so that the quantitative morphological structure of the entire living cell can be acquired with 89.2 nm axial resolution and 1.91 nm optical path difference sensitivity. A cell incubator was integrated to culture living cells for in situ measurement and expensive precise optical components were not needed. The proposed system can reveal native and dynamic cellular nanoscale structure, providing an alternative approach for long-term monitoring and quantitative analysis of living cells.

An interferometric imaging biosensor using weighted spectrum analysis to confirm DNA monolayer films with attogram sensitivity

Interferometric imaging biosensors are powerful and convenient tools for confirming the existence of DNA monolayer films on silicon microarray platforms. However, their accuracy and sensitivity need further improvement because DNA molecules contribute to an inconspicuous interferometric signal both in thickness and size. Such weaknesses result in poor performance of these biosensors for low DNA content analyses and point mutation tests. In this paper, an interferometric imaging biosensor with weighted spectrum analysis is presented to confirm DNA monolayer films. The interferometric signal of DNA molecules can be extracted and then quantitative detection results for DNA microarrays can be reconstructed. With the proposed strategy, the relative error of thickness detection was reduced from 88.94% to merely 4.15%. The mass sensitivity per unit area of the proposed biosensor reached 20 attograms (ag). Therefore, the sample consumption per unit area of the target DNA content was only 62.5 zeptomoles (zm), with the volume of 0.25 picolitres (pL). Compared with the fluorescence resonance energy transfer (FRET), the measurement veracity of the interferometric imaging biosensor with weighted spectrum analysis is free to the changes in spotting concentration and DNA length. The detection range was more than 1µm. Moreover, single nucleotide mismatch could be pointed out combined with specific DNA ligation. A mutation experiment for lung cancer detection proved the high selectivity and accurate analysis capability of the presented biosensor.