Detection of Vesicoureteral Reflux Using Electrical Impedance Tomography

A successful centre for translational paediatric surgical research

The National Children's Research Centre (NCRC), the single largest paediatric research centre in Ireland, has been in existence for over 50 years and is located on the grounds of the largest children's hospital in Ireland; Children's Health Ireland at Crumlin. Professor Puri was appointed as the Director of the Research in 1989 and became President of the NCRC in 2009, a position he held until 2016. Professor Puri is one of the most cited paediatric surgical researchers in the world. His research work has been cited over 23,500 times in peer-reviewed articles with an h-index of 76 and i10-index of 494. The aim of this review is to analyse the most relevant areas of academic research at the NCRC, Dublin, during the years when Prof. Puri was Director/President of the NCRC. In addition, the relevant factors essential to create a successful paediatric surgical research centre will be discussed. A literature search using PubMed/Medline was carried out using the search terms "Prem Puri" over a 40-year period (1980-2020). Articles were analysed to identify the most significant research areas in the field of paediatric surgical research and the relevant laboratory and clinical findings. In addition, a separate analysis of successful funding and human factors, such as research fellows working at the NCRC, was also carried out. During the period under review, Professor Puri's team published 750 articles in peer-reviewed journals. Three main areas of research were reviewed with a total number of 391 articles: congenital diaphragmatic hernia (CDH) was the topic with the largest number of publications (153), followed by Hirschsprung's disease (HSCR) (144) and Vesicoureteral reflux (VUR) (94). Eighty research fellows, all paediatric surgeons, from 18 different countries were trained in basic science under the supervision of Professor Puri at the NCRC. Over the last three decades, the NCRC has been one of the most successful centres for paediatric surgical research in the world. The three areas of research with the largest number of publications were identified as CDH, HSCR and VUR. Various factors can explain the success of the NCRC: (a) the constant presence, for over 30 years, of a very successful paediatric surgeon leading the centre, (b) a multicultural laboratory with research fellows from all over the world and (c) grants of more than 15 million raised over the years, which guaranteed a constant flow of resources for laboratory research.

An Automated Microrobotic Platform for Rapid Detection of C. diff Toxins

OBJECTIVE

Clostridium difficile (C. diff) infection leads to hundreds of nosocomial infections, and early diagnosis of this toxin-mediated disease is important. This paper aims to develop a microrobotic system and related methods that enable the automated and rapid detection of toxins secreted by C. diff that exist in patient's stool.

METHODS

We utilize the fluorescent magnetic spore-based microrobot (FMSM), a microscale mobile sensing tool, to efficiently detect C. diff toxins by utilizing its property of selective fluorescence responses to C. diff toxins. A plug-and-play (PnP) electromagnetic coil system integrated with fluorescence microscopy is developed for actuation, control and observation of FMSMs. In order to track in real time and accurately obtain the fluorescence parameters of a FMSM under varied background noise in fluorescence signal, an image gradient-based method is proposed. For accelerating the FMSM-toxin interaction in different samples, an automated navigation control scheme for the FMSM is proposed and implemented. Moreover, data post-processing methods that can optimally extract the fluorescence decay trend from the dense and fluctuated fluorescence data are developed.

RESULTS

This automated mobile detection process finishes within only 20 minutes, and the toxin detection result is immediately given by adopting the proposed system and methods. Experimental results on different biological samples confirm the qualitative detection capability. And, C. diff toxins are automatically detected from the clinical stool of infectious patients and the relationship between the fluorescence decay and the toxin concentration is calibrated for semi-quantitative detection purpose.

SIGNIFICANCE

The proposed automated microrobotic platform provides a rapid and low-cost detection technique for C. diff toxins, and it has good competency for future clinical use.