Novel Isoprene Sensor for a Flu Virus Breath Monitor

Efficient detection of nitric oxide a biomarker associated with COVID19 via N, P co-doped C60 fullerene: a computational study

CONTEXT

Coronavirus (COVID-19) is a novel respiratory viral infection, causing a relatively large number of deaths especially in people who underly lung diseases such as chronic obstructive pulmonary and asthma, and humans are still suffering from the limited testing capacity. In this article, a solution is proposed for the detection of COVID-19 viral infections through the analysis of exhaled breath gasses, i.e., nitric oxide, a prominent biomarker released by respiratory epithelial, as a non-invasive and time-saving approach. Here, we designed a novel and low-cost N and P co-doped C60 fullerene-based breathalyzer for the detection of NO gas exhaled from the respiratory epithelial cells. This breathalyzer shows a quick response to the detection of NO gas by directly converting NO to NO2 without passing any energy barrier (0 kcal/mol activation energy). The recovery time of breathalyzer is very short (0.98 × 103 s), whereas it is highly selective for NO sensing in the mixture of CO2 and H2O gasses. The study provides an idea for the synthesis of low-cost (compared to previously reported Au atom decorated nanostructure and metal-based breathalyzer), efficient, and highly selective N and P co-doped C60 fullerene-based breathalyzer for COVID-19 detection.

METHODS

The geometries of N and P-doped systems and gas molecules are simulated using spin-polarized density functional theory calculations.

Simplifying the complex: accessible microfluidic solutions for contemporary processes within in vitro diagnostics

In vitro diagnostics (IVDs) form the cornerstone of modern medicine. They are routinely employed throughout the entire treatment pathway, from initial diagnosis through to prognosis, treatment planning, and post-treatment surveillance. Given the proven links between high quality diagnostic testing and overall health, ensuring broad access to IVDs has long been a focus of both researchers and medical professionals. Unfortunately, the current diagnostic paradigm relies heavily on centralized laboratories, complex and expensive equipment, and highly trained personnel. It is commonly assumed that this level of complexity is required to achieve the performance necessary for sensitive and specific disease diagnosis, and that making something affordable and accessible entails significant compromises in test performance. However, recent work in the field of microfluidics is challenging this notion. By exploiting the unique features of microfluidic systems, researchers have been able to create progressively simple devices that can perform increasingly complex diagnostic assays. This review details how microfluidic technologies are disrupting the status quo, and facilitating the development of simple, affordable, and accessible integrated IVDs. Importantly, we discuss the advantages and limitations of various approaches, and highlight the remaining challenges within the field.

AuNP@ZeNose (ZIF-based electrochemical nose) for detection of flu biomarker in breath

A novel electrochemical sensor is reported for the detection of isoprene levels in breath using a ZIF-based electrochemical nose. This sensor incorporates a hybrid detection system using gold nanoparticles encapsulated inside the ZIF-8 moiety. Breath-based analysis is widely being used for monitoring the metabolic state of the body. It is associated with the change in the concentration of volatile organic compounds and inorganic gases released endogenously and can be tracked using breath as the sample. One such volatile organic compound, isoprene, has been correlated to the presence of influenza virus or respiratory inflammation. Analytical techniques such as powder X-ray diffraction, scanning electron microscopy, atomic force microscopy, Fourier transform infrared spectroscopy, and tunneling electron microscopy were used to understand the structural features of the composite. The electrochemical nose system uses chronoamperometry as the transduction mechanism to monitor the diffusion kinetics of the target analyte across the electrode-electrolyte interface. The presented work demonstrates isoprene sensing with high sensitivity and specificity and a detection limit of 10 parts per billion in air. We successfully demonstrate the functionality of the ZIF-based electrochemical nose for point-of-care screening of isoprene levels by developing a prototype device using a commercially available development board. We foresee that the developed sensing platform can help in early screening for the presence of influenza virus and help control the infection rate.

Micro and Nanoscale Technologies for Diagnosis of Viral Infections

Viral infection is one of the leading causes of mortality worldwide. The growth of globalization significantly increases the risk of virus spreading, making it a global threat to future public health. In particular, the ongoing coronavirus disease 2019 (COVID-19) pandemic outbreak emphasizes the importance of devices and methods for rapid, sensitive, and cost-effective diagnosis of viral infections in the early stages by which their quick and global spread can be controlled. Micro and nanoscale technologies have attracted tremendous attention in recent years for a variety of medical and biological applications, especially in developing diagnostic platforms for rapid and accurate detection of viral diseases. This review addresses advances of microneedles, microchip-based integrated platforms, and nano- and microparticles for sampling, sample processing, enrichment, amplification, and detection of viral particles and antigens related to the diagnosis of viral diseases. Additionally, methods for the fabrication of microchip-based devices and commercially used devices are described. Finally, challenges and prospects on the development of micro and nanotechnologies for the early diagnosis of viral diseases are highlighted.

Exhaled nitric oxide detection for diagnosis of COVID-19 in critically ill patients

BACKGROUND

COVID-19 may present with a variety of clinical syndromes, however, the upper airway and the lower respiratory tract are the principle sites of infection. Previous work on respiratory viral infections demonstrated that airway inflammation results in the release of volatile organic compounds as well as nitric oxide. The detection of these gases from patients' exhaled breath offers a novel potential diagnostic target for COVID-19 that would offer real-time screening of patients for COVID-19 infection.

METHODS AND FINDINGS

We present here a breath tester utilizing a catalytically active material, which allows for the temporal manifestation of the gaseous biomarkers' interactions with the sensor, thus giving a distinct breath print of the disease. A total of 46 Intensive Care Unit (ICU) patients on mechanical ventilation participated in the study, 23 with active COVID-19 respiratory infection and 23 non-COVID-19 controls. Exhaled breath bags were collected on ICU days 1, 3, 7, and 10 or until liberation from mechanical ventilation. The breathalyzer detected high exhaled nitric oxide (NO) concentration with a distinctive pattern for patients with active COVID-19 pneumonia. The COVID-19 "breath print" has the pattern of the small Greek letter omega (). The "breath print" identified patients with COVID-19 pneumonia with 88% accuracy upon their admission to the ICU. Furthermore, the sensitivity index of the breath print (which scales with the concentration of the key biomarker ammonia) appears to correlate with duration of COVID-19 infection.

CONCLUSIONS

The implication of this breath tester technology for the rapid screening for COVID-19 and potentially detection of other infectious diseases in the future.

Exhaled breath biomarkers of influenza infection and influenza vaccination

Respiratory viral infections are considered a major public health threat, and breath metabolomics can provide new ways to detect and understand how specific viruses affect the human pulmonary system. In this pilot study, we characterized the metabolic composition of human breath for an early diagnosis and differentiation of influenza viral infection, as well as other types of upper respiratory viral infections. We first studied the non-specific effects of planned seasonal influenza vaccines on breath metabolites in healthy subjects after receiving the immunization. We then investigated changes in breath content from hospitalized patients with flu-like symptoms and confirmed upper respiratory viral infection. The exhaled breath was sampled using a custom-made breath condenser, and exhaled breath condensate (EBC) samples were analysed using liquid chromatography coupled to quadruplole-time-of-flight mass spectrometer (LC-qTOF). All metabolomic data was analysed using both targeted and untargeted approaches to detect specific known biomarkers from inflammatory and oxidative stress biomarkers, as well as new molecules associated with specific infections. We were able to find clear differences between breath samples collected before and after flu vaccine administration, together with potential biomarkers that are related to inflammatory processes and oxidative stress. Moreover, we were also able to discriminate samples from patients with flu-related symptoms that were diagnosed with confirmatory respiratory viral panels (RVP). RVP positive and negative differences were identified, as well as differences between specific viruses defined. These results provide very promising information for the further study of the effect of influenza A and other viruses in human systems by using a simple and non-invasive specimen like breath.

Wearable materials with embedded synthetic biology sensors for biomolecule detection

Integrating synthetic biology into wearables could expand opportunities for noninvasive monitoring of physiological status, disease states and exposure to pathogens or toxins. However, the operation of synthetic circuits generally requires the presence of living, engineered bacteria, which has limited their application in wearables. Here we report lightweight, flexible substrates and textiles functionalized with freeze-dried, cell-free synthetic circuits, including CRISPR-based tools, that detect metabolites, chemicals and pathogen nucleic acid signatures. The wearable devices are activated upon rehydration from aqueous exposure events and report the presence of specific molecular targets by colorimetric changes or via an optical fiber network that detects fluorescent and luminescent outputs. The detection limits for nucleic acids rival current laboratory methods such as quantitative PCR. We demonstrate the development of a face mask with a lyophilized CRISPR sensor for wearable, noninvasive detection of SARS-CoV-2 at room temperature within 90 min, requiring no user intervention other than the press of a button.

COVID-19 new diagnostics development: novel detection methods for SARS-CoV-2 infection and considerations for their translation to routine use

PURPOSE OF REVIEW

COVID-19 has put the in-vitro-diagnostic community under an unprecedented spotlight, with a global requirement for accurate SARS-CoV-2 tests. This review will outline technological responses to this need and the analytical considerations required for their translation to routine use.

RECENT FINDINGS

SARS-CoV-2 diagnostic solutions directly detect the virus or measure host-derived surrogate markers of infection. With pressure upon supply chains for the 'traditional' molecular approaches, a wide variety of analytical tools spanning the molecular, serology, imaging and chemistry space are being developed, including high throughput solutions and simplified near-patient formats.

SUMMARY

The unique genetic nature of SARS-CoV-2 means high analytical specificity is achievable by most diagnostic formats. However, clinical sensitivity assessment is complicated by wide discrepancies in analytical range and challenges associated with standardising these differences. When coupled with the acute nature of SARS-CoV-2 infection, reported precise metrics of test performance must be questioned. The response to SARS-CoV-2 has delivered considerable diagnostic innovation, but for a technology to be maximised, it must be demonstrably reproducible and fit for purpose. If novel diagnostic solutions for SARS-CoV-2 are to succeed, equally innovative mechanisms are needed to ensure widespread clinical and surveillance application, enabling agreed standards and metrics to ensure comparability.

Jinschek J, Gouma PI. Effect of (100) and (001) Hexagonal WO3 Faceting on Isoprene and Acetone Gas Selectivity

The hexagonal WO3 polymorph, h-WO3, has attracted attention due to its interatomic channels, allowing for a greater degree of intercalation compared to other WO3 polymorphs. Our research group has previously demonstrated h-WO3 to be a highly sensitive gas sensing material for a flu biomarker, isoprene. In this work, the gas sensing performance of this polymorph has been further investigated in two distinct configurations of the material produced by different processing routes. The first sample was synthesized using Na2WO4·2H2O and showed (100) faceting. The second sample was synthesized using WCl6 and showed (001) faceting. The gas sensing response of the nanostructured films deposited using the (100) textured h-WO3 sample 1 had a higher response to acetone at 350 °C. The (001) textured h-WO3 sample 2 favored isoprene at 350 °C. The selectivity of the latter to isoprene is explained in terms of the dangling bonds present on the (001) facets. The tungsten and oxygen dangling bonds present on the (001) plane favor the adsorption of the isoprene molecule over that of the acetone molecule due to the oxygen containing dipole present in the acetone molecule.

Highly selective gas sensing enabled by filters

Portable and inexpensive gas sensors are essential for the next generation of non-invasive medical diagnostics, smart air quality monitoring & control, human search & rescue and food quality assessment to name a few of their immediate applications. Therein, analyte selectivity in complex gas mixtures like breath or indoor air remains the major challenge. Filters are an effective and versatile, though often unrecognized, route to overcome selectivity issues by exploiting additional properties of target analytes (e.g., molecular size and surface affinity) besides reactivity with the sensing material. This review provides a tutorial for the material engineering of sorption, size-selective and catalytic filters. Of specific interest are high surface area sorbents (e.g., activated carbon, silica gels and porous polymers) with tunable properties, microporous materials (e.g., zeolites and metal-organic frameworks) and heterogeneous catalysts, respectively. Emphasis is placed on material design for targeted gas separation, portable device integration and performance. Finally, research frontiers and opportunities for low-cost gas sensing systems in emerging applications are highlighted.

Recent Progress in Graphene Derivatives/Metal Oxides Binary Nanocomposites Based Chemi-resistive Sensors for Disease Diagnosis by Breath Analysis

Background::

The scientific and clinical interest of breath analysis for non-invasive disease diagnosis has been focused by the scientific community over the past decade. This was due to the exhalation of prominent volatile organic compounds (VOCs) corresponding to the metabolic activities in the body and their concentration variation. To identify these biomarkers, various analytical techniques have been used in the past and the threshold concentration was established between a healthy and diseased state. Subsequently, various nanomaterials-based gas sensors were explored for their demand in quantifying these biomarkers for real-time, low cost and portable breathalyzers along with the essential sensor performances.

Methods::

We focus on the classification of graphene derivatives and their composites’ gas sensing efficiency for the application in the development of breathalyzers. The review begins with the feasibility of the application of nanomaterial gas sensors for healthcare applications. Then, we systematically report the gas sensing performance of various graphene derivatives/semiconductor metal oxides (SMO) binary nanocomposites and their optimizing strategies in selective detection of biomarkers specific to diseases. Finally, we provide insights on the challenges, opportunity and future research directions for the development of breathalyzers using other graphene derivatives/SMO binary nanocomposites.

Results::

On the basis of these analyses, graphene and its derivatives/metal oxides based binary nanocomposites have been a choice for gas sensing material owing to their high electrical conductivity and extraordinary thickness-dependent physicochemical properties. Moreover, the presence of oxygen vacancies in SMO does not only alter the conductivity but also accelerates the carrier transport rate and influence the adsorption behavior of target analyte on the sensing materials. Hence researchers are exploring the search of ultrathin graphene and metal oxide counterpart for high sensing performances.

Conclusion::

Their impressive properties compared to their bulk counterpart have been uncovered towards sensitive and selective detection of biomarkers for its use in portable breathalyzers.

The Acute Respiratory Infection Consortium: A Multi-Site, Multi-Disciplinary Clinical Research Network in the Department of Defense

Introduction

Acute respiratory infections (ARI) result in substantial annual morbidity among military personnel and decrease operational readiness. Herein, we summarize the research efforts of the Infectious Disease Clinical Research Program (IDCRP) related to ARIs.

Methods

The ARI Research Area of the IDCRP was established in response to the 2009 emergence of pandemic influenza A/H1N1. That year, IDCRP investigators deployed the ARI Consortium Natural History Study (ARIC NHS), a multi-centered, longitudinal observational study to assess etiology, epidemiology, and clinical characteristics of influenza-like illness (ILI) and severe acute respiratory infections (SARI) in the U.S. military. The success of this initial effort spurred implementation of several new initiatives. These include the FluPlasma trial, designed to evaluate the efficacy of hyperimmune anti-influenza plasma for the treatment of severe influenza; the self-administered live-attenuated influenza vaccine (SNIF) trial, which assessed the immunogenicity and acceptance of a self-administered live-attenuated influenza vaccine in military personnel; the Study to Address Threats of ARI in Congregate Military Populations (ATARI), a prospective study of ILI transmission, etiology and epidemiology in recruits; and the Flu Breath Test (FBT) study, a preliminary study of exhaled volatile organic compounds (VOC) in influenza patients. In addition, the InFLUenza Patient-Reported Outcome (FLU-PRO) survey, a daily diary to measure influenza symptoms during clinical trials, was developed. Lastly, the Pragmatic Assessment of Influenza Vaccine Effectiveness in the DoD (PAIVED) study, a two-year randomized trial designed to compare the effectiveness of the three types of licensed vaccines, launched in Fall 2018.

Results

The on-going ARIC NHS has enrolled over 2000 ILI and SARI cases since its inception, providing data on burden and clinical manifestations of ARI in military personnel and their families. The FluPlasma 2 trial concluded subject enrollment in 2018. Preliminary results from ATARI study show a high frequency of respiratory viruses circulating during the first two weeks of recruit training. Based on assessment of FLU-PRO responses, which were found to be reliable and reproducible, the survey may be a useful tool in clinical trials and epidemiological studies. The Flu Breath Study will complete enrollment in 2019. Findings from PAIVED are intended to provide evidence needed for assessing influenza vaccination policy in the military.

Conclusions

The ARI burden in the armed services remains significant every year and the threat is dynamic given emergent and evolving threats, such as influenzas. With strong successes to date, future initiatives of the ARI Research Area will focus on interventional studies, ARI transmission dynamics in congregate military settings, and determinants of risk of pandemic influenza and other emergent respiratory viruses.

Breath analysis for detection of viral infection, the current position of the field

The COVID-19 pandemic has highlighted the importance of rapid, cost effective, accurate, and non-invasive testing for viral infections. Volatile compounds (VCs) have been suggested for several decades as fulfilling these criteria. However currently very little work has been done in trying to diagnose viral infections using VCs. Much of the work carried out to date involves the differentiation of bacterial and viral sources of infection and often the detection of bacterial and viral co-infection. However, this has usually been done in vitro and very little work has involved the use of human participants. Viruses hijack the host cell metabolism and do not produce their own metabolites so identifying virus specific VCs is at best a challenging task. However, there are proteins and lipids that are potential candidates as markers of viral infection. The current understanding is that host cell glycolysis is upregulated under viral infection to increase the available energy for viral replication. There is some evidence that viral infection leads to the increase of production of fatty acids, alkanes, and alkanes related products. For instance, 2,3-butandione, aldehydes, 2,8-dimethyl-undecane and n-propyl acetate have all been correlated with viral infection. Currently, the literature points to markers of oxidative stress (e.g. nitric oxide, aldehydes etc) being the most useful in the determination of viral infection. The issue, however, is that there are also many other conditions that can lead to oxidative stress markers being produced. In this review a range of (mainly mass spectrometric) methods are discussed for viral detection in breath, including breath condensate. Currently MALDI-ToF-MS is likely to be the preferred method for the identification of viral strains and variants of those strains, however it is limited by its need for the viral strains to have been sequenced and logged in a database.

Au-decorated BN nanotube as a breathalyzer for potential medical applications

Respiratory viral infections such as coronavirus (COVID-19) will cause a great mortality, especially in people who underly lung diseases such as chronic obstructive pulmonary and asthma. Very recently, the COVID-19 outbreak has exposed the lack of quick approaches for screening people who may have risen risk of pathogen contact. One proposed non-invasive potential approach to recognize the viral infection is analysis of exhaled gases. It has been indicated that the nitric oxide is one of most important biomarkers which might be emanated by respiratory epithelial cells. Using density functional theory calculations, here, we introduced a novel Au-decorated BN nanotube-based breathalyzer for probable recognition of NO gas released from the respiratory epithelial cells in the presence of interfering CO₂ and H₂O gases. This breathalyzer benefits from different advantages including high sensitivity (sensing response = 101.5), high selectivity, portability, short recovery time (1.8 μs at 298 K), and low cost.

Fabrication of SnO2 Composite Nanofiber-Based Gas Sensor using the Electrospinning Method for Tetrahydrocannabinol (THC) Detection

This paper presents the development of a metal oxide semiconductor (MOS) sensor for the detection of volatile organic compounds (VOCs) which are of great importance in many applications involving either control of hazardous chemicals or noninvasive diagnosis. In this study, the sensor is fabricated based on tin dioxide (SnO₂) and poly(ethylene oxide) (PEO) using electrospinning. The sensitivity of the proposed sensor is further improved by calcination and gold doping. The gold doping of composite nanofibers is achieved using sputtering, and the calcination is performed using a high-temperature oven. The performance of the sensor with different doping thicknesses and different calcination temperatures is investigated to identify the optimum fabrication parameters resulting in high sensitivity. The optimum calcination temperature and duration are found to be 350 °C and 4 h, respectively and the optimum thickness of the gold dopant is found to be 10 nm. The sensor with the optimum fabrication process is then embedded in a microchannel coated with several metallic and polymeric layers. The performance of the sensor is compared with that of a commercial sensor. The comparison is performed for methanol and a mixture of methanol and tetrahydrocannabinol (THC) which is the primary psychoactive constituent of cannabis. It is shown that the proposed sensor outperforms the commercial sensor when it is embedded inside the channel.

Detection Methods of Human and Animal Influenza Virus-Current Trends

The basic affairs connected to the influenza virus were reviewed in the article, highlighting the newest trends in its diagnostic methods. Awareness of the threat of influenza arises from its ability to spread and cause a pandemic. The undiagnosed and untreated viral infection can have a fatal effect on humans. Thus, the early detection seems pivotal for an accurate treatment, when vaccines and other contemporary prevention methods are not faultless. Public health is being attacked with influenza containing new genes from a genetic assortment between animals and humankind. Unfortunately, the population does not have immunity for mutant genes and is attacked in every viral outbreak season. For these reasons, fast and accurate devices are in high demand. As currently used methods like Rapid Influenza Diagnostic Tests lack specificity, time and cost-savings, new methods are being developed. In the article, various novel detection methods, such as electrical and optical were compared. Different viral elements used as detection targets and analysis parameters, such as sensitivity and specificity, were presented and discussed.

Highly Selective and Rapid Breath Isoprene Sensing Enabled by Activated Alumina Filter

Isoprene is a versatile breath marker for noninvasive monitoring of high blood cholesterol levels as well as for influenza, end-stage renal disease, muscle activity, lung cancer, and liver disease with advanced fibrosis. Its selective detection in complex human breath by portable devices (e.g., metal-oxide gas sensors), however, is still challenging. Here, we present a new filter concept based on activated alumina powder enabling fast and highly selective detection of isoprene at the ppb level and high humidity. The filter contains high surface area adsorbents that retain hydrophilic compounds (e.g., ketones, alcohols, ammonia) representing major interferants in breath while hydrophobic isoprene is not affected. As a proof-of-concept, filters of commercial activated alumina powder are combined with highly sensitive but rather nonspecific, nanostructured Pt-doped SnO₂ sensors. This results in fast (10 s) measurement of isoprene down to 5 ppb at 90% relative humidity with outstanding selectivity (>100) to breath-relevant acetone, ammonia, ethanol, and methanol, superior to state-of-the-art isoprene sensors. Most importantly, when exposed continuously to simulated breath mixtures (four analytes) for 8 days, this filter-sensor system showed stable performance. It can be incorporated readily into a portable breath isoprene analyzer promising for simple-in-use monitoring of blood cholesterol or other patho/physiological conditions.

Understanding environmental contributions to autism: Causal concepts and the state of science

The complexity of neurodevelopment, the rapidity of early neurogenesis, and over 100 years of research identifying environmental influences on neurodevelopment serve as backdrop to understanding factors that influence risk and severity of autism spectrum disorder (ASD). This Keynote Lecture, delivered at the May 2016 annual meeting of the International Society for Autism Research, describes concepts of causation, outlines the trajectory of research on nongenetic factors beginning in the 1960s, and briefly reviews the current state of this science. Causal concepts are introduced, including root causes; pitfalls in interpreting time trends as clues to etiologic factors; susceptible time windows for exposure; and implications of a multi-factorial model of ASD. An historical background presents early research into the origins of ASD. The epidemiologic literature from the last fifteen years is briefly but critically reviewed for potential roles of, for example, air pollution, pesticides, plastics, prenatal vitamins, lifestyle and family factors, and maternal obstetric and metabolic conditions during her pregnancy. Three examples from the case-control CHildhood Autism Risks from Genes and the Environment Study are probed to illustrate methodological approaches to central challenges in observational studies: capturing environmental exposure; causal inference when a randomized controlled clinical trial is either unethical or infeasible; and the integration of genetic, epigenetic, and environmental influences on development. We conclude with reflections on future directions, including exposomics, new technologies, the microbiome, gene-by-environment interaction in the era of -omics, and epigenetics as the interface of those two. As the environment is malleable, this research advances the goal of a productive and fulfilling life for all children, teen-agers and adults. Autism Res 2018, 11: 554-586. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.

LAY SUMMARY

This Keynote Lecture, delivered at the 2016 meeting of the International Society for Autism Research, discusses evidence from human epidemiologic studies of prenatal factors contributing to autism, such as pesticides, maternal nutrition and her health. There is no single cause for autism. Examples highlight the features of a high-quality epidemiology study, and what comprises a compelling case for causation. Emergent research directions hold promise for identifying potential interventions to reduce disabilities, enhance giftedness, and improve lives of those with ASD.