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Wei C, Lei X, Yu S. Multiplexed Detection Strategies for Biosensors Based on the CRISPR-Cas System. ACS Synth Biol 2024; 13:1633-1646. [PMID: 38860462 DOI: 10.1021/acssynbio.4c00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
A growing number of applications require simultaneous detection of multiplexed nucleic acid targets in a single reaction, which enables higher information density in combination with reduced assay time and cost. Clustered regularly interspaced short palindromic repeats (CRISPR) and the CRISPR-Cas system have broad applications for the detection of nucleic acids due to their strong specificity, high sensitivity, and excellent programmability. However, realizing multiplexed detection is still challenging for the CRISPR-Cas system due to the nonspecific collateral cleavage activity, limited signal reporting strategies, and possible cross-reactions. In this review, we summarize the principles, strategies, and features of multiplexed detection based on the CRISPR-Cas system and further discuss the challenges and perspective.
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Affiliation(s)
- Cong Wei
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Xueying Lei
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
| | - Songcheng Yu
- College of Public Health, Zhengzhou University, Zhengzhou 450001, China
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Licow-Kamińska AA, Ciećwież SM, Ptak M, Kotlęga D, Brodowska A. Quality of Life in Female Patients with Overactive Bladder after Botulinum Toxin Treatment. Toxins (Basel) 2023; 16:7. [PMID: 38276531 PMCID: PMC10819285 DOI: 10.3390/toxins16010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 12/10/2023] [Accepted: 12/18/2023] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Manifestations of OAB can considerably diminish the quality of life. Botulinum toxin has emerged as a valuable treatment option in diseases whose symptoms cannot be controlled adequately with other available therapies. The aim of the present study was to compare the subjective quality of life of patients with OAB before the injection of botulinum toxin and three and six months after the intervention. METHODS This study was based on a diagnostic survey with three validated questionnaires, ICIQ-OAB, ICIQ-OABqol, and ICIQ-LUTSqol, and an additional questionnaire developed by the authors to collect sociodemographic characteristics and selected medical data. RESULTS This study demonstrated significant differences between pre-treatment scores and those at three and six months post injection. At three and six months after the intervention, mean scores for all three instruments (ICIQ-OAB, ICIQ-OABqol, ICIQ-LUTSqol) were significantly lower than the respective pre-treatment values, implying a significant attenuation of OAB symptoms and their lower impact on the quality of life. However, the severity of OAB symptoms and their impact on the quality of life at six months post intervention were significantly higher than at three months, except for the social interaction domain. CONCLUSIONS Botulinum toxin is an effective treatment for OAB.
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Affiliation(s)
- Agnieszka A. Licow-Kamińska
- Department of Neonates, Pathology and Intensive Therapy, Independent Public Specialist Institute of Health “Zdroje”, ul. Mączna 4, 70-780 Szczecin, Poland;
- Department of Children Disease and Children Nursing, Pomeranian Medical University in Szczecin, ul. Żołnierska 48, 71-210 Szczecin, Poland
| | - Sylwester M. Ciećwież
- Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland;
| | - Magdalena Ptak
- Independent Subdepartment of Perineological Physiotherapy, Pomeranian Medical University in Szczecin, ul. Żołnierska 54, 51-210 Szczecin, Poland;
| | - Dariusz Kotlęga
- Department of Pharmacology and Toxicology, University of Zielona Góra, ul. Licealna 9, 65-417 Zielona Góra, Poland
| | - Agnieszka Brodowska
- Department of Gynecology, Endocrinology and Gynecologic Oncology, Pomeranian Medical University in Szczecin, ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland;
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Hefter H, Rosenthal D, Samadzadeh S. "Pseudo"-Secondary Treatment Failure Explained via Disease Progression and Effective Botulinum Toxin Therapy: A Pilot Simulation Study. Toxins (Basel) 2023; 15:618. [PMID: 37888649 PMCID: PMC10610736 DOI: 10.3390/toxins15100618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 09/18/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023] Open
Abstract
BACKGROUND The objective of this study was to provide evidence from a simple simulation. In patients with focal dystonia, an initial good response to botulinum neurotoxin (BoNT) injections followed by a secondary worsening does not necessarily arise from an antibody-induced secondary treatment failure (NAB-STF), but may stem from a "pseudo"-secondary treatment failure (PSEUDO-STF). METHODS The simulation of the outcome after BoNT long-term treatment was performed in four steps: 1. The effect of the first single BoNT injection (SI curve) was displayed as a 12-point graph, corresponding to the mean improvement from weeks 1 to 12. 2. The remaining severity of the dystonia during the nth injection cycle was calculated by subtracting the SI curve (weighted by the outcome after n - 1 cycles) from the outcome after week 12 of the (n - 1)th cycle. 3. A graph was chosen (the PRO curve), which represents the progression of the severity of the underlying disease during BoNT therapy. 4. The interaction between the outcome during the nth BoNT cycle and the PRO curve was determined. RESULTS When the long-term outcome after n cycles of BoNT injections (applied every 3 months) was simulated as an interactive process, subtracting the effect of the first cycle (weighted by the outcome after n - 1 cycles) and adding the progression of the disease, an initial good improvement followed by secondary worsening results. This long-term outcome depends on the steepness of the progression and the duration of action of the first injection cycle. We termed this response behavior a "pseudo"-secondary treatment failure, as it can be compensated via a dose increase. CONCLUSION A secondary worsening following an initial good response in BoNT therapy of focal dystonia might not necessarily indicate neutralizing antibody induction but could stem from a "PSEUDO"-STF (a combination of good response behavior and progression of the underlying disease). Thus, an adequate dose adaptation must be conducted before diagnosing a secondary treatment failure in the strict sense.
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Affiliation(s)
- Harald Hefter
- Departments of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.R.); (S.S.)
| | - Dietmar Rosenthal
- Departments of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.R.); (S.S.)
| | - Sara Samadzadeh
- Departments of Neurology, University of Düsseldorf, Moorenstrasse 5, 40225 Düsseldorf, Germany; (D.R.); (S.S.)
- Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Unverstät zu Berlin, Experimental and Clinical Research Center, 13125 Berlin, Germany
- Department of Regional Health Research and Molecular Medicine, University of Southern Denmark, 5230 Odense, Denmark
- Department of Neurology, Slagelse Hospital, 4200 Slagelse, Denmark
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Wang Z, Tang Y, Cui Y, Guan H, Cui X, Liu Y, Liu Y, Kang Z, Wu Q, Hao Y, Liu C. Delay in seeking health care from community residents during a time with low prevalence of COVID-19: A cross-sectional national survey in China. Front Public Health 2023; 11:1100715. [PMID: 36895687 PMCID: PMC9989024 DOI: 10.3389/fpubh.2023.1100715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/31/2023] [Indexed: 02/23/2023] Open
Abstract
Background The pandemic of COVID-19 has significant implications on health resources allocation and health care delivery. Patients with non-COVID illness may have to change their care seeking behaviors to mitigate the risk of infections. The research aimed to investigate potential delay of community residents in seeking health care at a time with an overall low prevalence of COVID-19 in China. Methods An online survey was conducted in March 2021 on a random sample drawn from the registered survey participants of the survey platform Wenjuanxing. The respondents who reported a need for health care over the past month (n = 1,317) were asked to report their health care experiences and concerns. Logistic regression models were established to identify predictors of the delay in seeking health care. The selection of independent variables was guided by the Andersen's service utilization model. All data analyses were performed using SPSS 23.0. A two-sided p value of <0.05 was considered as statistically significant. Key results About 31.4% of respondents reported delay in seeking health care, with fear of infection (53.5%) as a top reason. Middle (31-59 years) age (AOR = 1.535; 95% CI, 1.132 to 2.246), lower levels of perceived controllability of COVID-19 (AOR = 1.591; 95% CI 1.187 to 2.131), living with chronic conditions (AOR = 2.008; 95% CI 1.544 to 2.611), pregnancy or co-habiting with a pregnant woman (AOR = 2.115; 95% CI 1.154 to 3.874), access to Internet-based medical care (AOR = 2.529; 95% CI 1.960 to 3.265), and higher risk level of the region (AOR = 1.736; 95% CI 1.307 to 2.334) were significant predictors of the delay in seeking health care after adjustment for variations of other variables. Medical consultations (38.7%), emergency treatment (18.2%), and obtainment of medicines (16.5%) were the top three types of delayed care, while eye, nose, and throat diseases (23.2%) and cardiovascular and cerebrovascular diseases (20.8%) were the top two conditions relating to the delayed care. Self-treatment at home was the most likely coping strategy (34.9%), followed by Internet-based medical care (29.2%) and family/friend help (24.0%). Conclusions Delay in seeking health care remained at a relatively high level when the number of new COVID-19 cases was low, which may present a serious health risk to the patients, in particular those living with chronic conditions who need continuous medical care. Fear of infection is the top reason for the delay. The delay is also associated with access to Internet-based medical care, living in a high risk region, and perceived low controllability of COVID-19.
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Affiliation(s)
- Ziyu Wang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yurong Tang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yu Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Hanwen Guan
- School of Health Management, Harbin Medical University, Harbin, China
| | - Xiaoqian Cui
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yuan Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanni Liu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Zheng Kang
- School of Health Management, Harbin Medical University, Harbin, China
| | - Qunhong Wu
- School of Health Management, Harbin Medical University, Harbin, China
| | - Yanhua Hao
- School of Health Management, Harbin Medical University, Harbin, China
| | - Chaojie Liu
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
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Movement disorders in coronavirus disease 2019 times: impact on care in movement disorders and Parkinson disease. Curr Opin Neurol 2022; 35:494-501. [PMID: 35787539 DOI: 10.1097/wco.0000000000001075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to outline the impact of the COVID-19 pandemic on movement disorder holistic care, particularly in the care of people with Parkinson disease (PWP). RECENT FINDINGS As the pandemic unfolds, a flurry of literature was published regarding the impact of COVID-19 on people with Parkinson disease including the direct impact of infection, availability of ambulatory care, loss of community-based team care, and acceptability of telemedicine. SUMMARY COVID-19 has impacted the care of PWP in numerous ways. Recognizing infection in PWP poses challenges. Specific long-term complications, including emerging reports of long COVID syndrome is a growing concern. Caregivers and PWP have also been impacted by COVID-19 social isolation restrictions, with radical changes to the structure of social networks and support systems globally. In a matter of weeks, the global community saw an incredible uptake in telemedicine, which brought with benefits and pitfalls. As PWP adapted to virtual platforms and the changing architecture of care delivery, the pandemic amplified many preexisting inequities amongst populations and countries, exposing a new 'digital divide'.
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Teuschl Y, Bancher C, Brainin M, Dachenhausen A, Matz K, Pinter MM. COVID-19-related delays of botulinum toxin injections have a negative impact on the quality of life of patients with dystonia and spasticity: a single-center ambulatory care study. J Neural Transm (Vienna) 2021; 129:49-53. [PMID: 34689260 PMCID: PMC8541799 DOI: 10.1007/s00702-021-02430-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/08/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Botulinum toxin A (BoNT-A) is considered a safe and effective treatment for spasticity and dystonia. Individual interinjection intervals are critical for the maintenance of the effect. In Austria, BoNT outpatient clinics were shutdown from November to December 2020 during COVID-19 control measures, leading to rescheduling of BoNT-A injections. This survey aimed at investigating the influence of injection delays on symptoms, physical functioning, and quality of life (QoL) of the affected patients. METHODS Between April and July 2021, 32 outpatients (21 females, mean age: 63.4 ± 12.1 years) treated ≥ 12 months at the BoNT outpatient clinic Horn-Allentsteig (Austria) and experienced ≥ 2 week injection delays, completed a structured face-to-face questionnaire. RESULTS Indications were dystonia (34%), spasticity (63%), and hyperhidrosis (3%). Injections were delayed by 10 weeks (median, range: 2-15). Muscle cramps increased in 95% of patients with spasticity, muscle twitches in 91% of those with dystonia, and pain in 9% and 60% for dystonia and spasticity, respectively. Overall, 75% reported functional worsening, and deterioration in QoL by 62.6% ± 16.8 (mean ± SD). The impact on QoL correlated with the subjective global improvement induced by BoNT-A (Rs: 0.625; p < 0.001). For 75%, long-term assurance of BoNT-A therapy was very important, and 81% felt their patient rights not respected. CONCLUSIONS COVID-19-related delays in BoNT-A injections illustrate the importance of this therapy for symptom relief, functional outcome, and QoL in patients suffering from involuntary muscle hyperactivity. BoNT-A therapy is essential and has to be guaranteed even in circumstances such as the COVID-19 pandemic.
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Affiliation(s)
- Yvonne Teuschl
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria
| | - Christian Bancher
- Department of Neurology, Landesklinikum Horn-Allentsteig, Horn, Austria
| | - Michael Brainin
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria
| | - Alexandra Dachenhausen
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria
| | - Karl Matz
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria.,Department of Neurology, Landesklinikum Baden-Mödling, Mödling, Austria
| | - Michaela M Pinter
- Department for Clinical Neuroscience and Preventive Medicine, Danube University Krems - University for Continuing Education, Dr. Karl-Dorrek Str. 30, 3500, Krems, Austria. .,Department of Neurology, Landesklinikum Horn-Allentsteig, Horn, Austria.
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Hefter H, Nickels W, Rosenthal D, Samadzadeh S, Albrecht P. Continuous Increase of Efficacy under Repetitive Injections of Botulinum Toxin Type/A beyond the First Treatment for Adult Spastic Foot Drop. Toxins (Basel) 2021; 13:toxins13070466. [PMID: 34357938 PMCID: PMC8310361 DOI: 10.3390/toxins13070466] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 06/27/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022] Open
Abstract
The objective of this study was to quantify the increase in efficacy during the first four cycles of treatment with botulinum toxin type/A (BoNT/A) in 24 free-walking BoNT/A naïve adult patients with post-stroke hemispasticity and spastic foot drop. Patients were followed over 390 days and received five injections of 800 U aboBoNT/A every three months. Patients assessed the treatment effect at eight visits using a global assessment scale, physicians scored the muscle tone at the ankle joint, measured active and passive ranges of motion (aRoMs, pRoMs) at the knee and ankle joint and determined the distance patients succeeded to walk during a minute. Patients' assessments significantly (p < 0.006) increased with time and significantly correlated with all parameters measured. The best correlation (r = 0.927; p < 0.0001) was found with the sum of the aRoMs of knee and ankle joint. After one year of treatment outcome measures were better than and significantly correlated with the peak effect of the first injection. This correlation was higher for pRoMs (r = 0.855; p < 0.00001) compared to aRoMs (r = 0.567; p < 0.009). When BoNT/A treatment of the spastic foot in chronic hemispasticity is performed regularly every three months for at least one year, patients will experience a significant increase of benefit beyond the first treatment, but have to learn how to adapt to and use the new degree of freedom induced by the injections.
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Affiliation(s)
- Harald Hefter
- Department of Neurology, University Hospital, Moorenstrasse 5, D-40225 Düsseldorf, Germany; (W.N.); (D.R.); (S.S.); (P.A.)
- Correspondence:
| | - Werner Nickels
- Department of Neurology, University Hospital, Moorenstrasse 5, D-40225 Düsseldorf, Germany; (W.N.); (D.R.); (S.S.); (P.A.)
- Department of Neurology, Ruland-Kliniken, Neuenbürger Strasse 49, D-75335 Dobel, Germany
| | - Dietmar Rosenthal
- Department of Neurology, University Hospital, Moorenstrasse 5, D-40225 Düsseldorf, Germany; (W.N.); (D.R.); (S.S.); (P.A.)
| | - Sara Samadzadeh
- Department of Neurology, University Hospital, Moorenstrasse 5, D-40225 Düsseldorf, Germany; (W.N.); (D.R.); (S.S.); (P.A.)
| | - Philipp Albrecht
- Department of Neurology, University Hospital, Moorenstrasse 5, D-40225 Düsseldorf, Germany; (W.N.); (D.R.); (S.S.); (P.A.)
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Tarantino D, Gnasso R, Migliore F, Iommazzo I, Sirico F, Corrado B. The effects of COVID-19 pandemic countermeasures on patients receiving botulinum toxin therapy and on their caregivers: a study from an Italian cohort. Neurol Sci 2021; 42:3071-3077. [PMID: 33956258 PMCID: PMC8100930 DOI: 10.1007/s10072-021-05282-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 04/21/2021] [Indexed: 11/11/2022]
Abstract
COVID-19 outbreak had a huge worldwide impact, and several countermeasures to contain its spread have been adopted, such as the interruption of nonurgent outpatient clinics. We wanted to describe the effects of the national lockdown on the well-being of a cohort of Italian patients with cerebral palsy (CP) receiving botulinum toxin (BT) therapy and of their caregivers. Twenty-five patients receiving BT therapy were surveyed using the structuralized questionnaire by Dressler and Adib Saberi, while the caregivers were assessed using the Caregiver Burden Scale. The lockdown delayed BT therapy by 9 ± 2.8 months. Around 44% of the selected patients noticed increased muscle cramps, 24% increased muscle pain, and 32% both of them. Due to the lockdown, the patient’s quality of life was reduced by 68.4 ± 21.1%. After the lockdown, 100% of patients perceived BT therapy as more important than before. Around 76% of the patients perceived the lockdown as inadequate and felt that their rights were not respected. The overall score of the Caregiver Burden Scale, as regarded before the lockdown, was 29.12 ± 11.63, while the overall score as regarded after the lockdown was 37.44 ± 14.85. The overall score increased, from before the lockdown to after the lockdown, for 92% of caregivers. The BT outpatient clinic’s interruption was seen to significantly worsen the psychophysical condition of subjects with CP and the care burden of their caregivers, exposing them to greater stress than before. Therefore, any kind of BT treatment suspension or delay should be avoided.
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Affiliation(s)
- Domiziano Tarantino
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Rossana Gnasso
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Federico Migliore
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Irene Iommazzo
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Felice Sirico
- Department of Public Health, University Federico II of Naples, Naples, Italy
| | - Bruno Corrado
- Department of Public Health, University Federico II of Naples, Naples, Italy.
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