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Wang L, Hu Y, Jiang N, Yetisen AK. Biosensors for psychiatric biomarkers in mental health monitoring. Biosens Bioelectron 2024; 256:116242. [PMID: 38631133 DOI: 10.1016/j.bios.2024.116242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/10/2024] [Accepted: 03/22/2024] [Indexed: 04/19/2024]
Abstract
Psychiatric disorders are associated with serve disturbances in cognition, emotional control, and/or behavior regulation, yet few routine clinical tools are available for the real-time evaluation and early-stage diagnosis of mental health. Abnormal levels of relevant biomarkers may imply biological, neurological, and developmental dysfunctions of psychiatric patients. Exploring biosensors that can provide rapid, in-situ, and real-time monitoring of psychiatric biomarkers is therefore vital for prevention, diagnosis, treatment, and prognosis of mental disorders. Recently, psychiatric biosensors with high sensitivity, selectivity, and reproducibility have been widely developed, which are mainly based on electrochemical and optical sensing technologies. This review presented psychiatric disorders with high morbidity, disability, and mortality, followed by describing pathophysiology in a biomarker-implying manner. The latest biosensors developed for the detection of representative psychiatric biomarkers (e.g., cortisol, dopamine, and serotonin) were comprehensively summarized and compared in their sensitivities, sensing technologies, applicable biological platforms, and integrative readouts. These well-developed biosensors are promising for facilitating the clinical utility and commercialization of point-of-care diagnostics. It is anticipated that mental healthcare could be gradually improved in multiple perspectives, ranging from innovations in psychiatric biosensors in terms of biometric elements, transducing principles, and flexible readouts, to the construction of 'Big-Data' networks utilized for sharing intractable psychiatric indicators and cases.
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Affiliation(s)
- Lin Wang
- Department of Chemical Engineering, Imperial College London, South Kensington, London, SW7 2BU, UK
| | - Yubing Hu
- Department of Chemical Engineering, Imperial College London, South Kensington, London, SW7 2BU, UK.
| | - Nan Jiang
- West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, China; Jinfeng Laboratory, Chongqing, 401329, China.
| | - Ali K Yetisen
- Department of Chemical Engineering, Imperial College London, South Kensington, London, SW7 2BU, UK.
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Shukhratovich Abdullaev S, H Althomali R, Raza Khan A, Sanaan Jabbar H, Abosoda M, Ihsan A, Aggarwal S, Mustafa YF, Hammoud Khlewee I, Jabbar AM. Integrating of analytical techniques with enzyme-mimicking nanomaterials for the fabrication of microfluidic systems for biomedical analysis. Talanta 2024; 273:125896. [PMID: 38479027 DOI: 10.1016/j.talanta.2024.125896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/05/2024] [Accepted: 03/07/2024] [Indexed: 04/09/2024]
Abstract
Bioanalysis faces challenges in achieving fast, reliable, and point-of-care (POC) determination methods for timely diagnosis and prognosis of diseases. POC devices often display lower sensitivity compared to laboratory-based methods, limiting their ability to quantify low concentrations of target analytes. To enhance sensitivity, the synthesis of new materials and improvement of the efficiency of the analytical strategies are necessary. Enzyme-mimicking materials have revolutionized the field of the fabrication of new high-throughput sensing devices. The integration of microfluidic chips with analytical techniques offers several benefits, such as easy miniaturization, need for low biological sample volume, etc., while also enhancing the sensitivity of the probe. The use enzyme-like nanomaterials in microfluidic systems can offer portable strategies for real-time and reliable detection of biological agents. Colorimetry and electrochemical methods are commonly utilized in the fabrication of nanozyme-based microfluidic systems. The review summarizes recent developments in enzyme-mimicking materials-integrated microfluidic analytical methods in biomedical analysis and discusses the current challenges, advantages, and potential future directions.
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Affiliation(s)
- Sherzod Shukhratovich Abdullaev
- Faculty of Chemical Engineering, New Uzbekistan University, Tashkent, Uzbekistan; Scientific and Innovation Department, Tashkent State Pedagogical University Named After Nizami, Tashkent, Uzbekistan.
| | - Raed H Althomali
- Department of Chemistry, Prince Sattam Bin Abdulaziz University,College of Arts and Science, Wadi Al-Dawasir 11991, Saudi Arabia
| | - Ahmad Raza Khan
- Department of Industrial and Manufacturing Engineering (Rachna College), University of Engineering and Technology, Lahore, 54700, Pakistan
| | - Hijran Sanaan Jabbar
- Department of Chemistry, College of Science, Salahaddin University-Erbil, Kurdistan Region, Iraq.
| | - Munther Abosoda
- Chemistry department, the Islamic University, Najaf, Iraq; Chemistry department, the Islamic University of Al Diwaniyah, Iraq; Chemistry department, the Islamic University of Babylon, Iraq
| | - Ali Ihsan
- Chemistry department, Imam Ja'afar Al-Sadiq University, Al-Muthanna 66002, Iraq
| | - Saurabh Aggarwal
- Department of Mechanical Engineering, Uttaranchal Institute of Technology, Uttaranchal University, India
| | - Yasser Fakri Mustafa
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Mosul, Mosul-41001, Iraq
| | - Ibrahim Hammoud Khlewee
- Department of Prosthodontics, College of Health and Medical Technololgy, Al-Ayen University, Thi-Qar, Iraq
| | - Abeer Mhussan Jabbar
- college of pharmacy/ National University of Science and Technology, Dhi Qar, Iraq
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Fernández-Sánchez F, Martín-Bautista E, Rivas-Ruiz F, Wu W, García-Aranda M. Evaluation of the EasyNAT SARS-CoV-2 assay PCR test for the diagnosis of SARS-CoV-2 infection. J Virol Methods 2024; 326:114908. [PMID: 38423363 DOI: 10.1016/j.jviromet.2024.114908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
Reverse transcription polymerase chain reaction (RT-PCR) tests are commonly utilized in commercial settings but pose challenges due to labor-intensive procedures and extended response times during peak demand. In contrast, real-time fluorescence and isothermal amplification assays using Crossing Priming Amplification (CPA) offer faster genetic material analysis, eliminate subjectivity, and require less manipulation and personnel training. This study aimed to validate the EasyNAT SARS-CoV-2 Assay, a diagnostic kit based on CPA, using oral and nasopharyngeal samples. The EasyNAT kit was compared to the Xpert Xpress SARS-CoV-2 kit, evaluating 873 samples obtained during routine analysis at the Microbiology Laboratory of the Hospital Costa del Sol (Marbella, Spain). The overall sensitivity and specificity for the EasyNAT SARS-CoV-2 Assay were 79.1% (95%CI 74.5-83.7) and 99.5% (95%CI 98.7-100), respectively; with, validity index of 91.9%, positive predictive value of 98.9%, negative predictive value of 88.9%, positive likelihood ratio of 144.5, negative likelihood ratio of 0.21 and a total Youden Index of 0.79. Notably, sensitivity improved in fresh samples (91.4%), along with a high Youden Index (0.91). The EasyNAT SARS-CoV-2 Assay achieved a higher percentage of concordance in positive samples with Xpert Xpress SARS-CoV-2 when analyzing cycle threshold (Ct) intervals below 30 compared to intervals equal or greater than 30, and demons. In conclusion, the EasyNAT SARS-CoV-2 Assay demonstrated high sensitivity and agreement with Xpert Xpress SARS-CoV-2, particularly in fresh samples or when the signal was detected at Ct intervals below 30, indicating higher viral loads. This makes it suitable for rapid screening in various settings, including those with limited access to conventional molecular laboratory setting.
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Affiliation(s)
- Fernando Fernández-Sánchez
- Microbiology Unit. Hospital Universitario Costa del Sol, Autovía A-7, km 187, Málaga, Marbella 29603, Spain.
| | - Elena Martín-Bautista
- Research and Innovation Unit. Hospital Universitario Costa del Sol, Autovía A-7, km 187, Málaga, Marbella 29603, Spain
| | - Francisco Rivas-Ruiz
- Research and Innovation Unit. Hospital Universitario Costa del Sol, Autovía A-7, km 187, Málaga, Marbella 29603, Spain
| | - Winnie Wu
- GeneFirst, Abingdon Science Park, Abingdon Oxfordshire, United Kingdom
| | - Marilina García-Aranda
- Research and Innovation Unit. Hospital Universitario Costa del Sol, Autovía A-7, km 187, Málaga, Marbella 29603, Spain; Department of Surgical Specialties, Biochemistry and Immunology, Faculty of Medicine, University of Málaga. Málaga, Spain
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Chen J, Li Y, Chen J, Wang R, Lu M, Yu C. Miniature mass spectrometer-based point-of-care assay for quantification of metformin and sitagliptin in human blood and urine. Anal Bioanal Chem 2024:10.1007/s00216-024-05281-1. [PMID: 38642098 DOI: 10.1007/s00216-024-05281-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/12/2024] [Accepted: 03/25/2024] [Indexed: 04/22/2024]
Abstract
Metformin (MET) and sitagliptin (STG) are widely used as the first-line and long-term oral hypoglycemic agents for managing type 2 diabetes mellitus (T2DM). However, the current lack of convenient and rapid measurement methods poses a challenge for individualized management. This study developed a point-of-care (POC) assay method utilizing a miniature mass spectrometer, enabling rapid and accurate quantification of MET and STG concentrations in human blood and urine. By combining the miniature mass spectrometer with paper spray ionization, this method simplifies the process into three to four steps, requires minimal amounts of bodily fluids (50 μL of blood and 2 μL of urine), and is able to obtain quantification results within approximately 2 min. Stable isotope-labeled internal standards were employed to enhance the accuracy and stability of measurement. The MS/MS responses exhibited good linear relationship with concentration, with relative standard deviations (RSDs) below 25%. It has the potential to provide immediate treatment feedback and decision support for patients and healthcare professionals in clinical practice.
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Affiliation(s)
- Jingying Chen
- Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China
| | - Yaohan Li
- Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China
| | - Jingjing Chen
- Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China
| | - Ruimin Wang
- Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China
| | - Miaoshan Lu
- Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China
| | - Changbin Yu
- Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, Shandong Province, China.
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Maintz M, Tourbier C, de Wild M, Cattin PC, Beyer M, Seiler D, Honigmann P, Sharma N, Thieringer FM. Patient-specific implants made of 3D printed bioresorbable polymers at the point-of-care: material, technology, and scope of surgical application. 3D Print Med 2024; 10:13. [PMID: 38639834 PMCID: PMC11031859 DOI: 10.1186/s41205-024-00207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/04/2024] [Indexed: 04/20/2024] Open
Abstract
BACKGROUND Bioresorbable patient-specific additive-manufactured bone grafts, meshes, and plates are emerging as a promising alternative that can overcome the challenges associated with conventional off-the-shelf implants. The fabrication of patient-specific implants (PSIs) directly at the point-of-care (POC), such as hospitals, clinics, and surgical centers, allows for more flexible, faster, and more efficient processes, reducing the need for outsourcing to external manufacturers. We want to emphasize the potential advantages of producing bioresorbable polymer implants for cranio-maxillofacial surgery at the POC by highlighting its surgical applications, benefits, and limitations. METHODS This study describes the workflow of designing and fabricating degradable polymeric PSIs using three-dimensional (3D) printing technology. The cortical bone was segmented from the patient's computed tomography data using Materialise Mimics software, and the PSIs were designed created using Geomagic Freeform and nTopology software. The implants were finally printed via Arburg Plastic Freeforming (APF) of medical-grade poly (L-lactide-co-D, L-lactide) with 30% β-tricalcium phosphate and evaluated for fit. RESULTS 3D printed implants using APF technology showed surfaces with highly uniform and well-connected droplets with minimal gap formation between the printed paths. For the plates and meshes, a wall thickness down to 0.8 mm could be achieved. In this study, we successfully printed plates for osteosynthesis, implants for orbital floor fractures, meshes for alveolar bone regeneration, and bone scaffolds with interconnected channels. CONCLUSIONS This study shows the feasibility of using 3D printing to create degradable polymeric PSIs seamlessly integrated into virtual surgical planning workflows. Implementing POC 3D printing of biodegradable PSI can potentially improve therapeutic outcomes, but regulatory compliance must be addressed.
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Affiliation(s)
- Michaela Maintz
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
- Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences and Arts Northwestern Switzerland FHNW, Hofackerstrasse 30, Muttenz, Switzerland
| | - Céline Tourbier
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland.
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland.
| | - Michael de Wild
- Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences and Arts Northwestern Switzerland FHNW, Hofackerstrasse 30, Muttenz, Switzerland
| | - Philippe C Cattin
- Department of Biomedical Engineering, Center of Medical Image Analysis and Navigation (CIAN), University of Basel, Hegenheimermattweg 167C, Allschwil, Basel, Switzerland
| | - Michel Beyer
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
| | - Daniel Seiler
- Institute for Medical Engineering and Medical Informatics IM², University of Applied Sciences and Arts Northwestern Switzerland FHNW, Hofackerstrasse 30, Muttenz, Switzerland
| | - Philipp Honigmann
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
- Department of Orthopaedic Surgery and Traumatology, Hand- and peripheral Nerve Surgery, Kantonsspital Baselland, Bruderholz| Liestal| Laufen, Switzerland
- Biomedical Engineering and Physics, Amsterdam UMC location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Neha Sharma
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
| | - Florian M Thieringer
- Oral and Cranio-Maxillofacial Surgery, University Hospital Basel, Spitalstrasse 21, Basel, Switzerland
- Department of Biomedical Engineering, Medical Additive Manufacturing Research Group (Swiss MAM), University of Basel, Hegenheimermattweg 167C, Allschwil, Switzerland
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Colosimo G, Montemuro G, Lewbart GA, Gentile G, Gerber G. Hand grab or noose pole? Evaluating the least stressful practice for capture of endangered Turks and Caicos Rock Iguanas Cyclura carinata. PeerJ 2024; 12:e17171. [PMID: 38646487 PMCID: PMC11032654 DOI: 10.7717/peerj.17171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 03/07/2024] [Indexed: 04/23/2024] Open
Abstract
As the analysis of blood metabolites has become more readily accessible thanks to the use of point-of-care analyzers, it is now possible to evaluate stress level of wild animals directly in the field. Lactate is receiving much attention as a good stress level proxy in individuals subjected to capture, manual restraint, and data sampling in the wild, and appropriate protocols to maintain lactate values low should be preferred. In this study we compare how two different capture methodologies, hand grab vs. noose pole, affect the variation of blood lactate values in Cyclura carinata iguanas when captured for sampling. We used blood lactate concentration, measured immediately upon- and 15 min after-capture, as a proxy for stress level. While the primary goal of this work is to determine the least stressful capture methodology to be favored when sampling this and other wild iguanas, we also evaluated additional baseline physiological parameters relevant to the health and disease monitoring for this species. Our results show that while initial lactate values level-out in sampled individuals after 15 min in captivity, regardless of the capture methodology, rock iguanas captured by noose pole showed significantly higher lactate concentration and increased heartbeat rate immediately after capture. While the overall health evaluation determined that all analyzed individuals were in good health, based on our results we recommend that, when possible, hand capture should be preferred over noose pole when sampling wild individuals.
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Affiliation(s)
- Giuliano Colosimo
- Department of Biology, University of Rome Tor Vergata, Rome, Lazio, Italy
| | - Gwyneth Montemuro
- School of Veterinary Medicine, St. Mathew University of Grand Cayman, West Bay, Cayman Island
| | - Gregory A. Lewbart
- College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, United States
| | - Gabriele Gentile
- Department of Biology, University of Rome Tor Vergata, Rome, Lazio, Italy
| | - Glenn Gerber
- San Diego Zoo Wildlife Alliance, Escondido, California, United States
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Li J, Saidi AM, Seydel K, Lillehoj PB. Rapid diagnosis and prognosis of malaria infection using a microfluidic point-of-care immunoassay. Biosens Bioelectron 2024; 250:116091. [PMID: 38325074 DOI: 10.1016/j.bios.2024.116091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
Malaria is a major cause of illness and death worldwide. Rapid diagnostic tests are the most widely used tool for detecting malaria infection, however, they only provide binary results and lack the sensitivity needed to detect many asymptomatic infections. Molecular assays for quantifying malaria biomarkers offer higher detection sensitivity, however, they are time-consuming, and require expert training and expensive equipment, making them unsuitable for use in most of Africa. To address the need for simple, accurate and field-deployable malaria diagnostic tests, we have developed a microfluidic point-of-care (mPOC) immunoassay for rapid quantification of Plasmodium falciparum histidine-rich protein 2 (PfHRP2), a malaria parasite biomarker, in whole blood. This device features two diagnostic modes for detecting PfHRP2 at low (100's pg/mL) and high (1,000's ng/mL) concentrations, making it useful for multiple diagnostic applications, including the detection of asymptomatic infection, prediction of disease outcomes and diagnosis of cerebral malaria. Measurements of PfHRP2 in blood samples from malaria patients demonstrates that this platform offers similar accuracy as an ultra-sensitive PfHRP2 enzyme-linked immunosorbent assay (ELISA) test, while being 12× faster and simpler to use. This mPOC immunoassay can be deployed in rural health centers to assist clinicians in diagnosing and triaging malaria patients, ultimately improving patient outcomes.
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Affiliation(s)
- Jiran Li
- Department of Mechanical Engineering, Rice University, Houston, TX 77005, USA
| | - Alexuse M Saidi
- Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Karl Seydel
- Blantyre Malaria Project, Kamuzu University of Health Sciences, Blantyre, Malawi; Department of Osteopathic Medical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48864, USA
| | - Peter B Lillehoj
- Department of Mechanical Engineering, Rice University, Houston, TX 77005, USA; Department of Bioengineering, Rice University, Houston, TX 77030, USA.
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Acuña J, Situ-LaCasse E, Yarnish AA, McNinch NL, Adhikari S. Does Size Matter? A Prospective Study on the Feasibility of Using a Handheld Ultrasound Device in Place of a Cart-Based System in the Evaluation of Trauma Patients. J Emerg Med 2024; 66:e483-e491. [PMID: 38429215 DOI: 10.1016/j.jemermed.2023.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 03/03/2024]
Abstract
BACKGROUND As emergency physicians are looking at handheld devices as alternatives to the traditional, cart-based systems, concerns center around whether they are forsaking image quality for a lower price point and whether the handheld can be trusted for medical decision making. OBJECTIVE We aimed to determine the feasibility of using a handheld ultrasound device in place of a cart-based system during the evaluation of trauma patients using the Focused Assessment with Sonography for Trauma (FAST) examination. METHODS This was a prospective study of adult trauma patients who received a FAST examination as part of their evaluation. A FAST examination was performed using a cart-based machine and a handheld device. The results of the examinations were compared with computed tomography imaging. Images obtained from both ultrasound devices were reviewed by an expert for image quality. RESULTS A total of 62 patients were enrolled in the study. The mean (SD) time to perform a FAST examination using the handheld device was 307.3 (65.3) s, which was significantly less (p = 0.002) than the 336.1 (86.8) s with the cart-based machine. There was strong agreement between the examination results of the handheld and cart-based devices and between the handheld and computed tomography. Image quality scores obtained with the handheld device were lower than those from the cart-based system. Most operators and reviewers agreed that the images obtained from the handheld were adequate for medical decision making. CONCLUSIONS Data support that it is feasible to use the handheld ultrasound device for evaluation of the trauma patient in place of the cart-based system.
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Affiliation(s)
- Josie Acuña
- Department of Emergency Medicine, The University of Arizona, College of Medicine, Tucson, Arizona
| | - Elaine Situ-LaCasse
- Department of Emergency Medicine, The University of Arizona, College of Medicine, Tucson, Arizona
| | - Adrienne A Yarnish
- Department of Emergency Medicine, The University of Arizona, College of Medicine, Tucson, Arizona
| | | | - Srikar Adhikari
- Department of Emergency Medicine, The University of Arizona, College of Medicine, Tucson, Arizona
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Dietzel M, Laun FB, Heiß R, Wenkel E, Bickelhaupt S, Hack C, Uder M, Ohlmeyer S. Initial experience with a next-generation low-field MRI scanner: Potential for breast imaging? Eur J Radiol 2024; 173:111352. [PMID: 38330534 DOI: 10.1016/j.ejrad.2024.111352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 01/24/2024] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Broader clinical adoption of breast magnetic resonance imaging (MRI) faces challenges such as limited availability and high procedural costs. Low-field technology has shown promise in addressing these challenges. We report our initial experience using a next-generation scanner for low-field breast MRI at 0.55T. METHODS This initial cases series was part of an institutional review board-approved prospective study using a 0.55T scanner (MAGNETOM Free.Max, Siemens Healthcare, Erlangen/Germany: height < 2 m, weight < 3.2 tons, no quench pipe) equipped with a seven-channel breast coil (Noras, Höchberg/Germany). A multiparametric breast MRI protocol consisting of dynamic T1-weighted, T2-weighted, and diffusion-weighted sequences was optimized for 0.55T. Two radiologists with 12 and 20 years of experience in breast MRI evaluated the examinations. RESULTS Twelve participants (mean age: 55.3 years, range: 36-78 years) were examined. The image quality was diagnostic in all examinations and not impaired by relevant artifacts. Typical imaging phenotypes were visualized. The scan time for a complete, non-abbreviated breast MRI protocol ranged from 10:30 to 18:40 min. CONCLUSION This initial case series suggests that low-field breast MRI is feasible at diagnostic image quality within an acceptable examination time.
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Affiliation(s)
- Matthias Dietzel
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Frederik B Laun
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Rafael Heiß
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Evelyn Wenkel
- Radiologie München, Burgstrasse 7, 80331 München, Germany.
| | - Sebastian Bickelhaupt
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Carolin Hack
- Department of Gynecology, Erlangen University Hospital, Friedrich Alexander University of Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Universitätsstraße 21/23, 91054 Erlangen, Germany.
| | - Michael Uder
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
| | - Sabine Ohlmeyer
- Department of Radiology, University Hospital Erlangen, Maximiliansplatz 3, 91054 Erlangen, Germany.
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Araujo KG, Yoshida A, Juliato CRT, Sarian LO, Derchain S. Performance of a handheld point of care ultrasonography to assess IUD position compared to conventional transvaginal ultrasonography. EUR J CONTRACEP REPR 2024; 29:69-75. [PMID: 38651645 DOI: 10.1080/13625187.2024.2315231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 01/31/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To compare the performance of the abdominal handheld point-of-care ultrasonography (POCUS) Butterfly-iQ to gold standard transvaginal ultrasonography (US) in identifying the position of intrauterine devices (IUDs) in the hands of a medical doctor specialised in ultrasonography. METHODS In this diagnostic accuracy study, a single operator conducted abdominal POCUS followed by conventional transvaginal US. Seventy patients utilising copper or hormonal IUDs were assessed between June 2021 and October 2022. IUDs were categorised as entirely within the uterine cavity or malpositioned. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were calculated for detecting malpositioned IUDs, with conventional US results serving as the reference standard. Concordance rate and Kappa coefficient were computed to assess the agreement between the two ultrasound modalities. RESULTS Among the 70 patients, 46 (65.7%) used copper IUDs, and 24 (34.3%) used hormonal IUDs. Conventional transvaginal US showed IUDs entirely within the uterine cavity in 56 (80%) patients and 14 (20%) IUDs were malpositioned. Of the 14 malpositioned IUDs seen by conventional US, POCUS identified 13 demonstrating a sensitivity of 92.9% (66.1-99.8). Of the 56 IUDs entirely within the uterine cavity shown by conventional US, only two cases were considered malpositioned by POCUS demonstrating a specificity of 96.4% (87.7-99.6). The concordance rate was 95.7%, and the Kappa value was 0.87 in differentiating between IUDs entirely within the uterine cavity and those that were malpositioned. CONCLUSION Abdominal POCUS using Butterfly-iQ, when administered by an imaging specialist, exhibited excellent performance in confirming IUDs entirely within the uterine cavity.
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Affiliation(s)
- K G Araujo
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Unicamp, Campinas, São Paulo, Brazil
- Section of Ultrasonography, Prof. José Aristodemo Pinotti Women's Hospital, CAISM, University of Campinas, Unicamp, Campinas, São Paulo, Brazil
| | - A Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Unicamp, Campinas, São Paulo, Brazil
| | - C R T Juliato
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Unicamp, Campinas, São Paulo, Brazil
| | - L O Sarian
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Unicamp, Campinas, São Paulo, Brazil
| | - S Derchain
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Campinas, Unicamp, Campinas, São Paulo, Brazil
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11
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Damhorst GL, McLendon K, Morales E, Solis ZM, Fitts E, Bowers HB, Sabino C, Sullivan J, Greenleaf M, Roback JD, Colasanti JA, Sheth AN, Titanji BK, Martin GS, Bassit L, Lam WA, Rao A. Performance of the Xpert™ Mpox PCR assay with oropharyngeal, anorectal, and cutaneous lesion swab specimens. J Clin Virol 2024; 171:105659. [PMID: 38430669 DOI: 10.1016/j.jcv.2024.105659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 01/30/2024] [Accepted: 02/20/2024] [Indexed: 03/05/2024]
Abstract
Anorectal and oropharyngeal exposures are implicated in sexual transmission of mpox, but authorized assays in the United States are only validated with cutaneous lesion swabs. Diagnostic assays for anorectal and oropharyngeal swabs are needed to address potential future outbreaks. The Cepheid Xpert® Mpox is the first point-of-care assay to receive FDA emergency use authorization in the United States and would be a valuable tool for evaluating these sample types. Our exploratory study demonstrates 100 % positive agreement with our in-house PCR assay for natural positive anorectal and oropharyngeal specimens and 92 % sensitivity with low-positive spiked specimens. The Xpert® assay detected viral DNA in specimens not detected by our reference PCR assay from four participants with mpox DNA at other sites, suggesting it may be more sensitive at low viral loads. In conclusion, the validation of the Xpert® for oropharyngeal and anorectal sample types can be rapidly achieved if clinical need returns and prospective samples become available.
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Affiliation(s)
- Gregory L Damhorst
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA; The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Kaleb McLendon
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Evelyn Morales
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Zianya M Solis
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Eric Fitts
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Heather B Bowers
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Department of Pediatrics, Emory University, Atlanta, GA, USA; Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia, USA
| | - Courtney Sabino
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Department of Pediatrics, Emory University, Atlanta, GA, USA; Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia, USA
| | - Julie Sullivan
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - Morgan Greenleaf
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - John D Roback
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Jonathan A Colasanti
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA; Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Anandi N Sheth
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA; Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Boghuma K Titanji
- Division of Infectious Diseases, Department of Medicine, Emory University, Atlanta, GA, USA; Ponce de Leon Center, Grady Health System, Atlanta, Georgia, USA
| | - Greg S Martin
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Leda Bassit
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Department of Pediatrics, Emory University, Atlanta, GA, USA; Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia, USA
| | - Wilbur A Lam
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Department of Pediatrics, Emory University, Atlanta, GA, USA; Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Anuradha Rao
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA; Department of Pediatrics, Emory University, Atlanta, GA, USA.
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12
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Gurbel PA, Bliden K, Sherwood M, Taheri H, Tehrani B, Akbari M, Yazdani S, Asgar JA, Chaudhary R, Tantry US. Development of a routine bedside CYP2C19 genotype assessment program for antiplatelet therapy guidance in a community hospital catheterization laboratory. J Thromb Thrombolysis 2024; 57:566-575. [PMID: 38480590 PMCID: PMC11031274 DOI: 10.1007/s11239-024-02953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2024] [Indexed: 04/19/2024]
Abstract
Genotype based personalized antiplatelet therapy in the setting of percutaneous coronary intervention (PCI) has been studied in clinical trials. Despite the demonstrated risk associated with CYP2C19 loss-of-function (LoF) carriage in clopidogrel-treated PCI patients, real-world implementation of genotyping for PCI has been low. The goal of the current study was to provide CYP2C19 genotype information to the interventionalist prior to the completion of the catheterization to facilitate immediate personalized antiplatelet therapy. Routine personalization of P2Y12 inhibitor therapy for PCI in a community hospital cardiac catheterization laboratory by POC genotyping with the SpartanRx system was first offered in February 2017. A best practice advisory (BPA) based on the Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2C19 genotype and clopidogrel therapy was placed in the electronic health record prescription medication ordering system. By December 2019, 1,052 patients had CYP2C19 genotype testing, 429 patients underwent PCI with genotype guided antiplatelet therapy, and 250 patients underwent PCI without genotype testing and received antiplatelet therapy at the discretion of the treating physician. BPA compliance was 93. 87% of LoF allele carriers were prescribed ticagrelor or prasugrel whereas 96% of non-LoF allele carriers were prescribed clopidogrel. The genotyping results were available within 1 h and made immediately available for decision making by the interventional cardiologist. POC CYP2C19 genotyping is feasible in a community hospital catheterization laboratory and is associated with high rate of best practice compliance.Clinical Trial Registration: https://clinicaltrials.gov/ct2/show/NCT03040622.
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Affiliation(s)
- Paul A Gurbel
- Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, 21215, USA.
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA.
| | - Kevin Bliden
- Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, 21215, USA
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
| | - Matthew Sherwood
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
| | - Hamid Taheri
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
| | - Behnam Tehrani
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
| | - Marjaneh Akbari
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
| | - Shahram Yazdani
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
| | - Juzer Ali Asgar
- Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, 21215, USA
| | - Rahul Chaudhary
- Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Artificial Intelligence for Holistic Evaluation and Advancement of Cardiovascular Thrombosis (AI-HEART) Lab, Pittsburgh, PA, USA
| | - Udaya S Tantry
- Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, MD, 21215, USA
- Inova Center for Thrombosis Research and Drug Development, Inova Heart and Vascular Institute, Fairfax, VA, USA
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13
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Zhao J, Han H, Liu Z, Chen J, Liu X, Sun Y, Wang B, Zhao B, Pang Y, Xiao R. Portable fluorescent lateral flow assay for ultrasensitive point-of-care analysis of acute myocardial infarction related microRNA. Anal Chim Acta 2024; 1295:342306. [PMID: 38355230 DOI: 10.1016/j.aca.2024.342306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/02/2024] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
Point-of-care quantitative analysis of tracing microRNA disease-biomarkers remains a great challenge in the clinical diagnosis. In this paper, we developed a portable fluorescent lateral flow assay for ultrasensitive quantified detection of acute myocardial infarction related microRNAs in bio-samples. SiO2@DQD (bilayer quantum dots assembly with SiO2 core) based fluorescent lateral flow strip was fabricated as the analysis tool. In order to quantify the tracing microRNA in biosamples, a catalytic hairpin assembly and CRISPR/Cas12a cascade amplification method was performed and combined with the fabricated SiO2@DQD lateral flow strip. Thus, our platform gathered double advantages of portability and ultrasensitive quantification. Based on our strips, target myocardial biomarker microRNA-133a can be detected with a detection limit of 0.32 fM, which was almost 1000-fold sensitive compared with previous reported microRNAs-lateral flow strips. Significantly, this portable fluorescent strip can directly detect microRNAs in serum without any pretreatment and PCR amplification steps. When spiked in serum samples, a recovery of 99.65 %-102.38 % can be obtained. Therefore, our method offers a potential tool for ultrasensitive quantification of diseases related microRNA in the point-of-care diseases diagnosis field.
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Affiliation(s)
- Junnan Zhao
- College of Life Science, Hebei Normal University, Shijiazhuang, 050024, PR China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Han Han
- College of Life Science, Hebei Normal University, Shijiazhuang, 050024, PR China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Zhenzhen Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Jin Chen
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Xiaoxian Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Yinuo Sun
- College of Life Science, Hebei Normal University, Shijiazhuang, 050024, PR China; State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Bingwei Wang
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China
| | - Baohua Zhao
- College of Life Science, Hebei Normal University, Shijiazhuang, 050024, PR China.
| | - Yuanfeng Pang
- Department of Toxicology, Capital Medical University, No. 10 Xitoutiao, You An Men, Beijing, 100069, PR China.
| | - Rui Xiao
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, PR China.
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14
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Elsallab M, Bourgeois F, Maus MV. National Survey of FACT-Accredited Cell Processing Facilities: Assessing Preparedness for Local Manufacturing of Immune Effector Cells. Transplant Cell Ther 2024:S2666-6367(24)00289-6. [PMID: 38494077 DOI: 10.1016/j.jtct.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/19/2024]
Abstract
The utilization of the human immune system as a therapeutic modality has materialized in the form of novel biologics known as immune effector cells (IECs). However, currently approved IECs rely on autologous cells for manufacturing that are funneled through costly centralized supply chains leading to long wait times and potentially increased mortality. Alternative models for manufacturing at or near the point-of-care in a distributed and local approach are being proposed to overcome such a bottleneck. Cell processing facilities for minimally manipulated products, as well as academic good manufacturing practice facilities, are being considered for such manufacturing tasks. However, the infrastructure and the practices of these facilities remains unstudied. Here, we surveyed the cell processing facilities accredited by the Foundation for Accreditation of Cellular Therapy (FACT) in the United States to better understand their preparedness for local manufacturing of IECs. A structured survey consisting of 40 items was distributed to the directors of 157 facilities. The survey evaluated 6 domains, including facility characteristics, quality practices, personnel, use of automation, experience with IECs, and the perception of the point-of-care model. Thirty-eight facilities completed the survey (24.2%). Most facilities were involved in handling IEC products (35/38, 92.1%), and the majority had infrastructure to support basic operations and quality control such as viability (36/36, 100%), identity (33/36, 91.7%), and sterility (33/36, 91.7%). The quality practices varied among the facilities depending on the types of products processed. A slight majority implemented automation in their workflows (22/38, 57.9%). Facilities expressed a general interest in adopting point-of-care models (23/38, 61%), with financial and human resources identified as the most significant constraints. In conclusion, FACT-accredited cell processing facilities may provide the infrastructure required for local manufacturing. However, there is a need for standardization and minimum quality requirements to effectively implement such models.
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Affiliation(s)
- Magdi Elsallab
- Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, Massachusetts; Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - Florence Bourgeois
- Harvard-MIT Center for Regulatory Science, Harvard Medical School, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Computational Health Informatics Program, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Marcela V Maus
- Cellular Immunotherapy Program, Cancer Center, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Cancer Center, Massachusetts General Hospital, Boston, Massachusetts.
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15
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Kumar AS, Venkatesalu S, Dilliyappan S, Pasupulla AP, Prathap L, Palaniyandi T, Baskar G, Ravi M, Sugumaran A. Microfluidics as diagnostic tools. Clin Chim Acta 2024; 556:117841. [PMID: 38395126 DOI: 10.1016/j.cca.2024.117841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 02/17/2024] [Accepted: 02/18/2024] [Indexed: 02/25/2024]
Abstract
The challenges in the management of human diseases are largely determined by the precision, speed and ease of diagnostic procedures available. Developments in biomedical engineering technologies have greatly helped in transforming human health care, especially for disease diagnosis which in turn lead to better patient outcomes. One such development is in the form of microfluidic chip technology which has transformed various aspects of human health care. We present in this review, a comprehensive account on the utility of microfluidic chip technologies for the diagnosis of autoimmune disorders, cardiovascular diseases (CVDs), infectious diseases, and neurodegenerative conditions. We have included the diseases posing global threat such as rheumatoid arthritis, diabetes, pernicious anemia, tuberculosis, COVID-19, influenza, alzheimer's, multiple sclerosis, and epilepsy. Apart from discussing the ways of microfluidic chip in diagnosis, we included a section presenting electrochemical, electrical, optical, and acoustic detection technologies for the precise diagnosis of CVDs. Microfluidics platforms have thus revolutionized novel capabilities in addressing the requirements of point-of-care diagnostics enabling miniaturization by integrating multiple laboratory functions into a single chip resulting in "one flow - one solution" systems. Hence, the precision and early diagnoses of diseases are now possible due to the advancements of microfluidics-based technology.
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Affiliation(s)
- Avanthika Satish Kumar
- Department of Biotechnology, Dr. M.G.R. Educational and Research Institute, Chennai, India
| | - Sneha Venkatesalu
- Department of Biotechnology, Dr. M.G.R. Educational and Research Institute, Chennai, India
| | | | - Ajay Prakash Pasupulla
- Oral and Maxillofacial Pathologist, School of Medicine, College of Health Sciences, Nigist Eleni Comprehensive Specialized Hospital, Wachemo University, Hossana, Ethiopia, East Africa
| | - Lavanya Prathap
- Department of Anatomy, Biomedical Research Unit and Laboratory Animal Centre, Saveetha Dental College and Hospital, SIMATS, Saveetha University, Chennai, India
| | - Thirunavukkarasu Palaniyandi
- Department of Biotechnology, Dr. M.G.R. Educational and Research Institute, Chennai, India; Department of Anatomy, Biomedical Research Unit and Laboratory Animal Centre, Saveetha Dental College and Hospital, SIMATS, Saveetha University, Chennai, India.
| | - Gomathy Baskar
- Department of Biotechnology, Dr. M.G.R. Educational and Research Institute, Chennai, India
| | - Maddaly Ravi
- Department of Human Genetics, Sri Ramachandra Institute of Higher Education and Research, Chennai, India
| | - Abimanyu Sugumaran
- Department of Pharmaceutical Sciences, Assam University, Silchar, Assam, India
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16
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Zarama V, Arango-Granados MC, Manzano-Nunez R, Sheppard JP, Roberts N, Plüddemann A. The diagnostic accuracy of cardiac ultrasound for acute myocardial ischemia in the emergency department: a systematic review and meta-analysis. Scand J Trauma Resusc Emerg Med 2024; 32:19. [PMID: 38468316 PMCID: PMC10926567 DOI: 10.1186/s13049-024-01192-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 02/29/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Chest pain is responsible for millions of visits to the emergency department (ED) annually. Cardiac ultrasound can detect ischemic changes, but varying accuracy estimates have been reported in previous studies. We synthetized the available evidence to yield more precise estimates of the accuracy of cardiac ultrasound for acute myocardial ischemia in patients with chest pain in the ED and to assess the effect of different clinical characteristics on test accuracy. METHODS A systematic search for studies assessing the diagnostic accuracy of cardiac ultrasound for myocardial ischemia in the ED was conducted in MEDLINE, EMBASE, CENTRAL, CINAHL, LILACS, Web of Science, two trial registries and supplementary methods, from inception to December 6th, 2022. Prospective cohort, cross-sectional, case-control studies and randomized controlled trials (RCTs) that included data on diagnostic accuracy were included. Risk of bias was assessed with the QUADAS-2 tool and a bivariate hierarchical model was used for meta-analysis with paired Forest and SROC plots used to present the results. Subgroup analyses was conducted on clinically relevant factors. RESULTS Twenty-nine studies were included, with 5043 patients. The overall summary sensitivity was 79.3% (95%CI 69.0-86.8%) and specificity was 87.3% (95%CI 79.9-92.2%), with substantial heterogeneity. Subgroup analyses showed increased sensitivity in studies where ultrasound was conducted at ED admission and increased specificity in studies that excluded patients with previous heart disease, when the target condition was acute coronary syndrome, or when final chart review was used as the reference standard. There was very low certainty in the results based on serious risk of bias and indirectness in most studies. CONCLUSIONS Cardiac ultrasound may have a potential role in the diagnostic pathway of myocardial ischemia in the ED; however, a pooled accuracy must be interpreted cautiously given substantial heterogeneity and that important patient and test characteristics affect its diagnostic performance. PROTOCOL REGISTRATION PROSPERO (CRD42023392058).
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Affiliation(s)
- Virginia Zarama
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia.
- Department of Emergency Medicine, Fundación Valle del Lili, Carrera 98 # 18-49, 760032, Cali, Colombia.
- Nuffield Department of Primary Care Health Sciences and the Department for Continuing Education, University of Oxford, Oxford, Oxfordshire, UK.
| | - María Camila Arango-Granados
- Facultad de Ciencias de la Salud, Universidad ICESI, Cali, Colombia
- Department of Emergency Medicine, Fundación Valle del Lili, Carrera 98 # 18-49, 760032, Cali, Colombia
| | | | - James P Sheppard
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
| | - Nia Roberts
- Bodleian Health Care Libraries, University of Oxford, Oxfordshire, UK
| | - Annette Plüddemann
- Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, Oxfordshire, UK
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Strohmaier-Nguyen D, Horn C, Baeumner AJ. NT-proBNP detection with a one-step magnetic lateral flow channel assay. Anal Bioanal Chem 2024:10.1007/s00216-024-05223-x. [PMID: 38459191 DOI: 10.1007/s00216-024-05223-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 03/10/2024]
Abstract
Point-of-care sensors targeting blood marker analysis must be designed to function with very small volumes since acquiring a blood sample through a simple, mostly pain-free finger prick dramatically limits the sample size and comforts the patient. Therefore, we explored the potential of converting a conventional lateral flow assay (LFA) for a significant biomarker into a self-contained and compact polymer channel-based LFA to minimize the sample volume while maintaining the analytical merits. Our primary objective was to eliminate the use of sample-absorbing fleece and membrane materials commonly present in LFAs. Simultaneously, we concentrated on developing a ready-to-deploy one-step LFA format, characterized by dried reagents, facilitating automation and precise sample transport through a pump control system. We targeted the detection of the heart failure biomarker NT-proBNP in only 15 µL human whole blood and therefore implemented strategies that ensure highly sensitive detection. The biosensor combines streptavidin-functionalized magnetic beads (MNPs) as a 3D detection zone and fluorescence nanoparticles as signal labels in a sandwich-based immunoassay. Compared to the currently commercialized LFA, our biosensor demonstrates comparable analytical performance with only a tenth of the sample volume. With a detection limit of 43.1 pg∙mL-1 and a mean error of 18% (n ≥ 3), the biosensor offers high sensitivity and accuracy. The integration of all-dried long-term stable reagents further enhances the convenience and stability of the biosensor. This lateral flow channel platform represents a promising advancement in point-of-care diagnostics for heart failure biomarkers, offering a user-friendly and sensitive platform for rapid and reliable testing with low finger-prick blood sample volumes.
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Affiliation(s)
- Dan Strohmaier-Nguyen
- Institute of Analytical Chemistry, Chemo- and Biosensors, University of Regensburg, 93053, Regensburg, Germany
| | - Carina Horn
- Roche Diagnostics GmbH, 68305, Mannheim, Germany
| | - Antje J Baeumner
- Institute of Analytical Chemistry, Chemo- and Biosensors, University of Regensburg, 93053, Regensburg, Germany.
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Silva SJRD, Magalhães JJFD, Matthews Q, Divarzak ALL, Mendes RPG, Santos BNR, Cabral DGDA, Silva JBD, Kohl A, Pardee K, Pena L. Development and field validation of a reverse transcription loop-mediated isothermal amplification assay (RT-LAMP) for the rapid detection of chikungunya virus in patient and mosquito samples. Clin Microbiol Infect 2024:S1198-743X(24)00116-2. [PMID: 38460820 DOI: 10.1016/j.cmi.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Revised: 03/02/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVES We aimed to develop a reverse transcription loop-mediated isothermal amplification (RT-LAMP) platform for the rapid detection of chikungunya virus (CHIKV) in both patient and mosquito samples from Brazil. METHODS We optimized an RT-LAMP assay and then evaluated the specificity and sensitivity using visual detection. In comparison with the RT-qPCR reference method, we validated the utility of this assay as a molecular diagnostic test in a reference laboratory for arbovirus diagnostics using 100 serum samples collected from suspected CHIKV cases. RESULTS Our RT-LAMP assay specifically detected CHIKV without cross-reactivity against other arboviruses. The limit of detection of our RT-LAMP was estimated in -1.18 PFU (confidence interval [CI] ranging from -2.08 to 0.45), resulting in a similar analytical sensitivity when directly compared with the reference standard RT-qPCR assay. Then, we demonstrate the ability of our RT-LAMP assay to detect the virus in different human specimens (serum, urine, and saliva), and crude lysate of Aedes aegypti mosquitoes in as little as 20-30 minutes and without a separate RNA isolation step. Lastly, we showed that our RT-LAMP assay could be lyophilized and reactivated by adding water, indicating potential for room-temperature storage. Our RT-LAMP had a clinical sensitivity of 100% (95% CI, 90.97-100.00%), clinical specificity of 96.72% (95% CI, 88.65-99.60%), and overall accuracy of 98.00% (95% CI, 92.96-99.76%). DISCUSSION Taken together, these findings indicate that the RT-LAMP assay reported here solves important practical drawbacks to the deployment of molecular diagnostics in the field and can be used to improve testing capacity, particularly in low- and middle-income countries.
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Affiliation(s)
- Severino Jefferson Ribeiro da Silva
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada.
| | - Jurandy Júnior Ferraz de Magalhães
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil; Department of Virology, Pernambuco State Central Laboratory (LACEN/PE), Recife, Pernambuco, Brazil; University of Pernambuco (UPE), Serra Talhada Campus, Serra Talhada, Pernambuco, Brazil; Public Health Laboratory of the XI Regional Health, Pernambuco, Brazil
| | - Quinn Matthews
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada
| | | | - Renata Pessôa Germano Mendes
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
| | - Bárbara Nazly Rodrigues Santos
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil
| | | | | | - Alain Kohl
- MRC-University of Glasgow Centre for Virus Research, Glasgow, UK; Department of Vector Biology and Tropical Disease Biology, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Keith Pardee
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada; Department of Mechanical and Industrial Engineering, University of Toronto, Toronto, ON, Canada
| | - Lindomar Pena
- Laboratory of Virology and Experimental Therapy (Lavite), Department of Virology, Aggeu Magalhães Institute (IAM), Oswaldo Cruz Foundation (Fiocruz), Recife, Pernambuco, Brazil.
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Costa-Ribeiro A, Lamas A, Mora A, Prado M, Garrido-Maestu A. Moving towards on-site detection of Shiga toxin-producing Escherichia coli in ready-to-eat leafy greens. Curr Res Food Sci 2024; 8:100716. [PMID: 38511154 PMCID: PMC10950744 DOI: 10.1016/j.crfs.2024.100716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024] Open
Abstract
Rapid identification of Shiga toxin-producing Escherichia coli, or STEC, is of utmost importance to assure the innocuousness of the foodstuffs. STEC have been implicated in outbreaks associated with different types of foods however, among them, ready-to-eat (RTE) vegetables are particularly problematic as they are consumed raw, and are rich in compounds that inhibit DNA-based detection methods such as qPCR. In the present study a novel method based on Loop-mediated isothermal amplification (LAMP) to overcome the limitations associated with current molecular methods for the detection of STEC in RTE vegetables targeting stx1 and stx2 genes. In this sense, LAMP demonstrated to be more robust against inhibitory substances in food. In this study, a comprehensive enrichment protocol was combined with four inexpensive DNA extraction protocols. The one based on silica purification enhanced the performance of the method, therefore it was selected for its implementation in the final method. Additionally, three different detection chemistries were compared, namely real-time fluorescence detection, and two end-point colorimetric strategies, one based on the addition of SYBR Green, and the other based on a commercial colorimetric master mix. After optimization, all three chemistries demonstrated suitable for the detection of STEC in spiked RTE salad samples, as it was possible to reach a LOD50 of 0.9, 1.4, and 7.0 CFU/25 g for the real-time, SYBR and CC LAMP assays respectively. All the performance parameters reached values higher than 90 %, when compared to a reference method based on multiplex qPCR. More specifically, the analytical sensitivity was 100, 90.0 and 100 % for real-time, SYBR and CC LAMP respectively, the specificity 100 % for all three assays, and accuracy 100, 96 and 100 %. Finally, a high degree of concordance was also obtained (1, 0.92 and 1 respectively). Considering the current technological advances, the method reported, using any of the three detection strategies, demonstrated suitable for their implementation in decentralized settings, with low equipment resources.
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Affiliation(s)
- Ana Costa-Ribeiro
- International Iberian Nanotechnology Laboratory, Av. Mestre José Veiga s/n, 4715-330, Braga, Portugal
- Department of Biochemistry, Genetics and Immunology, University of Vigo, 36310, Vigo, Spain
| | - Alexandre Lamas
- Food Hygiene, Inspection and Control Laboratory (Lhica), Department of Analytical Chemistry, Nutrition, and Bromatology, Veterinary School, Campus Terra, Universidade de Santiago de Compostela (USC), 27002, Lugo, Spain
| | - Azucena Mora
- Laboratorio de Referencia de E. coli (LREC), Dpto. de Microbioloxía e Parasitoloxía, Facultade de Veterinaria, Universidade de Santiago de Compostela (USC), Lugo, Spain
- Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago, Spain
| | - Marta Prado
- International Iberian Nanotechnology Laboratory, Av. Mestre José Veiga s/n, 4715-330, Braga, Portugal
- Food Hygiene, Inspection and Control Laboratory (Lhica), Department of Analytical Chemistry, Nutrition, and Bromatology, Veterinary School, Campus Terra, Universidade de Santiago de Compostela (USC), 27002, Lugo, Spain
| | - Alejandro Garrido-Maestu
- International Iberian Nanotechnology Laboratory, Av. Mestre José Veiga s/n, 4715-330, Braga, Portugal
- Laboratory of Microbiology and Technology of Marine Products (MicroTEC), Instituto de Investigaciones Marinas (IIM), CSIC, Eduardo Cabello, 6, 36208, Vigo, Spain
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Wu W, Li Y, Song P, Xu Q, Lei D, Wang J, Fu B, Kong W. UiOL@AIEgens-assisted lateral flow immunosensor for the ultrasensitive dual-modal point-of-care detection of aflatoxin B 1. J Hazard Mater 2024; 465:133103. [PMID: 38043421 DOI: 10.1016/j.jhazmat.2023.133103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/13/2023] [Accepted: 11/25/2023] [Indexed: 12/05/2023]
Abstract
Aflatoxin B1 (AFB1) contamination in food has attracted worldwide attention. The sensitive detection of AFB1 is vital for ensuring food quality and safety. This study developed an ultrasensitive signal-enhanced lateral flow immunosensor (LFIS) based on the functionalized zirconium metal-organic framework (MOF) of a UiO linker enriched with abundant aggregation-induced emission luminogen (UiOL@AIEgens) probes for the rapid dual-modal point-of-care (POC) determination of AFB1. Using UiO MOFs with numerous active sites as the carrier facilitated abundant AIEgens enrichment on the surface. After coupling with enough anti-AFB1 monoclonal antibodies (mAbs), the green-emissive UiOL@AIEgens-mAbs probes with high specificity and remarkably-enhanced fluorescence responses were obtained to competitively capture target AFB1 in the standard or sample solution and AFB1 antigen immobilized on the test (T) line of the POC LFIS. Under optimum conditions, the LFIS was capable of visual qualitative and smartphone-assisted dual-modal determination of target AFB1 within 7 min. Detection occurred in a range of 0.01-5 ng/mL at an ultra-low detection limit of 0.003 ng/mL, which was 300- and 600-fold lower than traditional immunoassays and the maximum limit set by the European Union, respectively. Moreover, the feasibility and robustness of the LFIS platform were assessed by detecting AFB1 in maize and lotus seed samples with average recoveries of 94.3-109.0%. The developed UiOL@AIEgens-based POC LFIS can be used for ultrasensitive, reliable, on-site detection in food. This study provides a new method for the real-time monitoring of AFB1 and other harmful contaminants in food and more complex matrices.
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Affiliation(s)
- Wenjuan Wu
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China; College of Science, China Agricultural University, Beijing 100193, China
| | - Ying Li
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Pengyue Song
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Qingbin Xu
- Institute of Medicinal Plant Development, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100193, China
| | - Doudou Lei
- State Key Laboratory of Southwestern Chinese Medicine Resources, Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Jiabo Wang
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China
| | - Bin Fu
- College of Science, China Agricultural University, Beijing 100193, China
| | - Weijun Kong
- School of Traditional Chinese Medicine, Capital Medical University, Beijing 100069, China.
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21
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Jin X, Liu J, Wang J, Gao M, Zhang X. Paper-based uric acid assay in whole blood samples by Zn 2+ protein precipitation and enzyme-free colorimetric detection. Anal Bioanal Chem 2024; 416:1589-1597. [PMID: 38289356 DOI: 10.1007/s00216-024-05160-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 02/29/2024]
Abstract
Uric acid (UA) is an important biomarker, as a high concentration in blood can lead to gout and further renal syndrome. Although several point-of-care testing (POCT) devices have been reported to detect UA, there are some limitations such as the requirement for uricase and the complicated pretreatment of serum/plasma samples, which restricts their use at home or in undeveloped areas. In this work, we developed an approach by applying Zn2+ to precipitate proteins and cells in whole blood to avoid interference with the chromogenic reaction. We used carboxymethylcellulose (CMC) to immobilize tetramethylbenzidine (TMB) on a nitrocellulose membrane for colorimetric detection. Using the oxidization properties of H2O2, which turns TMB into oxidized tetramethylbenzidine (TMBox) in the presence of catalyst gold nanoparticles (AuNPs), we successfully constructed an enzyme-free paper-based POCT device using the reduction reaction of UA and TMBox for simple, speedy, and cheap colorimetric detection of UA, achieving a detection time of 8 min, a linear range of 0-150 μg/mL, and an LOD of 25.79 μg/mL. The UA concentration in whole blood samples was further measured and correlated well with the clinical value (R2 = 0.8212). Thus, the proposed assay has the potential for POCT diagnosis, monitoring, and prognosis of diseases related to UA.
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Affiliation(s)
- Xue Jin
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Jia Liu
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Jiaxi Wang
- Shanghai Key Laboratory of Metabolic Remodeling and Health, Institute of Metabolism and Integrative Biology, Fudan University, Shanghai, 200438, China
| | - Mingxia Gao
- Department of Chemistry, Fudan University, Shanghai, 200433, China
| | - Xiangmin Zhang
- Department of Chemistry, Fudan University, Shanghai, 200433, China.
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22
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Han E, Lee S, Kim HS, Yu H, Lee GD, Kim Y, Kim M. Analytical performance of the Abbott ID NOW 2.0 assay for SARS-CoV-2 detection in clinical samples from symptomatic patients. Diagn Microbiol Infect Dis 2024; 108:116164. [PMID: 38157639 DOI: 10.1016/j.diagmicrobio.2023.116164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/18/2023] [Accepted: 12/19/2023] [Indexed: 01/03/2024]
Abstract
We evaluated the analytical performance of ID NOW™ COVID-19 2.0 assay versus conventional real-time reverse transcription-polymerase chain reaction (RT-PCR) using a total of 792 clinical samples from nasopharyngeal and oropharyngeal swabs, stored in frozen universal transport medium samples. Positive percent agreement (PPA) and negative percent agreement of ID NOW were 97.6 % and 100 %, respectively. The overall percent agreement between ID NOW and RT-PCR was 99.5 %. The PPA of ID NOW in detecting SARS-CoV-2 in 164 RT-PCR positive patients, all of whom had symptoms related COVID-19, was 97.1 % within 8 days since symptom onset, 97.9 % from 8 to 14 days since symptom onset, and 97.6 % after 14 days since symptom onset, with no significant difference between the days since symptom onset. The ID NOW assay demonstrated good performance, providing a rapid and randomly accessible alternative to conventional RT-PCR for timely SARS-CoV-2 detection, particularly in situations requiring rapid results for patient care.
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Affiliation(s)
- Eunhee Han
- Department of Laboratory Medicine, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seungok Lee
- Department of Laboratory Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hoon Seok Kim
- Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Haein Yu
- Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Gun Dong Lee
- Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yonggoo Kim
- Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Myungshin Kim
- Catholic Laboratory Development and Evaluation Center, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Catholic Genetic Laboratory Center, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Department of Laboratory Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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23
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Grebely J, Matthews S, Causer LM, Feld JJ, Cunningham P, Dore GJ, Applegate TL. We have reached single-visit testing, diagnosis, and treatment for hepatitis C infection, now what? Expert Rev Mol Diagn 2024; 24:177-191. [PMID: 38173401 DOI: 10.1080/14737159.2023.2292645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
INTRODUCTION Progress toward hepatitis C virus (HCV) elimination is impeded by low testing and treatment due to the current diagnostic pathway requiring multiple visits leading to loss to follow-up. Point-of-care testing technologies capable of detecting current HCV infection in one hour are a 'game-changer.' These tests enable diagnosis and treatment in a single visit, overcoming the barrier of multiple visits that frequently leads to loss to follow-up. Combining point-of-care HCV antibody and RNA tests should improve cost-effectiveness, patient/provider acceptability, and testing efficiency. However, implementing HCV point-of-care testing programs at scale requires multiple considerations. AREAS COVERED This commentary explores the need for point-of-care HCV tests, diagnostic strategies to improve HCV testing, key considerations for implementing point-of-care HCV testing programs, and remaining challenges for point-of-care testing (including operator training, quality management, connectivity and reporting systems, regulatory approval processes, and the need for more efficient tests). EXPERT OPINION It is exciting that single-visit testing, diagnosis, and treatment for HCV infection have been achieved. Innovations afforded through COVID-19 should facilitate the accelerated development of low-cost, rapid, and accurate tests to improve HCV testing. The next challenge will be to address barriers and facilitators for implementing point-of-care testing to deliver them at scale.
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Affiliation(s)
- Jason Grebely
- The Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - Susan Matthews
- Flinders University International Centre for Point-of-Care Testing, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Louise M Causer
- The Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - Jordan J Feld
- Toronto Centre for Liver Disease, Toronto General Hospital, Toronto, Canada
| | - Philip Cunningham
- Flinders University International Centre for Point-of-Care Testing, Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
| | - Gregory J Dore
- The Kirby Institute, UNSW, Sydney, New South Wales, Australia
| | - Tanya L Applegate
- The Kirby Institute, UNSW, Sydney, New South Wales, Australia
- NSW State Reference Laboratory for HIV, St Vincent's Centre for Applied Medical Research, Sydney, New South Wales, Australia
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24
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Spinelli M, Gandhi M. Point-of-care urine tenofovir monitoring of adherence to drive interventions for HIV treatment and prevention. Expert Rev Mol Diagn 2024; 24:169-175. [PMID: 38353417 DOI: 10.1080/14737159.2024.2312122] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/26/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Although effective antiretroviral and pre-exposure prophylaxis/PrEP regimens are available globally, adherence challenges persist. Objective measures of adherence can both measure adherence accurately and can be used to drive interventions. The first point-of-care pharmacologic adherence measure, urine tenofovir testing using a lateral flow assay, is now available. AREAS COVERED This review examines the ability of pharmacologic metrics of adherence to predict HIV and PrEP clinical outcomes and the past use of pharmacologic metrics of adherence as tools to drive adherence interventions. The success of preliminary studies using point-of-care adherence metrics to guide interventions is then discussed. EXPERT OPINION Large randomized clinical trials are now needed to test the impact of point-of-care adherence interventions on HIV and PrEP clinical outcomes, given promising results of the pilot studies summarized here. Hybrid implementation-effectiveness studies will be needed to examine optimal approaches to incorporating point-of-care testing into routine clinical care delivery, including in guiding resistance testing, adherence counseling, and delivery of other evidence-based adherence interventions. Given the ability of point-of-care tenofovir testing to be implemented in settings where viral load testing is not available, and at more frequent intervals due to its low cost, urine-based tenofovir assays have the potential to be highly scalable in diverse clinical settings.
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Affiliation(s)
- Matthew Spinelli
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Monica Gandhi
- Division of HIV, Infectious Diseases and Global Medicine, Department of Medicine, University of California, San Francisco (UCSF), San Francisco, CA, USA
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25
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Saeed M, Saddique Z, Mujahid A, Afzal A. Discerning biomimetic nanozyme electrodes based on g-C 3N 4 nanosheets and molecularly imprinted polythiophene nanofibers for detecting creatinine in microliter droplets of human saliva. Biosens Bioelectron 2024; 247:115899. [PMID: 38091897 DOI: 10.1016/j.bios.2023.115899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/26/2023] [Accepted: 11/27/2023] [Indexed: 01/02/2024]
Abstract
The growing risk of death associated with kidney dysfunction underlines the requirement for a cost-effective and precise point-of-care (POC) diagnostic tool to identify chronic kidney disease (CKD) at an early stage. This work reports the development of a non-invasive POC diagnostic based on cost-efficient, disposable electrodes and in situ-designed biomimetic nanozymes. The nanozymes are composed of graphitic carbon nitride nanosheets (gCN) and creatinine-imprinted polythiophene nanofibers (miPTh). Microscopic analyses reveal porous nanofibrous surface morphology of biomimetic miPTh/gCN nanozymes. Bulk imprinting and the inclusion of conductive gCN nanosheets drastically reduced the charge transfer resistance and improved the electron exchange kinetics at the nanozyme-electrolyte interface. The electrochemical oxidation of creatinine is studied via cyclic voltammetry (CV), and differential pulse voltammetry (DPV), which exhibit excellent creatinine recognition ability of biomimetic miPTh/gCN nanozyme sensors compared to pristine polymeric or non-imprinted nanozymes. The sensor reveals linear response toward 200-1000 nmol L-1 creatinine, high sensitivity (4.27 μA cm-2 nmol-1 L), sub-nanomolar detection limit (340 pmol L-1), and excellent selectivity over common salivary analytes. To corroborate its real-world utility, the miPTh/gCN nanozyme sensor shows an impressive 94.8% recovery of spiked creatinine concentrations in microliter droplets of human saliva samples. This disposable sensor reveals great potential in the realm of reliable and efficient non-invasive POC diagnostics for healthcare delivery.
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Affiliation(s)
- Maleeha Saeed
- Sensors and Diagnostics Lab, School of Chemistry, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590, Pakistan
| | - Zohaib Saddique
- Sensors and Diagnostics Lab, School of Chemistry, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590, Pakistan
| | - Adnan Mujahid
- Sensors and Diagnostics Lab, School of Chemistry, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590, Pakistan
| | - Adeel Afzal
- Sensors and Diagnostics Lab, School of Chemistry, University of the Punjab, Quaid-i-Azam Campus, Lahore, 54590, Pakistan.
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26
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Enders A, Grünberger A, Bahnemann J. Towards Small Scale: Overview and Applications of Microfluidics in Biotechnology. Mol Biotechnol 2024; 66:365-377. [PMID: 36515858 PMCID: PMC10881759 DOI: 10.1007/s12033-022-00626-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 11/26/2022] [Indexed: 12/15/2022]
Abstract
Thanks to recent and continuing technological innovations, modern microfluidic systems are increasingly offering researchers working across all fields of biotechnology exciting new possibilities (especially with respect to facilitating high throughput analysis, portability, and parallelization). The advantages offered by microfluidic devices-namely, the substantially lowered chemical and sample consumption they require, the increased energy and mass transfer they offer, and their comparatively small size-can potentially be leveraged in every sub-field of biotechnology. However, to date, most of the reported devices have been deployed in furtherance of healthcare, pharmaceutical, and/or industrial applications. In this review, we consider examples of microfluidic and miniaturized systems across biotechnology sub-fields. In this context, we point out the advantages of microfluidics for various applications and highlight the common features of devices and the potential for transferability to other application areas. This will provide incentives for increased collaboration between researchers from different disciplines in the field of biotechnology.
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Affiliation(s)
- Anton Enders
- Institute of Technical Chemistry, Leibniz University Hannover, Callinstraße 5, 30167, Hannover, Germany
| | - Alexander Grünberger
- Institute of Process Engineering in Life Sciences: Microsystems in Bioprocess Engineering, Karlsruhe Institute of Technology, Fritz-Haber-Weg 2, 76131, Karlsruhe, Germany
| | - Janina Bahnemann
- Institute of Physics, University of Augsburg, Universitätsstraße 1, 86159, Augsburg, Germany.
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Lee WF, Goh SJ, Lee B, Juan SJ, Asinas-Tan M, Lim BL. Renal point-of-care ultrasound performed by ED staff with limited training and 30-day outcomes in patients with renal colic. CAN J EMERG MED 2024; 26:198-203. [PMID: 38219263 DOI: 10.1007/s43678-023-00645-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 12/28/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND AND AIM Emergency Department (ED) renal point-of-care ultrasound (PoCUS) in renal colic by accredited specialists has good prognostic value. This may not be generalizable to under-resourced EDs. We investigated PoCUS in renal colic in our ED with lesser training. METHODS We performed a single-centre health records review of adult ED patients with renal colic and PoCUS. Patients were managed by a non-ED specialist/resident doctor with no POCUS accreditation in consultation with an attending. These doctors attended a 3.5-h training session conducted by accredited attendings to examine hydronephrosis. They needed to verify their PoCUS findings with an attending during the first two weeks of their six-month posting before performing it independently. The primary outcome was 30-day urological procedures in hydronephrotic vs. non-hydronephrotic groups. Secondary outcomes were the distribution of primary outcome with grades of hydronephrosis, 30-day ED nephrolithiasis-related reattendances in hydronephrotic vs. non-hydronephrotic groups and its distribution with grades of hydronephrosis. We compared outcomes using Fisher's exact test. We also reported crude odds ratio (COR) and 95% CI of primary outcome between hydronephrotic vs. non-hydronephrotic groups. p values ≤ 0.05 were significant. RESULTS We recruited 651 patients; 160 (24.6%) without and 491 (75.4%) with hydronephrosis. Rates of grades of hydronephrosis were: mild (76.6%), moderate (13.8%), severe (1.2%) and undifferentiated (8.4%). There was a difference in 30-day urological procedures (rates [95% CI]) in hydronephrotic vs. non-hydronephrotic groups, 11.2 [8.7-14.0]% vs. 2.5 [1.0-6.3]%; p < 0.001; COR (95% CI) 4.9 (1.8-13.8); p = 0.002. Increasing 30-day urological procedural rates were associated with increasing grade of hydronephrosis [no: 2.5%, mild: 7.7%, moderate: 23.5%, severe: 67.0% and undifferentiated: 14.6%; p < 0.001]. No differences occurred in other secondary outcomes. CONCLUSIONS Renal PoCUS could be performed by non-ED specialist/resident doctors to identify patients without hydronephrosis who rarely required urological intervention. Hydronephrotic patients could benefit from further risk stratification.
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Affiliation(s)
- W F Lee
- Emergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore.
| | - S J Goh
- Emergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore
| | - Berlin Lee
- Emergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore
| | - S J Juan
- Emergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore
| | - Marxengel Asinas-Tan
- Emergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore
| | - B L Lim
- Emergency Department, Ng Teng Fong General Hospital, 1, Jurong East Street 21, Singapore, 609606, Singapore
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28
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Blairon L, Tré-Hardy M, Collignon S, Coenen F, Beukinga I, Cupaiolo R. Added value of a connected glucose meter for glycorrhachia assessment. Pract Lab Med 2024; 39:e00384. [PMID: 38463197 PMCID: PMC10924199 DOI: 10.1016/j.plabm.2024.e00384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 02/27/2024] [Accepted: 02/29/2024] [Indexed: 03/12/2024] Open
Abstract
Objectives The aim of this study was to demonstrate the performance and added value of rapid glucose determination in cerebrospinal fluid using a connected glucometer. Design and Methods Intra-assay and inter-assay accuracies were calculated using residual clinical samples. Accuracies were measured by comparing the results obtained with the glucometer to those from the central laboratory on a large routine chemistry platform. Results The intra-assay coefficients of variation were between 6.1% and 6.2% for low values (18 mg/dL) and between 5.6% and 6.8% for high values (58 mg/dL). The inter-assay coefficients of variation were between 9.4% and 16.3% for the low values (18 mg/dL) and between 5.7% and 8.7% for the high values (pool; ±75 mg/dL). The regression equation by comparison to the central laboratory was y = 4.08 + 0.82 x, with a coefficient of determination (r2) of 0.95. Conclusions The measurement of glycorrhachia with a connected glucometer before the analysis in the central laboratory allows a rapid orientation in the deferential diagnosis of a meningitis of viral vs bacterial origin. The response time is fast (6 s) and requires only a small amount of fluid (1.2 μL), which is important in infants, especially since lumbar puncture is an integral part of the investigation of the origin of a fever in this population.
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Affiliation(s)
- Laurent Blairon
- Department of Laboratory Medicine, Iris Hospitals South, Brussels, Belgium
| | - Marie Tré-Hardy
- Department of Laboratory Medicine, Iris Hospitals South, Brussels, Belgium
- Faculty of Medicine, Université Libre de Bruxelles, Brussels, Belgium
- Department of Pharmacy, Namur Research Institute for Life Sciences, University of Namur, Belgium
| | - Sophie Collignon
- Department of Emergency Medicine, Iris Hospitals South, Brussels, Belgium
| | - François Coenen
- Department of Emergency Medicine, Iris Hospitals South, Brussels, Belgium
| | - Ingrid Beukinga
- Department of Laboratory Medicine, Iris Hospitals South, Brussels, Belgium
| | - Roberto Cupaiolo
- Department of Laboratory Medicine, Iris Hospitals South, Brussels, Belgium
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Gradisteanu Pircalabioru G, Raileanu M, Dionisie MV, Lixandru-Petre IO, Iliescu C. Fast detection of bacterial gut pathogens on miniaturized devices: an overview. Expert Rev Mol Diagn 2024; 24:201-218. [PMID: 38347807 DOI: 10.1080/14737159.2024.2316756] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 02/06/2024] [Indexed: 03/23/2024]
Abstract
INTRODUCTION Gut microbes pose challenges like colon inflammation, deadly diarrhea, antimicrobial resistance dissemination, and chronic disease onset. Development of early, rapid and specific diagnosis tools is essential for improving infection control. Point-of-care testing (POCT) systems offer rapid, sensitive, low-cost and sample-to-answer methods for microbe detection from various clinical and environmental samples, bringing the advantages of portability, automation, and simple operation. AREAS COVERED Rapid detection of gut microbes can be done using a wide array of techniques including biosensors, immunological assays, electrochemical impedance spectroscopy, mass spectrometry and molecular biology. Inclusion of Internet of Things, machine learning, and smartphone-based point-of-care applications is an important aspect of POCT. In this review, the authors discuss various fast diagnostic platforms for gut pathogens and their main challenges. EXPERT OPINION Developing effective assays for microbe detection can be complex. Assay design must consider factors like target selection, real-time and multiplex detection, sample type, reagent stability and storage, primer/probe design, and optimizing reaction conditions for accuracy and sensitivity. Mitigating these challenges requires interdisciplinary collaboration among scientists, clinicians, engineers, and industry partners. Future efforts are essential to enhance sensitivity, specificity, and versatility of POCT systems for gut microbe detection and quantification, advancing infectious disease diagnostics and management.
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Affiliation(s)
- Gratiela Gradisteanu Pircalabioru
- eBio-hub Research Centre, National University of Science and Technology "Politehnica" Bucharest, Bucharest, Romania
- Division of Earth, Environmental and Life Sciences, The Research Institute of University of Bucharest (ICUB), Bucharest, Romania
- Academy of Romanian Scientists, Bucharest, Romania
| | - Mina Raileanu
- eBio-hub Research Centre, National University of Science and Technology "Politehnica" Bucharest, Bucharest, Romania
- Department of Life and Environmental Physics, Horia Hulubei National Institute of Physics and Nuclear Engineering, Magurele, Romania
| | - Mihai Viorel Dionisie
- eBio-hub Research Centre, National University of Science and Technology "Politehnica" Bucharest, Bucharest, Romania
| | - Irina-Oana Lixandru-Petre
- eBio-hub Research Centre, National University of Science and Technology "Politehnica" Bucharest, Bucharest, Romania
| | - Ciprian Iliescu
- eBio-hub Research Centre, National University of Science and Technology "Politehnica" Bucharest, Bucharest, Romania
- Academy of Romanian Scientists, Bucharest, Romania
- Microsystems in Biomedical and Environmental Applications, National Research and Development Institute for Microtechnology, Bucharest, Romania
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MacIsaac MB, Whitton B, Anderson J, Cogger S, Vella-Horne D, Penn M, Weeks A, Elmore K, Pemberton D, Winter RJ, Papaluca T, Howell J, Hellard M, Stoové M, Wilson D, Pedrana A, Doyle JS, Clark N, Holmes JA, Thompson AJ. Point-of-care HCV RNA testing improves hepatitis C testing rates and allows rapid treatment initiation among people who inject drugs attending a medically supervised injecting facility. Int J Drug Policy 2024; 125:104317. [PMID: 38281385 DOI: 10.1016/j.drugpo.2024.104317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 12/27/2023] [Accepted: 01/01/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND To achieve hepatitis C virus (HCV) elimination targets, simplified care engaging people who inject drugs is required. We evaluated whether fingerstick HCV RNA point-of-care testing (PoCT) increased the proportion of clients attending a supervised injecting facility who were tested for hepatitis C. METHODS Prospective single-arm study with recruitment between 9 November 2020 and 28 January 2021 and follow-up to 31 July 2021. Clients attending the supervised injecting facility were offered HCV RNA testing using the Xpert® HCV Viral Load Fingerstick (Cepheid, Sunnyvale, CA) PoCT. Participants with a positive HCV RNA test were prescribed direct acting antiviral (DAA) therapy. The primary endpoint was the proportion of clients who engaged in HCV RNA PoCT, compared to a historical comparator group when venepuncture-based hepatitis C testing was standard of care. RESULTS Among 1618 clients who attended the supervised injecting facility during the study period, 228 (14%) engaged in PoCT. This was significantly higher than that observed in the historical comparator group (61/1,775, 3%; p < 0.001). Sixty-five (28%) participants were HCV RNA positive, with 40/65 (62%) receiving their result on the same day as testing. Sixty-one (94%) HCV RNA positive participants were commenced on DAA therapy; 14/61 (23%) started treatment on the same day as diagnosis. There was no difference in the proportion of HCV RNA positive participants commenced on treatment with DAA therapy when compared to the historical comparator group (61/65, 94% vs 22/26, 85%; p = 0.153). However, the median time to treatment initiation was significantly shorter in the PoCT cohort (2 days (IQR 1-20) vs 41 days (IQR 22-76), p < 0.001). Among participants who commenced treatment and had complete follow-up data available, 27/36 (75%) achieved hepatitis C cure. CONCLUSIONS HCV RNA PoCT led to a significantly higher proportion of clients attending a supervised injecting facility engaging in hepatitis C testing, whilst also reducing the time to treatment initiation.
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Affiliation(s)
- Michael B MacIsaac
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Bradley Whitton
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia
| | - Jenine Anderson
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Shelley Cogger
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Dylan Vella-Horne
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Matthew Penn
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Anthony Weeks
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Kasey Elmore
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - David Pemberton
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia
| | - Rebecca J Winter
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Timothy Papaluca
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Jessica Howell
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Margaret Hellard
- Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia; Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - Mark Stoové
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
| | - David Wilson
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Alisa Pedrana
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
| | - Joseph S Doyle
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Department of Infectious Diseases, The Alfred and Monash University, Melbourne, Victoria, Australia
| | - Nicolas Clark
- Medically Supervised Injecting Room, North Richmond Community Health, Richmond, Victoria, Australia; Department of Addiction Medicine, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Jacinta A Holmes
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia
| | - Alexander J Thompson
- Department of Gastroenterology, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia; Faculty of Medicine, University of Melbourne, Parkville, Victoria, Australia.
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Maldonado-Barrueco A, Gutiérrez-Arroyo A, Bloise I, de Ceano-Vivas M, Rivera-Nuñez A, Santos-Olmos RT, Vega DM, García-Rodríguez J. Evaluation of CLINITEST® Rapid Covid-19 + Influenza antigen test in a cohort of symptomatic patients in an emergency department. Eur J Clin Microbiol Infect Dis 2024:10.1007/s10096-024-04788-w. [PMID: 38421466 DOI: 10.1007/s10096-024-04788-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 02/16/2024] [Indexed: 03/02/2024]
Abstract
OBJECTIVES Rapid management of patients with respiratory tract infections in hospital emergency departments is one of the main objectives since the concurrent circulation of respiratory viruses following the SARS-CoV-2 pandemic. The use of new combined point-of-care antigen tests for detecting influenza A/B and SARS-CoV-2 represents an advantage in response time over the molecular tests. The objective was to evaluate the suitability of the CLINITEST® Rapid Covid-19 + Influenza Antigen test (Siemens Healthineers, Germany) (RCIA test) by measuring the sensitivity, specificity, Cohen's kappa, and cut-off values. METHODS Nasopharyngeal samples were collected from a randomised group of symptomatic patients of all ages at emergency department during January-February 2023. In parallel, these patients were screened for influenza A/B, and SARS-CoV-2 using RT-PCR. The Ct (cycle threshold) values were collected for positive [RT-PCR (+) /RCIA test (+)] and false negative [(RT-PCR (+) /RCIA test (-)] samples. A subanalysis was performed in the paediatric population (< 16 years-old). RESULTS We included 545 patients (55.8% females) with a median age of 7 years-old (IQR: 1-66.5). The RCIA test showed a sensitivity of 59.7% [95%CI: 46.9-67.33] for influenza A, 65.6% [95%CI: 49.5-80.3] for influenza B, and 76.9% [95%CI: 45.8-84.8] for SARS-CoV-2. The specificity was between 90.7%-99.7% with a moderate/high level of agreement with RT-PCR (kappa score: 0.6-0.8) for the three respiratory viruses included in the RCIA test. CONCLUSIONS The sensitivity of the RCIA test is insufficient for screening of patients, including patients with low Ct values (Ct > 20). Despite its good specificity and Cohen's kappa value, its use as a screening test is not comparable to RT-PCR systems in the ED environment with a high number of false negative results.
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Affiliation(s)
| | | | - Iván Bloise
- Clinical Microbiology Department, Hospital Universitario La Paz, Madrid, Spain
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Fernàndez-López L, Reyes-Urueña J, Egea L, Chernyshev A, Upmace I, Ćosić M, Mejías W, González V, Blondeel K, Thwin SS, Gios L, Mirandola M, Peeling R, Kiarie J, Casabona J, Toskin I. A clinical utility evaluation of dual HIV/Syphilis point-of-care tests in non-clinical settings for screening for HIV and syphilis in men who have sex with men. BMC Infect Dis 2024; 24:264. [PMID: 38419023 PMCID: PMC10902924 DOI: 10.1186/s12879-024-09017-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 01/11/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Dual point-of-care tests (POCTs) for the simultaneous detection of antibodies to HIV and syphilis have been developed. Since community-based organisations (CBO) are effective providers of HIV and syphilis testing among men who have sex with men (MSM), evaluation of the utility of these dual tests at CBO testing services is a high priority. The aim of this study is to determine the feasibility of performing dual HIV-syphilis POCT testing among both users and providers at these non-clinical sites. METHODS This evaluation assessed the utility of two lateral flow immunochromatographic antibody technologies for dual screening for HIV/syphilis among MSM seeking testing in four CBO testing services in Spain, Slovenia, Latvia, and Ukraine. The study's conceptual framework divides the concept of feasibility into two inter-related domains, acceptability, and usability and further breaks it down into six subdomains: learnability, willingness, suitability, satisfaction, efficacy, and effectiveness. The feasibility analysis was performed by calculating the median score in 3 stages (for individual questions, subdomains, and domains), using a summated scores method. RESULTS The final sample included 844 participants, 60 of which were found to be HIV test positive (7.1%) and 61 (7.2%) positive on testing for syphilis. There was a small difference (1.1%) when comparing the results of the two dual POCTs under evaluation to the tests routinely used at each site. The inter-rater agreement showed a high concordance between two independent readings. The analysis of the feasibility for the users of the services indicated good satisfaction, suitability, and willingness. In addition, among 18 providers the total mean score showed good acceptability and usability, good willingness, easy learnability, high suitability, and good efficacy, but lower satisfaction and effectiveness. The operational characteristics of both dual study POCTs were well evaluated by providers. CONCLUSIONS The introduction of dual HIV and syphilis POCTs in CBO testing services for screening of MSM is feasible, with a high acceptability and usability both for users and providers. Implementation of dual POCTs for HIV and syphilis in CBO testing services is an opportunity for scaling up integrated HIV/syphilis testing for MSM.
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Affiliation(s)
- Laura Fernàndez-López
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain.
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain.
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
| | - Juliana Reyes-Urueña
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain
| | - Laia Egea
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- School of Mathematics, Statistics and Operations Research, Victoria University of Wellington, Wellington, New Zealand
| | | | | | | | | | - Victoria González
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain
- Microbiology Department, Laboratori Clínic Metropolitana Nord. Hospital Universitari Germans Trias I Pujol, Badalona, Spain
| | - Karel Blondeel
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Soe Soe Thwin
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Lorenzo Gios
- Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
| | - Massimo Mirandola
- Epidemiology Unit - Division of Infectious Diseases, Department of Medicine, Verona University Hospital, Verona, Italy
- School of Sport and Health Sciences, University of Brighton, Brighton, UK
| | - Rosanna Peeling
- International Diagnostics Centre, London School of Hygiene & Tropical Medicine, London, UK
| | - James Kiarie
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Jordi Casabona
- Centre of Epidemiological Studies of HIV/AIDS and STI of Catalonia (CEEISCAT), Health Department, Generalitat de Catalunya, Badalona, Spain
- Institute for Health Science Research Germans Trias I Pujol (IGTP), Badalona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research (SRH), including UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Albaroudi O, Albaroudi B, Haddad M, Abdle-Rahman ME, Kumar TSS, Jarman RD, Harris T. Can absence of cardiac activity on point-of-care echocardiography predict death in out-of-hospital cardiac arrest? A systematic review and meta-analysis. Ultrasound J 2024; 16:10. [PMID: 38376658 PMCID: PMC10879065 DOI: 10.1186/s13089-024-00360-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 01/26/2024] [Indexed: 02/21/2024] Open
Abstract
AIM The purpose of this systematic review and meta-analysis was to evaluate the accuracy of the absence of cardiac motion on point-of-care echocardiography (PCE) in predicting termination of resuscitation (TOR), short-term death (STD), and long-term death (LTD), in adult patients with cardiac arrest of all etiologies in out-of-hospital and emergency department setting. METHODS A systematic review and meta-analysis was conducted based on PRISMA guidelines. A literature search in Medline, EMBASE, Cochrane, WHO registry, and ClinicalTrials.gov was performed from inspection to August 2022. Risk of bias was evaluated using QUADAS-2 tool. Meta-analysis was divided into medical cardiac arrest (MCA) and traumatic cardiac arrest (TCA). Sensitivity and specificity were calculated using bivariate random-effects, and heterogeneity was analyzed using I2 statistic. RESULTS A total of 27 studies (3657 patients) were included in systematic review. There was a substantial variation in methodologies across the studies, with notable difference in inclusion criteria, PCE timing, and cardiac activity definition. In MCA (15 studies, 2239 patients), the absence of cardiac activity on PCE had a sensitivity of 72% [95% CI 62-80%] and specificity of 80% [95% CI 58-92%] to predict LTD. Although the low numbers of studies in TCA preluded meta-analysis, all patients who lacked cardiac activity on PCE eventually died. CONCLUSIONS The absence of cardiac motion on PCE for MCA predicts higher likelihood of death but does not have sufficient accuracy to be used as a stand-alone tool to terminate resuscitation. In TCA, the absence of cardiac activity is associated with 100% mortality rate, but low number of patients requires further studies to validate this finding. Future work would benefit from a standardized protocol for PCE timing and agreement on cardiac activity definition.
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Affiliation(s)
- Omar Albaroudi
- Emergency Medicine, Hamad Medical Corporation, Doha, Qatar.
| | | | | | - Manar E Abdle-Rahman
- Department of Public Health, College of Health Science, QU Health, Qatar University, Doha, Qatar
| | | | - Robert David Jarman
- Emergency Medicine, Royal Victoria Infirmary, Newcastle Upon Tyne, UK
- School of Health and Life Sciences, Teesside University, Middlesbrough, UK
| | - Tim Harris
- Emergency Medicine, Barts Health NHS Trust, London, UK
- Queen Mary University of London, London, UK
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Kamel AH, Abd-Rabboh HSM, Bajaber MA. Non-enzymatic paper-based analytical device for direct potentiometric detection of urine creatinine. Mikrochim Acta 2024; 191:128. [PMID: 38334814 DOI: 10.1007/s00604-024-06203-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 01/08/2024] [Indexed: 02/10/2024]
Abstract
A paper-based analytical device (PAD) with an integrated composite electrode has been designed and fabricated for non-enzymatic creatinine sensing. Reduced graphene oxide (rGO) was employed to modify the PAD so that it could function as a solid-contact transducer. A new macrocyclic pyrido-hexapeptide derivative was made and used as a special ionophore in the creatinine membrane sensor. The synthesized PAD showed a detection limit of 1.0 µM (S/N = 3) and a potentiometric response towards creatinine throughout a log-linear range of 2.0 µM-10 mM (R2 = 0.9998). The sensor shows significant selectivity for a few related substances, including ephedrine, codeine, ketamine, caffeine, urea, urate, carbinoxamine, and dextromethorphan. It has been established that the testing method is appropriate for the direct potentiometric detection of creatinine in a variety of human urine sample types. When an indicating electrode and a reference electrode are put on the same flexible disposable, this lets applications with a small sample volume be done. For point-of-care creatinine measurement, the developed paper-based analytical equipment is a good choice because it is affordable, easily accessible, and self-pumping (especially when combined with potentiometric detection).
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Affiliation(s)
- Ayman H Kamel
- Department of chemistry, College of Science, University of Bahrain, Sakhir, 32038, Kingdom of Bahrain.
- Chemistry Department, Faculty of Science, Ain Shams University, Cairo, 11566, Egypt.
| | - Hisham S M Abd-Rabboh
- Chemistry Department, Faculty of Science, King Khalid University, 62529, Abha, Saudi Arabia
| | - Majed A Bajaber
- Chemistry Department, Faculty of Science, King Khalid University, 62529, Abha, Saudi Arabia
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Pittman TW, Zhang X, Punyadeera C, Henry CS. Electrochemical Immunosensor for the Quantification of Galectin-3 in Saliva. Sens Actuators B Chem 2024; 400:134811. [PMID: 38046365 PMCID: PMC10688601 DOI: 10.1016/j.snb.2023.134811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Heart failure (HF) is an emerging epidemic and remains a major clinical and public health problem. Advances in the healthcare management of HF may lead to lower morbidity and mortality rates but require diagnostics to guide the process. Current diagnostics/prognostics approaches rely on expensive equipment, centralized facilities and trained personnel, marginalizing healthcare access in developing countries and rural communities. These issues have led researchers to focus on developing portable and affordable diagnostics that can be deployed at the point-of-care (POC). Typically, HF biomarkers are measured in blood not saliva. Recently, our team correlated concentrations of salivary Galectin-3 (Gal-3) to outcomes in patients with HF. We have developed an analytical device which consists of an immunoassay based on a screen-printed carbon electrode (SPCE) to quantify Gal-3 levels in saliva samples. Using 10 μL of saliva, the proposed electrochemical immunoassay achieved a concentration dependent signal response in the clinically relevant range with a limit of detection of 9.66 ng/mL. In addition, the storage stability of the modified electrode was investigated, and only a 10.9% loss in current response over a 35-day period. The results of the immunoassay on the modified SPCEs suggest validity as a POC biosensor system for the management of HF.
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Affiliation(s)
- Trey W. Pittman
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, USA
| | - Xi Zhang
- Griffith Institute for Drug Discover, Griffith University, Nathan, Australia
| | - Chamindie Punyadeera
- Griffith Institute for Drug Discover, Griffith University, Nathan, Australia
- Menzies Health Institute, Griffith University, Gold Coast, Australia
- Translational Research Institute, Woolloongabba, Australia
| | - Charles S. Henry
- Department of Chemistry, Colorado State University, Fort Collins, Colorado 80523, USA
- Metallurgy and Materials Science Research Institute, Chulalongkorn University, Soi Chula 12, Phayathai Rd., Pathumwan, Bangkok 10330, Thailand
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Kiblinger T, Daniels K, Calamaro C. Point-of-care communication for patients with limited language proficiency: A scoping review of healthcare interpretation applications. Patient Educ Couns 2024; 119:108060. [PMID: 37976669 DOI: 10.1016/j.pec.2023.108060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 10/17/2023] [Accepted: 11/07/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Linguistic diversity has the potential to create barriers for limited language proficiency (LLP) patients when navigating the healthcare system. When a verified interpretation method is utilized, there are improvements in LLP patient outcomes. The purpose of this scoping review is to identify articles that outline applications used for point-of-care tasks between LLP patients and providers. METHODS The Arksey and O'Malley methodologic framework was utilized for study selection, data charting and analysis. Each application was evaluated on patient and provider satisfaction, overall feasibility, and time associated with interpretation. RESULTS Eight peer-reviewed journals are included (four pilot studies, one prospective study, two participatory studies, and one mixed methods design). Applications ranged in number of unique phrases (32-1800 phrases) and number of languages supported (1-39 languages). Overall, the applications were feasible to use and assisted with basic communication between providers and patients. CONCLUSIONS As patients and families become more comfortable with using technology, interpretation applications provide an innovative approach to streamline the interpretation process for point-of-care healthcare encounters. PRACTICE IMPLICATIONS Interpretation applications may increase an LLP patient's access to interpretation tools which can improve outcomes. Further studies should focus on implementing robust evaluation methods to assess these tools and evaluate the LLP patient's perspectives of interpretation applications.
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Affiliation(s)
- Theresa Kiblinger
- Children's Healthcare of Atlanta, Atlanta, USA; Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, USA.
| | | | - Christina Calamaro
- Children's Healthcare of Atlanta, Atlanta, USA; Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, USA
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Johnson KN, Vacek J, Carter S. Applications for ultrasound in pediatric surgery. Semin Pediatr Surg 2024; 33:151383. [PMID: 38190770 DOI: 10.1016/j.sempedsurg.2024.151383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Ultrasound (US) use within pediatric surgery is expanding rapidly. While US guidance for central line placement has been common practice for many years now, advances in the quality of images, portability of US machines, and a lack of radiation associated with imaging has led to broader application in many other aspects of surgery, ranging from diagnostics to performing operations under the direction of point-of-care ultrasound (POCUS). The relatively short learning curve for providers along with excellent image quality in children due to their small size provides an easy, effective imaging modality with diverse applications. Discussed here is a broad overview of the spectrum of US use within current pediatric surgical practices.
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Affiliation(s)
- Kevin N Johnson
- Assistant Professor of Pediatric Surgery, Monroe Carell Jr. Children's Hospital, Vanderbilt University, 2200 Children's Way, Nashville TN 37232, United States.
| | - Jonathan Vacek
- Pediatric Surgery Fellow, Division of Pediatric Surgery, Norton Children's Hospital, University of Louisville, Louisville KY, United States
| | - Stewart Carter
- Assistant Professor of Pediatric Surgery, Norton Children's Hospital, University of Louisville, Louisville KY, United States
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Abdalla M, Abdalla S, Abdalla M, Jones DB. Modeling the Adoption of 5760 Clinical Studies Into Practice Across 5 Surgical Specialties. J Surg Res 2024; 294:269-278. [PMID: 37453837 DOI: 10.1016/j.jss.2023.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 03/20/2023] [Accepted: 05/18/2023] [Indexed: 07/18/2023]
Abstract
INTRODUCTION No studies exist that explore the factors that influence the process of synthesizing new knowledge into perioperative standards of care and the operating room. We sought to model the adoption of clinical research into surgical practice and identify modifiable factors influencing the latency of this translation. METHODS We created a data set comprised of all UpToDate articles between 2011 and 2020, sampled at 3-mo intervals, to explore how research is incorporated at the point-of-care (POC)-studying 5760 new references from 204 journals across five surgical specialties, compared to all uncited articles published during the same interval. UpToDate authors serve as specialty curators of the vast surgical literature, with an audience of more than a million clinicians in over 180 countries across 3200 institutions. Unlike society guidelines, UpToDate also provides the necessary granularity to quantify the time in bringing research to the bedside. Our main outcomes are citation rates and time-to-citation, split by specialty, journal, article type, and topics. We also model the influence of impact factor, geography, and funding and, finally, propose new impact indices to help with prioritizing surgical literature. RESULTS We highlight variation in adoption of clinical research by specialty. We show, despite representing a lower quality of evidence, surgical case reports are one of the most cited article types. Furthermore, most clinical trials (94%-100%) in surgical journals are never incorporated into POC reference lists. While few, pragmatic trials were the most likely to be cited of any article type in any surgical specialty (40%). Journal impact factor did not correlate with time-to-citation or proportion of articles cited in three of five surgical specialties, suggesting differences in how specialties synthesize/value research from specialty journals. Our two metrics, the Clinical Relevancy and Immediacy Indices, were defined to capture this impact/relevance to surgical practice. Of the five surgical subspecialties, gynecology references were >5-fold more likely to get cited, had a larger fraction of higher quality evidence incorporated, and demonstrated more success with POC adoption of practice guidelines. We also quantified the cost of translating research to surgical practice per specialty and generated maps that highlight institutions successful in translating research to the POC. The higher expenditure of National Institutes of Health funding in gynecology may reflect the cost of higher quality research per citation. CONCLUSIONS Understanding translational latency is the first step to exposing blocks that slow the adoption of research into everyday surgical practice and to understanding why increasing research funding has not yielded comparative gains in surgical outcomes. Our approach reveals new methods to monitoring the efficiency of research investments and evaluating the efficacy of policies influencing the translation of research to surgical practice.
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Affiliation(s)
- Moustafa Abdalla
- Department of Surgery, Harvard Medical School, Harvard University, Boston, Massachusetts; Computational Statistics and Machine Learning Group, Department of Statistics, University of Oxford, Oxford, UK.
| | - Salwa Abdalla
- Department of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Mohamed Abdalla
- Department of Computer Science, University of Toronto, Toronto, Ontario, Canada
| | - Daniel B Jones
- Department of Surgery, Harvard Medical School, Harvard University, Boston, Massachusetts; Division of Minimally Invasive Surgery & Bariatric Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
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Ahmadipour M, Bhattacharya A, Sarafbidabad M, Syuhada Sazali E, Krishna Ghoshal S, Satgunam M, Singh R, Rezaei Ardani M, Missaoui N, Kahri H, Pal U, Ling Pang A. CA19-9 and CEA biosensors in pancreatic cancer. Clin Chim Acta 2024; 554:117788. [PMID: 38246211 DOI: 10.1016/j.cca.2024.117788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
Cancer is a complex pathophysiological condition causing millions of deaths each year. Early diagnosis is essential especially for pancreatic cancer. Existing diagnostic tools rely on circulating biomarkers such as Carbohydrate Antigen 19-9 (CA19-9) and Carcinoembryonic Antigen (CEA). Unfortunately, these markers are nonspecific and may be increased in a variety of disorders. Accordingly, diagnosis of pancreatic cancer generally involves more invasive approaches such as biopsy as well as imaging studies. Recent advances in biosensor technology have allowed the development of precise diagnostic tools having enhanced analytical sensitivity and specificity. Herein we examine these advances in the detection of cancer in general and in pancreatic cancer specifically. Furthermore, we highlight novel technologies in the measurement of CA19-9 and CEA and explore their future application in the early detection of pancreatic cancer.
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Affiliation(s)
- Mohsen Ahmadipour
- Institute of Power Engineering, Universiti Tenaga Nasional, 43650 Serdang, Selangor, Malaysia.
| | - Anish Bhattacharya
- Advanced Optical Materials Research Group, Department of Physics, Faculty of Science, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia; Ibnu Sina Institute of Laser Centre, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia
| | - Mohsen Sarafbidabad
- Biomedical Engineering Department, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Ezza Syuhada Sazali
- Advanced Optical Materials Research Group, Department of Physics, Faculty of Science, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia; Ibnu Sina Institute of Laser Centre, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia
| | - Sib Krishna Ghoshal
- Advanced Optical Materials Research Group, Department of Physics, Faculty of Science, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia; Ibnu Sina Institute of Laser Centre, Universiti Teknologi Malaysia, 81310 Skudai, Johor, Malaysia
| | - Meenaloshini Satgunam
- Institute of Power Engineering, Universiti Tenaga Nasional, 43650 Serdang, Selangor, Malaysia; Department of Mechanical Engineering, Universiti Tenaga Nasional, 43650 Serdang, Selangor, Malaysia
| | - Ramesh Singh
- Institute of Power Engineering, Universiti Tenaga Nasional, 43650 Serdang, Selangor, Malaysia; Center of Advanced Manufacturing and Materials Processing (AMMP), Faculty of Engineering, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohammad Rezaei Ardani
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia, Engineering Campus, 14300 Nibong Tebal, Pulau Pinang, Malaysia
| | - Nadhem Missaoui
- Laboratory of Interfaces and Advanced Materials, Faculty of Sciences, University of Monastir, Monastir, Tunisia
| | - Hamza Kahri
- Laboratory of Interfaces and Advanced Materials, Faculty of Sciences, University of Monastir, Monastir, Tunisia
| | - Ujjwal Pal
- Department of Analytical and Structural Chemistry, CSIR-Indian Institute of Chemical Technology, Hyderabad, India
| | - Ai Ling Pang
- Department of Chemical Science, Faculty of Science, Universiti Tunku Abdul Rahman, 31900 Kampar, Perak, Malaysia
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Charuvila S, Imam MS, Reza T, Datta PK, Aziz TT, Davidson S, Sumi SA, Alam S, Ismail M, Banu T, Lakhoo K. A Prospective Observational Study of Preoperative Anaemia Management Aided by Bedside Haemoglobin Testers in a Low-Resource Setting. J Pediatr Surg 2024; 59:305-309. [PMID: 38030532 DOI: 10.1016/j.jpedsurg.2023.10.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 10/11/2023] [Indexed: 12/01/2023]
Abstract
AIM Paediatric-preoperative anaemia management is challenging in settings where clinical judgment is used to diagnose anaemia owing to a lack of timely, affordable preoperative haemoglobin testing. We analysed anaemia management in such a setting after the introduction of point-of-care bedside haemoglobin testers. METHOD 1033 children who underwent surgery at a hospital in Bangladesh were included in this study. 569 underwent major surgery, and 464 underwent minor surgery and belonged to predominantly ASA category 1 or 2. RESULTS 940/1033 children underwent preoperative anaemia testing. Average haemoglobin was 11.7 g/dL. 103/1033 children were deemed clinically anaemic. However, 285 children were found to have anaemia based on bedside testing. Sensitivity of clinical judgement was 33.68% (95 % CI 28.22%-39.49%), and the specificity was 99.08% (95 % CI 98.02%-99.66%). 63/1033 had preoperative anaemia treatment, of whom 60 underwent transfusion. Subgroup analysis of children with haemoglobin <10 g/dL (n = 124) was done to compare conservative vs liberal transfusion strategy. 43/124 of this subset was transfused. Average length of stay for those transfused was 11.7 days, and those who weren't was 9.9 days (p = 0.087). 4 patients in the transfused subgroup required post-op ICU, and only 1 patient in the conservatively managed arm required ICU (p = 0.048). CONCLUSION This study demonstrates the positive impact of bedside haemoglobin testers as they have resulted in a significantly higher proportion of children diagnosed with anaemia at a fraction of the cost and logistics involved in laboratory testing. Further research on haemoglobin thresholds is required to understand the safety and long-term impact of restrictive transfusion in the surgical context. LEVEL OF EVIDENCE 2c (Grading as per the Oxford Centre for Evidence Based Medicine).
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Affiliation(s)
- Somy Charuvila
- University of Oxford, Nuffield Department of Surgical Sciences, Oxford, UK.
| | - Md Sharif Imam
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Tanjim Reza
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Pranay Kumar Datta
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Tasmiah Tahera Aziz
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Sarah Davidson
- University of Oxford, Nuffield Department of Surgical Sciences, Oxford, UK
| | - Sharmin Alam Sumi
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Sakibul Alam
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Mohammad Ismail
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh
| | - Tahmina Banu
- Chittagong Research Institute for Children Surgery [CRICS], Chittagong, Bangladesh.
| | - Kokila Lakhoo
- University of Oxford, Nuffield Department of Surgical Sciences, Oxford, UK.
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Fratzl M, Bigotte P, Gorbenkov R, Goubet G, Halfon P, Kauffmann P, Kirk D, Masse V, Payet-Burin X, Ramel O, Delshadi S. Magnetically localized and wash-free fluorescent immuno-assay: From a research platform (MLFIA) to a multiplexed POC system (MagIA). SLAS Technol 2024:S2472-6303(24)00001-3. [PMID: 38302059 DOI: 10.1016/j.slast.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/21/2023] [Accepted: 01/23/2024] [Indexed: 02/03/2024]
Abstract
Sexually transmitted infections (STI) remain one of the world's public health priorities: Nearly 400 million people are infected not only in emerging, but also in western countries. HIV, HBV and HCV share common infection pathways; thus these 3 diseases are recommended to be tested at the same time. However, this combined approach is currently mainly available in laboratories, and seldomly at the Point-of-care (POC). Consequently, there is a need for a STI screening POC platform with laboratory-like performance. Such a platform should be autonomous and portable and enable multiplexed screening from capillary blood. The previously developed and introduced MLFIA (Magnetically Localized and wash-free Fluorescent Immuno-Assay) technology has the potential to address these needs, as the MLFIA 18-chamber microfluidic cartridge and the MLFIA Analyzer were previously characterized and evaluated with plasma and serum from patients infected with HIV, Hepatitis B (Hep B) or C (Hep C). Here, we present the efforts to transfer this research platform (MLFIA) to a fully integrated multi-analysis solution (MagIA). First, we present the design changes of the consumable enabling to perform multiple assays in parallel, a fast filling of the cartridge with patient samples, and a homogeneous reagent/sample incubation. Second, we describe the development a piezoelectric actuator integrated into the Analyzer: this mixing module allows for an automated, fully integrated and portable workflow, with homogeneous in-situ mixing capabilities. The obtained MagIA platform was further characterized and validated for immunoassays (LOD, cartridge stability over time), using various biological models including OVA and IgG. We discuss the performances of the MLFIA and MagIA platforms for the detection of HIV / Hep B / Hep C using results from 102 patient plasma samples. Lastly, we assessed the compatibility of the MagIA platform with veinous and capillary blood samples as a final step towards its POC validation.
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Affiliation(s)
- M Fratzl
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - P Bigotte
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - R Gorbenkov
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - G Goubet
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - P Halfon
- Hopital Europeen, Laboratoire Alphabio-Biogroup, Marseille 13003, France
| | - P Kauffmann
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - D Kirk
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - V Masse
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - X Payet-Burin
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - O Ramel
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France
| | - S Delshadi
- MagIA diagnostics, 15 rue Maréchal Leclerc, Échirolles 38130, France.
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Gómez VJ, Martín-González A, Zafra-Vallejo V, Zubillaga-Rodríguez I, Fernández-García A, Sánchez-Aniceto G. Controversies in point-of-care 3D printing for oncological and reconstructive surgery with free software in oral and maxillofacial surgery: European regulations, costs, and timeframe. Int J Oral Maxillofac Surg 2024:S0901-5027(24)00007-9. [PMID: 38290865 DOI: 10.1016/j.ijom.2024.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 12/01/2023] [Accepted: 01/05/2024] [Indexed: 02/01/2024]
Abstract
The aim of this paper is to discuss the controversies surrounding the most recent European regulations, as well as the cost, for a 3D printing workflow using free-source software in the context of a tertiary level university hospital in the Spanish public health system. Computer-aided design and manufacturing (CAD/CAM) for head and neck oncological surgery with the printing of biomodels, cutting guides, and patient-specific implants has made it possible to simplify and make this type of highly complex surgery more predictable. This technology is not without drawbacks, such as increased costs and the lead times when planning with the biomedical industry. A review of the current European legislation and the literature on this subject was performed, and comparisons made with the authors' in-house 3D printing setup using free software and different 3D printers. The cost analysis revealed that for the cheapest setup with free software, it would be possible to amortize the investment from case 2, and in all cases the initial investment would be amortized before case 9. The timeframe ranged from 2 weeks with the biomedical industry to 72 h with point-of-care 3D printing. It is now possible to develop point-of-care 3D printing in any hospital with almost any budget.
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Affiliation(s)
- V J Gómez
- Oral and Maxillofacial Surgery Department, 12 de Octubre University Hospital, Madrid, Spain.
| | - A Martín-González
- Engineering Department, 3D Printing Point-of-Care Unit, 12 de Octubre University Hospital, Madrid, Spain
| | - V Zafra-Vallejo
- Oral and Maxillofacial Surgery Department, 12 de Octubre University Hospital, Madrid, Spain
| | - I Zubillaga-Rodríguez
- Oral and Maxillofacial Surgery Department, 12 de Octubre University Hospital, Madrid, Spain
| | - A Fernández-García
- Oral and Maxillofacial Surgery Department, 12 de Octubre University Hospital, Madrid, Spain
| | - G Sánchez-Aniceto
- Oral and Maxillofacial Surgery Department, 12 de Octubre University Hospital, Madrid, Spain
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Chen Y, Zhu Y, Wang X, Peng C, Wang R, Wang T, Che Y, Wu J, Junfeng Xu. Gravity-driven and rotation-controlled microfluidic chip for point-of-care nucleic acid detection in the fully closed environment. Talanta 2024; 267:125258. [PMID: 37801929 DOI: 10.1016/j.talanta.2023.125258] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/08/2023]
Abstract
Point-of-care nucleic acid detection is essential for diagnosis and food safety, especially in resource-limited areas. This study reports a gravity-driven and rotation-controlled (GR) chip-coupled lateral flow-based assay (LFA) for point-of-care nucleic acid detection. The sample solution is added to the inlet of the GR chip and flows into the loop-medicated isothermal amplification (LAMP) chamber by the action of gravity. After the LAMP reaction, the GR chip is manually rotated to allow the amplified solution to flow into the LFA chamber for result readout. The GR chip integrates the LAMP reaction and LFA in a fully closed environment, avoiding the aerosol contamination problem. The GR chip's simple and ingenious structure simplifies the fabrication and reduces its cost, making it possible for point-of-care and even home self-testing.
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Affiliation(s)
- Yanju Chen
- College of Biosystems Engineering and Food Science, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China; ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 311215, China
| | - Yuanyuan Zhu
- College of Biosystems Engineering and Food Science, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China; ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 311215, China
| | - Xiaofu Wang
- Key Laboratory of Traceability for Agricultural Genetically Modified Organisms, Ministry of Agriculture and Rural Affairs, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
| | - Cheng Peng
- Key Laboratory of Traceability for Agricultural Genetically Modified Organisms, Ministry of Agriculture and Rural Affairs, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China
| | - Rui Wang
- State Key Laboratory of Genetic Engineering, Human Phenome Institute, Pudong Hospital, Fudan University, Shanghai, 200438, China.
| | - Tingzhang Wang
- Key Laboratory of Microbiol Technology and Bioinformatics of Zhejiang Province, Zhejiang Institute of Microbiology, Hangzhou, 310012, China
| | - Yang Che
- Key Laboratory of Microbiol Technology and Bioinformatics of Zhejiang Province, Zhejiang Institute of Microbiology, Hangzhou, 310012, China
| | - Jian Wu
- College of Biosystems Engineering and Food Science, Zhejiang University, 866 Yuhangtang Road, Hangzhou, 310058, China; ZJU-Hangzhou Global Scientific and Technological Innovation Center, Zhejiang University, Hangzhou, 311215, China.
| | - Junfeng Xu
- Key Laboratory of Traceability for Agricultural Genetically Modified Organisms, Ministry of Agriculture and Rural Affairs, Zhejiang Academy of Agricultural Sciences, Hangzhou, 310021, China.
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Doria SM, Islam MN, Gagnon ZR. Teíchophoresis-enabled electrokinetic sample preparation and detection of calcium in natural plant samples. Talanta 2024; 267:125094. [PMID: 37666085 DOI: 10.1016/j.talanta.2023.125094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 08/14/2023] [Accepted: 08/18/2023] [Indexed: 09/06/2023]
Abstract
We present a novel upstream electrokinetic sample preparation and liquid interfacial microfluidic method to pre-concentrate, detect and quantify the concentration of a charged species, such as calcium, from a natural plant sample. We employ a new electrokinetic phenomenon, termed as "Teíchophoresis" (TPE) to preconcentrate sample calcium ions (up to a 20X increase) against a conductive wall. Using microfluidic flow, we then continuously transport the pre-concentrated calcium to a hydrodynamically streamed interfacial sensing zone where we utilize the model fluorescent chelation reaction between calcium and Calcium Green-1 (CG1) to fluorescently quantify the calcium concentration. Using a combination of finite element analysis and finite difference numerical modelling, we model the kinetics of the CG1-calcium interfacial binding and predictably validate our TPE-driven concentration results. Finally, we demonstrate the applicability of our device for real world samples by determining the calcium concentration in a tree bark extract acquired from a southern live oak and confirm our concentration results using ICP-MS.
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Affiliation(s)
- Steven M Doria
- Artie McFerrin Department of Chemical Engineering, Texas A & M University, College Station, TX, 77843, USA
| | - Md Nazibul Islam
- Artie McFerrin Department of Chemical Engineering, Texas A & M University, College Station, TX, 77843, USA
| | - Zachary R Gagnon
- Artie McFerrin Department of Chemical Engineering, Texas A & M University, College Station, TX, 77843, USA.
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Kumar Y, Dogra A, Dhiman V, Singh V, Kaushik A, Kumar S. Machine Learning-based Deep Analysis of Human Blood using NIR Spectrophotometry Signatures. Curr Med Imaging 2024; 20:1-19. [PMID: 38389375 DOI: 10.2174/0115734056271761231204093832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/06/2023] [Accepted: 10/25/2023] [Indexed: 02/24/2024]
Abstract
BACKGROUND Non-invasive bio-diagnostics are essential for providing patients with safer treatment. In this subject, significant growth is attained for noninvasive anaemia detection in terms of Hb concentration by means of spectroscopic and image analysis. The lower satisfaction rate is found due to inconsistent results in various patient settings. OBJECTIVE This observational study aims to present an adaptable point-of-care Near-Infrared (NIR) spectrophotometric approach with a constructive Machine Learning (ML) algorithm for monitoring Haemoglobin (Hb) concentration by considering dominating influencing factors into account. METHODS To accomplish this objective, 121 subjects (19.2-55.4 years) were enrolled in the study, having a wide range of Hb concentrations (8.2-17.4 g/dL) obtained from two standard Laboratory analyzers. To inspect the performance, the unique dimensionality reduction approaches are applied with numerous regression models using 5-fold cross-validation. RESULTS The optimum accuracy is found using support vector regression (SVR) and mutual information having 3 independent features i.e. Pearson correlation (r)= 0.79, standard deviation (SD)= 1.07 g/dL, bias=-0.13 g/dL and limits of agreement (LoA)=-2.22 to 1.97 g/dL. Additionally, comparability between two standard laboratory analyzers is found as; r=0.97, SD=0.50 g/dL, bias=0.21 g/dL, and LoA= -0.77 to 1.19 g/dL. CONCLUSION The precision of ±1 g/dL in 5-fold cross-validation ensures the same performance irrespective of different age groups, gender, BMI, smoking level, drinking level, and skin type. The outcomes with the offered NIR sensing system and an exclusive ML algorithm can accelerate its' requirement at remote locative rural areas and critical care units where continuous Hb monitoring is compulsory.
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Affiliation(s)
- Yogesh Kumar
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh 160030, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad- 201002, India
| | - Ayush Dogra
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh 160030, India
- Chitkara University Institute of Engineering and Technology, Chitkara University, Punjab, India
| | - Varun Dhiman
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh 160030, India
| | - Vishavpreet Singh
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh 160030, India
| | - Ajeet Kaushik
- NanoBioTech Laboratory, Health Systems Engineering, Department of Environmental Engineering, Florida Polytechnic University, Lakeland, FL, 33805-8531, United States
| | - Sanjeev Kumar
- Biomedical Applications, CSIR-Central Scientific Instruments Organisation, Chandigarh 160030, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad- 201002, India
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Valdés-Delgado T, Aguado-Paredes A, Merino-Bohórquez V, Martín-Manzanares J, Alonso MM, Maldonado B, Castro L, Belvis M, Benítez B, Caunedo Á, Calleja MÁ, Argüelles-Arias F. Performance of a New Rapid Point-of-Care Test for Infliximab Levels in Patients with Inflammatory Bowel Disease: A Comparison to ELISA. Dig Dis Sci 2024; 69:228-234. [PMID: 37943382 PMCID: PMC10787688 DOI: 10.1007/s10620-023-08139-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 08/24/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Therapeutic drug monitoring of infliximab levels in patients with inflammatory bowel disease (IBD) optimizes patients' treatment. The reference technique is based on enzyme-linked immunosorbent assay (ELISA) although point of care (POC) assays are being developed. AIMS To assess the performance of a new rapid immunochromatographic POC assay (Promonitor Quick IFX) compared with ELISA technique to measure infliximab levels in patients with IBD. METHODS A prospective, observational, unicentric study was performed on capillary blood samples from patients with IBD before infliximab infusion (trough levels). Infliximab levels and anti-infliximab antibodies were measured using the ELISA technique (Promonitor IFX) and the POC assay. Correlation between both techniques was assessed by Pearson's coefficient. Quantitative differences were evaluated by Bland-Altman analysis. Samples were stratified according to infliximab therapeutic ranges (< 3 μg/mL, 3-8 μg/mL, and > 8 μg/mL). RESULTS A total of 135 experimental samples were assessed. Infliximab levels showed a high correlation between POC and ELISA tests (r = 0.84, P < 0.001). The mean difference between tests was 1.46 μg/mL (P < 0.001), being minimal for concentrations < 8 μg/mL. POC and ELISA assays showed an overall concordance of 87.4%. Most samples were in the same therapeutic range, which lead to equivalent therapeutic decisions. POC and ELISA assays detected the presence of anti-infliximab antibodies in 2.2% and 3.7% of the samples, respectively. CONCLUSIONS POC assay results in blood samples from patients with IBD were comparable to those obtained with the reference ELISA technique. The POC assay could be considered for routine testing based on its ease of use and rapidity.
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Affiliation(s)
- Teresa Valdés-Delgado
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | | | - Vicente Merino-Bohórquez
- Pharmacy Department, Hospital Universitario Virgen Macarena, Seville, Spain
- Faculty of Pharmacy, University of Sevilla, Seville, Spain
| | | | - María Mercedes Alonso
- Nursing, Hospital Virgen Universitario Virgen Macarena y de Sán Lázaro, Seville, Spain
| | - Belén Maldonado
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - Luisa Castro
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - María Belvis
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - Beatriz Benítez
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | - Ángel Caunedo
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain
| | | | - Federico Argüelles-Arias
- Gastroenterology Department, Hospital Universitario Virgen Macarena, C/Dr. Fedriani, 3, 41009, Seville, Spain.
- Faculty of Medicine, University of Sevilla, Seville, Spain.
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Walther LH, Lassen AT, Mogensen CB, Christensen EF, Mikkelsen S. Prehospital blood gas analyses in acute patients treated by a ground-based physician-manned emergency unit: a cohort study. Scand J Trauma Resusc Emerg Med 2023; 31:102. [PMID: 38115069 PMCID: PMC10729417 DOI: 10.1186/s13049-023-01170-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND The prehospital patients treated by ambulances and mobile emergency care units (MECU) are potentially critically ill or injured. Knowing the risks of serious outcomes in these patients is important for guiding their treatment. Some settings allow for prehospital arterial blood gas analyses. This study aimed to assess the outcomes of prehospital patients in relation to their prehospitally measured lactate, pH, and CO2 levels. The primary outcome was 7-day mortality. METHODS This register-based cohort study included patients with one or more prehospital blood gas analyses during their prehospital treatment by a physician-manned MECU, from January 2015 to December 2018. The blood samples were analyzed on an ABL90 Flex analyzer. Absolute values with percentages and odds ratios (OR) with 95% confidence intervals (CI) were calculated for the primary and secondary outcomes within prespecified subgroups. RESULTS The study included 745 patients, with an overall 7-day mortality rate of 20.0%. LACTATE LEVEL The 7-day mortality rates were 11.5% in patients with normal lactate levels (< 2.0 mmol/L), 14.4% with intermediate lactate levels (2.0-3.9 mmol/L), and 33.0% with high lactate levels (≥ 4.0 mmol/L). This corresponded to an OR of 1.30 (95% CI: 0.75-2.24) in the intermediate lactate group (2.0-3.9 mmol/L) and an OR of 3.77 (95% CI: 2.44-5.85) in the high lactate group (≥ 4.0 mmol/L), compared to the reference group with normal lactate. PH LEVEL The ORs of 7-day mortality rates were 4.82 (95% CI: 3.00-7.75) in patients with blood pH of < 7.35 and 1.33 (95% CI: 0.65-2.72) in patients with blood pH > 7.45, compared to the reference group with normal pH (7.35-7.45). CO2 LEVEL : The ORs of 7-day mortality rates were 2.54 (95% CI: 1.45-4.46) in patients with blood CO2 of < 4.3 kPa and 2.62 (95% CI: 1.70-4.03) in patients with blood CO2 > 6.0 kPa, compared to the reference group with normal CO2 (4.3-6.0 kPa). CONCLUSIONS This study found a strong correlation between increasing 7-day mortality rates and high blood lactate levels, low levels of pH, and abnormal CO2 blood levels, in prehospital patients undergoing prehospital blood analysis.
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Affiliation(s)
- Louise Houlberg Walther
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark.
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | | | - Christian Backer Mogensen
- Emergency Medicine Research Unit, Hospital Soenderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark
| | - Erika Frischknecht Christensen
- Centre for Prehospital and Emergency Research, Aalborg University Hospital and Institute of Clinical Medicine, Aalborg University, Aalborg, Denmark
- Department of Emergency and Trauma Care, Center for Internal Medicine and Emergency Care, Aalborg University Hospital, Aalborg, Denmark
| | - Søren Mikkelsen
- The Prehospital Research Unit, Region of Southern Denmark, Odense University Hospital, Odense, Denmark
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
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Boonroumkaew P, Sadaow L, Janwan P, Rodpai R, Sanpool O, Buadee P, Suprom C, Thanchomnang T, Intapan PM, Maleewong W. Improved diagnostic sensitivity of human strongyloidiasis using point-of-care mixed recombinant antigen-based immunochromatography. Parasite 2023; 30:60. [PMID: 38099622 PMCID: PMC10723528 DOI: 10.1051/parasite/2023063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/25/2023] [Indexed: 12/17/2023] Open
Abstract
Strongyloidiasis is a neglected tropical disease that can cause fatal complications due to hyperinfection and disseminated strongyloidiasis in immunocompromised patients. We used two Strongyloides stercoralis recombinant antigenic proteins, L3NieAg.01 (NIE) and IgG-immunoreactive antigen (SsIR), to develop the recombinant antigen-based immunochromatography test (ICT) kit. We constructed and compared kits using either the NIE (NIE ICT kit) or the SsIR (SsIR ICT kit) antigens and a kit using a mixture of both (NIE-SsIR ICT kit) for detection of anti-Strongyloides IgG antibody in human serum samples. Serum samples from normal healthy individuals (Group I, n = 40), proven strongyloidiasis patients (Group II, n = 100), and those with other parasitic infections (Group III, n = 154) were evaluated. Sensitivity and specificity were 81.0% and 84.0% for the NIE ICT kit, 89.0% and 83.5% for the SsIR ICT kit, and 95.0% and 90.2% for the NIE-SsIR ICT kit, respectively. The NIE-SsIR ICT kit provided the best diagnostic results; it can supplement stool examination for clinical diagnosis and can be used to screen for asymptomatic S. stercoralis infection in people at risk in endemic areas. The NIE-SsIR ICT kit can also be used in large-scale sero-epidemiological investigations in endemic areas without the need for additional facilities or ancillary supplies.
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Affiliation(s)
- Patcharaporn Boonroumkaew
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Lakkhana Sadaow
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Penchom Janwan
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
- Department of Medical Technology, School of Allied Health Sciences, Walailak University 80161 Nakhon Si Thammarat Thailand
- Hematology and Transfusion Science Research Center, Walailak University 80161 Nakhon Si Thammarat Thailand
| | - Rutchanee Rodpai
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Oranuch Sanpool
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Punyisa Buadee
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Chanida Suprom
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Tongjit Thanchomnang
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
- Faculty of Medicine, Mahasarakham University 44000 Maha Sarakham Thailand
| | - Pewpan M. Intapan
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
| | - Wanchai Maleewong
- Department of Parasitology, Faculty of Medicine, Khon Kaen University 40002 Khon Kaen Thailand
- Mekong Health Science Research Institute, Khon Kaen University 40002 Khon Kaen Thailand
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Blanco P, Abdo-Cuza A, Palomares EA, Díaz CM, Gutiérrez VF. Ultrasonography and procedures in intensive care medicine. Med Intensiva 2023; 47:717-732. [PMID: 38035918 DOI: 10.1016/j.medine.2023.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/20/2023] [Indexed: 12/02/2023]
Abstract
The use of point-of-care ultrasonography (POCUS) is not limited to the diagnosis and/or monitoring of critically ill patients. Further, ultrasound guidance is of paramount relevance to aid in successfully and safely performing several procedures in the intensive care unit (ICU). In this article, we review the role of POCUS as a procedural guidance in the ICU. Core procedures include, but are not limited to, vascular cannulation, pericardiocentesis, thoracentesis, paracentesis, aspiration of soft-tissue collections/arthrocentesis and lumbar puncture. With time, the procedures performed by intensivists may extend beyond the core competencies depicted in this review. Ultrasound guidance should be part of the intensivist's competencies, for which appropriate training should be achieved.
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Affiliation(s)
- Pablo Blanco
- High Dependency Unit, Hospital "Dr. Emilio Ferreyra", Necochea, Argentina.
| | | | | | - Cristina Martínez Díaz
- Intensive Care Unit, Hospital Universitario "Príncipe de Asturias Alcalá de Henares", Madrid, Spain
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50
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Sharma VJ, Green A, McLean A, Adegoke J, Gordon CL, Starkey G, D'Costa R, James F, Afara I, Lal S, Wood B, Raman J. Towards a point-of-care multimodal spectroscopy instrument for the evaluation of human cardiac tissue. Heart Vessels 2023; 38:1476-1485. [PMID: 37608153 PMCID: PMC10602956 DOI: 10.1007/s00380-023-02292-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 07/13/2023] [Indexed: 08/24/2023]
Abstract
To demonstrate that point-of-care multimodal spectroscopy using Near-Infrared (NIR) and Raman Spectroscopy (RS) can be used to diagnose human heart tissue. We generated 105 spectroscopic scans, which comprised 4 NIR and 3 RS scans per sample to generate a "multimodal spectroscopic scan" (MSS) for each heart, done across 15 patients, 5 each from the dilated cardiomyopathy (DCM), Ischaemic Heart Disease (IHD) and Normal pathologies. Each of the MSS scans was undertaken in 3 s. Data were entered into machine learning (ML) algorithms to assess accuracy of MSS in diagnosing tissue type. The median age was 50 years (IQR 49-52) for IHD, 47 (IQR 45-50) for DCM and 36 (IQR 33-52) for healthy patients (p = 0.35), 60% of which were male. MSS identified key differences in IHD, DCM and normal heart samples in regions typically associated with fibrosis and collagen (NIR wavenumbers: 1433, 1509, 1581, 1689 and 1725 nm; RS wavelengths: 1658, 1450 and 1330 cm-1). In principal component (PC) analyses, these differences explained 99.2% of the variation in 4 PCs for NIR, 81.6% in 10 PCs for Raman, and 99.0% in 26 PCs for multimodal spectroscopic signatures. Using a stack machine learning algorithm with combined NIR and Raman data, our model had a precision of 96.9%, recall of 96.6%, specificity of 98.2% and Area Under Curve (AUC) of 0.989 (Table 1). NIR and Raman modalities alone had similar levels of precision at 94.4% and 89.8% respectively (Table 1). MSS combined with ML showed accuracy of 90% for detecting dilated cardiomyopathy, 100% for ischaemic heart disease and 100% for diagnosing healthy tissue. Multimodal spectroscopic signatures, based on NIR and Raman spectroscopy, could provide cardiac tissue scans in 3-s to aid accurate diagnoses of fibrosis in IHD, DCM and normal hearts. Table 1 Machine learning performance metrics for validation data sets of (a) Near-Infrared (NIR), (b) Raman and (c and d) multimodal data using logistic regression (LR), stochastic gradient descent (SGD) and support vector machines (SVM), with combined "stack" (LR + SGD + SVM) AUC Precision Recall Specificity (a) NIR model Logistic regression 0.980 0.944 0.933 0.967 SGD 0.550 0.281 0.400 0.700 SVM 0.840 0.806 0.800 0.900 Stack 0.933 0.794 0.800 0.900 (b) Raman model Logistic regression 0.985 0.940 0.929 0.960 SGD 0.892 0.869 0.857 0.932 SVM 0.992 0.940 0.929 0.960 Stack 0.954 0.869 0.857 0.932 (c) MSS: multimodal (NIR + Raman) to detect DCM vs. IHD vs. normal patients Logistic regression 0.975 0.841 0.828 0.917 SGD 0.847 0.803 0.793 0.899 SVM 0.971 0.853 0.828 0.917 Stack 0.961 0.853 0.828 0.917 (d) MSS: multimodal (NIR + Raman) to detect pathological vs. normal patients Logistic regression 0.961 0.969 0.966 0.984 SGD 0.944 0.967 0.966 0.923 SVM 1.000 1.000 1.000 1.000 Stack 1.000 0.944 0.931 0.969 Bold values indicate values obtained from the stack algorithm and used for analyses.
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Affiliation(s)
- Varun J Sharma
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia.
- Brian F. Buxton Department of Cardiac Surgery, Austin Hospital, Melbourne, Australia.
- Spectromix Laboratory, Melbourne, VIC, Australia.
| | - Alexander Green
- Spectromix Laboratory, Melbourne, VIC, Australia
- Monash Biospectroscopy, Monash University, Melbourne, Australia
| | - Aaron McLean
- Spectromix Laboratory, Melbourne, VIC, Australia
- Monash Biospectroscopy, Monash University, Melbourne, Australia
| | - John Adegoke
- Spectromix Laboratory, Melbourne, VIC, Australia
- Monash Biospectroscopy, Monash University, Melbourne, Australia
| | - Claire L Gordon
- Department of Infectious Diseases, Austin Health, Melbourne, VIC, Australia
- Department of Microbiology and Immunology, The University of Melbourne, The Peter Doherty Institute for Infection and Immunity, Melbourne, VIC, Australia
- North Eastern Public Health Unit, Austin Health, Melbourne, VIC, Australia
| | - Graham Starkey
- Liver Transplant Unit, Austin Hospital, Melbourne, Australia
| | - Rohit D'Costa
- DonateLife Victoria, Carlton, Melbourne, VIC, Australia
- Department of Intensive Care Medicine, Melbourne Health, Melbourne, VIC, Australia
| | - Fiona James
- Department of Infectious Diseases, Austin Health, Melbourne, VIC, Australia
- North Eastern Public Health Unit, Austin Health, Melbourne, VIC, Australia
| | - Isaac Afara
- School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia
| | - Sean Lal
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Bayden Wood
- Spectromix Laboratory, Melbourne, VIC, Australia
- Monash Biospectroscopy, Monash University, Melbourne, Australia
| | - Jaishankar Raman
- Department of Surgery, Melbourne Medical School, University of Melbourne, Melbourne, Australia
- Brian F. Buxton Department of Cardiac Surgery, Austin Hospital, Melbourne, Australia
- Spectromix Laboratory, Melbourne, VIC, Australia
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