POC

PoC
  • 文章类型: Journal Article
    脑膜炎的快速准确诊断对于预防严重并发症和死亡至关重要。这项研究通过开发一种新型的诊断方法,解决了在没有专用设备的情况下对可访问诊断的需求。该测定利用具有独特内部引物的双引发等温扩增(DAMP)来显著降低非特异性。对于荧光检测,染料选自亮绿,硫黄素T,dsGreen由于其可用性,BrilliantGreen是该测定的首选,高荧光水平,和最佳样本背景比(S/B)。该测定法用于检测脑膜炎的主要病原体(流感嗜血杆菌,脑膜炎奈瑟菌,和肺炎链球菌),并在临床样本上进行了测试。所开发的方法具有很高的特异性,没有误报,灵敏度与环介导等温扩增(LAMP)相当,和高S/B比。这种多功能测定可用作独立测试或集成测定到即时护理系统中,以进行快速可靠的病原体检测。
    The rapid and accurate diagnosis of meningitis is critical for preventing severe complications and fatalities. This study addresses the need for accessible diagnostics in the absence of specialized equipment by developing a novel diagnostic assay. The assay utilizes dual-priming isothermal amplification (DAMP) with unique internal primers to significantly reduce non-specificity. For fluorescence detection, the dye was selected among Brilliant Green, Thioflavin T, and dsGreen. Brilliant Green is preferred for this assay due to its availability, high fluorescence level, and optimal sample-to-background (S/B) ratio. The assay was developed for the detection of the primary causative agents of meningitis (Haemophilus influenzae, Neisseria meningitidis, and Streptococcus pneumoniae), and tested on clinical samples. The developed method demonstrated high specificity, no false positives, sensitivity comparable to that of loop-mediated isothermal amplification (LAMP), and a high S/B ratio. This versatile assay can be utilized as a standalone test or an integrated assay into point-of-care systems for rapid and reliable pathogen detection.
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  • 文章类型: Journal Article
    核酸测试是检测和诊断许多疾病的关键工具。在许多情况下,核酸的扩增需要达到可检测的水平。为了使核酸扩增测试更易于即时(POC)设置,等温扩增可以用简单的加热源进行。尽管这些测试是在本体反应中进行的,定量不如数字扩增准确。这里,我们介绍了振动尖端毛细管的使用,用于可按需可调液滴生成的简单便携式系统。由于可能的液滴尺寸范围很大,并且振动的尖端毛细管具有可调性,已开发出高动态范围(〜2至6000拷贝/µL)数字液滴环介导等温扩增(ddLAMP)系统。还指出,通过改变振动尖端毛细管上的毛细管类型,相同的机制可以用于简单和便携式的DNA片段化。随着这些元素的结合,目前的工作为在资源有限的POC环境中实现数字核酸测试铺平了道路。
    Nucleic acid tests are key tools for the detection and diagnosis of many diseases. In many cases, the amplification of the nucleic acids is required to reach a detectable level. To make nucleic acid amplification tests more accessible to a point-of-care (POC) setting, isothermal amplification can be performed with a simple heating source. Although these tests are being performed in bulk reactions, the quantification is not as accurate as it would be with digital amplification. Here, we introduce the use of the vibrating sharp-tip capillary for a simple and portable system for tunable on-demand droplet generation. Because of the large range of droplet sizes possible and the tunability of the vibrating sharp-tip capillary, a high dynamic range (~2 to 6000 copies/µL) digital droplet loop-mediated isothermal amplification (ddLAMP) system has been developed. It was also noted that by changing the type of capillary on the vibrating sharp-tip capillary, the same mechanism can be used for simple and portable DNA fragmentation. With the incorporation of these elements, the present work paves the way for achieving digital nucleic acid tests in a POC setting with limited resources.
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  • 文章类型: Journal Article
    目的:研究客观表达上眼睑轮廓对称性的最合适的数学公式。
    方法:研究纳入31例患者的62只眼。患者的上眼睑轮廓对称性被主观归类为不良(与MR1无关),可接受,并由三名眼塑专家(高级,专家,和初级外科医生)。用ImageJ软件绘制上眼睑轮廓的贝塞尔曲线(NIH,贝塞斯达,MA,美国)。使用作者SKC在Spyder中创建的算法(Python3.7.9.),根据y轴获得左眼睑的贝塞尔曲线的对称性,两只眼睛的中瞳孔重叠。较低的曲线垂直移动到与另一条曲线相同的高度,以使MRD1相等。R2(测定系数),RMSE(均方根误差),MSE(均方误差),POC(协同效率百分比),并计算MAE(平均绝对误差)。我们使用Spearman的rho(ρ)评估了这些客观公式与三名外科医生的主观评分之间的相关性。
    结果:所有外科医生分级的RMSE和MSE的相关系数相同。高级外科医生的主观评分(N;差=8,可接受=16,好=8)与R2,RMSE,POC,MAE(分别为ρ=0.643,p<0.001,ρ=-0.607,p<0.001,ρ=0.562,p<0.001,ρ=-0.517,p<0.001)。我们发现专家外科医生的主观评分(N;差=9,可接受=13,好:10)和R2(ρ=0.611,p<0.001)之间存在很强的关系,RMSE(ρ=-0.549,p<0.001),POC(ρ=0.511,p<0.001),和MAE(ρ=-0.450,p<0.05)。我们发现初级外科医生的主观评分(N;差=6,可接受=18,好=8)和R2,RMSE,和POC(ρ:-0.517,p<0.001;ρ:-0.470,p<0.001;ρ:0.521,p<0.001;分别)和MAE之间的中等相关性(ρ:-0.394,p<0.05)。用R2观察到最高的相关性。
    结论:RMSE,MSE,POC,MAE,尤其是R2,可以定量表达上眼睑轮廓对称性,与眼整形外科医生相当。在高级外科医生和R2之间观察到最高的相关性,并且随着外科医生的经验而降低。
    OBJECTIVE: Investigate the most appropriate mathematical formula to objectively express upper eyelid contour symmetry.
    METHODS: 62 eyes of 31 patients were included in the study. The upper eyelid contour symmetry of the patients was classified subjectively (independent of MRD1) as poor, acceptable, and good by three oculoplastic specialists (senior, expert, and junior surgeon). Bézier curves of the upper lid contour were drawn with ImageJ software (NIH, Bethesda, MA, USA). Using the algorithms created by Author SKC in Spyder (Python 3.7.9.), the symmetry of the Bézier curves of the left eyelids were obtained according to the y-axis, and the mid-pupils of both eyes were superimposed. The lower curve moved vertically to the equal height of the other curve to equalize MRD1\'s. R2 (Coefficient of determination), RMSE (Root-mean-square error), MSE (Mean squared error), POC (Percentage of co-efficiency), and MAE (Mean absolute error) were calculated. We evaluated the correlation between these objective formulas and the subjective grading of three surgeons using Spearman\'s rho (ρ).
    RESULTS: The correlation coefficient of RMSE and MSE were the same for all surgeons grading. There was a strong correlation between the senior surgeon\'s subjective scoring (N; poor = 8, acceptable = 16, good = 8) and R2, RMSE, POC, MAE (ρ = 0.643, p < 0.001, ρ = -0.607, p < 0.001, ρ = 0.562, p < 0.001, ρ = -0.517, p < 0.001, respectively). We found a strong relationship between the expert surgeon\'s subjective scoring (N; poor = 9, acceptable = 13, good:10) and R2 (ρ = 0.611, p < 0.001), RMSE (ρ = -0.549, p < 0.001), POC (ρ = 0.511, p < 0.001), and MAE (ρ = -0.450, p < 0.05). We found a strong correlation between junior surgeon\'s subjective scoring (N; poor = 6, acceptable = 18, good = 8) and R2, RMSE, and POC (ρ: -0.517, p < 0.001; ρ: -0.470, p < 0.001; ρ: 0.521, p < 0.001; respectively) and moderate correlation between MAE (ρ:-0.394, p < 0.05). The highest correlation is observed with R2.
    CONCLUSIONS: RMSE, MSE, POC, MAE, and especially R2, may quantitatively express upper eyelid contour symmetry, comparable with the oculoplastic surgeon. The highest correlation was observed between the senior surgeon and R2, and decreases with the experience of the surgeon.
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  • 文章类型: Journal Article
    寡核苷酸探针标记和逆转录酶聚合酶链反应(RT-PCR)是目前用于检测和分析RNA的最广泛使用的技术。使用标记的基于寡核苷酸探针的方法进行RNA检测适用于即时护理(POC)应用,但缺乏测定灵敏度,而RT-PCR需要复杂的仪器。作为替代,已经提出了与等温RNA扩增技术耦合的免疫测定检测格式用于手持测定开发。在这一章中,我们描述了一种强大的技术,其包括:(a)用互补寡核苷酸探针标记靶RNA,所述互补寡核苷酸探针用半抗原部分标记以形成DNA/RNA双链体杂交体;(b)将DNA/RNA双链体与针对半抗原部分的预包被抗体(Ab)复合;(c)与选择性识别DNA/RNA结构基序的Ab形成夹心复合物;和(d)使用第二抗体免疫吸附酶连接的RNA缀合物,随后
    Oligonucleotide probe tagging and reverse transcriptase polymerase-chain reaction (RT-PCR) are the most widely used techniques currently used for detecting and analyzing RNA. RNA detection using labeled oligonucleotide probe-based approaches is suitable for point-of-care (POC) applications but lacks assay sensitivity, whereas RT-PCR requires complex instrumentation. As an alternative, immunoassay detection formats coupled with isothermal RNA amplification techniques have been proposed for handheld assay development. In this chapter, we describe a robust technique comprising of: (a) target RNA tagging with a complementary oligonucleotide probe labeled with a hapten moiety to form a DNA/RNA duplex hybrid; (b) complexing the DNA/RNA duplex with a pre-coated antibody (Ab) directed at the hapten moiety; (c) sandwich complex formation with an Ab that selectively recognizes the DNA/RNA structural motif; and (d) detection of the sandwich complex using a secondary Ab enzyme conjugate targeting the anti-DNA/RNA Ab followed by standard enzyme-linked immunosorbent assay (ELISA) visualization.
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  • 文章类型: Journal Article
    丙烯酰胺(AA),一种无味无色有机小分子化合物,通常存在于热加工食品中,具有潜在的致癌性,神经毒性,生殖,和发育毒性。与传统的AA检测方法相比,近年来,生物/化学传感器由于其可靠性而引起了人们的极大兴趣,灵敏度,选择性,便利性,和低成本。本文提供了在过去十年中用于检测AA的生物/化学传感器的全面综述。具体来说,从感知机制的角度对内容进行总结和系统组织,选择性状态,线性范围,检测限,和鲁棒性。随后,随之而来的是对各种分析技术的优势和局限性的分析,在这篇综述的结论中,有助于深入讨论热加工食品中AA检测的即时护理(POC)的潜在发展。
    Acrylamide (AA), an odorless and colorless organic small-molecule compound found generally in thermally processed foods, possesses potential carcinogenic, neurotoxic, reproductive, and developmental toxicity. Compared with conventional methods for AA detection, bio/chemical sensors have attracted much interest in recent years owing to their reliability, sensitivity, selectivity, convenience, and low cost. This paper provides a comprehensive review of bio/chemical sensors utilized for the detection of AA over the past decade. Specifically, the content is concluded and systematically organized from the perspective of the sensing mechanism, state of selectivity, linear range, detection limits, and robustness. Subsequently, an analysis of the strengths and limitations of diverse analytical technologies ensues, contributing to a thorough discussion about the potential developments in point-of-care (POC) for AA detection in thermally processed foods at the conclusion of this review.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    基于实验室的侧流(LF)测试,利用上转换报告颗粒(UCP)对尿液中的血吸虫循环阳极抗原(CAA)进行超灵敏定量,是一种公认的测试,可用于识别活动性感染。然而,此UCP-LFCAA测试需要与现场应用不兼容的样品预处理步骤。流量,一种新的低成本一次性,允许将大量预浓缩的尿液分析物和LF检测集成到单个现场可部署的装置中。我们评估了带有集成UCP-LFCAA测试条的原型流血吸虫(Flow-S)装置,省略所有基于实验室的步骤,能够使用尿液在现场诊断活动性血吸虫感染。Flow-S专为大容量(5-20mL)尿液而设计,应用被动纸基过滤和基于抗体的CAA浓度。血吸虫感染的样本是从居住在坦桑尼亚地区的育龄妇女那里收集的,那里的血吸虫感染是地方性的。15个阴性和15个阳性尿样,根据配对血清中定量的CAA水平选择,用原型Flow-S进行了分析。当前的Flow-S原型,分析检测下限为1pgCAA/mL,产生的结果与基于实验室的UCP-LFCAA测试相关。尿液沉淀发生在冷冻库存样品中,影响了准确的定量;然而,这不应该发生在新鲜尿液中。根据这项研究的结果,Flow-S似乎适合取代基于实验室的UCP-LFCAA测试所需的尿液预处理,从而允许真正的现场应用与新鲜的尿样。用冷冻样品观察到的尿液沉淀,尽管考虑到测试新鲜尿液的目标不那么重要,需要进行额外的调查,以评估缓解方法。Flow-S设备允许对合并的尿液样本进行测试,并应用于人群分层测试。用新鲜尿液样本进行现场测试,进一步优化的Flow-S装置,并且已经安排了更大的统计能力。
    A laboratory-based lateral flow (LF) test that utilizes up-converting reporter particles (UCP) for ultrasensitive quantification of Schistosoma circulating anodic antigen (CAA) in urine is a well-accepted test to identify active infection. However, this UCP-LF CAA test requires sample pre-treatment steps not compatible with field applications. Flow, a new low-cost disposable, allows integration of large-volume pre-concentration of urine analytes and LF detection into a single field-deployable device. We assessed a prototype Flow-Schistosoma (Flow-S) device with an integrated UCP-LF CAA test strip, omitting all laboratory-based steps, to enable diagnosis of active Schistosoma infection in the field using urine. Flow-S is designed for large-volume (5-20 mL) urine, applying passive paper-based filtration and antibody-based CAA concentration. Samples tested for schistosome infection were collected from women of reproductive age living in a Tanzania region where S. haematobium infection is endemic. Fifteen negative and fifteen positive urine samples, selected based on CAA levels quantified in paired serum, were analyzed with the prototype Flow-S. The current Flow-S prototype, with an analytical lower detection limit of 1 pg CAA/mL, produced results correlated with the laboratory-based UCP-LF CAA test. Urine precipitates occurred in frozen banked samples and affected accurate quantification; however, this should not occur in fresh urine. Based on the findings of this study, Flow-S appears suitable to replace the urine pre-treatment required for the laboratory-based UCP-LF CAA test, thus allowing true field-based applications with fresh urine samples. The urine precipitates observed with frozen samples, though less important given the goal of testing fresh urines, warrant additional investigation to evaluate methods for mitigation. Flow-S devices permit testing of pooled urine samples with applications for population stratified testing. A field test with fresh urine samples, a further optimized Flow-S device, and larger statistical power has been scheduled.
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  • 文章类型: Journal Article
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  • 文章类型: Journal Article
    脓毒症是一种危及生命的疾病,如果诊断和干预延迟,这是不可逆转的。免疫细胞对感染的反应通过细胞因子的产生引发广泛的炎症,这可能导致多器官功能障碍和最终死亡。常规检测技术由于其有限的灵敏度和冗长的方案而不能提供快速诊断。这项研究提出了一种即时(POC)电化学生物传感器,通过与电动力学的整合,克服了临床环境中当前生物传感技术的局限性。与当前诊断技术的纳克极限相比,提高了对皮克水平的敏感性。这种生物传感器促进了微电极条的使用,以解决常规光刻制造方法的局限性。肿瘤坏死因子-α(TNF-α),白细胞介素-6(IL-6),在脂多糖(LPS)诱导的脓毒症小鼠模型中监测microRNA-155(miR-155)。与传统的酶联免疫吸附测定(ELISA)的4小时检测时间相比,在高电导率介质中观察到的最佳靶杂交时间为60s,导致整个操作在5分钟内完成。计算的检测限(LOD)分别为0.84、0.18和0.0014pgmL-1。这种新型传感器可能具有在临床环境中早期诊断败血症的潜力。
    Sepsis is a life-threatening condition, which is irreversible if diagnosis and intervention are delayed. The response of the immune cells towards an infection triggers widespread inflammation through the production of cytokines, which may result in multiple organ dysfunction and eventual death. Conventional detection techniques fail to provide a rapid diagnosis because of their limited sensitivity and tedious protocol. This study proposes a point-of-care (POC) electrochemical biosensor that overcomes the limitations of current biosensing technologies in the clinical setting by its integration with electrokinetics, enhancing the sensitivity to picogram level compared with the nanogram limit of current diagnostic technologies. This biosensor promotes the use of a microelectrode strip to address the limitations of conventional photolithographic fabrication methods. Tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), and microRNA-155 (miR-155) were monitored in a lipopolysaccharide (LPS)-induced septic mouse model. The optimum target hybridization time in a high conductivity medium was observed to be 60 s leading to the completion of the whole operation within 5 min compared with the 4-h detection time of the traditional enzyme-linked immunosorbent assay (ELISA). The limit of detection (LOD) was calculated to be 0.84, 0.18, and 0.0014 pg mL-1, respectively. This novel sensor may have potential for the early diagnosis of sepsis in the clinical setting.
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  • 文章类型: Journal Article
    HIV病毒RNA定量的护理点似乎是现有常规系统的补充策略。这项研究评估了m-PIMA™HIV1/2病毒载量对HIV-1和HIV-2RNA病毒载量的定量的性能。先前由雅培RealTimeHIV-1(雅培,芝加哥,美国)和通用HIV-2®收费病毒(生物中心,法国)在塞内加尔的HIV国家参考实验室使用m-PIMA™HIV1/2病毒载量进行了测试。对于HIV-1,皮尔逊相关性和Bland-Altman图显示,m-PIMA™HIV1/2病毒载量的系数r=0.97,偏倚为-0.11log10拷贝/ml(95%置信区间[CI]:-0.086至-0.133log10拷贝/ml),分别。3log10拷贝/ml(病毒学失败阈值)时的敏感性和特异性分别为93.6%(95%[CI]:91.5%至95.6%)和99.1%(95%[CI]:98.3%至99.9%),分别。对于HIV-2,还注意到r=0.95的相关性,偏倚为-0.229log10拷贝/ml(95%[CI]:-0.161至-0.297log10拷贝/ml)。3log10拷贝/ml时的敏感性和特异性分别为97.6%(95%[CI]:94.3%至100%)和93.9%(95%[CI]:88.9%至98.8%),分别。这些结果证实,m-PIMA™HIV1/2VL可能是塞内加尔分散环境中HIV-1和HIV-2病毒载量测试的良好替代方案。
    Point-of-Care for HIV viral RNA quantification seems to be a complementary strategy to the existing conventional systems. This study evaluated the performance of the m-PIMA™ HIV1/2 Viral Load for the quantification of both HIV-1 and HIV-2 RNA viral load. A total of 555 HIV-1 and 90 HIV-2 samples previously tested by Abbott RealTime HIV-1 (Abbott, Chicago, USA) and Generic HIV-2® Charge virale (Biocentric, France) were tested using the m-PIMA™ HIV1/2 Viral Load at the HIV National Reference lab in Senegal. For HIV-1, Pearson correlation and Bland-Altman plots showed a coefficient r = 0.97 and a bias of -0.11 log10 copies/ml (95% confidence interval [CI]: -0.086 to -0.133 log10 copies/ml) for the m-PIMA™ HIV1/2 Viral Load, respectively. Sensitivity and specificity at 3 log10 copies/ml (threshold of virological failure) were 93.6% (95%[CI]: 91.5% to 95.6%) and 99.1% (95%[CI]: 98.3% to 99.9%), respectively. For HIV-2, a correlation of r = 0.95 was also noted with a bias of - 0.229 log10 copies/ml (95%[CI]: -0.161 to -0.297 log10 copies/ml). Sensitivity and specificity at 3 log10 copies/ml were 97.6% (95%[CI]: 94.3% to 100%) and 93.9% (95%[CI]: 88.9% to 98.8%), respectively. These results confirmed that m-PIMA™ HIV1/2 VL could be a good alternative for HIV-1 and HIV-2 viral load testing in decentralized settings in Senegal.
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