Portable Breath-Based Volatile Organic Compound Monitoring for the Detection of COVID-19 During the Circulation of the SARS-CoV-2 Delta Variant and the Transition to the SARS-CoV-2 Omicron Variant.

Importance: Breath analysis has been explored as a noninvasive means to detect COVID-19. However, the impact of emerging variants of SARS-CoV-2, such as Omicron, on the exhaled breath profile and diagnostic accuracy of breath analysis is unknown. Objective: To evaluate the diagnostic accuracies of breath analysis on detecting patients with COVID-19 when the SARS-CoV-2 Delta and Omicron variants were most prevalent. Design, Setting, and Participants: This diagnostic study included a cohort of patients who had positive and negative test results for COVID-19 using reverse transcriptase polymerase chain reaction between April 2021 and May 2022, which covers the period when the Delta variant was overtaken by Omicron as the major variant. Patients were enrolled through intensive care units and the emergency department at the University of Michigan Health System. Patient breath was analyzed with portable gas chromatography. Main Outcomes and Measures: Different sets of VOC biomarkers were identified that distinguished between COVID-19 (SARS-CoV-2 Delta and Omicron variants) and non-COVID-19 illness. Results: Overall, 205 breath samples from 167 adult patients were analyzed. A total of 77 patients (mean [SD] age, 58.5 [16.1] years; 41 [53.2%] male patients; 13 [16.9%] Black and 59 [76.6%] White patients) had COVID-19, and 91 patients (mean [SD] age, 54.3 [17.1] years; 43 [47.3%] male patients; 11 [12.1%] Black and 76 [83.5%] White patients) had non-COVID-19 illness. Several patients were analyzed over multiple days. Among 94 positive samples, 41 samples were from patients in 2021 infected with the Delta or other variants, and 53 samples were from patients in 2022 infected with the Omicron variant, based on the State of Michigan and US Centers for Disease Control and Prevention surveillance data. Four VOC biomarkers were found to distinguish between COVID-19 (Delta and other 2021 variants) and non-COVID-19 illness with an accuracy of 94.7%. However, accuracy dropped substantially to 82.1% when these biomarkers were applied to the Omicron variant. Four new VOC biomarkers were found to distinguish the Omicron variant and non-COVID-19 illness (accuracy, 90.9%). Breath analysis distinguished Omicron from the earlier variants with an accuracy of 91.5% and COVID-19 (all SARS-CoV-2 variants) vs non-COVID-19 illness with 90.2% accuracy. Conclusions and Relevance: The findings of this diagnostic study suggest that breath analysis has promise for COVID-19 detection. However, similar to rapid antigen testing, the emergence of new variants poses diagnostic challenges. The results of this study warrant additional evaluation on how to overcome these challenges to use breath analysis to improve the diagnosis and care of patients.

Accuracy of Predicting One-Repetition Maximum from Submaximal Velocity in The Barbell Back Squat and Bench Press.

This study examined the accuracy of predicting a free-weight back squat and a bench press one-repetition maximum (1RM) using both 2- and 4-point submaximal average concentric velocity (ACV) methods. Seventeen resistance trained men performed a warm-up and a 1RM test on the squat and bench press with ACV assessed on all repetitions. The ACVs during the warm-up closest to 1.0 and 0.5m.s-1 were used in the 2-point linear regression forecast of the 1RM and the ACVs established at loads closest to 20, 50, 70, and 80% of the 1RM were used in the 4-point 1RM prediction. Repeated measures ANOVA and Bland-Altman and Mountain plots were used to analyze agreement between predicted and actual 1RMs. ANOVA indicated significant differences between the predicted and the actual 1RM for both the 2- and 4-point equations in both exercises (p<0.001). The 2-point squat prediction overestimated the 1RM by 29.12±0.07kg and the 4-point squat prediction overestimated the 1RM by 38.53±5.01kg. The bench press 1RM was overestimated by 9.32±4.68kg with the 2-point method and by 7.15±6.66kg using the 4-point method. Bland-Altman and Mountain plots confirmed the ANOVA findings as data were not tightly conformed to the respective zero difference lines and Bland-Altman plots showed wide limits of agreement. These data demonstrate that both 2- and 4-point velocity methods predicted the bench press 1RM more accurately than the squat 1RM. However, a lack of agreement between the predicted and the actual 1RM was observed for both exercises when volitional velocity was used.

Near field communication (NFC) device: Evaluation of MRI issues.

OBJECTIVE: Near field communication (NFC) is a wireless, short-range, secure communication technology that may be used for healthcare-related applications. An NFC device was recently developed that was intended for implantation in the dorsal fascia, above the interosseous compartment of the hand. This implant uses a ferrite rod to increase the distance of communication between devices. The purpose of this investigation was to evaluate MRI issues for this NFC device using standardized techniques and well-accepted methodology. METHODS: The NFC device (Vivokey Spark 2, Cryptobionic Implant, Vivokey Technologies, www.vivokey.com) was assessed for magnetic field interactions (force and torque) at 3-Tesla, magnetic field interactions according to the simulated intended use of the implant, MRI-related heating at 1.5-Tesla/64-MHz and 3-Tesla/128-MHz, functional change associated with MRI conditions at 1.5-Tesla/64-MHz and 3-Tesla/128-MHz, and artifacts at 3-Tesla. RESULTS: The mean deflection angle was 90° ± 0 and torque was "positive". However, tests evaluating the simulated intended use of the NFC device demonstrated no movement, displacement, or rotational alignment. The highest temperature changes at 1.5-Tesla/64-MHz and 3-Tesla/128-MHz were 1.7 °C and 1.9 °C, respectively. There was no change in the operational capabilities of the NFC device related to the MRI exposures. Artifacts were relatively large in comparison to the size of the NFC device. CONCLUSIONS: The findings indicated that the particular NFC device that underwent evaluation is "MR Conditional" for a patient undergoing MRI at 1.5-Tesla or 3-Tesla, operating the scanner in the Normal Operating Mode (i.e., default whole-body averaged SAR of 2.0-W/kg). Notably, this is the first NFC device evaluated for MRI-related issues.