Paper-Based procalcitonin and Interleukin-6 test strip with Spectrum-Based optical reader for enterovirus severity differentiation in children.

Infectious diseases significantly impact global health, necessitating prompt diagnosis to mitigate life-threatening sepsis risk. Identifying patients at risk of severe neurological complications from enterovirus infections is challenging due to nonspecific initial presentations. Point-of-care testing (POCT) has emerged as a transformative tool, with low-cost lateral-flow colorimetric assays showing promise in deployable POCT devices. We developed a PCT/IL-6 rapid diagnostic system integrating lateral flow assay (LFA) test strips and a portable optical spectrum reader, allowing simultaneous semi-quantitative measurement of serum PCT and IL-6 within 30 min at the point of care. The system demonstrated a strong correlation with traditional ELISA and effectively differentiated severe pediatric enterovirus cases using serum samples. IL-6 showed superior discriminatory ability over PCT in identifying patients with severe neurological complications. This novel diagnostic platform holds great potential for early sepsis recognition and infectious disease management, especially in resource-limited settings.

Case report: Cytokine and miRNA profiling in multisystem inflammatory syndrome in children.

Multisystem inflammatory syndrome in children (MIS-C) is an imperative pediatric inflammatory condition closely linked to COVID-19, which garners substantial attention since the onset of the pandemic. Like Kawasaki illness, this condition is characterized by an overactive immune response, leading to symptoms including pyrexia, cardiac and renal complications. To elucidate the pathogenesis of MIS-C and identify potential biomarkers, we conducted an extensive examination of specific cytokines (IL-6, IL-1ß, IL-6R, IL-10, and TNF-α) and microRNA (miRNA) expression profiles at various intervals (ranging from 3 to 20 days) in the peripheral blood sample of a severely affected MIS-C patient. Our investigation revealed a gradual decline in circulating levels of IL-6, IL-1ß, IL-10, and TNF-α following intravenous immune globulin (IVIG) therapy. Notably, IL-6 exhibited a significant reduction from 74.30 to 1.49 pg./mL, while IL-6R levels remained consistently stable throughout the disease course. Furthermore, we observed an inverse correlation between the expression of hsa-miR-596 and hsa-miR-224-5p and the aforementioned cytokines. Our findings underscore a robust association between blood cytokine and miRNA concentrations and the severity of MIS-C. These insights enhance our understanding of the genetic regulatory mechanisms implicated in MIS-C pathogenesis, offering potential avenues for early biomarker detection and therapy monitoring through miRNA analysis.

Corrigendum: Efficacy of a paper-based interleukin-6 test strip combined with a spectrum-based optical reader for sequential monitoring and early recognition of respiratory failure in elderly pneumonia-a pilot study.

[This corrects the article DOI: 10.3389/fphar.2023.1166923.].

Cell-scale hemolysis evaluation of intervenient ventricular assist device based on dissipative particle dynamics.

Most of the existing hemolysis mechanism studies are carried out on the macro flow scale. They assume that the erythrocyte membranes with different loads will suffer the same damage, which obviously has limitations. Thus, exploring the hemolysis mechanism through the macroscopic flow field information is a tough challenge. In order to further understand the non-physiological shear hemolysis phenomenon at the cell scale, this study used the coarse-grained erythrocytes damage model at the mesoscopic scale based on the transport dissipative particle dynamics (tDPD) method. Combined with computational fluid dynamics the hemolysis of scalarized shear stress (τ) in the clearance of "Impella 5.0" was evaluated under the Lagrange perspective and Euler perspective. The results from the Lagrange perspective showed that the change rate of scaled shear stress (τ˙) was the most critical factor in damaging RBCs in the rotor region of "Impella 5.0"and other transvalvular micro-axial blood pumps. Then, we propose a dimensionless number Dk with time integration based on τ˙ to evaluate hemolysis. The Dissipative particle dynamics simulation results are consistent with the Dk evaluation results, so τ˙ may be an important factor in the hemolysis of VADs. Finally, we tested the hemolysis of 30% hematocrit whole blood in the "Impella 5.0" shroud clearance from the Euler perspective. Relevant results indicate that because of the wall effect, the RBCs near the impeller side are more prone to damage, and most of the cytoplasm is also gathered at the rotor side.

Full-scale numerical simulation of hemodynamics based on left ventricular assist device.

Ventricular assist devices have been widely used and accepted to treat patients with end-stage heart failure. The role of VAD is to improve circulatory dysfunction or temporarily maintain the circulatory status of patients. In order to be closer to the medical practice, a multi-Domain model of the left ventricular coupled axial flow artificial heart was considered to study the effect of its hemodynamics on the aorta. Because whether LVAD itself was connected between the left ventricular apex and the ascending aorta by catheter in the loop was not very important for the analysis of simulation results, on the premise of ensuring the multi-Domain simulation, the simulation data of the import and export ends of LVAD were imported to simplify the model. In this paper, the hemodynamic parameters in the ascending aorta, such as blood flow velocity vector, wall shear stress distribution, vorticity current intensity, vorticity flow generation, etc., have been calculated. The numerical conclusion of this study showed the vorticity intensity under LVAD was significantly higher than that under patients' conditions and the overall condition is similar to that of a healthy ventricular spin, which can improve heart failure patients' condition while minimizing other pitfalls. In addition, high velocity blood flow during left ventricular assist surgery is mainly concentrated near the lining of the ascending aorta lumen. What's more, the paper proposes to use Q criterion to determine the generation of vorticity flow. The Q criterion of LVAD is much higher than that of patients with heart failure, and the closer the LVAD is to the wall of the ascending aorta, the greater the Q criterion is. All these are beneficial to the effectiveness of LVAD in the treatment of heart failure patients and provide clinical suggestions for the LVAD implantation in clinical practice.

Case report: Distinct neurologic manifestation and cytokine profile of a child with COVID-19-associated acute fulminant encephalitis.

The neurologic manifestations of coronavirus disease 2019 (COVID-19) may range from mild symptoms such as headache or confusion to profound encephalopathy with variable outcomes and sequelae. Here, we reported a case of fatal COVID-19-associated encephalitis with acute fulminant cerebral edema, presenting first with visual hallucination and then a rapid progression into comatose status in a few hours. Serial brain computed tomography depicted cerebral edematous changes from bilateral ventral temporal lobe to the whole brain leading to brain herniation. Multiple cytokines in serum and cerebrospinal fluid (CSF) were increased, with a more prominent rise in the CSF. Therefore, we postulated a hypothesis regarding the mechanism of this fulminant encephalitis that the SARS-CoV-2 virus attacked ventral temporal lobes initially, triggered a severe cytokine storm, and then led to subsequent disruption of the blood-brain barrier, diffuse brain edema, and brain herniation. The trend of cytokine profiles over time may aid in diagnosing and evaluating the severity and prognosis of COVID-19-associated encephalitis.

Efficacy of a paper-based interleukin-6 test strip combined with a spectrum-based optical reader for sequential monitoring and early recognition of respiratory failure in elderly pneumonia-a pilot study.

Introduction: Community-acquired pneumonia (CAP) is lethal in elderly individuals who are more vulnerable to respiratory failure and require more emergency ventilation support than younger individuals. Interleukin-6 (IL-6) plays a crucial role and has predictive value in CAP; high serum IL-6 concentrations in adults are associated with high respiratory failure and mortality rates. Early detection of IL-6 concentrations can facilitate the timely stratification of patients at risk of acute respiratory failure. However, conventional enzyme-linked immunosorbent assay (ELISA) IL-6 measurement is laborious and time-consuming. Methods: The IL-6 rapid diagnostic system combined with a lateral flow immunoassay-based (LFA-based) IL-6 test strip and a spectrum-based optical reader is a novel tool developed for rapid and sequential bedside measurements of serum IL-6 concentrations. Here, we evaluated the correlation between the IL-6 rapid diagnostic system and the ELISA and the efficacy of the system in stratifying high-risk elderly patients with CAP. Thirty-six elderly patients (median age: 86.5 years; range: 65-97 years) with CAP were enrolled. CAP diagnosis was established based on the Infectious Diseases Society of America (IDSA) criteria. The severity of pneumonia was assessed using the CURB-65 score and Pneumonia Severity Index (PSI). IL-6 concentration was measured twice within 24 h of admission. Results: The primary endpoint variable was respiratory failure requiring invasive mechanical or non-invasive ventilation support after admission. IL-6 rapid diagnostic readouts correlated with ELISA results (p < 0.0001) for 30 samples. Patients were predominantly male and bedridden (69.4%). Ten patients (27.7%) experienced respiratory failure during admission, and five (13.9%) died of pneumonia. Respiratory failure was associated with a higher mortality rate (p = 0.015). Decreased serum IL-6 concentration within 24 h after admission indicated a lower risk of developing respiratory failure in the later admission course (Receiver Operating Characteristic [ROC] curve = 0.696). Conclusion: Sequential IL-6 measurements with the IL-6 rapid diagnostic system might be useful in early clinical risk assessment and severity stratification of elderly patients with pneumonia. This system is a potential point-of-care diagnostic device for sequential serum IL-6 measurements that can be applied in variable healthcare systems.

Microglia-mediated inflammatory destruction of neuro-cardiovascular dysfunction after stroke.

Stroke, a serious systemic inflammatory disease, features neurological deficits and cardiovascular dysfunction. Neuroinflammation is characterized by the activation of microglia after stroke, which disrupts the cardiovascular-related neural network and the blood-brain barrier. Neural networks activate the autonomic nervous system to regulate the cardiac and blood vessels. Increased permeability of the blood-brain barrier and the lymphatic pathways promote the transfer of the central immune components to the peripheral immune organs and the recruitment of specific immune cells or cytokines, produced by the peripheral immune system, and thus modulate microglia in the brain. In addition, the spleen will also be stimulated by central inflammation to further mobilize the peripheral immune system. Both NK cells and Treg cells will be generated to enter the central nervous system to suppress further inflammation, while activated monocytes infiltrate the myocardium and cause cardiovascular dysfunction. In this review, we will focus on microglia-mediated inflammation in neural networks that result in cardiovascular dysfunction. Furthermore, we will discuss neuroimmune regulation in the central-peripheral crosstalk, in which the spleen is a vital part. Hopefully, this will benefit in anchoring another therapeutic target for neuro-cardiovascular dysfunction.

Potential Application of the WST-8-mPMS Assay for Rapid Viable Microorganism Detection.

To ensure clean drinking water, viable pathogens in water must be rapidly and efficiently screened. The traditional culture or spread-plate process-the conventional standard for bacterial detection-is laborious, time-consuming, and unsuitable for rapid detection. Therefore, we developed a colorimetric assay for rapid microorganism detection using a metabolism-based approach. The reaction between a viable microorganism and the combination of 2-(2-methoxy-4-nitrophenyl)-3-(4-nitrophenyl)-5-(2,4-disulfophenyl)-2H-tetrazolium sodium salt (WST-8) and 1-methoxy-5-methylphenazinium methyl sulfate (mPMS) results in a color change. In combination with a microplate reader, WST-8-mPMS reactivity was leveraged to develop a colorimetric assay for the rapid detection of various bacteria. The detection limit of the WST-8-mPMS assay for both gram-negative and gram-positive bacteria was evaluated. This WST-8-mPMS assay can be used to perform colorimetrical semi-quantitative detection of various bacterial strains in buffers or culture media within 1 h without incubation before the reaction. The easy-to-use, robust, rapid, and sensitive nature of this novel assay demonstrates its potential for practical and medical use for microorganism detection.

The potential use of Zymomonas mobilis for the food industry.

Zymomonas mobilis is a gram-negative facultative anaerobic spore, which is generally recognized as a safe. As a promising ethanologenic organism for large-scale bio-ethanol production, Z. mobilis has also shown a good application prospect in food processing and food additive synthesis for its unique physiological characteristics and excellent industrial characteristics. It not only has obvious advantages in food processing and becomes the biorefinery chassis cell for food additives, but also has a certain healthcare effect on human health. Until to now, most of the research is still in theory and laboratory scale, and further research is also needed to achieve industrial production. This review summarized the physiological characteristics and advantages of Z. mobilis in food industry for the first time and further expounds its research status in food industry from three aspects of food additive synthesis, fermentation applications, and prebiotic efficacy, it will provide a theoretical basis for its development and applications in food industry. This review also discussed the shortcomings of its practical applications in the current food industry, and explored other ways to broaden the applications of Z. mobilis in the food industry, to promote its applications in food processing.

Potential applications of Zymomonas mobilis in food industry summarized for the first time.Research status of Z. mobilis in food additive synthesis, fermentation applications, and probiotics are discussed in details.Future research perspectives of Z. mobilis in food industry further proposed.

Preoperative MRI for postoperative seizure prediction: a radiomics study of dysembryoplastic neuroepithelial tumor and a systematic review.

OBJECTIVE: In this systematic review the authors aimed to evaluate the effectiveness and superiority of radiomics in detecting tiny epilepsy lesions and to conduct original research in the use of radiomics for preliminary prediction of postoperative seizures in patients with dysembryoplastic neuroepithelial tumor (DNET). METHODS: The PubMed and Web of Science databases were searched from the earliest record, January 1, 2018, to December 29, 2021, for reports of the detection of epilepsy using radiomics, and the resulting articles were carefully checked according to the PRISMA 2020 guidelines. The authors then conducted original research by evaluating MR images in 18 patients, who were then separated into two groups, the epilepsy recurrence group (ERG) and the epilepsy nonrecurrence group. The tumor region and the edema region were segmented manually by 3D Slicer. The radiomics data were extracted from MR images by using "Slicer Radiomics" running on Mac OS X. Tumor regions were observed with T1-weighted imaging, and edema with FLAIR imaging. Radiomics features with significant differences were selected through comparison according to epilepsy relapses performed with the Mann-Whitney U-test. The edema and tumor regions were also compared within groups to identify their distinctive features. Radiomics features were tested to verify their ability to predict recurrence epilepsy by receiver operating characteristic curve. RESULTS: This systematic review located 9 original articles related to epilepsy and radiomics published from 2018 to 2021. The reported studies demonstrated that radiomics is useful for detecting tiny epilepsy lesions. Among the radiomics features used, the predictive ability of the area under the curve was more than 0.8. The heterogeneity of the peritumoral edema region was found to be higher in the ERG. CONCLUSIONS: Satellite lesions in the peritumoral edema region of DNET patients may cause epilepsy recurrence, and radiomics is an emerging method to detect and evaluate these epilepsy-associated lesions.

Biomarkers during COVID-19: Mechanisms of Change and Implications for Patient Outcomes.

As the COVID-19 (Coronavirus disease 19) pandemic spreads worldwide, the massive numbers of COVID-19 patients have created a considerable healthcare burden for every country. The clinical spectrum of SARS-CoV-2 infection is broad, ranging from asymptomatic to mild, moderate, severe, and critical. Most COVID-19 patients present with no or mild symptoms, but nearly one-fifth of all patients develop severe or life-threatening complications. In addition to localized respiratory manifestations, severe COVID-19 cases also show extra-pulmonary complications or induce multiorgan failure. Identifying, triaging, and treating patients at risk early is essential and urgent. This article reviews the potential prognostic value of various biomarkers at different clinical spectrum stages of COVID-19 infection and includes information on fundamental prognostic mechanisms as well as potential clinical implications. Biomarkers are measurable biochemical substances used to recognize and indicate disease severity or response to therapeutic interventions. The information they provide is objective and suitable for delivering healthcare providers with a means of stratifying disease state in COVID-19 patients. This, in turn, can be used to help select and guide intervention efforts as well as gauge the efficacy of therapeutic approaches. Here, we review a number of potential biomarkers that may be used to guide treatment, monitor treatment efficacy, and form individualized therapeutic guidance based on patient response. Implementation of the COVID-19 biomarkers discussed here may lead to significantly improved quality of care and patient outcomes for those infected with SARS-CoV-2 worldwide.

Potential next-generation medications for self-administered platforms.

The Coronavirus Disease (COVID-19) pandemic has reshaped clinical chronic disease management. Patients reduced the number of physical clinic visits for regular follow-up care because of the pandemic. However, in developing countries, the scattered healthcare system hindered accessibility to clinical consultation, and poorly controlled chronic diseases resulted in numerous complications. Furthermore, the longer patients suffered from the chronic disease being treated, the more physical and psychological stress they experienced. "Diabetes Burnout," as an example, is a term to describe the phenomenon of psychological reluctance in long-term glycemic control. A comprehensive, patient-centered, and automatic drug administration and delivery model may reduce patient stress and increase compliance. Potential next-generation medication platforms, consisting of internal regulation and external interaction, may conduct autonomous dose adjustment and continuous selfmonitoring with the assistance of artificial intelligence, telemedicine, and wireless technologies. Internal regulation forms a closed-loop system in which drug administration is optimized in an implanted drug-releasing device according to a patient's physiopathological response. The other feature, external interaction, creates an ecosystem among patients, healthcare providers, and pharmaceutical researchers to monitor and adjust post-market therapeutic efficacy and safety. These platforms may provide a solution for self-medication and self-care for a wide variety of patients but may be life-changing for patients who live in developing countries where the healthcare system is scattered, as they could effectively remove healthcare barriers. As the technology matures, these self-administrated platforms may become more available and increasingly affordable, offering considerable impact to health and wellness efforts worldwide.

Irrigating digestate to improve cadmium phytoremediation potential of Pennisetum hybridum.

The bioavailability of heavy metal and growth of hyperaccumulator are key factors controlling the phytoextraction of heavy metal from soil. In this study, the efficacy and potential microbial mechanisms of digestate application in enhancing Cd extraction from soil by Pennisetum hybridum were investigated. The results showed that digestate application significantly promoted the height, tiller number, and biomass yield of Pennisetum hybridum. The application also increased the activities of urease, sucrase, dehydrogenase, available Cd contents of rhizosphere soils (from 2.21 to 2.46 mg kg-1), and the transfer factors of Cd from root to shoot and leaf. Assuming three annual harvests, digestate application would substantially reduce time needed for Pennisetum hybridum to completely absorb Cd from soil-from 15-16 yr-10 yr. Furthermore, the results of microbial community diversity analysis showed that digestate irrigation was more facilitated for the growth of the predominant bacteria, which were Actinobacteria and Chloroflexi at phylum level, and Sphingomonas and Nitrospiraat genus level, which mainly have the functions of promoted plant growth and metal resistance. The results suggested that the enhanced phytoextraction of Cd by Pennisetum hybridum with digestate application might mainly attributed to the increased Cd bio-availability and the enhanced plant growth, indicating that an approach combining digestate and Pennisetum hybridum could be a promising strategy for remediating Cd-contaminated soils.

Detection of Microorganisms in Body Fluids via MTT-PMS Assay.

Early detection of microorganisms is essential for the management of infectious diseases. However, this is challenging, as traditional culture methods are labor-intensive and time-consuming. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide-phenazine methosulfate (MTT-PMS) assay has been used to evaluate the metabolic activity in live cells and can thus be used for detecting living microorganisms. With the addition of NaOH and Tris-EDTA, the same approach can be accelerated (within 15 min) and used for the quick detection of common bacterial pathogens. The assay results can be evaluated colorimetrically or semi-quantitatively. Here, the quick detection by MTT-PMS assay was further investigated. The assay had a detection limit of approximately 104 CFU/mL. In clinical evaluations, we used the MTT-PMS assay to detect clinical samples and bacteriuria (>105 CFU/mL). The negative predictive value of the MTT-PMS assay for determining bacteriuria was 79.59% but was 100% when the interference of abnormal blood was excluded. Thus, the MTT-PMS assay might be a potential "rule-out" tool for bacterial detection in clinical samples, at a cost of approximately USD 1 per test. Owing to its low cost, rapid results, and easy-to-use characteristics, the MTT-PMS assay may be a potential tool for microorganism detection.

Enrichment of waste sewage sludge for enhancing methane production from cellulose.

Low ability of waste sewage sludge to degrade cellulose is observed due to its less cellulolytic bacteria content. The enrichment of sewage sludge in the absence or presence of carboxymethylcellulose (CMC) was conducted to improve anaerobic digestion (AD) of cellulose in this study. Compared to initial sewage sludge (IS), enriched sludge without CMC addition (ES) displayed 69.81% higher CH4 yield and about 1.7-fold greater anaerobic biodegradation of cellulose. In particular, bacterial and archaeal diversities in samples inoculated with ES were significantly altered, with Ruminiclostridium and Methanobacterium as the predominant genera. Enriched sludge with CMC addition (ESC) displayed enhanced methane production at initial cellulose fermentation but showed no distinct difference compared with the control after incubation 24 days. These findings suggest that enrichment of waste sewage sludge without CMC addition is more beneficial for promoting AD of cellulose, providing a novel insight for efficient energy utilization of lignocellulosic wastes.

Urinalysis Using a Diaper-Based Testing Device.

Urinary tract infections (UTI), one of the most common bacterial infections, annually affect 150 million people worldwide. Infants and the elderly are likely to have missed or delayed diagnosis of UTI due to difficulty clearly describing their symptoms. A rapid screening method for UTI is a critical and urgent need for these populations. The aim of our study is to develop a diaper-based testing device to assay urine biomarkers including pH, leukocyte, and nitrite level. This all-in-one device assists in urine collection and testing using a colorimetric approach to provide easily read visual results on the outside surface of a test strip-integrated diaper. In this study, we tested samples from 46 patients using testing strips and examined the results from 7 patients recruited to validate the strip-integrated diaper. In conclusion, this new diaper-based testing device is easy to use, rapid, and inexpensive, all of which imbue it with tremendous potential for development into a commercially viable UTI screening system.

Comparison of in-hospital and out-of-hospital cardiac arrest patients receiving targeted temperature management: A matched case-control study.

BACKGROUND: Evidences that support the use of targeted temperature management (TTM) for in-hospital cardiac arrest (IHCA) are lacking. We aimed to investigate the hypothesis that TTM benefits for patients with IHCA are similar to those with out-of-hospital cardiac arrest (OHCA) and to determine the independent predictors of resuscitation outcomes in patients with cardiac arrest receiving subsequent TTM. METHODS: This is a retrospective, matched, case-control study (ratio 1:1) including 93 patients with IHCA treated with TTM after the return of spontaneous circulation, who were admitted to Partners HealthCare system in Boston from January 2011 to December 2018. Controls were defined as the same number of patients with OHCA, matched for age, Charlson score, and sex. Survival and neurological outcomes upon discharge were the primary outcome measures. RESULTS: Patients with IHCA were more likely to have experienced a witnessed arrest and receive bystander cardiopulmonary resuscitation, a larger total dosage of epinephrine, and extracorporeal membrane oxygenation. The time duration for ROSC was shorter in patients with IHCA than in those with OHCA. The IHCA group was more likely associated with mild thrombocytopenia during TTM than the OHCA group. Survival after discharge and favorable neurological outcomes did not differ between the two groups. Among all patients who had cardiac arrest treated with TTM, the initial shockable rhythm, time to ROSC, and medical history of heart failure were independent outcome predictors for survival to hospital discharge. The only factor to predict favorable neurological outcomes at discharge was initial shockable rhythm. CONCLUSION: The beneficial effects of TTM in eligible patients with IHCA were similar with those with OHCA. Initial shockable rhythm was the only independent predictor of both survival and favorable neurological outcomes at discharge in all cardiac arrest survivors receiving TTM.