Improved method for quantification of intact oxaliplatin by ultra high performance liquid chromatography-inductively coupled plasma mass spectrometry: Applications to clinical and speciation studies.

Interest is increasing in the use of different liquid chromatography techniques coupled online to mass spectrometry for the quantification of platinum anticancer drugs in human plasma to inform cancer chemotherapy. We developed, validated and studied the application of a method for quantification of intact oxaliplatin in human plasma using ultra high performance liquid chromatography hyphenated to inductively coupled plasma mass spectrometry (UHPLC-ICP-MS). Plasma samples were processed instantly after collection from patients to preserve oxaliplatin speciation by methanol-deproteinization, and storage of diluted supernatants (plasma:methanol 1:2 v/v) at -80 °C. UHPLC separation of intact oxaliplatin and internal standard (carboplatin) was achieved using a C18 column and linear gradient mobile phase (Mobile phase A: water-methanol (97:3 v/v), 0.075 mM sodium dodecyl sulfate, 9.79 nM thallium adjusted to pH 2.5 with trifluoromethanesulfonic acid; Mobile phase B: 100 % methanol (v/v)) with ICP-MS detection to monitor platinum and thallium at m/z 195 and 205, respectively. The limit of quantification was 50 nM in methanol-deproteinized diluted plasma (1:2 v/v). Linearity was established for calibration standards ranging from 50 to 500 nM made in methanol-deproteinized diluted plasma (1:2 v/v), and for dilution of higher concentration samples in blank matrix containing internal standard (final dilution 1:29 v/v). Intra-day and inter-day accuracy ranged from 96.8 to 103 % of nominal concentration and precision from 0.62 to 2.49 % coefficient of variation. Recovery was complete and a matrix effect confirmed the requirement for matrix-matched standards. Intact oxaliplatin was stable during storage for at least 473 days, and during analysis, in methanol-deproteinized diluted plasma (1:2 v/v). The method was applied to determining the plasma concentrations of intact oxaliplatin in patients undergoing cancer chemotherapy, and studies of oxaliplatin degradation in vitro. This improved method based on UHPLC-ICP-MS will allow more specific, efficient and reliable quantification of intact oxaliplatin in human plasma.

Wireless sequential dual light delivery for programmed PDT in vivo.

Using photodynamic therapy (PDT) to treat deep-seated cancers is limited due to inefficient delivery of photosensitizers and low tissue penetration of light. Polymeric nanocarriers are widely used for photosensitizer delivery, while the self-quenching of the encapsulated photosensitizers would impair the PDT efficacy. Furthermore, the generated short-lived reactive oxygen spieces (ROS) can hardly diffuse out of nanocarriers, resulting in low PDT efficacy. Therefore, a smart nanocarrier system which can be degraded by light, followed by photosensitizer activation can potentially overcome these limitations and enhance the PDT efficacy. A light-sensitive polymer nanocarrier encapsulating photosensitizer (RB-M) was synthesized. An implantable wireless dual wavelength microLED device which delivers the two light wavelengths sequentially was developed to programmatically control the release and activation of the loaded photosensitizer. Two transmitter coils with matching resonant frequencies allow activation of the connected LEDs to emit different wavelengths independently. Optimal irradiation time, dose, and RB-M concentration were determined using an agent-based digital simulation method. In vitro and in vivo validation experiments in an orthotopic rat liver hepatocellular carcinoma disease model confirmed that the nanocarrier rupture and sequential low dose light irradiation strategy resulted in successful PDT at reduced photosensitizer and irradiation dose, which is a clinically significant event that enhances treatment safety.

Correction: Investigating Father or Partner Involvement in Family Integrated Care in Neonatal Units: Protocol for a Prospective, Multicenter, Multiphase Study.

[This corrects the article DOI: 10.2196/53160.].

Single body-coupled fiber enables chipless textile electronics.

Intelligent textiles provide an ideal platform for merging technology into daily routines. However, current textile electronic systems often rely on rigid silicon components, which limits seamless integration, energy efficiency, and comfort. Chipless electronic systems still face digital logic challenges owing to the lack of dynamic energy-switching carriers. We propose a chipless body-coupled energy interaction mechanism for ambient electromagnetic energy harvesting and wireless signal transmission through a single fiber. The fiber itself enables wireless visual-digital interactions without the need for extra chips or batteries on textiles. Because all of the electronic assemblies are merged in a miniature fiber, this facilitates scalable fabrication and compatibility with modern weaving techniques, thereby enabling versatile and intelligent clothing. We propose a strategy that may address the problems of silicon-based textile systems.

Harnessing metamaterials for efficient wireless power transfer for implantable medical devices.

Wireless power transfer (WPT) within the human body can enable long-lasting medical devices but poses notable challenges, including absorption by biological tissues and weak coupling between the transmitter (Tx) and receiver (Rx). In pursuit of more robust and efficient wireless power, various innovative strategies have emerged to optimize power transfer efficiency (PTE). One such groundbreaking approach stems from the incorporation of metamaterials, which have shown the potential to enhance the capabilities of conventional WPT systems. In this review, we delve into recent studies focusing on WPT systems that leverage metamaterials to achieve increased efficiency for implantable medical devices (IMDs) in the electromagnetic paradigm. Alongside a comparative analysis, we also outline current challenges and envision potential avenues for future advancements.

Investigating Father or Partner Involvement in Family Integrated Care in Neonatal Units: Protocol for a Prospective, Multicenter, Multiphase Study

BACKGROUND: Neonatal unit (NU) admissions for premature babies can last for months, which can significantly impact parental mental health (MH) with symptoms of depression, stress, and anxiety. Literature suggests fathers experience comparable MH symptoms to mothers. Family integrated care (FICare) is a culture where parents are collaborators and partners in caring for their hospitalized newborns. FICare improves infant outcomes and maternal MH. Similar reports on fathers are limited. OBJECTIVE: The primary aim of this study is to investigate the impact of supporting father or partner engagement in FICare of preterm infants on their MH up to 6 weeks postdischarge. The secondary aim is to investigate the impact on maternal MH. METHODS: This is a 2-phase study: phase 1 to gather baseline information and phase 2 to assess the impact of enhanced father or partner engagement in FICare on their MH, involving 2 NUs (tertiary and level 2). Enhanced FICare will be developed and introduced (eg, information booklet, workbook, classes, and a father peer-support group) alongside standard FICare practices. Father or partner MH will be assessed with semistructured qualitative interviews and validated questionnaires: Generalized Anxiety Disorder Assessment, Patient Health Questionnaire, and Parental Stressor Scale: Neonatal Intensive Care Unit from NU admission to 6 weeks postdischarge. Mothers will be assessed by focus groups and the same questionnaires. Descriptive statistics and appropriate comparative tests, such as the 2-tailed t test, will be used to analyze and compare phase 1 and 2 data. Qualitative data will be coded line by line with the use of NVivo (Lumivero) and thematically analyzed. Simultaneously, systematic reviews (SRs) of fathers' experiences of FICare and their MH outcomes will be conducted. The study was approved by the National Research Ethics Committee (22/EM/0140) in August 2022. A parent advisory group was formed to advise on the study methodology, materials, involvement of participant parents, and dissemination of study findings. RESULTS: A recent SR demonstrated that data saturation is likely to be achieved by interviewing 9 to 17 participants. We will study a maximum of 20 parents of infants born at less than 33 weeks' gestation in each phase. As of October 2023, the study was ongoing. The SR studies are registered with the PROSPERO database (324275 and 306760). The projected end date for data collection is July 2024; data analysis will be conducted in November 2024 and publication will occur in 2025. CONCLUSIONS: The study aims to demonstrate the feasibility of using a father or partner-sensitive FICare model for parents of premature babies with a positive impact on their MH. It will demonstrate the feasibility of providing FICare to extremely premature babies receiving intensive care. This study may support the development of inclusive FICare guidelines for nonbirthing parents and their extremely premature infants. TRIAL REGISTRATION: ClinicalTrials.gov: NCT06022991; https://classic.clinicaltrials.gov/ct2/show/NCT06022991. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53160.

Ambient health sensing on passive surfaces using metamaterials.

Ambient sensors can continuously and unobtrusively monitor a person's health and well-being in everyday settings. Among various sensing modalities, wireless radio-frequency sensors offer exceptional sensitivity, immunity to lighting conditions, and privacy advantages. However, existing wireless sensors are susceptible to environmental interference and unable to capture detailed information from multiple body sites. Here, we present a technique to transform passive surfaces in the environment into highly sensitive and localized health sensors using metamaterials. Leveraging textiles' ubiquity, we engineer metamaterial textiles that mediate near-field interactions between wireless signals and the body for contactless and interference-free sensing. We demonstrate that passive surfaces functionalized by these metamaterials can provide hours-long cardiopulmonary monitoring with accuracy comparable to gold standards. We also show the potential of distributed sensors and machine learning for continuous blood pressure monitoring. Our approach enables passive environmental surfaces to be harnessed for ambient sensing and digital health applications.

A Magnetic Particle Imaging Approach for Minimally Invasive Imaging and Sensing With Implantable Bioelectronic Circuits.

Minimally-invasive and biocompatible implantable bioelectronic circuits are used for long-term monitoring of physiological processes in the body. However, there is a lack of methods that can cheaply and conveniently image the device within the body while simultaneously extracting sensor information. Magnetic Particle Imaging (MPI) with zero background signal, high contrast, and high sensitivity with quantitative images is ideal for this challenge because the magnetic signal is not absorbed with increasing tissue depth and incurs no radiation dose. We show how to easily modify common implantable devices to be imaged by MPI by encapsulating and magnetically-coupling magnetic nanoparticles (SPIOs) to the device circuit. These modified implantable devices not only provide spatial information via MPI, but also couple to our handheld MPI reader to transmit sensor information by modulating harmonic signals from magnetic nanoparticles via switching or frequency-shifting with resistive or capacitive sensors. This paper provides proof-of-concept of an optimized MPI imaging technique for implantable devices to extract spatial information as well as other information transmitted by the implanted circuit (such as biosensing) via encoding in the magnetic particle spectrum. The 4D images present 3D position and a changing color tone in response to a variable biometric. Biophysical sensing via bioelectronic circuits that take advantage of the unique imaging properties of MPI may enable a wide range of minimally invasive applications in biomedicine and diagnosis.

Ambient Cardiovascular Monitoring with Metamaterial Textile Sensors.

Contactless sensors embedded in the ambient environment have broad applications in unobtrusive, long-term health monitoring for preventative and personalized healthcare. Microwave radar sensors are an attractive candidate for ambient sensing due to their high sensitivity to physiological motions, ability to penetrate through obstacles and privacy-preserving properties, but practical applications in complex real-world environments have been limited because of challenges associated with background clutter and interference. In this work, we propose a thin and soft textile sensor based on microwave metamaterials that can be easily integrated into ordinary furniture for contactless ambient monitoring of multiple cardiovascular signals in a localized manner. Evaluations of our sensor's performance in human subjects show high accuracy of heartbeat and arterial pulse detection, with ≥ 96.5% sensitivity and < 5% mean absolute relative error (MARE) across all subjects. We demonstrate our sensor's utility for cuffless blood pressure monitoring on a human subject over a continuous 10-minute period. Our results highlight the potential of metamaterial textile sensors in ambient health and wellness monitoring applications.Clinical relevance-The contactless metamaterial textile sensors demonstrated in this paper provide unobtrusive, convenient and long-term monitoring of multiple cardiovascular health metrics, including heart rate, pulse rate and cuffless blood pressure, which can facilitate preventative and personalized healthcare.

Amino acid substitution L232F in non-structural protein 6 identified as a possible human-adaptive mutation in clade B MERS coronaviruses.

IMPORTANCE: Viral host adaptation plays an important role in inter-species transmission of coronaviruses and influenza viruses. Multiple human-adaptive mutations have been identified in influenza viruses but not so far in MERS-CoV that circulates widely in dromedary camels in the Arabian Peninsula leading to zoonotic transmission. Here, we analyzed clade B MERS-CoV sequences and identified an amino acid substitution L232F in nsp6 that repeatedly occurs in human MERS-CoV. Using a loss-of-function reverse genetics approach, we found the nsp6 L232F conferred increased viral replication competence in vitro, in cultures of the upper human respiratory tract ex vivo, and in lungs of mice infected in vivo. Our results showed that nsp6 L232F may be an adaptive mutation associated with zoonotic transmission of MERS-CoV. This study highlighted the capacity of MERS-CoV to adapt to transmission to humans and also the need for continued surveillance of MERS-CoV in camels.

Frictionless multiphasic interface for near-ideal aero-elastic pressure sensing.

Conventional pressure sensors rely on solid sensing elements. Instead, inspired by the air entrapment phenomenon on the surfaces of submerged lotus leaves, we designed a pressure sensor that uses the solid-liquid-liquid-gas multiphasic interfaces and the trapped elastic air layer to modulate capacitance changes with pressure at the interfaces. By creating an ultraslippery interface and structuring the electrodes at the nanoscale and microscale, we achieve near-friction-free contact line motion and thus near-ideal pressure-sensing performance. Using a closed-cell pillar array structure in synergy with the ultraslippery electrode surface, our sensor achieved outstanding linearity (R2 = 0.99944 ± 0.00015; nonlinearity, 1.49 ± 0.17%) while simultaneously possessing ultralow hysteresis (1.34 ± 0.20%) and very high sensitivity (79.1 ± 4.3 pF kPa-1). The sensor can operate under turbulent flow, in in vivo biological environments and during laparoscopic procedures. We anticipate that such a strategy will enable ultrasensitive and ultraprecise pressure monitoring in complex fluid environments with performance beyond the reach of the current state-of-the-art.

Implant-to-implant wireless networking with metamaterial textiles.

Implanted bioelectronic devices can form distributed networks capable of sensing health conditions and delivering therapy throughout the body. Current clinically-used approaches for wireless communication, however, do not support direct networking between implants because of signal losses from absorption and reflection by the body. As a result, existing examples of such networks rely on an external relay device that needs to be periodically recharged and constitutes a single point of failure. Here, we demonstrate direct implant-to-implant wireless networking at the scale of the human body using metamaterial textiles. The textiles facilitate non-radiative propagation of radio-frequency signals along the surface of the body, passively amplifying the received signal strength by more than three orders of magnitude (>30 dB) compared to without the textile. Using a porcine model, we demonstrate closed-loop control of the heart rate by wirelessly networking a loop recorder and a vagus nerve stimulator at more than 40 cm distance. Our work establishes a wireless technology to directly network body-integrated devices for precise and adaptive bioelectronic therapies.

Synergetic positivity of loss and noise in nonlinear non-Hermitian resonators.

Loss and noise are usually undesirable in electronics and optics, which are generally mitigated by separate ways in the cost of bulkiness and complexity. Recent studies of non-Hermitian systems have shown a positive role of loss in various loss-induced counterintuitive phenomena, while noise still remains a fundamental challenge in non-Hermitian systems particularly for sensing and lasing. Here, we simultaneously reverse the detrimental loss and noise and reveal their coordinated positive role in nonlinear non-Hermitian resonators. This synergetic effect leads to the amplified spectrum intensity with suppressed spectrum fluctuations after adding both loss and noise. We reveal the underlying mechanism of nonlinearity-induced bistability engineered by loss in the non-Hermitian resonators and noise-loss enhanced coherence of eigenfrequency hopping driven by temporal modulation of detuning. Our findings enrich counterintuitive non-Hermitian physics and lead to a general recipe to overcome loss and noise from electronics to photonics with applications from sensing to communication.

Stochastic Exceptional Points for Noise-Assisted Sensing.

Noise is a fundamental challenge for sensors deployed in daily environments for ambient sensing, health monitoring, and wireless networking. Current strategies for noise mitigation rely primarily on reducing or removing noise. Here, we introduce stochastic exceptional points and show the utility to reverse the detrimental effect of noise. The stochastic process theory illustrates that the stochastic exceptional points manifest as fluctuating sensory thresholds that give rise to stochastic resonance, a counterintuitive phenomenon in which the added noise increases the system's ability to detect weak signals. Demonstrations using a wearable wireless sensor show that the stochastic exceptional points lead to more accurate tracking of a person's vital signs during exercise. Our results may lead to a distinct class of sensors that overcome and are enhanced by ambient noise for applications ranging from healthcare to the internet of things.

Mutation nsp6 L232F associated with MERS-CoV zoonotic transmission confers higher viral replication in human respiratory tract cultures ex-vivo.

Middle East respiratory syndrome coronavirus (MERS-CoV) causes zoonotic disease. Dromedary camels are the source of zoonotic infection. We identified a mutation of amino acid leucine to phenylalanine in the codon 232 position of the non-structural protein 6 (nsp6) (nsp6 L232F) that is repeatedly associated with zoonotic transmission. We generated a pair of isogenic recombinant MERS-CoV with nsp6 232L and 232F residues, respectively, and showed that the nsp6 L232F mutation confers higher replication competence in ex-vivo culture of human nasal and bronchial tissues and in lungs of mice experimentally infected in-vivo. Mechanistically, the nsp6 L232F mutation appeared to modulate autophagy and was associated with higher exocytic virus egress, while innate immune responses and zippering activity of the endoplasmic reticulum remained unaffected. Our study suggests that MERS-CoV nsp6 may contribute to viral adaptation to humans. This highlights the importance of continued surveillance of MERS-CoV in both camels and humans.

Replication of Novel Zoonotic-Like Influenza A(H3N8) Virus in Ex Vivo Human Bronchus and Lung.

Human infection with avian influenza A(H3N8) virus is uncommon but can lead to acute respiratory distress syndrome. In explant cultures of the human bronchus and lung, novel H3N8 virus showed limited replication efficiency in bronchial and lung tissue but had a higher replication than avian H3N8 virus in lung tissue.

Technology Roadmap for Flexible Sensors.

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.

Cation-Induced Assembly of Conductive MXene Fibers for Wearable Heater, Wireless Communication, and Stem Cell Differentiation.

Emerging wearable electronics, wireless communication, and tissue engineering require the development of conductive fiber-shaped electrodes and biointerfaces. Ti3C2Tx MXene nanosheets serve as promising building block units for the construction of highly conductive fibers with integrated functionalities, yet a facile and scalable fabrication scheme is highly required. Herein, a cation-induced assembly process is developed for the scalable fabrication of conductive fibers with MXene sheaths and alginate cores (abbreviated as MXene@A). The fabrication scheme of MXene@A fibers includes the fast extrusion of alginate fibers followed by electrostatic assembly of MXene nanosheets, enabling high-speed fiber production. When multiple fabrication parameters are optimized, the MXene@A fibers exhibit a superior electrical conductivity of 1083 S cm-1, which can be integrated as Joule heaters into textiles for wearable thermal management. By triggering reversible de/hydration of alginate cores upon heating, the MXene@A fibers can be repeatedly contracted and generate large contraction stress that is >40 times higher than the ones of mammalian skeletal muscle. Furthermore, the MXene@A springs demonstrate large contraction strains up to 65.5% and are then fabricated into a reconfigurable dipole antenna to wirelessly monitor the surrounding heat sources. In the end, with the biocompatibility of MXene nanosheets, the MXene@A fibers enable the guidance of neural stem/progenitor cells differentiation and the promotion of neurite outgrowth. With a cation-induced assembly process, our multifunctional MXene@A fibers exhibit high scalability for future manufacturing and hold the prospect to inspire other applications.

Bioelectronic devices for light-based diagnostics and therapies.

Light has broad applications in medicine as a tool for diagnosis and therapy. Recent advances in optical technology and bioelectronics have opened opportunities for wearable, ingestible, and implantable devices that use light to continuously monitor health and precisely treat diseases. In this review, we discuss recent progress in the development and application of light-based bioelectronic devices. We summarize the key features of the technologies underlying these devices, including light sources, light detectors, energy storage and harvesting, and wireless power and communications. We investigate the current state of bioelectronic devices for the continuous measurement of health and on-demand delivery of therapy. Finally, we highlight major challenges and opportunities associated with light-based bioelectronic devices and discuss their promise for enabling digital forms of health care.

Topographic design in wearable MXene sensors with in-sensor machine learning for full-body avatar reconstruction.

Wearable strain sensors that detect joint/muscle strain changes become prevalent at human-machine interfaces for full-body motion monitoring. However, most wearable devices cannot offer customizable opportunities to match the sensor characteristics with specific deformation ranges of joints/muscles, resulting in suboptimal performance. Adequate wearable strain sensor design is highly required to achieve user-designated working windows without sacrificing high sensitivity, accompanied with real-time data processing. Herein, wearable Ti3C2Tx MXene sensor modules are fabricated with in-sensor machine learning (ML) models, either functioning via wireless streaming or edge computing, for full-body motion classifications and avatar reconstruction. Through topographic design on piezoresistive nanolayers, the wearable strain sensor modules exhibited ultrahigh sensitivities within the working windows that meet all joint deformation ranges. By integrating the wearable sensors with a ML chip, an edge sensor module is fabricated, enabling in-sensor reconstruction of high-precision avatar animations that mimic continuous full-body motions with an average avatar determination error of 3.5 cm, without additional computing devices.