Simultaneous multiple target detection platform based on vertical flow immunoassay.

In general, vertical flow assay (VFA) has a disadvantage of requiring a complex analysis process that involves manually injecting various reagents (target analyte, washing buffer, detection conjugate, etc.) sequentially. However, in this study, we have developed an innovative paper-based VFA device that replaces the complex analysis process with one-step and enables the detection of multiple targets. The fabrication process of the multi-target detection VFA device is as follows: preparation and pre-treatment of the strip materials, design of strip cartridge, design of the multiple detection VFA device, optimization experiments for strip sample flow rates, determination of device analysis time, determination of device limit of detection (LOD), multiple target signal uniformity experiment, immunoglobulin G (IgG) and C-reactive protein (CRP) antigen-antibody multiple detection experiment, and data extraction and analysis method. The use of paper-based materials enables the device to be produced at cost-effective, and cartridge production allowed for uniform array formation. IgG and CRP are used to evaluate the performance of the device as common biomarkers. The device proposed in this study is currently under research. To validate multiple target detection capability of the VFA device proposed in this study, two types of antigens-antibodies (Human IgG and Human CRP) were employed. The detection limit is 0.15 µg/mL for IgG and 0.19 µg/mL for CRP in naked eye. Furthermore, it was confirmed that there is no cross-reactivity caused by the device structure through IgG and CRP antigens. In conclusion, the VFA device proposed in this study consists of a one-step analysis process, and it has been confirmed that it can detect multiple targets simultaneously.

Life Expectancy of Patients Undergoing Total Knee Arthroplasty: Comparison With General Population.

BACKGROUND: This study aimed to analyze the life expectancy and cause of death in osteoarthritis (OA) patients who underwent total knee arthroplasty (TKA) and to identify risk factors that affect long-term mortality rate after TKA. METHODS: Among 601 patients, who underwent primary TKA due to OA by a single surgeon from July 2005 to December 2011, we identified patients who died after the operation using data obtained from the National Statistical Office of Korea. We calculated 5-, 10-, and 15-year survival rates of the patients and age-specific standardized mortality ratios (SMRs) compared to general population of South Korea according to the causes of death. We also identified risk factors for death. RESULTS: The 5-year, 10-year, and 15-year survival rates were 94%, 84%, and 75%, respectively. The overall age-specific SMR of the TKA cohort was lower than that of the general population (0.69; P < 0.001). Cause-specific SMRs for circulatory diseases, neoplasms, and digestive diseases after TKA were significantly lower than those of the general population (0.65, 0.58, and 0.16, respectively; all P < 0.05). Male gender, older age, lower body mass index (BMI), anemia, and higher Charlson comorbidity index (CCI) were significant factors associated with higher mortality after TKA. CONCLUSION: TKA is a worthwhile surgery that can improve life expectancy, especially from diseases of the circulatory system, neoplasms, and digestive system, in patients with OA compared to the general population. However, careful follow-up is needed for patients with male gender, older age, lower BMI, anemia, and higher CCI, as these factors may increase long-term mortality risk after TKA. LEVEL OF EVIDENCE: III.

Spatial and temporal trends in food security during the COVID-19 pandemic in Asia Pacific countries: India, Indonesia, Myanmar, and Vietnam.

BACKGROUND/OBJECTIVES: The economic recession caused by the coronavirus disease 2019 pandemic disproportionately affected poor and vulnerable populations globally. Better uunderstanding of vulnerability to shocks in food supply and demand in the Asia Pacific region is needed. SUBJECTS/METHODS: Using secondary data from rapid assessment surveys during the pandemic response (n = 10,420 in mid-2020; n = 6,004 in mid-2021) in India, Indonesia, Myanmar, and Vietnam, this study examined the risk factors for reported income reduction or job loss in mid-2021 and the temporal trend in food security status (household food availability, and market availability and affordability of essential items) from mid-2020 to mid-2021. RESULTS: The proportion of job loss/reduced household income was highest in India (60.4%) and lowest in Indonesia (39.0%). Urban residence (odds ratio [OR] range, 2.20-4.11; countries with significant results only), female respondents (OR range, 1.40-1.69), engagement in daily waged labor (OR range, 1.54-1.68), and running a small trade/business (OR range, 1.66-2.71) were significantly associated with income reduction or job loss in three out of 4 countries (all P < 0.05). Food stock availability increased significantly in 2021 compared to 2020 in all four countries (OR range, 1.91-4.45) (all P < 0.05). Availability of all essential items at markets increased in India (OR range, 1.45-3.99) but decreased for basic foods, hygiene items, and medicine in Vietnam (OR range, 0.81-0.86) in 2021 compared to 2020 (all P < 0.05). In 2021, the affordability of all essential items significantly improved in India (OR range, 1.18-3.49) while the affordability of rent, health care, and loans deteriorated in Indonesia (OR range, 0.23-0.71) when compared to 2020 (all P < 0.05). CONCLUSIONS: Long-term social protection programs need to be carefully designed and implemented to address food insecurity among vulnerable groups, considering each country's market conditions, consumer food purchasing behaviors, and financial support capacity.

Multiple thromboses, including intracardiac thrombi, accompanied by HIT during ECMO successfully treated with NOACs: A case report.

INTRODUCTION: Unfractionated heparin remains the mainstay of anticoagulation therapy during extracorporeal membrane oxygenation (ECMO) maintenance. However, its continued use in clinical practice exposes patients to the risk of developing heparin-induced thrombocytopenia (HIT). CASE REPORT: A 50-year-old male was diagnosed with multiple thromboses, including an intracardiac thrombi, accompanied by HIT during ECMO after cardiogenic shock related to acute myocardial infarction. The patient was successfully treated with new oral anticoagulants (NOAC), without significant complications. DISCUSSION: HIT during ECMO resulting in multiple thromboses is rare. To our knowledge, this is the first reported case of NOAC use in this context. CONCLUSION: Although thrombocytopenia and thrombosis can occur for various reasons during ECMO maintenance, it is important to consider HIT as a potential cause. NOACs can be considered as a therapeutic option.

Optimal Coverage of Full Frequency Reuse in FFR Networks in Relation to Power Scaling of a Base Station.

As a strategy to coordinate inter-cell interference in cellular networks, a fractional frequency reuse (FFR) system is proposed, in which the frequency bandwidth is split into two orthogonal bands; users staying near the center of a FFR cell use the band with a frequency reuse (FR) factor of one (i.e., full FR), and users located close to the cell edge utilize the band with a FR factor greater than one (i.e., partial FR). Full FR coverage, which identifies full FR and partial FR regions (that is, near-center and near-edge regions) within a FFR cell, has a crucial effect on system performance. Some of the authors of this paper recently investigated the optimization of full FR coverage to maximize system throughput. They analytically showed that under the constraint of satisfying a specified target outage probability, the optimal full FR coverage is a non-increasing function of base station power when all base station powers in the cellular network are scaled at an equal rate. Interestingly, in this paper, it is proven that as the power of a single base station is scaled, the optimal full FR coverage in that cell is a non-decreasing function of base station power. Our results provide useful insight into the design of full FR coverage in relation to the transmit power of a base station. It gives a deeper understanding of the intricate relationship between important FFR system parameters of base station power and full FR coverage.

Quantitative injection strip platform using water-soluble paper and magnet based on a lateral flow assay.

Quantitative analysis for lateral flow immunoassay (LFA) strips was conducted continuously. Quantitative analysis means measuring concentration, which represents the number of molecules per unit volume. In this study, we designed a quantitative injection (QI) strip by modifying the structure of general LFA strips to inject the same unit volume. To achieve the injection of the same unit volume, we used water-soluble paper and magnet. In addition, the QI strip was fabricated to enable the physical separation of the gold conjugate pad from the nitrocellulose membrane (NC membrane) at the optimized time after sample injection. The optimized time refers to the time from the point at which the sample started flowing on the NC membrane to the point at which the strip was separated. At the samples of same concentration, the LFA strip increases detection signals as the volume of injected sample increases. In contrast to the LFA strip, the QI strip maintained consistent detection signals even with increasing volume of injected sample. Furthermore, the QI strip demonstrated an 11-fold lower deviation compared to the LFA strip. These results are attributed to the separation function of the QI strip. In conclusion, the QI strip is more suitable for quantitative analysis compared to the LFA strip due to the same unit volume without additional equipment such as a pipette. This study is expected to contribute to the development of user-friendly POCT and strip-based quantitative analysis.

A novel paper-based lysis strip for SARS-CoV-2 RNA detection at low resource settings.

Infectious respiratory diseases such as COVID-19 are serious and global concerns from the past to the present. To isolate the spread of infectious diseases even in the absence of a health system, a simple, inexpensive, reliable, sensitive, and selective molecular diagnosis platform for Point of Care Test (POCT) is required. Especially, the nucleic acid extraction step is difficult to perform out of laboratory. Here, we propose a paper-based lysis (PBL) strip for nucleic acid extraction, especially in low-resource settings (LRS). PBL strips are suitable for isolating RNA from viruses with biological interference and inhibitors. We optimized the buffer compositions and membranes of the strip. A simple preparation method using a PBL strip could obtain an eluent for downstream inspection within 20 min. Overall, 104 copies/swaps were detected for 20 min for amplification in combination with Reverse Transcription Loop-Mediated Amplification (RT-LAMP).

Inhibition of Non-specific Amplification in Loop-Mediated Isothermal Amplification via Tetramethylammonium Chloride.

Loop-mediated isothermal amplification (LAMP) may be used in molecular and point-of-care diagnostics for pathogen detection. The amplification occurs under isothermal conditions using up to six primers. However, non-specific amplification is frequently observed in LAMP. Non-specific amplification has the potential to be triggered by forward and reverse internal primers. And the relatively low reaction temperature (55-65 °C) induces the secondary structure via primer-primer interactions. Primer redesign and probe design have been recommended to solve this problem. LAMP primers have strict conditions, such as Tm, GC contents, primer dimer, and distance between primers compared to conventional PCR primers. Probe design requires specialized knowledge to have high specificity for a target. In polymerase chain reaction (PCR), some chemicals or proteins are used for improving specificity and efficiency. Therefore, we hypothesized that additives can suppress the non-specific amplification. In this study, tetramethylammonium chloride (TMAC), formamide, dimethyl sulfoxide, Tween 20, and bovine serum albumin have been used as LAMP additives. In our study, TMAC was presented as a promising additive for suppressing non-specific amplification in LAMP. Supplementary Information: The online version contains supplementary material available at 10.1007/s13206-022-00070-3.

Clinical evaluation of an innovative isothermal amplification detection system for COVID-19 diagnosis.

A pre-integrated system design intended for a point-of-care (POC) and sample-to-result diagnostic platform with nucleic acid amplification has been developed, which is equipment/electricity-free without any permanent instruments or manual sample processing. This semi-integrated system focuses on pandemic situations that are suitable for the Affordable, Sensitive, Specific, User-friendly, Robust and rapid, Equipment-free, and Deliverable to the end-user "ASSURED" concept recommended by the World Health Organization (WHO). Nucleic acid amplification is an essential rate-limiting factor in the performance of integrated systems that involve sample preparation and detection. The ORF1ab (RdRp) gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been targeted by RT-LAMP optimization and evaluation using a commercial hot-pack as a heat source that successfully achieves a femto-scale (<6.8 × 102 copies per rxn) limit of detection (LOD) within 40 min (except for the RNA extraction step). Therefore, the prototype system was assessed using COVID-19-suspected clinical samples (eighty eight) and compared with the results of a commercial real-time reverse transcription polymerase chain reaction (RT-qPCR) assay (Allplex SARS-CoV-2 Assay kit (Seegene, Seoul, Republic of Korea)). These innovative approaches achieved over 95% sensitivity and specificity. In conclusion, the developed system using a hot-pack as a heat source is a promising tool that enables the rapid identification of infectious diseases in the real world.

Rapid and simple detection of influenza virus via isothermal amplification lateral flow assay.

Respiratory illness caused by influenza virus is a serious public health problem worldwide. As the symptoms of influenza virus infection are similar to those of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it is essential to distinguish these two viruses. Therefore, to properly respond to a pathogen, a detection method that is capable of rapid and accurate diagnosis in a hospital or at home is required. To satisfy this need, we applied loop-mediated isothermal amplification (LAMP) and an isothermal nucleic acid amplification technique, along with a system to analyze the results without specialized equipment, a lateral flow assay (LFA). Using the platform developed in this study, all processes, from sample preparation to detection, can be performed without special equipment. Unlike existing PCR methods, the nucleic acid amplification can be performed in the field because hot packs do not require electricity. Thus, the designed platform can provide rapid results without the need to transport the samples to a laboratory or hospital. These advantages are not limited to operations in developing countries with poor access to medical systems. In conclusion, the developed technology is a promising tool for infectious disease management that allows for rapid identification of infectious diseases and appropriate treatment of patients.

Reduction of postoperative nausea and vomiting risk in the second stage during bilateral total knee arthroplasty with a 1-week interval.

PURPOSE: Total knee arthroplasty (TKA) is often performed sequentially on both sides during a single hospital stay. Patients who experience postoperative nausea and vomiting (PONV) after the first operation are concerned about PONV recurrence after the second operation. However, there are few studies regarding the incidence of PONV in staged bilateral TKA with a ≥ 1-week interval. This study aimed to identify the differences in (1) PONV incidence, (2) use of rescue antiemetics, and (3) the amount of opioid consumption between the first and second operations for staged bilateral TKA with a 1-week interval. Based on our anecdotal experience, the hypothesis of this study was that during staged bilateral TKA at a 1-week interval, the PONV incidence and rescue antiemetic requirement after the second operation will be lower than those after the first operation, regardless of opioid consumption. METHODS: Fifty-eight consecutive patients who underwent staged bilateral TKA with a 1-week interval were retrospectively reviewed. All second-stage operations were performed with the same anaesthesia protocol and perioperative patient management protocol as the first-stage operation. PONV incidence was the primary outcome. The requirement for rescue antiemetic drugs and the amount of opioid consumption were secondary outcome variables. The outcome variables were recorded during three postoperative days (Days 0-2) for each stage and were compared between the first and second operations. RESULTS: The incidence rates of nausea and vomiting on Day 0 (p = 0.001 and p = 0.004, respectively) and nausea on Day 1 (p = 0.008) were significantly lower after the second operation. Rescue antiemetic use on Day 0 was significantly lower after the second operation (p = 0.001). The total opioid consumption 72 h after surgery was significantly higher after the second operation (61.76 vs. 34.28 mg, p < 0.001). CONCLUSION: During staged bilateral TKA with a 1-week interval, PONV incidence was lower after the second operation, even with increased opioid consumption. LEVEL OF EVIDENCE: III.

A simple and innovative sample preparation method for on-site SARS-CoV-2 molecular diagnostics.

Nucleic acid amplification is a widely used diagnostic tool, although it requires a relatively time-consuming and complicated extraction step. To address this issue outside the laboratory, we investigated a sample preparation system and determined that a silica membrane and silica-coated beads are powerful tools for the extraction from raw samples: nucleic acids are kept in the silica membrane, retained during a single wash step, and released at the elution step. The eluent is appropriate for the quantitative real-time polymerase chain reaction (qPCR) and loop-mediated amplification (LAMP) assay in terms of purity and quantity. We also built an innovative equipment-free nucleic acid extraction squeeze system which requires less than 20 min. The sample with improved purity augments the specificity and sensitivity. This system is simple, user-friendly, low-cost, and equipment-free, thus making nucleic acid extraction more accessible and affordable for researchers and untrained users. Furthermore, when combined with the reverse-transcription quantitative real-time polymerase chain reaction method, the method will accelerate the detection of diseases. The same goes when combined with the LAMP assay, especially in developing countries.

Highly sensitive and rapid detection of porcine circovirus 2 by avidin-biotin complex based lateral flow assay coupled to isothermal amplification.

In this study, a new platform for the detection of porcine circovirus 2 was developed by avidin-biotin complex based lateral flow assay (LAMP-LFA). Improved detection sensitivity was attained by using loop mediated isothermal amplification (LAMP) with a low limit of detection (LOD), so the platform can be used to detect even early or asymptomatic stages of infection. LFA, which requires no specialized equipment, facilitates the use of point-of-care (POC) tests. Therefore, by applying LFA, the result can be confirmed accurately with the naked eye. Moreover, this platform has a unique structure using a single-tag detection system. The avidin-biotin interaction is the strongest interaction between proteins and has a higher Kd value than antigen-antibody interactions. Thus, the results are stable and can be clearly confirmed. The high sensitivity of LAMP-LFA enables all steps to be completed in 30 min. As a result, it could be applied to different targets, such as other pathogens. Future POC diagnostic studies are expected to be of great practical benefit.

Synthesis of silver nanoparticles conjugated with kaempferol and hydrocortisone and an evaluation of their antibacterial effects.

Silver nanoparticles (AgNPs) have shown a wide range of antibacterial activities over the last 2 decades. Conjugated AgNPs have attracted much interest among researchers for their properties which allow alterations of their physicochemical and biological properties. In this study, two potential stabilizing agents, flavonoids (kaempferol) and corticosteroids (hydrocortisone), were employed in the preparation of silver conjugated kaempferol and hydrocortisone nanoparticles (i.e., KH-AgNPs). The as-synthesized KH-AgNPs demonstrated a uniform spherical morphology by the transmission electron microscopy (TEM) results along with excellent stability and also shown strong bactericidal properties against different bacterial strains, including Escherichia coli, Bacillus subtilis, and Staphylococcus aureus. The KH-AgNPs were characterized by UV-Visible and FTIR spectroscopy studies and powder X-ray diffraction analysis. The KH-AgNPs activity was further analyzed by reactive oxygen species, live/dead bacterial assays, lactate dehydrogenase, and lipid peroxidation assays. The results have demonstrated the better antibacterial efficacy of the nanoparticles.

Ruthenium(II)-curcumin liposome nanoparticles: Synthesis, characterization, and their effects against cervical cancer.

Ruthenium complexes have increased the scope for improvement in current cancer treatment by replacing platinum-based drugs. However, to reduce metal-associated toxicity, a biocompatible flavonoid, such as curcumin, is indispensable, as it offers uncompensated therapeutic benefits through formation of complexes. In this study, we synthesized metal-based flavonoid complexes using ruthenium(II) and curcumin by adopting a convenient reflux reaction, represented as Ru-Cur complexes. These complexes were thoroughly characterized using 1H, 13C NMR, XPS, FT-IR, and UV-vis spectroscopy. As curcumin is sparingly soluble in water and has poor chemical stability, we loaded Ru-Cur complexes into liposomes and further formed nanoparticles (NPs) using the thin layer evaporation method. These were named Ru-Cur loaded liposome nanoparticles (RCLNPs). The effects of RCLNPs on cell proliferation was investigated using human cervical cancer cell lines (HeLa). These RCLNPs exhibited significant cytotoxicity in HeLa cells. The anticancer properties of RCLNPs were studied using reactive oxygen species (ROS), LDH, and MTT assays as well as live-dead staining. Nuclear damage studies of RCLNPs were performed in HeLa cells using the Hoechst staining assay.

Lanthanum mediated rutin yellow-fluorescent carbon dots as multifaceted sensing probes for the detection of calcium ions in melanoma and plant cells.

Calcium (Ca2 +) as a signaling ion and intracellular second messenger plays a crucial role in living organisms for various cellular functions. In the present work, we have designed a novel yellow-fluorescent carbon dots (LERCDs) using lanthanum, ethylenediaminetetraacetic acid (EDTA), and rutin as precursors for the sensing of Ca2 + ions. In this sense, a combination of hydrothermal and reflux methods was adopted. The as-designed LERCDs display bright yellow color emission in the aqueous solutions with a high quantum yield (23.8%). The LERCDs showed excitation-independent emission property along with magnificent photostability and time stability. The LERCDs show potential fluorescence quenching response towards the Ca2+ ions in the concentration range of 0-25 µM with a detection limit of 2.19 µM. The LERCDs have studied for extracellular sensing of Ca2 + ions in both melanoma cell lines (A375) and onion epidermal cells by employing fluorescence microscopy. The LERCDs facilitate low cytotoxicity and superior biocompatibility features in A375 cells. The practicality of LERCDs was studied in biological samples like the human serum.

On Training Neural Network Decoders of Rate Compatible Polar Codes via Transfer Learning.

Neural network decoders (NNDs) for rate-compatible polar codes are studied in this paper. We consider a family of rate-compatible polar codes which are constructed from a single polar coding sequence as defined by 5G new radios. We propose a transfer learning technique for training multiple NNDs of the rate-compatible polar codes utilizing their inclusion property. The trained NND for a low rate code is taken as the initial state of NND training for the next smallest rate code. The proposed method provides quicker training as compared to separate learning of the NNDs according to numerical results. We additionally show that an underfitting problem of NND training due to low model complexity can be solved by transfer learning techniques.

Identifying Food Deserts and People with Low Food Access, and Disparities in Dietary Habits and Health in Korea.

This study aims to identify the regions and people with low food access (LFA) for Korea at the national level and to examine disparities in food consumption, dietary behavior, and health outcome for those regions and people. Based on the distance to the nearest grocery store from residence, the regions and people with LFA are identified through geographical information system (GIS) analysis. To examine disparities between the regions and people with LFA and without LFA, a consumer survey is conducted and data from National Health and Nutrition Examination Survey and Community Health Survey are analyzed. This study found that there exists a serious access to food issue in Korea, especially for the aged. Moreover, there also exist significant disparities between the regions and people with and without LFA in the distance and one-way travel time to the grocery store that is mainly visited, frequency of offline/online grocery shopping, availability of various foods, dietary habits such as eating regularly, eating nutritionally balanced foods, and eating sufficient fruit/vegetable/whole grains, the acquisition and utilization of food-related information, and health outcomes. This study suggests that, to resolve such a serious food access problem, assistance policies, such as mobile grocery stores and lunch-box delivery, need to be activated in countries similar to Korea since this problem could potentially deteriorate the national medical finances as well as the regional and individual disparities.

Linear hybrid siloxane-based side chains for highly soluble isoindigo-based conjugated polymers.

Three isoindigo-based conjugated polymers modified with linear hybrid siloxane-based side chains were synthesized (PIID-Cm-Si7, m = 5-7). All polymers showed good solubilities in halogenated hydrocarbons, aromatic hydrocarbons, ethers, alkanes, and esters. The polymer films of PIID-C5-Si7, PIID-C6-Si7, and PIID-C7-Si7 achieved mobilities of 0.32, 0.82, and 1.58 cm2 V-1 s-1, respectively.

Azaisoindigo-Based Polymers with a Linear Hybrid Siloxane-Based Side Chain for High-Performance Semiconductors Processable with Nonchlorinated Solvents.

Developing nonchlorinated solvent-processed polymeric semiconductors to avoid environmental concerns and health hazards caused by chlorinated solvents is especially urgent. Here, a molecular design strategy, composed of backbone fluorination and side chain optimization, is used for preparing high-solubility and high-performance azaisoindigo-based polymers. The effects of different backbones and side chains on the solubility, film crystallinity, molecular stacking, and charge transport properties are mainly investigated. A long linear hybrid siloxane-based chain (C6-Si7) is chosen to improve the solubility, while the incorporation of fluorine (F) is used to enhance the film crystallinity and charge mobility. By optimizing the backbone and side chain, both solubility and charge mobility of the azaisoindigo-based polymer are significantly improved. As a result, PAIIDBFT-Si films processed with toluene, tetrahydrofuran, ether, and alkanes, achieved charge mobilities of 4.14, 3.78, 2.14, and 2.34 cm2 V-1 s-1, respectively. The current study provides an effective strategy for the design and synthesis of high-performance polymeric semiconductors processed with nonchlorinated solvents.