Utility of Handheld Ultrasound in Identifying Millimeter-Sized Vasculature in Living and Cadaveric Subjects.

Objective This study aims to investigate the utility of handheld, Bluetooth-capable ultrasound in identifying millimeter-sized vasculature in both living and cadaveric subjects. Methods Using handheld, linear ultrasound probes, the carpal tunnel of 87 living individuals (174 forearms) was assessed for the presence of a persistent median artery (PMA). Radial, ulnar, and persistent median arterial diameters were measured, along with forearm circumference. Using the same probes, 46 cadaveric forearms were assessed for the presence of a "potential" PMA. Those same forearms were subsequently dissected to confirm the presence of the artery.  Results A PMA was identified in 3.4% of individuals (1.7% of forearms). Radial, ulnar, and persistent median arterial diameters were 2.12 ± 0.40 mm, 1.89 ± 0.41 mm, and 0.82 ± 0.33 mm, respectively. The radial artery was significantly larger than the ulnar artery (p < 0.0001). In cadaveric subjects, four "potential" PMAs were identified by pre-dissection ultrasound. Upon dissection, only one of the "potential" PMAs was confirmed, and three previously unidentified PMAs were identified.  Conclusions The prevalence of PMA in living subjects was lower than previously reported. Additionally, handheld ultrasound had low accuracy in identifying PMAs in cadavers prior to dissection. This could be an indication that current handheld ultrasound lacks the sensitivity to identify millimeter-sized vasculature, such as a PMA. In both populations of subjects, key, non-anomalous anatomy was readily seen, indicating the utility of handheld ultrasound in the proper context.

Comparison between Handheld Echocardiography and Cardiac Magnetic Resonance for Stroke Volume and Left Ventricular Ejection Fraction Quantification.

Background: Reliable quantification of stroke volume (SV) and left ventricular ejection fraction (LVEF) is essential for point-of-care assessment in hemodynamically compromised patients. Handheld echocardiography (HHE) equipment has entered the market a few years ago and is now available for clinical use. However, the performance of HHE for SV and LVEF quantification in comparison to cardiac magnetic resonance (CMR) imaging as golden standard is yet unknown. Methods: Twenty volunteers were scanned with HHE, standard echocardiography (SE), and CMR. LVEF and SV were measured with each modality, and their accuracy and precision were evaluated. Results: Bias and limits of agreement (LOA) between HHE and CMR were -0.21% (-2.89: 2.48) and 11.24% (-15.79: 15.59) for LVEF and 29.85 ml (22.13: 37.57) and 32.34 ml (-15.01: 44.86) for SV, respectively. Bias and LOA between SE and CMR were -0.60% (-3.74:2.55) and 13.16% (-18.85:18.26) for LVEF and 32.08 ml (24.61:39.54) and 31.34 ml (-11.29:43.37) for SV, respectively. Conclusion: HHE versus CMR showed comparable accuracy and precision compared to SE versus CMR.

Use of a handheld ultrasound device for detecting orbital inflammation.

Purpose: Orbital inflammatory disease has been historically diagnosed with computed tomography (CT) and magnetic resonance imaging (MRI). Orbital ultrasound has served as a non-radiation alternative that has been successful at diagnosing many orbital pathologies but is not commonly used in clinical practice due to need for specialized ultrasound training and equipment needs. We demonstrate use of handheld ultrasound for detecting orbital inflammation. Observations: We present five patients with orbital inflammation where a handheld ultrasound probe was able to capture features consistent with concurrent CT scans. Conclusions and importance: Handheld ultrasound is an accessible and portable method that can assist in the diagnosis and monitoring of orbital pathology.

Prospective Comparison of Nine Different Handheld Ultrasound (HHUS) Devices by Ultrasound Experts with Regard to B-Scan Quality, Device Handling and Software in Abdominal Sonography.

BACKGROUND: The HHUS market is very complex due to a multitude of equipment variants and several different device manufacturers. Only a few studies have compared different HHUS devices under clinical conditions. We conducted a comprehensive prospective observer study with a direct comparison of nine different HHUS devices in terms of B-scan quality, device handling, and software features under abdominal imaging conditions. METHODS: Nine different HHUS devices (Butterfly iQ+, Clarius C3HD3, D5CL Microvue, Philips Lumify, SonoEye Chison, SonoSite iViz, Mindray TE Air, GE Vscan Air, and Youkey Q7) were used in a prospective setting by a total of 12 experienced examiners on the same subjects in each case and then assessed using a detailed questionnaire regarding B-scan quality, handling, and usability of the software. The evaluation was carried out using a point scale (5 points: very good; 1 point: insufficient). RESULTS: In the overall evaluation, Vscan Air and SonoEye Chison achieved the best ratings. They achieved nominal ratings between "good" (4 points) and "very good" (5 points). Both devices differed significantly (p < 0.01) from the other seven devices tested. Among the HHUS devices, Clarius C3HD3 and Vscan Air achieved the best results for B-mode quality, D5CL Microvue achieved the best results for device handling, and SonoEye Chison and Vscan Air achieved the best results for software. CONCLUSIONS: This is the first comprehensive study to directly compare different HHUS devices in a head-to-head manner. While the majority of the tested devices demonstrated satisfactory performance, notable discrepancies were observed between them. In particular, the B-scan quality exhibited considerable variation, which may have implications for the clinical application of HHUS. The findings of this study can assist in the selection of an appropriate HHUS device for specific applications, considering the clinical objectives and acknowledging the inherent limitations.

Handheld Ultrasound Devices Used by Newly Certified Operators for Pneumonia in the Emergency Department-A Diagnostic Accuracy Study.

The diagnostic accuracy of handheld ultrasound (HHUS) devices operated by newly certified operators for pneumonia is unknown. This multicenter diagnostic accuracy study included patients prospectively suspected of pneumonia from February 2021 to February 2022 in four emergency departments. The index test was a 14-zone focused lung ultrasound (FLUS) examination, with consolidation with air bronchograms as diagnostic criteria for pneumonia. FLUS examinations were performed by newly certified operators using HHUS. The reference standard was computed tomography (CT) and expert diagnosis using all medical records. The sensitivity and specificity of FLUS and chest X-ray (CXR) were compared using McNemar's test. Of the 324 scanned patients, 212 (65%) had pneumonia, according to the expert diagnosis. FLUS had a sensitivity of 31% (95% CI 26-36) and a specificity of 82% (95% CI 78-86) compared with the experts' diagnosis. Compared with CT, FLUS had a sensitivity of 32% (95% CI 27-37) and specificity of 81% (95% CI 77-85). CXR had a sensitivity of 66% (95% CI 61-72) and a specificity of 76% (95% CI 71-81) compared with the experts' diagnosis. Compared with CT, CXR had a sensitivity of 69% (95% CI 63-74) and a specificity of 68% (95% CI 62-72). Compared with the experts' diagnosis and CT diagnosis, FLUS performed by newly certified operators using HHUS devices had a significantly lower sensitivity for pneumonia when compared to CXR (p < 0.001). FLUS had a significantly higher specificity than CXR using CT diagnosis as a reference standard (p = 0.02). HHUS exhibited low sensitivity for pneumonia when used by newly certified operators.

Postponing first colostrum collection: impact on immunoglobulin G in goat colostrum.

This experiment was motivated by the need to understand the impacts of delaying the first colostrum collection on immunoglobulin G (IgG) concentrations in goat colostrum, addressing a gap in caprine-specific research, despite its significance in dairy farming. Concurrently, we examined the relationship between colostral IgG, total protein (TP) and Brix values. Two colostrum samples were collected from 56 Saanen goats, one from each udder half. The first sample was collected from the right teat immediately postbirth, and the second sample was collected from the left teat at one of the predetermined postpartum intervals: 0, 4-6, 8-10, or 12-14 h postpartum, each time interval comprising 14 goats. Colostral IgG was determined by ELISA, Brix was determined by digital refractometry, and TP was determined by the Bradford protein method. Sperman's correlations and Lin's concordance correlation coefficient were used to determine the direction and strength of the association and to assess agreement (prediction accuracy) between methods, respectively. Receiver operator characteristic analysis was used to determine Brix and TP thresholds for predicting good-quality colostrum using several cut-offs (20, 30, 40, and 50 g/L IgG). Mean (± SD) for colostral IgG, Brix, and TP were 54 ± 22.6 g/L, 22 ± 5.0%, and 12 ± 2.8 g/dL, respectively. The statistical analysis did not provide evidence of a significant impact of time of first collection (up to 14 h postpartum), on IgG, Brix, and TP. Brix and IgG values exhibited both a high degree of correlation (r = 0.89-90) and concordance (ρc = 0.89-90), indicating a strong and reliable relationship between the two measurements. The prevalence of samples ≥ 20, 30, 40, and 50 g of IgG/L were 96, 88, 71, and 54%, respectively. Optimal Brix and TP thresholds predicting IgG ≥ 20, 30, 40, and 50 g/L IgG were 13.8, 17.5, 20.1, and 22.5%, and 6.8, 9.3, 10.8, and 11.1 g/dL, respectively. Increasing the IgG threshold resulted in lower sensitivity but higher specificity for estimating colostral IgG using Brix or TP values. The present findings indicate that delaying the first colostrum collection up to 14 h postpartum did not result in conclusive changes in colostral IgG concentration, Brix values, or total protein levels. Our results also confirm the reliability of Brix refractometry as an on-farm tool for estimating IgG concentrations in goat colostrum. These results are particularly relevant to intensive dairy systems, offering insights to enhance colostrum management and task prioritisation, especially during the bustling kidding periods.

Intraocular Pressure Measurements in Standing, Sitting, Prone, and Supine Positions.

In this study, intraocular pressure (IOP) was measured in sitting, supine, prone, and standing (ST) positions and again five minutes after standing (ST-5) utilizing a Tono-Pen AVIA in 124 eyes of 62 healthy subjects with ages ranging from 21 to 59 years (mean 30 ± 10 years). In each subject, the average IOP of both eyes was used for the statistical evaluation. The mean IOP difference between the ST and sitting positions was -0.13 ± 1.63 mmHg (p = 0.548); between ST-5 and sitting, it was 0.53 ± 1.24 mmHg (p = 0.001); between supine and sitting, it was 1.30 ± 1.48 mmHg (p < 0.001); between ST and supine, it was -1.43 ± 1.74 mmHg (p < 0.001); between ST-5 and supine, it was -0.77 ± 1.59 mmHg (p < 0.001); between prone and supine, it was 2.24 ± 1.92 mmHg (p < 0.001); between ST and ST-5, it was -0.67 ± 1.84 mmHg (range: -7.5 to 5 mmHg) (p = 0.007); between prone and ST, it was 3.46 ± 2.01 mmHg (p < 0.001); between ST-5 and prone, it was -2.46 ± 1.67 mmHg (p < 0.001); and between sitting and prone, it was -3.22 ± 1.56 mmHg (p < 0.001). The results show a significant IOP increase in the ST-5 position, suggesting that such measurements need to be performed in an attempt to explain the progression of glaucoma in apparently normal-tension patients.

Gamified Mobile App (MobERAS) for Telemonitoring Patients in the Postoperative Period Based on the Enhanced Recovery after Surgery Program: Development and Validation Study.

BACKGROUND: Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users' actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results. OBJECTIVE: This study aimed to describe the development and validation of a mobile app for enhanced recovery after surgery (MobERAS), a gamified mobile health app for telemonitoring patients in the postoperative period based on the ERAS program, and to evaluate its functionality and usability and the experience of patients, health care professionals, and computer professionals with its use. METHODS: We developed MobERAS for postoperative telemonitoring, with active participation of patients in the process, and offering availability of real-time information for the health team. The app development process included idealization, interdisciplinary team formation, potential needs assessment, and product deployment. Usability tests were conducted throughout the development process with improvements, technical adjustments, and updates. After finalization, comprehensive verification tests were performed. The parameters evaluated are those that can influence the length of hospital stay, such as nausea, vomiting, pain scales, return to normal gastrointestinal function, and thromboembolic events. MobERAS was designed to be downloaded by users on their phones, tablets, or other mobile devices and to provide postoperative data. The app has a GPS that monitors the patient's walking time and distance and is connected to a virtual database that stores the collected data. RESULTS: Women undergoing medium and major gynecologic oncologic surgeries were included. We included 65 patients with an average age of 53.2 (SD 7.4, range 18-85) years. The time of use ranged from 23.4 to 70 hours (mean 45.1, SD 19.2 hours). Regarding adherence to the use of MobERAS, the mean fill rate was 56.3% (SD 12.1%, range 41.7%-100%), and ambulation data were obtained for 60 (92.3%) of the 65 patients. The researcher had access to the data filled out by the patients in real time. There was good acceptance of the use of MobERAS by the patients, with good evaluation of the app's usability. MobERAS was easy to use and considered attractive because of its gamified design. The app was rated as good or very good in all items by health care professionals (n=20) and professionals specializing in technological innovation (n=10). CONCLUSIONS: MobERAS is easy to use, safe, well accepted by patients, and well evaluated by experts. It can be of great use in clinical surgical practice and an important tool for greater engagement of patients and health care professionals with the ERAS program.

Rapid prediction of the chemical composition of pet food using a benchtop and handheld near-infrared spectrometer.

Quality of pet foods can be affected by many factors such as raw materials, formulations, and processing techniques. The pet food manufacturers require fast analyses to control the nutritional quality of their products. Herein, near-infrared spectroscopy (NIR) was evaluated to quantify the chemical composition of pet food, and the performances of two NIR spectrometers were investigated and compared: a benchtop instrument (1000-2500 nm) and a low-cost handheld instrument (900-1700 nm). Seventy cat food and thirty-six dog samples were characterized using reference methods for crude protein, crude fat, crude fibre, crude ash, moisture, calcium (Ca), and phosphorus (P). Principal component regression (PCR) and partial least squares regression (PLSR) were used to establish the models that involved the cat food and mixed model. The characteristic wavelengths were selected using a competitive adaptive reweighted-sampling (CARS) algorithm. The Optimal models obtained from the benchtop instrument for crude protein, crude fat, and moisture were classified as "Good" or "Very good" (Residual prediction variation (RPD) > 3), for crude fibre were classified as "Poor" (RPD>2), and for crude ash, Ca and P (RPD<2) were classified as "Very poor". The Optimal calibrations obtained from the handheld instrument for crude protein, crude fat, and moisture were classified as "Good" or "Very good" (RPD>3), for crude fibre, crude ash, Ca, and P were classified as "Very poor" (RPD<2). Generally, the the performance of benchtop and handheld instrument was close, and the cat food model outperformed the mixed model. Results from the current study revealed the potential to monitor the chemical compositions in pet food on a large scale.

Toothpick DNA extraction combined with handheld LAMP microfluidic platform for simple and rapid meat authentication.

Adulteration of meat is a global issue, necessitating rapid, inexpensive, and simple on-site testing methods. Therefore, the present study aimed to develop a one-minute toothpick-based DNA extraction method, a handheld microfluidic chip, and a smartphone-controlled portable analyzer for detecting multiple meat adulterations. A toothpick was inserted into the meat to promote DNA release and adsorption. Furthermore, a handheld microfluidic chip was designed for DNA elution on toothpicks and fluid distribution. Finally, a smartphone-actuated portable analyzer was developed to function as a heater, signal detector, and result reader. The portable device comprises a microcontroller, a fluorescence detection module, a step scanning unit, and a heating module. The proposed device is portable, and the app is user-friendly. This simple design, easy operation, and fast-response system could rapidly detect as little as 1% of simulated adulterated samples (following UK standards) within 40 min at a cost of less than USD 1 per test.

A Low-Cost Handheld Centrifugal Microfluidic System for Multiplexed Visual Detection Based on Isothermal Amplification.

A low-cost, handheld centrifugal microfluidic system for multiplexed visual detection based on recombinase polymerase amplification (RPA) was developed. A concise centrifugal microfluidic chip featuring four reaction units was developed to run multiplexed RPA amplification in parallel. Additionally, a significantly shrunk-size and cost-effective handheld companion device was developed, incorporating heating, optical, rotation, and sensing modules, to perform multiplexed amplification and visual detection. After one-time sample loading, the metered sample was equally distributed into four separate reactors with high-speed centrifugation. Non-contact heating was adopted for isothermal amplification. A tiny DC motor on top of the chip was used to drive steel beads inside reactors for active mixing. Another small DC motor, which was controlled by an elaborate locking strategy based on magnetic sensing, was adopted for centrifugation and positioning. Visual fluorescence detection was optimized from different sides, including material, surface properties, excitation light, and optical filters. With fluorescence intensity-based visual detection, the detection results could be directly observed through the eyes or with a smartphone. As a proof of concept, the handheld device could detect multiple targets, e.g., different genes of African swine fever virus (ASFV) with the comparable LOD (limit of detection) of 75 copies/test compared to the tube-based RPA.

Relationship Between the Flexion Torque of the First Metatarsophalangeal Joint and Intrinsic Foot Muscles Depends on the Ankle Joint Position.

Background: Clinicians and researchers are beginning to pay attention to the importance of the intrinsic foot muscles (IFMs). Among IFMs, the abductor hallucis (AbH) is associated with foot disorders. However, so far no method for assessing the strength of the AbH has been established. In addition, previous studies have shown increased IFM activity in the plantarflexed position of the ankle. Therefore, this study tests the hypothesis that a correlation will be found between the cross-sectional area (CSA) of the AbH and the flexion torque and that the first metatarsophalangeal (MTP) joint would be stronger in the plantarflexed (PF) position of the ankle joint than in the neutral (N) position. Methods: Eight male and 8 female patients (16 lower limbs) were included in this study to measure the CSA of IFM and the extrinsic foot muscles of the lower leg. Furthermore, the flexion torque of the first MTP joint was measured using a handheld dynamometer at the N and PF positions of the ankle joint. Correlation analysis was performed to examine the relationship between the CSA of each muscle and the flexion torque of the first MTP joint in the N and PF positions. Results: In the N position, a correlation was found between the flexion torque of the first MTP joint and the CSA of the AbH (r = 0.818), flexor hallucis brevis (r = 0.730), and flexor hallucis longus (r = 0.726). In the PF position, a correlation was found between the flexion torque of the first MTP joint and the CSA of the AbH (r = 0.863) and flexor hallucis brevis (r = 0.680). (P < .05). Conclusion: Overall, this study suggested that by measuring flexion torque of the first MTP joint in the PF position, AbH strength can be estimated without using any expensive equipment. Level of Evidence: Level V, mechanism-baced reasoning.

Reliability of belt-stabilized handheld or isokinetic dynamometer-based isometric knee-extensor strength-testing when seated with the toes of the contralateral nonexamined side off the floor.

[Purpose] To determine the intra-rater and inter-devices reliability of isometric knee-extensor muscle-strength-measurement. [Participants and Methods] The participants were 77 university students (50 males; 27 females) who underwent isometric knee-extension muscle-strength measurement twice with a belt-stabilized handheld dynamometer and isokinetic dynamometer. The intra-rater and inter-devices reliability was ascertained from measurements that were performed with the participant seated on the edge of the bed, the toes of the contralateral nonexamined side off the floor, and the trunk supported by the upper limb. [Results] In the overall, male, and female cohorts, the 95% confidence intervals of intra-rater reliabilities (1,1) in the belt-stabilized handheld and isokinetic dynamometers were 0.96-0.98, 0.92-0.97, and 0.81-0.96, 0.82-0.92, 0.73-0.90, and 0.78-0.95, respectively, and the inter-device 95% confidence intervals were 0.52-0.77, 0.28-0.69, and -0.03 to 0.63, respectively. Compared to the belt-stabilized handheld dynamometer group, the isokinetic dynamometer group had higher knee-extension muscle strength. [Conclusion] The intra-rater reliability was rated good-to-excellent and moderate-to-excellent for the belt-stabilized handheld and isokinetic dynamometers, respectively. The inter-devices reliability was poor, and isometric knee-extension muscle strength in the isokinetic dynamometer group was higher than that in the belt-stabilized handheld dynamometer group.

Accuracy of lung ultrasound performed with handheld ultrasound device in internal medicine: an observational study.

AIMS: Lung ultrasound (LUS) is increasingly used in Internal Medicine to complement medical examination, documenting pleural and lung conditions. This study aimed to compare the accuracy of handheld ultrasound device (HHUSD) with high-end ultrasound device (HEUSD) in patients with heart failure or pneumonia, also including the assessment of costs and time-savings. METHODS: In this observational study 72 patients (aged ≥ 18) admitted to Internal Medicine Unit for heart failure or pneumonia underwent LUS plus evaluation of inferior cava vein (ICV) when indicated, using both HHUSD and HEUSD. Each evaluation, independently performed by 2 different experienced operators, included B-lines number, pleural effusion, lung consolidations, ICV ectasia and its respiratory excursions. RESULTS: Concordance between HHUSD and HEUSD findings was 79.3% ± 17.7 (mean ± SD) for B-lines, 88.6% for pleural effusion, 82.3% for consolidations and 88.7% and 84.9% for ICV ectasia and its respiratory excursions respectively. BMI didn't significantly influence concordance between the two methods. Moreover, examination time (as mean ± SD) was shorter with HHUSD (8 ± 1.5 min) compared to HEUSD (10 ± 2.5 min). CONCLUSIONS: HHUSD demonstrated high accuracy in detecting B-lines, pleural effusions, lung consolidations and ICV evaluation when compared to HEUSD. Thus, HHUSD, not only is characterized by accessibility, portability, and easy handling due to its small size, but it also offers advantages in terms of saving costs and time, ultimately contributing to faster patient assessment compared to HEUSD.

How well can the fetal heart rate baseline be assessed by intrapartum intermittent auscultation? An interrater reliability and agreement study.

BACKGROUND: We aimed to examine the inter-reliability and agreement among midwives when assessing the fetal heart rate (FHR) using the handheld Doppler. The primary aim was to measure the reliability and agreement of FHR baseline (baseline) as beats per minute (bpm). The secondary aims were to measure fluctuations from the baseline, defined as increases and decreases, and classifications (normal or abnormal) of FHR soundtracks. This is the first interrater reliability and agreement study on intermittent auscultation (IA) to our knowledge. METHODS: The participant population consisted of 154 women in labor, from a mixed-risk population and admitted to hospital for intrapartum care. The rater population were 16 midwives from various maternity care settings in Norway. A total of 154 soundtracks were recorded with a handheld Doppler device, and the 16 raters assessed 1-min soundtracks once, through an online survey (Nettskjema). They assessed the baseline, FHR increase or decrease, and the FHR classification. The primary outcome, baseline, was measured with intraclass correlation coefficient (ICC). The secondary outcomes were measured with kappa and proportion of agreement. RESULTS: The interrater reliability for the baseline (bpm) was ICC(A,1) 0.74 (95% CI 0.69-0.78). On average, an absolute difference of 7.9 bpm (95% CI 7.3-8.5 bpm) was observed between pairs of raters. CONCLUSION: Our results demonstrate an acceptable level of reliability and agreement in assessing the baseline using a handheld Doppler.

Automatic tablet-based monoplane quantification of stroke volume and left ventricular ejection fraction: A comparative assessment against computer-based biplane and monoplane tools.

BACKGROUND: Point-of-care cardiovascular left ventricle ejection fraction (LVEF) quantification is established, but automatic tablet-based stroke volume (SV) quantification with handheld ultrasound (HAND) devices is unexplored. We evaluated a tablet-based monoplane LVEF and LV volume quantification tool (AutoEF) against a computer-based tool (Tomtec) for LVEF and SV quantification. METHODS: Patients underwent HAND scans, and LVEF and SV were quantified using AutoEF and computer-based software that utilized either apical four-chamber views (Auto Strain-monoplane [AS-mono]) or both apical four-chamber and apical two-chamber views (Auto Strain-biplane [AS-bi]). Correlation and Bland-Altman analysis were used to compare AutoEF with AS-mono and AS-bi. RESULTS: Out of 43 participants, eight were excluded. AutoEF showed a correlation of .83 [.69:.91] with AS-mono for LVEF and .68 [.44:.82] for SV. The correlation with AS-bi was .79 [.62:.89] for LVEF and .66 [.42:.81] for SV. The bias between AutoEF and AS-mono was 4.88% [3.15:6.61] for LVEF and 17.46 mL [12.99:21.92] for SV. The limits of agreement (LOA) were [-5.50:15.26]% for LVEF and [-8.02:42.94] mL for SV. The bias between AutoEF and AS-bi was 6.63% [5.31:7.94] for LVEF and 20.62 mL [16.18:25.05] for SV, with LOA of [-1.20:14.47]% for LVEF and [-4.71:45.94] mL for SV. CONCLUSION: LVEF quantification with AutoEF software was accurate and reliable, but SV quantification showed limitations, indicating non-interchangeability with neither AS-mono nor AS-bi. Further refinement of AutoEF is needed for reliable SV quantification at the point of care.

An artificial intelligence handheld sensor for direct reading of nickel ion and ethylenediaminetetraacetic acid in food samples using ratiometric fluorescence cellulose paper microfluidic chip.

User-friendly in-field sensing protocol is crucial for the effective tracing of intended analytes under less-developed countries or resources-limited environments. Nevertheless, existing sensing strategies require professional technicians and expensive laboratory-based instrumentations, which are not capable for point-of-care on-site analyses. To address this issue, artificial intelligence handheld sensor has been designed for direct reading of Ni2+ and EDTA in food samples. The sensing platform incorporates smartphone with machine learning-driven application, 3D-printed handheld device, and cellulose paper microfluidic chip stained with ratiometric red-green-emission carbon dots (CDs). Intriguingly, Ni2+ introduction makes green fluorescent (FL) of CDs glow but red FL fade because of the coordination of Ni2+ with CDs verified by density functional theory (DFT), concurrently manifesting continuous FL colour transition from red to green. Subsequent addition of EDTA renders FL of CDs-Ni2+ recover owing to the capture of Ni2+ from CDs by EDTA based on strong chelation effect of EDTA on Ni2+ confirmed via DFT, accompanying with a noticeable colour returning from green to red. Inspired by above FL phenomena, CDs-based cellulose paper microfluidic chips are first fabricated to facilitate point-of-care testing of Ni2+ and EDTA. Designed fully-automatic handheld sensor is utilized to directly output Ni2+ and EDTA concentration in water, milk, spinach, bread, and shampoo based on wide linear ranges of 0-48 µM and 0-96 µM, and low limits of detection of 0.274 µM and 0.624 µM, respectively. The proposed protocol allows for speedy straightforward on-site determination of target analytes, which will trigger the development of automated and intelligent sensors in near future.

Breast Cancer Screening With Automated Breast US and Mammography vs Handheld US and Mammography in Women With Dense Breasts in a Real-World Clinical Setting.

OBJECTIVE: We compared the performance of 2 breast cancer screening approaches, automated breast US (ABUS) with same-day mammography (ABUS/MG) and handheld US (HHUS) with same-day mammography (HHUS/MG), in women with dense breasts to better understand the relative usefulness of ABUS and HHUS in a real-world clinical setting. METHODS: In this institutional review board-approved, retrospective observational study, we evaluated all ABUS/MG and HHUS/MG screening examinations performed at our institution from May 2013 to September 2021. BI-RADS categories, biopsy pathology results, and diagnostic test characteristics (eg, sensitivity, specificity) were compared between the 2 screening approaches using Fisher's exact test. RESULTS: A total of 1120 women with dense breasts were included in this study, with 852 undergoing ABUS/MG and 268 undergoing HHUS/MG. The sensitivities of ABUS/MG and HHUS/MG were 100% (5/5) and 75.0% (3/4), respectively, which was not a statistically significant difference (P = .444). The ABUS/MG approach demonstrated a slightly higher specificity (97.4% [825/847] vs 94.3% [249/264]; P = .028), higher accuracy (97.4% [830/852] vs 94.0% [252/268]; P = .011), and lower biopsy recommendation rate (3.2% [27/852] vs 6.7% [18/268]; P = .019) than the HHUS/MG approach in our patient population. CONCLUSION: Our findings suggest that ABUS/MG performs comparably with HHUS/MG as a breast cancer screening approach in women with dense breasts in a real-world clinical setting, with the ABUS/MG approach demonstrating a similar sensitivity and slightly higher specificity than the HHUS/MG approach. Additional variables, such as patient experience and physician time, may help determine which imaging approach to employ in specific clinical settings.

Comparing the potential of benchtop and handheld mid-infrared spectrometers for predicting soil phosphorus (P) sorption capacity and evaluating the influence of sample preparation.

Traditional soil phosphorus (P) sorption capacity is examined from a Langmuir isotherm batch technique, which is time-consuming, labour intensive and generates chemical waste. In this work, we provide an efficient and convenient technique with MIR spectroscopy to predict the Langmuir parameter of soil P sorption maximum capacity (Smax, mg·kg-1). Four spectral libraries from benchtop (Bruker) and handheld (Agilent) MIR spectrometers were built with samples in two particle size ranges, <0.100 mm (ball-milled) and <2 mm. respectively. Using an archive of samples with a database of sorption parameters, soils were classified into 'low' and 'high' sorption capacities. Chemometric regression models of partial least squares (PLS), Cubist, support vector machine (SVM) regression and random forest (RF) were evaluated for Smax prediction. Bruker spectral libraries with both soil particle sizes yielded 'excellent models', with SVM predicting Smax values with high accuracy (RPIQV = 4.50 and 4.25 for the spectral libraries of the ball-milled and <2 mm samples, respectively). In comparison, the Agilent handheld spectral libraries contained more noise and less resolution. For Agilent MIR spectroscopy, more homogeneous samples after ball milling resulted in a higher accurate Smax prediction. For Agilent libraries of ball-milled samples, an 'approximate quantitative model' (RPIQV = 2.74) was obtained from the raw spectra using the Cubist algorithm. However, for Agilent spectroscopy of <2 mm samples, the best performing Cubist algorithm can only achieve a 'fair model' (RPIQV=2.23) with the potential to discriminate between 'low' and 'high' Smax values. The results suggest that the benchtop spectrometer can predict the Langmuir Smax value with high accuracy without the need to ball mill samples. However, the handheld spectrometer can only make approximate quantitative predictions of Smax for ball-milled samples. For <2 mm samples, Agilent can only be used to classify 'low' and 'high' sorption capacity soils.

Handheld 6-Lead ECG for Early Detection of Acute Inferior Wall ST-T Segment Elevation Myocardial Infarction: HINT-MI Study Design and Rationale.

Background: ST-T segment elevation myocardial infarction (STEMI) is a critical condition that requires rapid diagnosis and treatment. Recently, various ECG recording devices have been developed. In this study, we aim to determine the utility of a 6-lead handheld ECG recording device to shorten the time taken for the diagnosis of inferior wall STEMI. Methods and Design: HINT-MI is an investigator-derived, observational, prospective study that will evaluate the ability of a handheld 6-lead ECG device to diagnose acute inferior wall STEMI. Patients who have undergone coronary angiography for STEMI or for other reasons will be enrolled in the study. This study aims to evaluate sensitivity and specificity of a handheld 6-lead ECG device by the level of agreement with a standard 12-lead ECG for diagnosing inferior wall STEMI. Further, we will determine whether the use of the handheld device can reduce the time needed for reperfusion treatment through faster diagnosis. Conclusions: This study aims to investigate the feasibility of a handheld 6-lead ECG device for diagnosing inferior wall STEMI to reduce the time required to diagnose inferior wall STEMI and to allow timely treatment.