Pilot study: Utility of long-wave infrared thermography as a correlate to transcutaneous oximetry for candidates of hyperbaric oxygen therapy.

Hyperbaric oxygen (HBO2 ) has been used as an adjunctive treatment for the care of advanced non-healing diabetic foot ulcers (DFUs). A patient's in-chamber transcutaneous oximetry measurement (TCOM) is currently the most effective predictor for response to HBO2 therapy but still excludes close to one in four patients who would benefit out of treatment groups when used for patient selection. Improving selection tools and criteria could potentially help better demonstrate HBO2 therapy's efficacy for such patients. We sought to identify if long-wave infrared thermography (LWIT) measurements held any correlation with a patient's TCOM measurements and if LWIT could be used in a response prediction role for adjunctive HBO2 therapy. To investigate, 24 patients already receiving TCOM measurements were enrolled to simultaneously be imaged with LWIT. LWIT measurements were taken throughout each patient's therapeutic course whether they underwent only standard wound care or adjunctive HBO2 treatments. A significant correlation was found between in-chamber TCOM and post-HBO2 LWIT. There was also a significant difference in the post-HBO2 LWIT measurement from 1st treatment to 6 weeks or the last treatment recorded. These initial findings are important as they indicate a possible clinical use for LWIT in the selection process for patients for HBO2 therapy. Larger studies should be carried out to further articulate the clinical use of LWIT in this capacity.

Rapid single-molecule digital detection of protein biomarkers for continuous monitoring of systemic immune disorders.

Digital protein assays have great potential to advance immunodiagnostics because of their single-molecule sensitivity, high precision, and robust measurements. However, translating digital protein assays to acute clinical care has been challenging because it requires deployment of these assays with a rapid turnaround. Herein, we present a technology platform for ultrafast digital protein biomarker detection by using single-molecule counting of immune-complex formation events at an early, pre-equilibrium state. This method, which we term "pre-equilibrium digital enzyme-linked immunosorbent assay" (PEdELISA), can quantify a multiplexed panel of protein biomarkers in 10 µL of serum within an unprecedented assay incubation time of 15 to 300 seconds over a 104 dynamic range. PEdELISA allowed us to perform rapid monitoring of protein biomarkers in patients manifesting post-chimeric antigen receptor T-cell therapy cytokine release syndrome, with ∼30-minute sample-to-answer time and a sub-picograms per mL limit of detection. The rapid, sensitive, and low-input volume biomarker quantification enabled by PEdELISA is broadly applicable to timely monitoring of acute disease, potentially enabling more personalized treatment.

A Systematic Review and Meta-Analysis of Decompression Sickness in Altitude Physiological Training.

INTRODUCTION: A review of decompression sickness (DCS) cases associated with the NASA altitude physiological training (APT) program at the Johnson Space Center (JSC) motivated us to place our findings into the larger context of DCS prevalence from other APT centers.METHODS: We reviewed JSC records from 1999 to 2016 and 14 publications from 1968 to 2004 about DCS prevalence in other APT programs. We performed a meta-analysis of 15 APT profiles (488 cases / 385,116 exposures). We used meta-regression to evaluate the relation between estimated exposures and probability of DCS in a test group, accounting for the heterogeneity between studies.RESULTS: Our in-house review identified 6 Type I DCS (1 from an inside observer) and 1 Type II DCS. There were 6 cases in 9560 student hypobaric exposures from 3 NASA training flights; a student pooled prevalence rate of 0.44 cases / 1000 exposures compared to 1.44 cases / 1000 from 12 published APT profiles. The overall pooled DCS prevalence rate was 1.16 cases / 1000 exposures. There was substantial heterogeneity in DCS prevalence across studies. Denitrogenation time, exposure pressure, and exposure time were associated with probability of DCS in the meta-regression model.CONCLUSIONS: While the overall DCS prevalence rate is relatively low, there is marked heterogeneity among profiles. The pooled DCS prevalence rate estimate for the NASA profiles was lower than the overall rate. Variability in APT profile DCS prevalence could be further explained given student level and additional test-level covariates.Conkin J, Sanders RW, Koslovsky MD, Wear ML, Kozminski AG, Abercromby AFJ. A systematic review and meta-analysis of decompression sickness in altitude physiological training. Aerosp Med Hum Perform. 2018; 89(11):941-951.