Microneedle electrochemical aptamer-based sensing: Real-time small molecule measurements using sensor-embedded, commercially-available stainless steel microneedles.

Microneedle sensors could enable minimally-invasive, continuous molecular monitoring - informing on disease status and treatment in real-time. Wearable sensors for pharmaceuticals, for example, would create opportunities for treatments personalized to individual pharmacokinetics. Here, we demonstrate a commercial-off-the-shelf (COTS) approach for microneedle sensing using an electrochemical aptamer-based sensor that detects the high-toxicity antibiotic, vancomycin. Wearable monitoring of vancomycin could improve patient care by allowing targeted drug dosing within its narrow clinical window of safety and efficacy. To produce sensors, we miniaturize the electrochemical aptamer-based sensors to a microelectrode format, and embed them within stainless steel microneedles (sourced from commercial insulin pen needles). The microneedle sensors achieve quantitative measurements in body-temperature undiluted blood. Further, the sensors effectively maintain electrochemical signal within porcine skin. This COTS approach requires no cleanroom fabrication or specialized equipment, and produces individually-addressable, sterilizable microneedle sensors capable of easily penetrating the skin. In the future, this approach could be adapted for multiplexed detection, enabling real-time monitoring of a range of biomarkers.

No evidence for a negative association between bovine leukemia virus status and fertility in Kansas beef herds: a cross-sectional study.

OBJECTIVE: Determine the association between bovine leukemia virus (BLV) status and fertility in beef cows. BLV-status was defined using 3 different testing strategies (ELISA-, quantitative polymerase chain reaction- [qPCR], and high proviral load [PVL]-status). Fertility was defined as the overall probability of pregnancy as well as the probability of becoming pregnant in the first 21 days of the breeding season. ANIMALS: Convenience sample of 2,820 cows from 43 beef herds. PROCEDURES: The association of BLV-status with the probability of becoming pregnant was evaluated with a multivariable logistic regression analysis that used pregnancy status as a binary outcome, herd nested within ranch as a random effect, and BLV-status (ELISA-, qPCR-, and PVL-status as separate models) and potential covariates (eg, age, Body Condition Score [BCS] category, and interactions) as fixed effects. RESULTS: Raw data revealed that 55% (1,552/2,820) of cows were classified as BLV-positive by ELISA, and 95.3% (41/43) of herds had a least 1 ELISA-positive cow. Classification as BLV ELISA-positive was positively associated with the probability of being pregnant; however, when qPCR or PVL were used to classify BLV-status, there was no association with the probability of being pregnant. None of the methods of classifying BLV-status were associated with the probability of becoming pregnant in the first 21 days of the breeding season. CLINICAL RELEVANCE: This study did not find evidence that testing beef cows for BLV-status using ELISA, qPCR, or a cut-off of 0.9 PVL and removing test-positive cows will improve cowherd fertility as described by the probability of becoming pregnant during the breeding season or becoming pregnant during the first 21 days of the breeding season.

Cross-sectional study to describe bovine leukemia virus herd and within-herd ELISA prevalence and bovine leukemia virus proviral load of convenience-sampled Kansas beef cow-calf herds.

OBJECTIVE: Determine bovine leukemia virus (BLV) seroprevalence of adult female cattle in Eastern Kansas beef herds and the proviral load (PVL) of those cattle found to be ELISA positive. ANIMALS: Convenience sample of 2,845 cows from 44 beef herds. PROCEDURES: BLV serostatus was determined using an ELISA antibody test (gp-51; IDEXX). BLV quantitative PCR (qPCR) status and PVL were determined utilizing a qPCR test (SS1 qPCR test; CentralStar Laboratories). The association of age, herd size, and body condition score (BCS) category on the probability of being BLV positive was evaluated with a multiple variable logistic regression analysis that used BLV status as a binary outcome, herd nested within ranch as a random effect, and BCS, herd size, and age category as fixed effects. RESULTS: Forty-two of 44 herds had at least 1 BLV ELISA-positive cow (95.5% herd seroprevalence). Overall, 1,564 of the 2,845 cows were BLV ELISA positive (55.0% individual animal prevalence). No association between BLV ELISA status and herd size or BCS was identified. When evaluated by age, the model-adjusted probability of being BLV ELISA positive was lowest for heifers (1 year of age, first parity) and increased until 5 to 6 years of age. Of the 1,564 ELISA-positive animals, 838 were qPCR positive (53.6%). The model-adjusted probability of being qPCR positive was not associated with age, herd size, or BCS category. CLINICAL RELEVANCE: This study indicated that BLV-seropositive status both as a herd classification and individual animal classification was very common in this population. Because the percentage of BLV-seropositive cows varied between herds and by age, this study provides evidence that it is essential for investigators to control for herd and age in any analysis of the association of BLV serostatus and health and production outcomes of interest. Some BLV ELSIA-seropositive cows were classified as BLV negative by qPCR, and risk factors may differ between classification status by ELISA and qPCR.

Follow-up observation of patients with obstructive sleep apnea treated by maxillomandibular advancement.

INTRODUCTION: This study aimed to evaluate the follow-up observation of patients with obstructive sleep apnea treated with maxillomandibular advancement (MMA) procedure with or without genial tubercle advancement (GTA). METHODS: A total of 25 patients (mean age 37.1 ± 17.3 years) were included in the study. Cone-beam computed tomography scans were taken before treatment; after presurgical orthodontic treatment; immediately after MMA procedure; and follow-up visit. All Digital Imaging and Communications in Medicine files were analyzed using the Dolphin 3D Imaging software program (Dolphin Imaging and Management Solutions, Chatsworth, Calif) to determine the total airway volume (TAV), airway area (AA), and minimal cross-sectional area (MCA). Dolphin 3D voxel-based superimposition was used to determine the amount of skeletal advancement with MMA and changes after surgery. RESULTS: Significant increase in TAV, AA, and MCA was found with MMA treatment (40.6%, 28.8%, and 56.4%, respectively, P <0.0001). Smaller but significant decrease in TAV, AA, and MCA was found during a follow-up visit (20.0%, 9.7%, and 26.8%, respectively, P <0.0001) giving a net increase of TAV, AA and MCA (35.8%, 27.1%, and 45.9%, respectively). No significant differences were found in any of the airway measurements with or without the GTA procedure. The average forward movements of the maxilla, mandible, and chin were 6.6 mm, 8.2 mm, and 11.4 mm, respectively. A relapse of less than 1 mm was found in each of the variables during the follow-up period. No correlation was found between the magnitudes of skeletal advancement and the change in oropharyngeal airway space (OPAS). CONCLUSIONS: Significant increase in OPAS can be expected with MMA surgery with or without GTA procedure in patients diagnosed with obstructive sleep apnea. A partial loss in OPAS was found during the follow-up visit. The surgical movements were found to be stable, with less than 1 mm of relapse during the follow-up period, which was not clinically significant.

Comparison of two maxillary protraction protocols: tooth-borne versus bone-anchored protraction facemask treatment.

BACKGROUND: Protraction facemask has been advocated for treatment of class III malocclusion with maxillary deficiency. Studies using tooth-borne rapid palatal expansion (RPE) appliance as anchorage have experienced side effects such as forward movement of the maxillary molars, excessive proclination of the maxillary incisors, and an increase in lower face height. A new Hybrid Hyrax bone-anchored RPE appliance claimed to minimize the side effects of maxillary expansion and protraction. A retrospective study was conducted to compare the skeletal and dentoalveolar changes in patients treated with these two protocols. METHODS: Twenty class III patients (8 males, 12 females, mean age 9.8 ± 1.6 years) who were treated consecutively with the tooth-borne maxillary RPE and protraction device were compared with 20 class III patients (8 males, 12 females, mean age 9.6 ± 1.2 years) who were treated consecutively with the bone-anchored maxillary RPE and protraction appliances. Lateral cephalograms were taken at the start of treatment and at the end of maxillary protraction. A control group of class III patients with no treatment was included to subtract changes due to growth to obtain the true appliance effect. A custom cephalometric analysis based on measurements described by Bjork and Pancherz, McNamara, Tweed, and Steiner analyses was used to determine skeletal and dental changes. Data were analyzed using a one-way analysis of variance. RESULTS: Significant differences between the two groups were found in 8 out of 29 cephalometric variables (p < .05). Subjects in the tooth-borne facemask group had more proclination of maxillary incisors (OLp-Is, Is-SNL), increase in overjet correction, and correction in molar relationship. Subjects in the bone-anchored facemask group had less downward movement of the "A" point, less opening of the mandibular plane (SNL-ML and FH-ML), and more vertical eruption of the maxillary incisors. CONCLUSIONS: The Hybrid Hyrax bone-anchored RPE appliance minimized the side effect encounter by tooth-borne RPE appliance for maxillary expansion and protraction and may serve as an alternative treatment appliance for correcting class III patients with a hyperdivergent growth pattern.

Effects of conscious sedation on patient recall of anxiety and pain after oral surgery.

OBJECTIVE: This study examined the effect of conscious ("moderate") sedation with amnestic effects and local anesthetic, versus local anesthetic alone, on recall of pain and anxiety related to surgical tooth extraction. Greater anxiety and pain were hypothesized in the local anesthesia-alone group. STUDY DESIGN: Patients undergoing tooth extraction, receiving moderate sedation plus local anesthetic (n = 27) or local anesthetic alone (n = 27), were assessed on trait dental anxiety, preextraction state pain and anxiety, anticipated pain and anxiety, and 1-month recall of pain and anxiety. RESULTS: Patients with moderate sedation, compared with those administered only local anesthetic, recalled less procedural pain and anxiety after 1 month. The local anesthetic-alone group reported more preextraction pain and anticipated more procedural anxiety. CONCLUSIONS: Moderate sedation had the desired effect of lower recalled pain and anxiety associated with extraction, even 1 month later. Anticipating moderate sedation also prompts expectation of less anxiety during the procedure.