Incidence of Clostridioides difficile Infections in Republic of Korea: A Prospective Study With Active Surveillance vs. National Data From Health Insurance Review & Assessment Service.

BACKGROUND: Since the emergence of hypervirulent strains of Clostridioides difficile, the incidence of C. difficile infections (CDI) has increased significantly. METHODS: To assess the incidence of CDI in Korea, we conducted a prospective multicentre observational study from October 2020 to October 2021. Additionally, we calculated the incidence of CDI from mass data obtained from the Health Insurance Review and Assessment Service (HIRA) from 2008 to 2020. RESULTS: In the prospective study with active surveillance, 30,212 patients had diarrhoea and 907 patients were diagnosed with CDI over 1,288,571 patient-days and 193,264 admissions in 18 participating hospitals during 3 months of study period; the CDI per 10,000 patient-days was 7.04 and the CDI per 1,000 admission was 4.69. The incidence of CDI was higher in general hospitals than in tertiary hospitals: 6.38 per 10,000 patient-days (range: 3.25-12.05) and 4.18 per 1,000 admissions (range: 1.92-8.59) in 11 tertiary hospitals, vs. 9.45 per 10,000 patient-days (range: 5.68-13.90) and 6.73 per 1,000 admissions (range: 3.18-15.85) in seven general hospitals. With regard to HIRA data, the incidence of CDI in all hospitals has been increasing over the 13-year-period: from 0.3 to 1.8 per 10,000 patient-days, 0.3 to 1.6 per 1,000 admissions, and 6.9 to 56.9 per 100,000 population, respectively. CONCLUSION: The incidence of CDI in Korea has been gradually increasing, and its recent value is as high as that in the United State and Europe. CDI is underestimated, particularly in general hospitals in Korea.

Epidemiological and Genetic Characterization of Coxsackievirus A6-Associated Hand, Foot, and Mouth Disease in Gwangju, South Korea, in 2022.

Coxsackievirus A6 (CV-A6) has emerged as the predominant causative agent of hand, foot, and mouth disease (HFMD) in young children. Since the declaration of coronavirus disease 2019 (COVID-19) as a global pandemic, the incidence of infectious diseases, including HFMD, has decreased markedly. When social mitigation was relaxed during the COVID-19 pandemic in 2022, the re-emergence of HFMD was observed in Gwangju, South Korea, and seasonal characteristics of the disease appeared to have changed. To investigate the molecular characteristics of enterovirus (EV) associated with HFMD during 2022, 277 specimens were collected. Children aged younger than 5 years accounted for the majority of affected individuals. EV detection and genotyping were performed using real-time RT-PCR and nested RT-PCR followed by sequence analysis. The EV detection rate was found to be 82.3%, and the main genotype identified was CV-A6. Sixteen CV-A6 samples were selected for whole genome sequencing. According to phylogenetic analysis, all CV-A6 strains from this study belonged to the sub-genotype D3 clade based on VP1 sequences. Analysis of 3D polymerase phylogeny showed that only the recombinant RF-A group was identified. In conclusion, circulating EV types should be continuously monitored to understand pathogen emergence and evolution during the post-pandemic era.

Synchronous Diagnosis of Respiratory Viruses Variants via Receptonics Based on Modeling Receptor-Ligand Dynamics.

The transmission and pathogenesis of highly contagious fatal respiratory viruses are increasing, and the need for an on-site diagnostic platform has arisen as an issue worldwide. Furthermore, as the spread of respiratory viruses continues, different variants have become the dominant circulating strains. To prevent virus transmission, the development of highly sensitive and accurate on-site diagnostic assays is urgently needed. Herein, a facile diagnostic device is presented for multi-detection based on the results of detailed receptor-ligand dynamics simulations for the screening of various viral strains. The novel bioreceptor-treated electronics (receptonics) device consists of a multichannel graphene transistor and cell-entry receptors conjugated to N-heterocyclic carbene (NHC). An ultrasensitive multi-detection performance is achieved without the need for sample pretreatment, which will enable rapid diagnosis and prevent the spread of pathogens. This platform can be applied for the diagnosis of variants of concern in clinical respiratory virus samples and primate models. This multi-screening platform can be used to enhance surveillance and discriminate emerging virus variants before they become a severe threat to public health.

Second Skin as Self-Protection Against γ-Hydroxybutyrate.

γ-Hydroxybutyrate (GHB), a date-rape drug, causes certain symptoms, such as amnesia, confusion, ataxia, and unconsciousness, when dissolved in beverages and consumed by a victim. Commonly, assailants use GHB in secret for the crime of drug-facilitated sexual assault because it is tasteless, odorless, and colorless when dissolved in beverages. Generally, GHB detection methods are difficult to use promptly and secretly in situ and in real life because of the necessary detection equipment and low selectivity. To overcome this problem, we have developed a fast, simple, and easy-to-use second skin platform as a confidential self-protection platform that can detect GHB in situ or in real life without equipment. The second skin platform for naked-eye detection of GHB is fabricated with poly(vinyl alcohol) (PVA), polyurethane (PU), and polyacrylonitrile (PAN) included in the chemical receptor 2-(3-bromo-4-hydroxystyryl)-3-ethylbenzothiazol-3-ium iodide (BHEI). PAN conjugated with BHEI nanofibers (PB NFs) has various characteristics, such as ease of use, high sensitivity, and fast color change. PB NFs rapidly detected GHB at 0.01 mg/mL. Furthermore, the second-skin platform attached to the fingertip and wrist detected both 1 and 0.1 mg/mL GHB in solution within 50 s. The color changes caused by the interaction of GHB and the second skin platform cannot be stopped due to strong chemical reactions. In addition, a second skin platform can be secretly utilized in real life because it can recognize fingerprints and object temperatures. Therefore, the second skin platform can be used to aid daily life and prevent drug-facilitated sexual assault crime when attached to the skin because it can be exposed anytime and anywhere.

Clinical performance of the STANDARD M10 SARS-CoV-2 rapid RT-PCR assay in patients visiting an emergency department.

In emergency departments, rapid screening of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was important for arranging limited isolation resources and patient care during the coronavirus disease 2019 (COVID-19) pandemic. STANDARD M10 SARS-CoV-2 (SD Biosensor) is a recently developed cartridge-based RT-PCR that provides a turnaround time of 1 h, which is shorter than that for conventional RT-PCR. This study evaluated the clinical performance of STANDARD M10 in patients visiting an emergency department. From March to June 2022, two specimens were collected from patients visiting an emergency department. Each specimen comprised one nasopharyngeal and one oropharyngeal swab. Respective specimens underwent rapid RT-PCR using STANDARD M10 and conventional RT-PCR using Allplex SARS-CoV-2 (Seegene). When discordant results occurred, specimens undergoing the STANDARD M10 were retested with the Allplex to exclude specimen variations. Retest results replaced initial results of the Allplex. Clinical performance of STANDARD M10 was compared with Allplex. The study enrolled 1971 patients. COVID-19 prevalence was 6.2% based on the Allplex. Compared with the Allplex, overall agreement, positive percent agreement, and negative percent agreement of STANDARD M10 were 99.5% (95% CI: 99.1%-99.8%), 95.9% (95% CI: 90.8%-98.3%), and 99.8% (95% CI: 99.4%-99.9%), respectively. Nine discordant results were all positive on droplet digital PCR, except for one specimen that was positive with STANDARD M10. The STANDARD M10 showed reliable diagnostic performance for detecting SARS-CoV-2 from patients visiting in emergency departments and is a useful tool in emergency healthcare systems because of its easy-to-use cartridge-based assay and short resulting time for detecting SARS-CoV-2.

Clinical Utility of SARS-CoV-2 Rapid Antigen Test in the Emergency Department.

BACKGROUND: Rapid screening for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was important in the emergency department during the coronavirus disease 2019 (COVID-19) pandemic. Real-time polymerase chain reaction (RT-PCR) is the standard method for detecting SARS-CoV-2, but it requires several hours to provide results. Instead, the rapid antigen test (RAT) has a short turnaround time and can be used at the bedside but shows low sensitivity. To overcome these shortcomings, the clinical utility of stepwise testing of RAT with RT-PCR in the emergency department was analyzed. METHODS: Patients who underwent SARS-CoV-2 RAT (SD Biosensor or Abbott) and RT-PCR (Seegene Allplex or GeneXpert) testing simultaneously at the emergency department in South Korea from January 2021 to March 2022 were enrolled. We compared the performance status of RAT with that of RT-PCR and evaluated the clinical utility of RAT as a screening tool for patients visiting the emergency department. RESULTS: A total of 7,574 patients were included. The overall prevalence of COVID-19 was 1.9% (146/7,574). The sensitivity and specificity of the RAT were 69.2% and 99.9%, respectively, and the positive and negative predictive values were 96.2% and 99.4%, respectively. Based on the cycle threshold (Ct) of the E gene, the sensitivity was 86.0% in patients with Ct < 26, but the sensitivity was 9.3% in patients with Ct ≥ 26. CONCLUSIONS: In the COVID-19 pandemic, RAT can be used as supplement test for the screening strategy using RT-PCR in the emergency department because it is rapid, highly specific, and relatively sensitive in patients with high viral load.

Reusable Electronic Tongue Based on Transient Receptor Potential Vanilloid 1 Nanodisc-Conjugated Graphene Field-Effect Transistor for a Spiciness-Related Pain Evaluation.

The sense of spiciness is related to the stimulation of vanilloid compounds contained in the foods. Although, the spiciness is commonly considered as the part of taste, it is more classified to the sense of pain stimulated on a tongue, namely, pungency, which is described as a tingling or burning on the tongue. Herein, first, a reusable electronic tongue based on a transient receptor potential vanilloid 1 (TRPV1) nanodisc conjugated graphene field-effect transistor is fabricated and spiciness-related pain evaluation with reusable electrode is demonstrated. The pungent compound reactive receptor TRPV1 is synthesized in the form of nanodiscs to maintain stability and reusability. The newly developed platform shows highly selective and sensitive performance toward each spiciness related vanilloid compound repeatably: 1 aM capsaicin, 10 aM dihydrocapsaicin, 1 fM piperine, 10 nM allicin, and 1 pM AITC. The binding mechanism is also examined by simulation. Furthermore, the elimination of the burning sensation on the tongue after eating spicy foods is not investigated. Based on the synthesis of micelles composed of casein protein (which is contained in skim milk) that remove pungent compounds bound to TRPV1 nanodisc, the deactivation of TRPV1 is investigated, and the electrode is reusable that mimics electronic tongue.

Fluorophore-encapsulated nanobeads for on-site, rapid, and sensitive lateral flow assay.

Since December 2019, the rapid and sensitive detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a priority for public health. Although the lateral flow assay (LFA) sensor has emerged as a rapid and on-site SARS-CoV-2 detection technique, the conventional approach of using gold nanoparticles for the signaling probe had limitations in increasing the sensitivity of the sensor. Herein, our newly suggested methodology to improve the performance of the LFA system could amplify the sensor signal with a facile fabrication method by concentrating fluorescent organic molecules. A large Stokes shift fluorophore (single benzene) was encapsulated into polystyrene nanobeads to enhance the fluorescence intensity of the probe for LFA sensor, which was detected on the test line with a longpass filter under ultraviolet light irradiation. This approach provides comparatively high sensitivity with the limit of detection of 1 ng mL-1 for the SARS-CoV-2 spike protein and a fast detection process, which takes less than 20 min. Furthermore, our sensor showed higher performance than gold nanoparticle-based commercial rapid diagnostics test kits in clinical tests, proving that this approach is more suitable and reliable for the sensitive and rapid detection of viruses, bacteria, and other hazardous materials.

Elastic Fluorescent Protein-Based Down-Converting Optical Films for Flexible Display.

Protein-based material design provides great advantages to developing smart biomaterials with tunable structures and desired functions. They have been widely used in many biomedical applications including tissue engineering and drug delivery. However, protein-based materials are not yet widely used in optoelectronic materials despite their excellent optical and tunable mechanical properties. Here, we synthesized engineered fluorescent proteins (FPs) fused with elastic protein for the development of optoelectrical down-converting optical filters for flexible display materials. We synthesized sequence-specific FPs to tune blue, green, yellow, and red colors and fused them with elastic protein to tune mechanical properties. We fabricated flexible self-supporting film materials and characterized mechanical properties and down-converting optical properties. We also fabricated a hybrid light-emitting diode (LED) to down convert blue to desired green, red, and white colors. Furthermore, we constructed a flexible white LED using organic LED as a flexible substrate. Our modular synthesis approach of tunable bio-optoelectrical material approaches will be useful to design future biocompatible and flexible display materials and technologies.

Maternal and Neonatal Outcomes in Pregnant Women With Coronavirus Disease 2019 in Korea.

BACKGROUND: This study aimed to describe the maternal, obstetrical, and neonatal outcomes in pregnant women with coronavirus disease 2019 (COVID-19) and identify the predictors associated with the severity of COVID-19. METHODS: This multicenter observational study included consecutive pregnant women admitted because of COVID-19 confirmed using reverse transcriptase-polymerase chain reaction (RT-PCR) test at 15 hospitals in the Republic of Korea between January 2020 and December 2021. RESULTS: A total of 257 women with COVID-19 and 62 newborns were included in this study. Most of the patients developed this disease during the third trimester. Nine patients (7.4%) developed pregnancy-related complications. All pregnant women received inpatient treatment, of whom 9 (3.5%) required intensive care, but none of them died. The gestational age at COVID-19 diagnosis (odds ratio [OR], 1.096, 95% confidence interval [CI], 1.04-1.15) and parity (OR, 1.703, 95% CI, 1.13-2.57) were identified as significant risk factors of severe diseases. Among women who delivered, 78.5% underwent cesarean section. Preterm birth (38.5%), premature rupture of membranes (7.7%), and miscarriage (4.6%) occurred, but there was no stillbirth or neonatal death. The RT-PCR test of newborns' amniotic fluid and umbilical cord blood samples was negative for severe acute respiratory syndrome coronavirus 2. CONCLUSION: At the time of COVID-19 diagnosis, gestational age and parity of pregnant women were the risk factors of disease severity. Vertical transmission of COVID-19 was not observed, and maternal severity did not significantly affect the neonatal prognosis.

Influence of Mechanical Fatigue at Different States of Charge on Pouch-Type Li-Ion Batteries.

Since flexible devices are being used in various states of charge (SoCs), it is important to investigate SoCs that are durable against external mechanical deformations. In this study, the effects of a mechanical fatigue test under various initial SoCs of batteries were investigated. More specifically, ultrathin pouch-type Li-ion polymer batteries with different initial SoCs were subjected to repeated torsional stress and then galvanostatically cycled 200 times. The cycle performance of the cells after the mechanical test was compared to investigate the effect of the initial SoCs. Electrochemical impedance spectroscopy was employed to analyze the interfacial resistance changes of the anode and cathode in the cycled cells. When the initial SoC was at 70% before mechanical deformation, both electrodes well maintained their initial state during the mechanical fatigue test and the cell capacity was well retained during the cycling test. This indicates that the cells could well endure mechanical fatigue stress when both electrodes had moderate lithiation states. With initial SoCs at 0% and 100%, the batteries subjected to the mechanical test exhibited relatively drastic capacity fading. This indicates that the cells are vulnerable to mechanical fatigue stress when both electrodes have high lithiation states. Furthermore, it is noted that the stress accumulated inside the batteries caused by mechanical fatigue can act as an accelerated degradation factor during cycling.

Wireless portable bioelectronic nose device for multiplex monitoring toward food freshness/spoilage.

Monitoring food freshness/spoilage is important to ensure food quality and safety. Current methods of food quality monitoring are mostly time-consuming and labor intensive processes that require massive analytical equipment. In this study, we developed a portable bioelectronic nose (BE-nose) integrated with trace amine-associated receptor (TAAR) nanodiscs (NDs), allowing food quality monitoring via the detection of food spoilage indicators, including the biogenic amines cadaverine (CV) and putrescine (PT). The olfactory receptors TAAR13c and TAAR13d, which have specific affinities for CV and PT, were produced and successfully reconstituted in ND structures. TAAR13 NDs BE-nose-based side-gated field-effect transistor (SG-FET) system was constructed by utilizing a graphene micropattern (GM) into which two types of olfactory NDs (TAAR13c ND and TAAR13d ND) were introduced, and this system showed ultrahigh sensitivity for a limit of detection (LOD) of 1 fM for CV and PT. Moreover, the binding affinities between the TAAR13 NDs and the indicators were confirmed by a tryptophan fluorescence quenching assay and biosimulations, in which the specific binding site was confirmed. Gas-phase indicators were detected by the TAAR13 NDs BE-nose platform, and the LODs for CV and PT were confirmed to be 26.48 and 7.29 ppb, respectively. In addition, TAAR13 NDs BE-nose was fabricated with commercial gas sensors as a portable platform for the measurement of NH3 and H2S, multiplexed monitoring was achieved with similar performance, and the change ratio of the indicators was observed in a real sample. The integration of commercial gas sensors on a BE-nose enhanced the accuracy and reliability for the quality monitoring of real food samples. These results indicate that the portable TAAR13 NDs BE-nose can be used to monitor CV and PT over a wide range of concentrations, therefore, the electronic nose platform can be utilized for monitoring the freshness/spoilage step in various foods.

Real-time monitoring of serotonin with highly selective aptamer-functionalized conducting polymer nanohybrids.

Adequate serotonin levels are pivotal to human well-being; thus, serotonin can be used as a biomarker because it regulates a wide range of physical and psychological functions. As an imbalance of serotonin is highly likely to initiate the pathogenesis of various disorders, monitoring serotonin levels in real time is in high demand for the early detection of disease. We fabricated a field-effect transistor (FET) biosensor based on aptamer-immobilized conducting polymer nanohybrids, which showed an instantaneous response toward serotonin in solution. The mechanism of serotonin detection was based on aptamer deformation after aptamer-ligand interaction and the consequential decrease in the charge carrier density of the FET template. Docking simulations with AutoDock/Vina and PyMOL were successfully used to investigate the binding site of serotonin in the loop structure of the aptamer. The fabricated FET template showed high sensitivity toward serotonin in the range of 10 fM to 100 nM, and the limit of detection (LOD) was exceptionally low at 10 fM. Moreover, the selectivity toward serotonin was confirmed by observing no signal after the injection of structural analogs, functional analogs and excess physiological biomolecules. The potential clinical application of this sensor was confirmed because it remained consistent when the buffer solution was exchanged for artificial serum or artificial cerebrospinal fluid (CSF). † S.G.L. and S.E.S. contributed equally to this work.

Which is the Preferred Regimen for Non-Severe Clostridioides difficile Infection in Korea, Vancomycin or Metronidazole?

The emergence of hypervirulent Clostridioides difficile strains has decreased the efficacy of metronidazole in the treatment of C. difficile infection (CDI). Therefore, revised guidelines no longer recommend the use of metronidazole as a first-line regimen for CDI and restrict its use for non-severe CDI, only when vancomycin and fidaxomicin are unavailable. In Korea, an epidemic caused by a hypervirulent C. difficile strain or the emergence of metronidazole resistant C. difficile strains have not been reported. This review article aims to compare the treatment outcomes and adverse effects of vancomycin and metronidazole and discuss the validity of the guidelines of various agencies, which restrict the use of metronidazole, for Korean patients. There are no substantial adverse effects of metronidazole, and its clinical outcomes against non-severe CDI are similar to those of vancomycin. Based on these findings, we recommend that the use of metronidazole for the treatment of non-severe CDI is still an appropriate option in Korea.

In situ, real-time, colorimetric detection of γ-hydroxybutyric acid (GHB) using self-protection products coated with chemical receptor-embedded hydrogel.

Due to the increase in drug-facilitated sexual assault (DFSA) enabled by the illegal use of drugs, there have been constant demands for simple methods that can be used to protect oneself against crime in real life. γ-Hydroxybutyric acid (GHB), a central nervous system depressant, is one of the most dangerous drugs for use in DFSA because it is colorless and has slow physiological effects, which pose challenges for developing in situ, real-time GHB monitoring techniques. In this study, we developed a method for in situ colorimetric GHB detection using various self-protection products (SPPs) coated with 2-(3-bromo-4-hydroxystyryl)-3-ethylbenzothiazol-3-ium iodide (BHEI) as a chemical receptor embedded in hydrogels. Additionally, smartphone-based detection offers enhanced colorimetric sensitivity compared to that of the naked eye. The developed SPPs will help address drug-facilitated social problems.

Association between gastric cancer and the risk of depression among South Korean adults.

OBJECTIVES: The diagnosis and treatment of cancer are stressful events that could trigger psychological distress in a large number of cancer patients. The aim of this study was to examine the association between gastric cancer and the risk of new onset of depression among South Korean adults. METHODS: Data from 12,664 participants aged over 40 years was derived from the National Health Service National Sample Cohort (2002-2013). The case cohort consists of patients who received a diagnosis of gastric cancer between 2002 and 2009, and the corresponding control group was selected through 1:1 propensity score matching (case: 6332, control: 6332). The new onset of depression was considered as the dependent variable. A Cox proportional hazards regression model was built to analyze the associations between variables in consideration. RESULTS: Individuals with gastric cancer had a higher risk of new onset of depression than those without cancer (hazard ratio [HR] = 1.28, 95% confidence interval [CI] = 1.13-1.45.) Female gastric patients had a higher risk of depression compared to male patients (Female; HR = 1.89, 95% CI = 1.66-2.16, Male; HR = 1.25, 95% CI = 1.10-1.41). Gastric cancer patients in their 60s had the highest risk of new onset of depression compared to other age groups and no cancer group (HR = 1.61, 95% CI = 1.40-1.85). Gastric cancer patients who were previously diagnosed with depression prior to their diagnosis of cancer had a higher risk of new onset of depression than gastric cancer patients without antecedent diagnosis of depression (Past Depression (Yes); HR = 5.17, 95% CI = 4.10-6.51, Past Depression (No); HR = 1.35, CI = 1.21-1.51). CONCLUSIONS: The study identified a significant relationship between gastric cancer and depression among South Korean adults, suggesting that the diagnosis and treatment of gastric cancer increases the risk of new onset of depression, especially among female patients between 60 and 69 years old of high income and living in metropolitan regions. Pre-existing health conditions also appeared to be a risk factor. Thus, in consideration of treatment efficacy and patients' quality of life, the results of the study emphasizes the need for attentive intervention, while distinguishing the most vulnerable groups.

Nanoencapsulated Phase-Change Materials: Versatile and Air-Tolerant Platforms for Triplet-Triplet Annihilation Upconversion.

Efficient and long-term stable triplet-triplet annihilation upconversion (TTA-UC) can be achieved by effectively protecting the excited organic triplet ensembles from photoinduced oxygen quenching, and discovery of a new material platform that promotes TTA-UC in ambient conditions is of paramount importance for practical applications. In this study, we present the first demonstration of an organic nonparaffin phase-change material (PCM) as an air-tolerant medium for TTA-UC with a unique solid-liquid phase transition in response to temperature variation. For the proposed concept, 2,4-hexadien-1-ol is used and extensively characterized with several key features, including good solvation capacity, mild melting point (30.5 °C), and exclusive antioxidant property, enabling a high-efficiency, low-threshold, and photostable TTA-UC system without energy-intensive degassing processes. In-depth characterization reveals that the triplet diffusion among the transient species, i.e., 3sensitizer* and 3acceptor*, is efficient and well protected from oxygen quenching in both aerated liquid- and solid-phase 2,4-hexadien-1-ol. We also propose a new strategy for the nanoencapsulation of PCM by employing hollow mesoporous silica nanoparticles as vehicles. This scheme is applicable to both aqueous- and solid-phase TTA-UC systems as well as suitable for various applications, such as thermal energy storage and smart drug delivery.

Wearable Cortisol Aptasensor for Simple and Rapid Real-Time Monitoring.

The necessity of managing stress levels is becoming increasingly apparent as the world suffers from different kinds of stresses including the extent of pandemic, the corona virus disease 2019 (COVID-19). Cortisol, a clinically confirmed stress hormone related to depression and anxiety, affects individuals mentally and physically. However, current cortisol monitoring methods require expert personnel, large and complex machines, and long time for data analysis. Here, we present a flexible and wearable cortisol aptasensor for simple and rapid cortisol real-time monitoring. The sensing channel was produced by electrospinning conducting polyacrylonitrile (PAN) nanofibers (NFs) and subsequent vapor deposition of carboxylated poly(3,4-ethylenedioxythiophene) (PEDOT). The conjugation of the cortisol aptamer on the PEDOT-PAN NFs provided the critical sensing mechanism for the target molecule. The sensing test was performed with a liquid-ion gated field-effect transistor (FET) on a polyester (polyethylene terepthalate). The sensor performance showed a detection limit of 10 pM (<5 s) and high selectivity in the presence of interference materials at 100 times higher concentrations. The practical usage and real-time monitoring of the cortisol aptasensor with a liquid-ion gated FET system was demonstrated by successful transfer to the swab and the skin. In addition, the real-time monitoring of actual sweat by applying the cortisol aptasensor was also successful since the aptasensor was able to detect cortisol approximately 1 nM from actual sweat in a few minutes. This wearable biosensor platform supports the possibility of further application and on-site monitoring for changes of other numerous biomarkers.

In-situ food spoilage monitoring using a wireless chemical receptor-conjugated graphene electronic nose.

Monitoring food spoilage is one of the most effective methods for preventing food poisoning caused by biogenic amines or microbes. Therefore, various analytical techniques have been introduced to detect low concentrations of cadaverine (CV) and putrescine (PT), which are representative biogenic polyamines involved in food spoilage (5-8 ppm at the stage of initial decomposition after storage for 5 days at 5 °C and 17-186 ppm at the stage of advanced decomposition after storage for 7 days at 5 °C). Although previous methods showed selective CV and PT detection even at low concentrations, the use of these methods remains challenging in research areas that require in-situ, real-time, on-site monitoring. In this study, we demonstrated for the first time an in-situ high-performance chemical receptor-conjugated graphene electronic nose (CRGE-nose) whose limits of detection (LODs), 27.04 and 7.29 ppb, for CV and PT are up to 102 times more sensitive than those of conventional biogenic amine sensors. Specifically, the novel chemical receptors 2,7-bis(3-morpholinopropyl)benzo[lmn][3,8] phenanthroline-1,3,6,8(2H,7H)-tetraone (NaPhdiMor (NPM)) and 2,7-bis(2-((3-morpholinopropyl)amino)ethyl)benzo[lmn][3,8]phenanthroline-1,3,6,8(2H,7H)-tetraone (NaPhdiEtAmMor (NPEAM)) were designed on the basis of density functional theory (DFT) calculations, and their interaction mechanism was characterized by a DFT 3D simulation. Interestingly, the CRGE-nose was connected on a micro sim chip substrate via wire bonding and then integrated into wireless portable devices, resulting in a cost-effective, high-performance prototype CRGE-nose device capable of on-site detection. The portable CRGE-nose can be used for in-situ monitoring of CV and PT concentration changes as low as 27.04 and 7.29 ppb in real meats such as pork, beef, lamb and chicken.

Clinical features of patients with Legionnaires disease showing initial clinical improvement but radiological deterioration: A retrospective single-center analysis.

ABSTRACT: Patients with Legionnaires disease occasionally experience initial clinical improvement but radiological progression. However, data on this issue are so far limited. The aim of this study was to investigate changes in chest radiograph findings in patients with Legionnaires disease who showed initial clinical improvement and to identify risk factors and outcomes in these patients.All patients diagnosed with Legionnaires disease at a tertiary hospital in South Korea between March 2011 and May 2020 were retrospectively enrolled. Legionnaires disease was defined as abnormal chest radiographs accompanied by a positive finding on at least one of the following tests: urinary antigen test, sputum Legionella polymerase chain reaction, and sputum Legionella culture. Clinical improvement was defined as defervescence and decreased C-reactive protein level. Clinical and radiological records were reviewed on treatment days 7 and 14 and at discharge. We describe the characteristics of patients with clinical improvement but radiological deterioration on treatment for Legionnaires disease and compared them with patients with initial clinical improvement and stable or resolving chest radiograph findings.Of 140 patients with Legionnaires disease, 33 (24%) showed initial clinical deterioration, while the remaining 107 (76%) showed initial clinical improvement on day 7. The latter 107 patients were analyzed in this study; 22 (21%) showed radiological progression despite the clinical improvement. Risk factors for these patients were a high pneumonia severity index score and the use of mechanical ventilation. Mortality did not significantly differ between those with initial clinical improvement but radiological deterioration and those with both initial clinical and radiological improvement (28% vs 12%, P = .49).About one-fifth of patients with Legionnaires disease, especially those who had a high pneumonia severity index score and underwent mechanical ventilation, showed radiological deterioration despite of clinical improvement 1 week after appropriate treatment, while outcomes were not significantly worse in these patients. Therefore, our findings support that close monitoring without modification of antibiotics use is warranted in those who have clinical improvement regardless of radiologic findings.