Conjunctival Biopsy of a Patient With Mpox.

This case report describes a conjunctival biopsy of a patient with mpox infection.

A Case of Sustained Viral Shedding of Mpox With Ocular Involvement Resulting in Vision Loss.

Mpox, caused by infection with Monkeypox virus, usually presents as a mild, self-limited illness in immunocompetent persons that resolves within 2-4 weeks. Serious complications have been reported when mpox lesions involve vulnerable anatomic sites, such as the eye, and in those with substantial immunosuppression. We describe a patient with advanced human immunodeficiency virus infection and sustained viral shedding of mpox with ocular involvement, which resulted in vision loss.

Management of healthcare waste collection and segregation for developing countries.

Healthcare waste (HCW) consists of hazardous material that may be radioactive, toxic or infectious. Inappropriate treatment and disposal of HCW may pose health risks to humans indirectly through the release of pathogens and toxic pollutants into the environment. The biggest problem in HCW management is its handling, which causes anxiety over sorting and categorizing the waste. Hence, the current study identifies and addresses the challenges towards sustainable environmental development by managing infectious HCW in developing countries. Fuzzy Delphi method is used in the present study to carefully examine the barrier drawn from the literature and experts' opinions. The number of barriers taken into consideration for study are 30, which are then grouped into four main categories, that is, social, environmental, technological and economic barriers. Additionally, a hybrid strategy based on the fuzzy decision-making trial and evaluation laboratory is developed in this work to examine the significance and interrelationships of the identified barrier. The research outcome is a hierarchy and classification model based on the relative importance of the barriers. The results of this study indicate that: 'Lack of segregation', 'Inconsistency in waste collection', 'Unregulated disposal site' and 'Inadequate programme for training and awareness' require quick action. The conclusions obtained through the study would facilitate the preparation of check sheets for documenting HCW management procedures by the healthcare administration and Pollution Control Boards. Understanding the priority cause-group barrier would improve the long-term protection of the hospital environment from the spread of infection caused by the HCW.

Ocular Monkeypox - United States, July-September 2022.

As of October 11, 2022, a total of 26,577 monkeypox cases had been reported in the United States.* Although most cases of monkeypox are self-limited, lesions that involve anatomically vulnerable sites can cause complications. Ocular monkeypox can occur when Monkeypox virus (MPXV) is introduced into the eye (e.g., from autoinoculation), potentially causing conjunctivitis, blepharitis, keratitis, and loss of vision (1). This report describes five patients who acquired ocular monkeypox during July-September 2022. All patients received treatment with tecovirimat (Tpoxx)†; four also received topical trifluridine (Viroptic).§ Two patients had HIV-associated immunocompromise and experienced delays between clinical presentation with monkeypox and initiation of monkeypox-directed treatment. Four patients were hospitalized, and one experienced marked vision impairment. To decrease the risk for autoinoculation, persons with monkeypox should be advised to practice hand hygiene and to avoid touching their eyes, which includes refraining from using contact lenses (2). Health care providers and public health practitioners should be aware that ocular monkeypox, although rare, is a sight-threatening condition. Patients with signs and symptoms compatible with ocular monkeypox should be considered for urgent ophthalmologic evaluation and initiation of monkeypox-directed treatment. Public health officials should be promptly notified of cases of ocular monkeypox. Increased clinician awareness of ocular monkeypox and of approaches to prevention, diagnosis, and treatment might reduce associated morbidity.

Sustainability assessment of waste cooking oil-based biodiesel plant in developing economy based on F-DEMATEL and F-ISM approaches.

Developing clean and renewable energy resources for long-term usage is a crucial concern in developing countries. In this regard, biodiesel technology is drawing a lot of public interest throughout the world. The issues associated with the sustainability of a biodiesel plant are intimately connected with restricted natural resources, political influences, energy independence, economic prosperity and global stability. Therefore, this paper aspires to identify the most influential factors that affect the sustainability of a biodiesel plant and describe interactions among them. The study focuses on identifying 36 factors based on an extensive literature review, questionnaire, experts' opinion and website in the context of developing economies. These factors include social, environmental and economic aspects. A framework based on fuzzy-interpretive structural modelling (F-ISM) and fuzzy-decision-making trial and evaluation laboratory (F-DEMATEL) is applied to investigate the identified factors. The F-ISM approach allows a better understanding of the contextual interactions between the factors and classify them based on their driving and dependent powers. The fuzzy-DEMATEL technique facilitates in identifying the influential and influenced factors and categorizes them into cause-and-effect groups. The findings of the study suggest that 'Legal and regulatory compliances', 'Political constraints', 'International relations', 'Health and education' and 'Public safety and security' are the five most influential factors that are needed to be addressed for the sustainability of biodiesel plant. The paper also presents a few strategies, which can be applied as a guiding step by the decision-makers to formulate policies for the effective implementation of sustainable growth of the biodiesel plant.

Analysis of barriers in e-waste management in developing economy: an integrated multiple-criteria decision-making approach.

An increasing amount of electronic waste (e-waste) is not a new concern. It has been causing trouble globally. This waste comprises valuable metals and harmful compounds that lead to detrimental environmental conditions. Managing this kind of waste in developing economies is difficult due to different barriers hindering the process. Therefore, the goal of this research work is to determine the barriers while taking expert opinions and through available literature, and subsequently prioritize them to address the challenges in e-waste management. Moreover, this study utilizes an integrated Fuzzy Decision-Making Trail and Evaluation Laboratory (F-DEMATEL) and Fuzzy Interpretive Structural Modeling (F-ISM) approaches to determine the interrelationship between these identified barriers. Performance data obtained from this combined approach is applied to determine an overall rank for 15 identified barriers. The F-DEMATEL technique facilitates in obtaining the influence of barriers on each other and categorizes them into causal or effect groups. In addition, a Fuzzy Matrice d'impacts Croisés Multiplication Appliquée an un Classeement (F-MICMAC) analysis is exercised to sort them into dependent or driving factor. The findings suggest that the underlying cause barriers include "lack of customer awareness about return," "less policies addressing e-waste problem," "lack of long-term planning," and "insensitiveness of public towards environmental issues." The methodology is integrated with fuzzy logic to take uncertainty in the data gathered into consideration. This approach aids policymakers and decision-makers in determining the barriers' mutual relationships and interconnections.

Application of ArcGIS and QFD-based model for site selection for bio-medical waste disposal.

With the increasing formalisation of the health sector in India, the bio-medical waste (BMW) disposal regulations are getting stringent and its implementation is being enforced strictly. The coronavirus disease 2019 (COVID-19) created a healthcare crisis because of the highly contagious nature of the novel virus. Measures employed for the prevention and management of COVID-19 resulted in the generation of an unprecedented amount of BMW in Indian medical history. This BMW needs to be disposed of safely at a suitable site to prevent secondary infection and the potential spread of the virus in the environment. The selection of an appropriate site for BMW disposal requires comparing a wide range of social, economic and environmental factors corresponding to different site locations, which makes it a multi-criteria decision-making (MCDM) problem. This study aims to solve the BMW site selection problems using a quality function deployment-based model that can consider both the subjective and the objective criteria, and evaluate them as per the user's requirements. The proposed model is applied to evaluate the suitability of waste disposal sites in the city of Bilaspur in Chhattisgarh, India. At first, eight possible locations for BMW disposal are identified, while utilising geographical information system (GIS). Consequently, the developed model is applied to evaluate the identified sites, taking 18 relevant criteria into consideration. A software prototype is developed in Visual BASIC 6 to automate the entire decision-making process, further adding to the novelty of the work.

Effects of Intense Pulsed Light on Tear Film TGF-ß and Microbiome in Ocular Rosacea with Dry Eye.

PURPOSE: To assess tear film transforming growth factor-beta (TGF-ß) and ocular microbiome changes after intense pulsed light with meibomian gland expression (IPL-MGX) vs only MGX in treating ocular rosacea with dry eye symptoms. METHODS: Twenty patients were randomly assigned to IPL-MGX or MGX. Patients were examined, treated, and administered the ocular surface disease index (OSDI) survey every 4-6 weeks for four total treatments. Tear film and conjunctival samples were collected at first and last visits, and analyzed for TGF-ß concentration and 16s rRNA amplicon sequencing of ocular microbiome. Wilcoxon Rank Sum and Sign-Rank were used to examine changes from baseline. RESULTS: OSDI revealed significantly greater improvement in symptoms after IPL-MGX (p=0.030) compared to MGX. There was no significant difference in mean TGF-ß1, 2, or 3 concentration after IPL-MGX (p=0.385, 0.709, 0.948, respectively). Quantities of Clostridium, Klebsiella, Brevibacterium, Lactobacillus, Neisseria, Streptococcus, Corynebacterium, Butyricicoccus, and Actinomyces were significantly reduced from baseline in both groups but without a significant difference between the two treatment groups. CONCLUSION: IPL-MGX improved dry eye symptoms more than MGX alone. IPL treatment offered no additional benefit to MGX in decreasing virulent bacteria present on the ocular surface and did not influence TGF-ß levels in tears. Prospective studies on IPL-MGX with larger sample sizes are needed to further investigate cytokines and IPL in patients suffering from ocular rosacea with dry eye symptoms. CLINICALTRIALSGOV IDENTIFIER: NCT03194698.

Effects of Holding Beta-Blockers on the Vital Signs of Heart Failure Patients.

BACKGROUND: Heart failure with reduced ejection fraction (HFrEF) is associated with recurrent hospitalizations and high mortality. Guideline-directed medical therapy (GDMT) reduces morbidity, mortality and re-admission rates. Despite the evidence, less than 50% of patients with HFrEF are prescribed appropriate medical therapy. When hospitalized patients have these medications discontinued on admission or during hospitalization, they are less likely to have them restarted on discharge. The goal of this study was to determine the incidence of disruption of beta-blocker (BB) therapy during hospitalization for HFrEF patients admitted to an academic tertiary referral hospital. METHODS: We conducted a retrospective study in a single teaching hospital over the course of 1 year, and utilized data queried from the electronic medical record (EPIC) database. Inclusion criteria were met by patients with an ICD-10 code diagnosis of heart failure, left ventricular ejection fraction less than 40% and BB prescription prior to admission. Additional information noted included age, sex, vital signs throughout the admission and dates where BB was not given for a full 24-h period. Patients in the intensive care unit (ICU) were excluded due to uncertainty of their hemodynamics. Data were extracted from the electronic medical record database and analyzed through Python, Microsoft Excel and RStudio. The incidence of BB disruption during hospitalization was defined as a 24-h period where no BB was administered. Blood pressure (BP) and heart rate (HR) levels were compared between patients who received BB and patients who had a disruption in their BB. Measurements were also obtained to assess whether a correlation exists between holding BB therapy and time of the year, age, or sex. RESULTS: Between January 2018 and January 2019, 780 patient encounters met inclusion criteria for the study. Patients who were continued on BB therapy had an average BP of 120.8/68.7 mm Hg and an HR of 82.4 bpm on days they received their BB. Patients who had a disruption of BB therapy had an average BP of 117.7/67.6 mm Hg and an HR of 88.6 bpm on the days of the disruption (P < 0.001). There was no association between holding BB and age, sex, or time of year. CONCLUSIONS: This study showed that in an academic tertiary referral center, patients with HFrEF who are not in an ICU have a 23% chance of not receiving their recommended BB therapy for 24 h. While the differences measured for BP and HR are statistically significant, they are not clinically significant.

Thyroid and Cardiovascular Disease: A Focused Review on the Impact of Hyperthyroidism in Heart Failure.

The association between thyroid hormones and cardiovascular conditions has been well studied, specifically, the effects of hypothyroidism on cardiomyopathy, and hyperthyroidism with arrhythmias. Nonetheless, an explicit correlation between hyperthyroidism and cardiomyopathy has yet to be established. Medical databases MEDLINE and PubMed were accessed and queried as primary sources for data acquisition. Search criteria consisted of "hyperthyroidism", "heart failure", and "thyroid and cardiovascular system", which allowed the retrieval of relevant and recent works. From these sources, a consensus was developed and employed to yield an updated review of the etiology of heart failure in the setting of hyperthyroidism. It is rare for patients with hyperthyroidism to remain in a chronic hyperthyroid state, making it difficult to analyze subsequent long-term effects on the cardiovascular system. Related to heart failure, some studies have demonstrated no change in ejection fraction, while others have shown an acute change along with diastolic dysfunction, with or without an underlying rhythm abnormality. Further investigation is warranted to elucidate the mechanism driving such cardiac dysfunction, and whether it is due to vascular changes, tachyarrhythmias, or myocyte remodeling and fibrosis. The intent of this review article is to improve our understanding of how a hyperthyroid state affects cardiovascular function. An enhanced understanding of the effects on cardiovascular physiology will afford physicians the ability to provide more comprehensive care in consideration of both endocrine and cardiovascular pathologies.

Conjunctival subepithelial fibrosis and meibomian gland atrophy in ocular graft-versus-host disease.

PURPOSE: Dry eye symptoms greatly impact patients' quality of life in ocular graft-versus-host disease (oGVHD). Various ocular surface changes have been reported in oGVHD, including meibomian gland atrophy (MGA) and clinical conjunctival scarring or subepithelial fibrosis (CSEF). The relationships between CSEF, MGA, and other ocular surface changes in oGVHD were examined. METHODS: Charts of 21 consecutive GVHD patients examined by a single ophthalmologist were retrospectively reviewed. International Chronic Ocular Graft-vs-Host-Disease Consensus Group (ICCG) scores were calculated for each patient using previously published methods. The severity of CSEF by slit lamp examination and MGA by infrared meibography were also assessed for each patient. Infrared meibography images were analyzed using ImageJ to determine percent of MGA. Pearson correlation coefficients were calculated using SAS Studio 9.3 (SAS Institute, Cary, NC). RESULTS: In the 42 eyes, no significant correlations were identified among the variables examined (CSEF score, ICCG score, MGA). Further examination revealed asymmetric ocular findings in 20 of 21 patients. Analysis of the more severe eye alone (n = 21) revealed a weakly positive correlation between ICCG score and CSEF (r = 0.54; p = 0.01). No other statistically significant correlations were found. CONCLUSIONS: Clinical CSEF may be an important sign of GVHD impact on the ocular surface and may be relevant in oGVHD severity assessment. Though meibomian glands and conjunctiva are in close proximity, MGA did not correlate with clinical CSEF findings. Some ocular GVHD patients may present with asymmetrical ocular findings, with one eye displaying more severe pathological changes and symptoms despite the systemic nature of GHVD. Further studies are needed to examine these findings.

Combination Therapy of Intense Pulsed Light Therapy and Meibomian Gland Expression (IPL/MGX) Can Improve Dry Eye Symptoms and Meibomian Gland Function in Patients With Refractory Dry Eye: A Retrospective Analysis.

PURPOSE: To assess the improvement in meibomian gland function and dry eye symptoms in patients with refractory dry eye treated with a combination therapy of intense pulsed light (IPL) and meibomian gland expression (MGX). METHODS: Medical records of 81 consecutive patients with dry eye treated with serial IPL/MGX were retrospectively examined to determine the outcome. All patients had a minimum of 6 months of follow-up after the first IPL/MGX treatment. Patients typically received 1 to 4 IPL treatments spaced 4 to 6 weeks apart. Each IPL session included MGX. Thirty-five charts had complete data for inclusion in analysis. We reviewed demographics, ocular histories, Standard Patient Evaluation of Eye Dryness 2 (SPEED2) symptom survey scores, slit-lamp examinations, and meibomian gland evaluations (MGE) at baseline and at each visit before IPL/MGX treatments. RESULTS: The paired t test showed a significant (P < 0.0001) decrease in SPEED2 with IPL/MGX therapy. Of the 35 patients, 8 (23%) had a ≥50% decrease in SPEED2, 23 (66%) had a 1% to 49% decrease in SPEED2, 1 (3%) had no change in SPEED2, and 3 (9%) had an increase in SPEED2. The Paired t test showed a significant increase in MGE in the left eye but not in the right eye (OD P = 0.163 and OS P = 0.0002). Thirteen patients (37%) had improved MGE bilaterally. Eight patients (23%) had either a decrease in MGE bilaterally or a decrease in 1 eye with no change in the other eye. CONCLUSIONS: This retrospective analysis shows that the combination of IPL and MGX can significantly improve dry eye symptoms (in 89% of patients) and meibomian gland function (in 77% of patients in at least 1 eye).

A Disposable Tear Glucose Biosensor-Part 4: Preliminary Animal Model Study Assessing Efficacy, Safety, and Feasibility.

OBJECTIVE: A prototype tear glucose (TG) sensor was tested in New Zealand white rabbits to assess eye irritation, blood glucose (BG) and TG lag time, and correlation with BG. METHODS: A total of 4 animals were used. Eye irritation was monitored by Lissamine green dye and analyzed using image analysis software. Lag time was correlated with an oral glucose load while recording TG and BG readings. Correlation between TG and BG were plotted against one another to form a correlation diagram, using a Yellow Springs Instrument (YSI) and self-monitoring of blood glucose as the reference measurements. Finally, TG levels were calculated using analytically derived expressions. RESULTS: From repeated testing carried over the course of 12 months, little to no eye irritation was detected. TG fluctuations over time visually appeared to trace the same pattern as BG with an average lag times of 13 minutes. TG levels calculated from the device current measurements ranged from 4 to 20 mg/dL and correlated linearly with BG levels of 75-160 mg/dL (TG = 0.1723 BG = 7.9448 mg/dL; R2 = .7544). CONCLUSION: The first steps were taken toward preliminary development of a sensor for self-monitoring of tear glucose (SMTG). No conjunctival irritation in any of the animals was noted. Lag time between TG and BG was found to be noticeable, but a quantitative modeling to correlate lag time in this study is unnecessary. Measured currents from the sensors and the calculated TG showed promising correlation to BG levels. Previous analytical bench marking showed BG and TG levels consistent with other literature.

A disposable tear glucose biosensor--part 3: assessment of enzymatic specificity.

BACKGROUND: A concept for a tear glucose sensor based on amperometric measurement of enzymatic oxidation of glucose was previously presented, using glucose dehydrogenase flavin adenine dinucleotide (GDH-FAD) as the enzyme. Glucose dehydrogenase flavin adenine dinucleotide is further characterized in this article and evaluated for suitability in glucose-sensing applications in purified tear-like saline, with specific attention to the effect of interfering substances only. These interferents are specifically saccharides that could interact with the enzymatic activity seen in the sensor's performance. METHODS: Bench top amperometric glucose assays were performed using an assay solution of GDH-FAD and ferricyanide redox mediator with samples of glucose, mannose, lactose, maltose, galactose, fructose, sucrose, and xylose at varying concentrations to evaluate specificity, linear dynamic range, signal size, and signal-to-noise ratio. A comparison study was done by substituting an equivalent activity unit concentration of glucose oxidase (GOx) for GDH-FAD. RESULTS: Glucose dehydrogenase flavin adenine dinucleotide was found to be more sensitive than GOx, producing larger oxidation currents than GOx on an identical glucose concentration gradient, and GDH-FAD exhibited larger slope response (-5.65 × 10(-7) versus -3.11 × 10(-7) A/mM), signal-to-noise ratio (18.04 versus 2.62), and linear dynamic range (0-30 versus 0-10 mM), and lower background signal (-7.12 versus -261.63 nA) than GOx under the same assay conditions. GDH-FAD responds equally to glucose and xylose but is otherwise specific for glucose. CONCLUSION: Glucose dehydrogenase flavin adenine dinucleotide compares favorably with GOx in many sensor-relevant attributes and may enable measurement of glucose concentrations both higher and lower than those measurable by GOx. GDH-FAD is a viable enzyme to use in the proposed amperometric tear glucose sensor system and perhaps also in detecting extreme hypoglycemia or hyperglycemia in blood.

Development of a novel single sensor multiplexed marker assay.

There is an increasing desire to measure multiple analytes simultaneously for disease management and detection. However, in the case of invasive devices, it would be better to obtain one small sample and immediately be able to detect the analytes rapidly, as in the case of self-monitoring blood glucose, without the need for additional steps, arrays, or reagents. Electrochemical impedance spectroscopy is used to measure the interaction between ultralow levels of analyte and molecular recognition element in a label-free and rapid manner. Gold nanoparticles were attached to antibodies against interleukin-12 and tumor necrosis factor-α, typical inflammatory markers found with near overlapping responses, on an impedance spectroscopy based biosensor. Cross-reactivity and specificity of tuned antibodies were verified using ELISA. Impedance frequency was quantified by concentration gradients of marker against the device. The natural impedance frequency for interleukin-12 (5.00 Hz) was tuned to a lower frequency four Hertz away from one another for better signal processing. This was accomplished without significantly altering the lower limits of detection (<4 pg ml(-1) and ∼60 pg ml(-1) for interleukin-12 and tumor necrosis factor-α, respectively), no cross-reactivity and specificity as determined by ELISAs. With modeling the nanoscale effects and further development, a larger tuning will be possible for making a better multiplexed sensor. Although interleukin-12 and TNF-α equivalent circuit calculations were modeled here, a sensor with the potential to measure multiple markers at once might offer a solution on the sensor front for simplified management of conditions such as diabetes, where both glucose and hemoglobin A1c values could be obtained.

Sequential anaerobic-adsorption treatment of chemical industry wastewater.

Treatment technologies needed to reduce the pollutant load of chemical industry effluent have been found to involve exorbitantly high costs. The present investigation aimed to treat the wastewater from chemical industry by cost effective sequential anaerobic-adsorption treatment. Wastewaters from chemical industry that are rich in biodegradable organics are tested for anaerobic treatability. The efficiency of anaerobic reactor is relatively lower 79.3%, and therefore post treatment of effluent was done by adsorption using Poly vinyl alcohol coated Datura stramonium (PVAC-DS) as an adsorbent. An overall COD removal of 93.8 % was achieved after sequential Anaerobic-Adsorption treatment, which lead to a better final effluent and a more economical treatment system.

Response to ticagrelor in clopidogrel nonresponders and responders and effect of switching therapies: the RESPOND study.

BACKGROUND: The antiplatelet effects of the Platelet Inhibition and Patient Outcomes (PLATO) trial dose of ticagrelor in patients nonresponsive to clopidogrel and after they switch agents are unknown. METHODS AND RESULTS: Patients with stable coronary artery disease on aspirin therapy received a 300-mg clopidogrel load; nonresponders were identified by light transmittance aggregometry. In a 2-way crossover design, nonresponders (n=41) and responders (n=57) randomly received clopidogrel (600 mg/75 mg once daily) or ticagrelor (180 mg/90 mg twice daily) for 14 days during period 1. In period 2, all nonresponders switched treatment; half of the responders continued the same treatment, whereas the others switched treatment. Inhibition of platelet aggregation was higher in nonresponders treated with ticagrelor compared with clopidogrel (P<0.05). Treatment with ticagrelor among nonresponders resulted in a >10%, >30%, and >50% decrease in platelet aggregation from baseline in 100%, 75%, and 13% of patients, respectively. Platelet aggregation fell from 59+/-9% to 35+/-11% in patients switched from clopidogrel to ticagrelor and increased from 36+/-14% to 56+/-9% in patients switched from ticagrelor to clopidogrel (P<0.0001 for both). Platelet reactivity was below the cut points previously associated with ischemic risk measured by light transmittance aggregometry, VerifyNow P2Y(12) assay, and vasodilator-stimulated phosphoprotein phosphorylation in 98% to 100% of patients after ticagrelor therapy versus 44% to 76% of patients after clopidogrel therapy. CONCLUSIONS: Ticagrelor therapy overcomes nonresponsiveness to clopidogrel, and its antiplatelet effect is the same in responders and nonresponders. Nearly all clopidogrel nonresponders and responders treated with ticagrelor will have platelet reactivity below the cut points associated with ischemic risk. Clinical Trial Registration- http://www.clinicaltrials.gov. Unique Identifier: NCT00642811.

A disposable tear glucose biosensor-part 1: design and concept testing.

BACKGROUND: Tear glucose has been suggested previously as a potential approach for the noninvasive estimation of blood glucose. While the topic remains unresolved, an overview of previous studies suggests the importance of a tear sampling approach and warrants new technology development. A concept device is presented that meets the needs of a tear glucose biosensor. METHODS: Three approaches to chronoamperometric glucose sensing were evaluated, including glucose oxidase mediated by potassium ferricyanide or oxygen with a hydrogen peroxide catalyst, Prussian blue, and potassium ferricyanide-mediated glucose dehydrogenase. For tear sampling, calcium alginate, poly(2-hydroxyethyl methacrylate), and polyurethane foam were screened as an absorbent tear sampling material. A quantitative model based on the proposed function of concept device was created. RESULTS: For glucose sensing, it was found that potassium ferricyanide with glucose dehydrogenase was ideal, featuring oxygen insensitivity, long-term stability, and a lower limit of detection of 2 muM glucose. Polyurethane foam possessed all of the required characteristics for tear sampling, including reproducible sampling from a hydrogel-simulated, eye surface (4.2 +/- 0.5 microl; n = 8). It is estimated that 100 microM of glucose tear fluid would yield 135 nA (14.9% relative standard deviation). CONCLUSION: A novel concept device for tear glucose sampling was presented, and the key functions of this device were tested and used to model the performance of the final device. Based on these promising initial results, the device is achievable and within reach of current technical capabilities, setting the stage for prototype development.

A disposable tear glucose biosensor-part 2: system integration and model validation.

BACKGROUND: We presented a concept for a tear glucose sensor system in an article by Bishop and colleagues in this issue of Journal of Diabetes Science and Technology. A unique solution to collect tear fluid and measure glucose was developed. Individual components were selected, tested, and optimized, and system error modeling was performed. Further data on prototype testing are now provided. METHODS: An integrated fluidics portion of the prototype was designed, cast, and tested. A sensor was created using screen-printed sensors integrated with a silicone rubber fluidics system and absorbent polyurethane foam. A simulated eye surface was prepared using fluid-saturated poly(2-hydroxyethyl methacrylate) sheets, and the disposable prototype was tested for both reproducibility at 0, 200, and 400 microM glucose (n = 7) and dynamic range of glucose detection from 0 to 1000 microM glucose. RESULTS: From the replicated runs, an established relative standard deviation of 15.8% was calculated at 200 microM and a lower limit of detection was calculated at 43.4 microM. A linear dynamic range was demonstrated from 0 to 1000 microM with an R(2) of 99.56%. The previously developed model predicted a 14.9% variation. This compares to the observed variance of 15.8% measured at 200 microM glucose. CONCLUSION: With the newly designed fluidics component, an integrated tear glucose prototype was assembled and tested. Testing of this integrated prototype demonstrated a satisfactory lower limit of detection for measuring glucose concentration in tears and was reproducible across a physiological sampling range. The next step in the device design process will be initial animal studies to evaluate the current prototype for factors such as eye irritation, ease of use, and correlation with blood glucose.

Synthesis and antimicrobial studies of s-triazine based heterocycles.

In an effort to discover new candidates with improved antimicrobial activities we report here the synthesis and in vitro biological evalution of various series of 2-(N-methylamino)-4-(N,N-dimethylamino)-6-(arylthioureido)-s-triazine (5a-j) and (N-methylamino)-4-(N,N-dimethylamino)-6-(arylureido)-s-triazine (6a-j). All the synthesized compounds were screened in vitro for their antibacterial activity against two different gram-positive bacteria (S. aureus, B. subtilis) and two different gram-negative bacteria (P. aeruginosa, E. coli) using the broth dilution method.