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•An integrated 3-D µPAD platform is proposed for whole blood creatinine detection.•The study is based on Jaffé reaction and combined with microfluidics technology.•Creatinine ...concentration of 30 real-world human whole blood samples are measured.
An integrated platform consisting of a three-dimensional (3-D) microfluidic paper-based analytical device (µPAD) and a portable detection system is proposed for the determination of human whole blood creatinine. In the proposed detection method, the reaction region of the 3-D µPAD is implanted with picric acid and NaOH reagent and allowed to dry. Whole human blood is then dripped onto the inlet region of the chip and the blood plasma diffuses through the separation channel into the reaction zone under the effects of capillary action. The µPAD is heated at a temperature of 37 °C for 5 min to induce a Jaffé reaction between the creatinine in the blood plasma and the reagent. Finally, the creatinine concentration is detected using a colorimetric method. The validity of the proposed approach is demonstrated using control samples with creatinine concentrations ranging from 0.19 to 7.64 mg/dL. The detection results obtained for 40 real-world human serum creatinine samples and 30 real-world whole blood samples are shown to be in excellent agreement with those obtained using a conventional macroscale assay technique. Overall, the results show that the proposed platform provides a compact, low-cost and reliable approach for whole blood creatinine concentration detection.
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•An integrated paper-based platform is proposed for the HSA concentration detection.•BCG reagent and HSA concentration is induced albumin-BCG complex for RGB detection.•HAS ...concentration of 36 real-world human samples are measured.•The results are in excellent agreement of R2 = 0.9912 versus official method.
A rapid analytical platform composed of a paper-based chip (µPB-Chip) and a small analytic box is developed to determine the concentration of human serum albumin (HSA). In this study, a Bromocresol Green (BCG) reagent is dropped into the reaction area of the µPB-Chip, and the HSA concentration was derived from the R (red) value intensity of the albumin-BCG complex formed after a reaction process at 37 °C for 12 min. The effectiveness of the developed method is displayed using albumin concentrations ranging from 0 to 5 g/dL in HSA control samples. The measurement results acquired from 36 volunteer patient’s HSA samples are presented to be in good consistency with those obtained utilizing a conventional assay technique (R2 = 0.9912). Ultimately, the results show that the developed platform provides a convenient, economical and dependable method for HSA concentration detection.
•An integrated 3-D μPAD platform is proposed for whole blood albumin (ALB) detection.•BCG reagent and ALB concentration is induced albumin-BCG complex for RGB detection.•ALB concentration of 30 ...real-world human whole blood samples are measured.
A method is proposed for determining the concentration of albumin (ALB) in human whole blood samples using a 3-dimensional (3D) microfluidic paper-based chip and a smart detection module. In fabricating the paper-based chip, the reaction area is implanted with bromocresol green (BCG) reagent and the device is stored in a nitrogen (N2) environment at a temperature of —15 °C until needed for use. In the detection process, 10 μl of whole blood is dropped onto the entrance area of the chip and the plasma within the sample diffuses through a separation channel into the reaction zone. A reaction is induced between the ALB in the plasma and the BCG reagent in the reaction area by heating the chip at 37 °C for 6 min. The ALB concentration is then detected using a colorimetry technique implemented on a cell phone in the form of a self-written app. It is shown that the detection results obtained for 40 pure ALB samples and 30 whole blood samples are consistent with those obtained using a traditional spectrophotometry method (R2 = 0.9837 and R2 = 0.9968). The proposed detection system thus provides a reliable tool for practical ALB determination purposes.
Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of long-term peritoneal dialysis (PD). However, previous studies reported large variations in its mortality rates that may ...associate with a different degree of EPS severity. This study reports the incidence and outcomes of EPS and identifies the risk factors associated with severe EPS.
We retrospectively analyzed clinical data of EPS patients from 3 medical centers in Taiwan from January 1982 to September 2015, and classified patients as having mild/moderate or severe EPS. Patients with intractable intestinal obstruction/gut-related sepsis that needed surgical intervention or resulted in mortality were in severe EPS group. Follow-up for outcome was through December 31, 2015. Clinical characteristics, peritoneal dialysis (PD)-related parameters, biochemical and imaging results were analyzed and compared between groups.
Fifty-eight of 3202 patients undergoing PD during the study period had EPS (prevalence 1.8%). The incidence of EPS increased for patients on PD for >6-8 years (≤6 yrs. vs. >6-8 yrs., 0.0% vs. 1.8%, p = 0.001). Relative to those on PD for >6-8 years, the risk of EPS significantly increased with PD duration longer than 10 years (>10-12 years vs. >6-8 years: OR: 5.5, 95% CI: 1.7-17.1, p < 0.01). Twenty-three patients fulfilled the criteria for severe EPS. The overall mortality rate of EPS was 35% (20/58), and was 74% (17/23) in the severe EPS group. The average serum levels of C-reactive protein (CRP) and intact-parathyroid hormone (i-PTH), which were checked every 3~6 months within one year before diagnosis of EPS, were higher in severe EPS group than in mild/moderate group (p = 0.02, p = 0.08, respectively). Multivariate analysis revealed severe EPS was independently associated with bowel tethering (based on CT), presentation with bloody ascites, diagnosis of EPS after withdrawal from PD, and i-PTH ≥ 384 pg/mL. Receiver operating characteristic analysis indicated that presentation with 2 or more of the 5 risk factors (EPS diagnosis after PD withdrawal, bloody ascites, bowel tethering, CRP ≥ 29 mg/L, and i-PTH ≥ 384 pg/mL) had a good accuracy (AUC = 0.80, p = 0.001) for prediction of severe EPS.
The incidence of EPS increases with PD duration. Severe EPS has high mortality rate and is associated with bowel tethering, presentation of bloody ascites, diagnosis after PD withdrawal, and higher serum levels of i-PTH before EPS diagnosis. Having 2 or more of the 5 risk factors can provide a good accuracy for prediction of severe EPS.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The advancement of wireless and mobile technologies has enabled students to learn in an environment that combines learning resources from both the real world and the digital world. Although such an ...approach has been recognized as being innovative and important, several problems have been revealed in practical learning activities. One major problem is owing to the lack of proper learning strategies or tools for assisting the students to acquire knowledge in such a complex learning scenario. Students might feel excited or engaged when using the mobile devices to learn in the real context; nevertheless, their learning achievements could be disappointing. To deal with this problem, this study presents a mobile learning system that employs Radio Frequency Identification (RFID) technology to detect and examine real-world learning behaviors of students. This study also utilizes each student’s responses from a two-tier test (i.e., multiple-choice questions in a two-level format) to provide personalized learning guidance (called two-tier test guiding, T
3G). The experimental results from a natural science course of an elementary school show that this innovative approach is able to improve the learning achievements of students as well as enhance their learning motivation.
Microfluidic paper-based analysis devices (μPADs) have undergone tremendous development in recent years and now provide a feasible low-cost alternative to traditional laboratory tests for the ...diagnosis of many common diseases and disorders. As such, they are of great interest and importance in developing regions of the world with a lack of medical resources and associated infrastructures. This review examines the advances made in microfluidic paper-based diagnostic technology in the past five years and describes the application of microfluidic paper-based assays to the detection of many common human diseases using 3 non-invasive samples sources such as saliva, tears and sweat. The review commences by introducing the basic principles of fluid transport in microfluidic paper-based devices. The structures and actuation systems used in common paper-based devices are then introduced and explained. A systematic review of recent proposals for the application of paper-based devices to the diagnosis of common human diseases is then presented. The review concludes with a brief discussion of the challenges facing the microfluidics paper-based diagnosis field in the coming years and the emerging opportunities for future research.
An electrochemical-biosensor (EC-biosensor) microchip consisting of screen-printed electrodes and a double-layer reagent paper detection zone impregnated with amaranth is proposed for the rapid ...determination of microalbuminuria (MAU) in human urine samples. Under the action of an applied deposition potential, the amaranth is adsorbed on the electrode surface and the subsequent reaction between the modified surface and the MAU content in the urine sample prompts the formation of an inert layer on the electrode surface. The inert layer impedes the transfer of electrons and hence produces a drop in the response peak current, from which the MAU concentration can then be determined. The measurement results obtained for seven artificial urine samples with known MAU concentrations in the range of 0.1–40 mg/dL show that the measured response peak current is related to the MAU concentration with a determination coefficient of R2 = 0.991 in the low concentration range of 0.1–10 mg/dL and R2 = 0.996 in the high concentration range of 10–40 mg/dL. Furthermore, the detection results obtained for 82 actual chronic kidney disease (CKD) patients show an excellent agreement (R2 = 0.988) with the hospital analysis results. Overall, the results confirm that the proposed detection platform provides a convenient and reliable approach for performing sensitive point-of-care testing (POCT) of the MAU content in human urine samples.
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•An EC-biosensor microchip system is presented for detection of urinary MAU concentration.•An electroactive substance of amaranth is used to modify the surface of the sensing electrodes.•The MAU concentration in the urine of 82 adult CKD patients was measured.•The measurement results are in good agreement (R2 = 0.988) with the official method.
Patients with end-stage kidney disease (ESKD) rely on dialysis to remove toxins and stay alive. However, hemodialysis alone is insufficient to completely remove all/major uremic toxins, resulting in ...the accumulation of specific toxins over time. The complexity of uremic toxins and their varying clearance rates across different dialysis modalities poses significant challenges, and innovative approaches such as microfluidics, biomarker discovery, and point-of-care testing are being investigated. This review explores recent advances in the qualitative and quantitative analysis of uremic toxins and highlights the use of innovative methods, particularly label-mediated and label-free surface-enhanced Raman spectroscopy, primarily for qualitative detection. The ability to analyze uremic toxins can optimize hemodialysis settings for more efficient toxin removal. Integration of multiple omics disciplines will also help identify biomarkers and understand the pathogenesis of ESKD, provide deeper understanding of uremic toxin profiling, and offer insights for improving hemodialysis programs. This review also highlights the importance of early detection and improved understanding of chronic kidney disease to improve patient outcomes.
Patients with end-stage kidney disease (ESKD) rely on dialysis to remove toxins and stay alive.
The PD-1/PD-L1 pathway is critical in T cell biology; however, the role of the PD-1/PD-L1 pathway in clinical characteristics and treatment outcomes in pulmonary tuberculosis (PTB) patients is ...unclear. We prospectively enrolled PTB, latent TB infection (LTBI), and non-TB, non-LTBI subjects. The expression of PD-1/PD-L1 on peripheral blood mononuclear cells (PBMCs) was measured and correlated with clinical characteristics and treatment outcomes in PTB patients. Immunohistochemistry and immunofluorescence were used to visualize PD-1/PD-L1-expressing cells in lung tissues from PTB patients and from murine with heat-killed MTB (HK-MTB) treatment. A total of 76 PTB, 40 LTBI, and 28 non-TB, non-LTBI subjects were enrolled. The expression of PD-1 on CD4+ T cells and PD-L1 on CD14+ monocytes was significantly higher in PTB cases than non-TB subjects. PTB patients with sputum smear/culture unconversion displayed higher PD-L1 expression on monocytes. PD-L1-expressing macrophages were identified in lung tissue from PTB patients, and co-localized with macrophages in murine lung tissues.
(MTB) whole cell lysate/EsxA stimulation of human and mouse macrophages demonstrated increased PD-L1 expression. In conclusion, increased expression of PD-L1 on monocytes in PTB patients correlated with higher bacterial burden and worse treatment outcomes. The findings suggest the involvement of the PD-1/PD-L1 pathway in MTB-related immune responses.
The role of urate‐lowering therapy (ULT) for the primary prevention of cardiovascular (CV) events has been widely discussed, but its evidence for the secondary prevention of myocardial infarction ...(MI) is limited. Therefore, we conduct a population‐based, propensity score‐matched cohort study to investigate the CV outcomes among patients with post‐MI with and without ULT. A total of 19,042 newly diagnosed in‐hospital patients with MI were selected using the Taiwan National Health Insurance Database between January 1, 2005, and December 31, 2016. After 1:1 propensity score matching with covariates, patients with MI with (n = 963) and without (n = 963) ULT were selected for further analysis. The primary outcome was the all‐cause mortality and the secondary outcomes were composite CV outcomes, including hospitalization for recurrent MI, stroke, heart failure, and cardiac arrhythmias. ULT users were associated with lower all‐cause mortality (adjusted hazard ratio (adjHR), 0.67; 95% confidence interval (CI), 0.51–0.87) compared to the ULT nonusers. In addition, ULT users had a significantly lower risk of recurrent MI, which needed revascularization by percutaneous coronary intervention or coronary artery bypass grafting (adjHR, 0.67; 95% CI, 0.53–0.86) than the ULT nonusers. The primary and secondary outcomes were not different between patients with post‐MI who received uricosuric agents and xanthine oxidase inhibitors. The anti‐inflammatory effect of ULT plays an essential role in MI management. From a real‐world setting, this study shows that ULT is associated with the lower risk of all‐cause mortality in patients with post‐MI. In addition, the result shows the possible lower incidence of repeat revascularization procedures in the ULT users.
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