Portable and Intelligent Urine Glucose Analyzer Based on a CdTe QDs@GOx Aerogel Circular Array Sensor

Diabetes is a public health problem characterized by hyperglycemia, high mortality, and morbidity. A simple, rapid, and sensitive glucose detection method for diabetes screening and health self-management of patients with diabetes is of great significance. Therefore, an attractive urine glucose (UG) analyzer with advantages of fastness, sensitivity, and portability was developed. A cadmium telluride quantum dots (CdTe QDs)@glucose oxidase (GOx) aerogel circular array sensor can emit visible red fluorescence when excited by a 365 nm ultraviolet light source inside the analyzer. When urine samples containing glucose were dropped onto the sensor, glucose was oxidized by GOx to produce hydrogen peroxide (H₂O₂), which quenched the red fluorescence of CdTe QDs. The fluorescence images of the sensor were obtained using a CCD camera, and the linear relationship between the glucose concentration and the gray value of the fluorescence image was established. The analyzer shows good sensitivity (LOD, 0.12 mM) with a wide linear range of 0.12-26 mM. Based on the linear relation, the software of the analyzer was written in the C++ language, which can automatically give the gray value of the image and the corresponding glucose concentration. The UG analyzer was used for the detection of a large number clinical samples and compared with a variety of UG test papers, which all showed good detection performance. The novel analyzer we proposed has an important significance in the screening of diabetes and the self-management of diabetic patients.

Electricity-free hand-held inertial microfluidic sorter for size-based cell sorting

Conventional batch-top cell sorters are often bulky and expensive, and miniaturized microfluidic sorters available mostly require field generators and electricity-powered pumping systems. Therefore, the development of a low-cost, portable cell sorter that can be used in low resource settings is essential. In this study, we propose such an electricity-free hand-held inertial microfluidic sorter that can be used for the high-efficiency sorting of differently sized cells in a continuous and passive manner. The proposed hand-held sorter is composed of a wheel-shaped all-in-one syringe inertial microfluidic sorter (i-sorter) with flow stabilizer units and two spring-driven mechanical syringe drivers. The release of the compression spring in the mechanical syringe driver through a one-click operation provides the flow driving force. Passive flow stabilizer units in the i-sorter enable flow-rate-sensitive inertial cell separation for the unstable driving flow rate generated by the low-cost mechanical syringe driver. We successfully achieved sorting of differently sized particles and high-efficiency separation of rare tumor cells from the blood using the fabricated prototype. Our hand-held inertial microfluidic cell sorter has many advantages, including low device cost, simple electricity-free operation, compactness, and portability; additionally, samples do not need to be pre-labelled. Therefore, it has potential for use in low-resource settings.

Sensitive Oxidation of Sorbitol-Mediated Fe2+ by H2O2: A Reliable TD-NMR Method for Clinical Blood Glucose Detection

The clinical challenge of high-accuracy blood glucose detection schemes is to overcome the detection error caused by the background interferences in different individuals. H₂O₂ as the specific product of glucose oxidation can be involved in the Fe²⁺/Fe³⁺ conversion and detected by the time-domain nuclear magnetic resonance (TD-NMR) method sensitively. But, in clinical applications, the oxidation of Fe²⁺ is susceptible to the complex sample substrates. In this work, we sorted out two kinds of possible interference mechanisms of Fe²⁺ oxidation in the NMR blood glucose detection method and proposed a feasible scheme that uses sorbitol to weaken the adverse effects of interference. We found that sorbitol-mediated Fe²⁺ can greatly enhance the sensitivity of the T₂ value to H₂O₂. The chain reaction caused by sorbitol can significantly amplify the efficiency of Fe²⁺ oxidation at the same concentration of H₂O₂. Thereby, we can achieve the higher dilution multiple of serum samples to reduce the amount of interfering substances involved in the Fe²⁺/Fe³⁺ conversion. We justified the accuracy and availability of our method by successfully detecting and confirming the correlation between the T₂ decrease and glucose concentration of the serum samples collected from 16 subjects. The sorbitol-Fe²⁺ glucose detection method with high sensitivity can be further combined with miniature NMR analyzers to satisfy the calibration requirements of glucose monitoring in diabetic patients instead of frequent medical visits.

Development and validation of a competency evaluation model for hospital infection prevention and control practitioners in the post-pandemic era: a mixed methods study

Background

During the coronavirus disease 2019 pandemic, the management of nosocomial infections became even more crucial. There is an urgent need to develop a competency model for healthcare practitioners to combat public health emergencies.

Aim

To determine practitioners' competency in hospital infection prevention and control measures.

Methods

A theoretical framework was developed based on a literature review, key informant interviews, the Delphi method and a questionnaire survey. These items were evaluated based on response rate, maximum score, minimum score and mean score. Factor analyses, both exploratory and confirmatory, were used to determine the structure of the competency model.

Results

The effective response rate for the questionnaire was 88.29%, and Cronbach's α-coefficient was 0.964. Factor analysis revealed a Kaiser–Meyer–Olkin score of 0.945. Bartlett's test gave a χ²-value of 10523.439 (df=435; P<0.001). After exploratory factor analysis, the five-factor model was retained, four items were deleted and a five-dimensional, 26-item scale was obtained. The new structure's confirmatory factor analysis revealed high goodness of fit (comparative fit index=0.921; Tucker–Lewis index=0.911; standardized root mean square residual=0.053; root mean square error of approximation=0.044).

Conclusion

The proposed scale is a useful tool to assess the competency of hospital infection prevention and control practitioners, which can help hospitals to improve infection prevention and control.

Inertial microfluidics for high-throughput cell analysis and detection: a review

Since it was first proposed in 2007, inertial microfluidics has been extensively studied in terms of theory, design, fabrication, and application. In recent years, with the rapid development of microfabrication technologies, a variety of channel structures that can focus, concentrate, separate, and capture bioparticles or fluids have been designed and manufactured to extend the range of potential biomedical applications of inertial microfluidics. Due to the advantages of high throughput, simplicity, and low device cost, inertial microfluidics is a promising candidate for rapid sample processing, especially for large-volume samples with low-abundance targets. As an approach to cellular sample pretreatment, inertial microfluidics has been widely employed to ensure downstream cell analysis and detection. In this review, a comprehensive summary of the application of inertial microfluidics for high-throughput cell analysis and detection is presented. According to application areas, the recent advances can be sorted into label-free cell mechanical phenotyping, sheathless flow cytometric counting, electrical impedance cytometer, high-throughput cellular image analysis, and other methods. Finally, the challenges and prospects of inertial microfluidics for cell analysis and detection are summarized.

Secondary-flow-aided single-train elastic-inertial focusing in low elasticity viscoelastic fluids

Elastic-inertial focusing has attracted increasing interest in recent years due to the three-dimensional (3D) single-train focusing ability it offers. However, multi-train focusing, instead of single-train focusing, was observed in viscoelastic fluids with low elasticity as a result of the competition between inertia effect and viscoelasticity effect. To address this issue, we employed the secondary flow to facilitate single-train elastic-inertial focusing in low elasticity viscoelastic fluids. A three-section contraction-expansion channel was designed to induce the secondary flow to pinch the multiplex focusing trains into a single one exactly at the channel centerline. After demonstrating the focusing process and mechanism in our device, we systematically explored and discussed the effects of particle diameter, operational flow rate, polymer concentration, and channel dimension on particle focusing performances. Our device enables single-train focusing of particles in viscoelastic fluids with low elasticity, and offers advantages of planar single-layer structure, and sheathless, external-field free operation.

An easy-fabricated and disposable polymer-film microfluidic impedance cytometer for cell sensing

We report here an easy-fabricated and disposable polymer-film microfluidic impedance cytometer (PMIC) integrated with inertial focusing and parallel facing electrodes for cell sensing. The cells are first focused in an asymmetric serpentine channel, and then their impedance signals are measured when passing through the electrode region. The proposed PMIC device is the first impedance cytometer that is fabricated into a flexible sheet (with a thickness of 0.45 mm) by using the materials of commonly-available ITO-coated polymer films and double-sided adhesive tapes, the whole fabrication process is shortened from traditional 3-4 days to less than 5 min by using UV laser cutting. To verify the feasibility of our device for cell sensing, we explore the focusing behaviors of three differently sized particles and two types of tumor cells, and analyze their impedance signals. The results show that our device is capable of obtaining impedance information on numbers, diameters, and longitudinal positions of cells. We envision that our PMIC device is promising in label-free cell sensing owning to the advantages of low cost, small footprint, and simple fabrication.

Microfluidic impedance cytometry for single-cell sensing: Review on electrode configurations

Single-cell analysis has gained considerable attention for disease diagnosis, drug screening, and differentiation monitoring. Compared to the well-established flow cytometry, which uses fluorescent-labeled antibodies, microfluidic impedance cytometry (MIC) offers a simple, label-free, and noninvasive method for counting, classifying, and monitoring cells. Superior features including a small footprint, low reagent consumption, and ease of use have also been reported. The MIC device detects changes in the impedance signal caused by cells passing through the sensing/electric field zone, which can extract information regarding the size, shape, and dielectric properties of these cells. According to recent studies, electrode configuration has a remarkable effect on detection accuracy, sensitivity, and throughput. With the improvement in microfabrication technology, various electrode configurations have been reported for improving detection accuracy and throughput. However, the various electrode configurations of MIC devices have not been reviewed. In this review, the theoretical background of the impedance technique for single-cell analysis is introduced. Then, two-dimensional, three-dimensional, and liquid electrode configurations are discussed separately; their sensing mechanisms, fabrication processes, advantages, disadvantages, and applications are also described in detail. Finally, the current limitations and future perspectives of these electrode configurations are summarized. The main aim of this review is to offer a guide for researchers on the ongoing advancement in electrode configuration designs.

A polymer-film inertial microfluidic sorter fabricated by jigsaw puzzle method for precise size-based cell separation

A polymer-film inertial microfluidic jigsaw (PIMJ) sorter with trapezoidal spiral channels using the jigsaw puzzle method was proposed to realize precise and high-throughput rare cell separation. The PIMJ sorter was fabricated by assembling laser-patterned polymer-film layers of different thicknesses. After illustrating the conceptual design and fabrication process, the effects of the cross-sectional dimension, particle size, and operational flow rate on particle focusing were systematically explored under a broad flow rate range. Then, the separation performances of the PIMJ sorter were characterized using the binary particle mixture and the blood samples spiked with four types of tumor cells. The results indicated that the complete separation of the binary particles with a minimum size difference of 2 μm was successfully realized at a high throughput up to 3000 μL/min. A high recovery ratio of 90.57%-94.14% and a high purity of 48.67%-79.05% were achieved for the separation of rare tumor cells from white blood cells (WBCs). Finally, the PIMJ sorter was successfully employed for separating rare circulating tumor cells (CTCs) from the metastatic breast and lung cancer patients with a capture ratio of 7-226 CTCs per 5 mL sample. The results proved the high sensitivity and high reliability of the PIMJ sorter. The PIMJ sorter is expected to be a potential device for precise CTC separation towards the clinical applications.

Ultrahigh throughput beehive-like device for blood plasma separation

We report here a low-cost, rapid-prototyping, and beehive-like multilayer polymer microfluidic device for ultrahigh-throughput blood plasma separation. To understand the device physics and optimize the device structure, the effect of cross-sectional dimension and operational parameter on particle focusing behavior was explored using a single spiral microchannel device. Then, the blood plasma separation performance of the determined channel structure was validated using the blood samples with different hematocrits (HCTs). It was found that a high separation efficiency of 99% could be achieved using the blood sample with an HCT of 0.5% at a high throughput of 1 mL/min. Finally, a multilayer microfluidic device with a novel beehive-like multiplexing channel arrangement was developed for ultrahigh-throughput blood plasma separation. The prototype device could be fabricated within ∼1 hour utilizing the laser cutting and thermal lamination methods. The total processing throughput could reach up to 72 mL/min for 0.5% HCT sample with a plasma separation ratio close to 90%. Our device may hold potentials for the ultrahigh-throughput separation of blood plasma from large volume blood samples for downstream disease diagnosis.

Developing a versatile electrochemical platform with optimized electrode configuration through screen-printing technology toward glucose detection

Rapid on-site detection of glucose has been attracting considerable attention nowadays. Screen-printed electrodes (SPEs) were assessed as ideal detection platforms due to their advantages such as, disposability, portability, ease of miniaturization, and mass production. The topology and shape of electrodes have a crucial impact on their electrical conductivity and electrochemical properties. In this study, a versatile electrochemical platform with optimized three-electrode configuration was developed through screen-printing technology. Three types of SPEs were prepared, and their electrocatalytic properties toward glucose detection were investigated. Based on this platform, both enzyme-based (denoted as GOD/rGO) and non-enzymatic (denoted as Co@MoS₂/rGO) bioactive compounds were deposited on the working electrode of the circular SPE through simply drop-casting, respectively. Their morphology was characterized through scanning electron microscopy (SEM). Cycle sweep voltammetry was used to study the electrocatalytic activity of these biosensors. The circular SPE exhibited satisfying electrochemical redox activity and much higher sensitivity towards glucose detection, which rendered it a promising candidate for point-of-care detection.

Super-factors associated with transmission of occupational COVID-19 infection among healthcare staff in Wuhan, China

BACKGROUND

Globally, there have been many cases of coronavirus disease 2019 (COVID-19) among medical staff; however, the main factors associated with the infection are not well understood.

AIM

To identify the super-factors causing COVID-19 infection in medical staff in China.

METHODS

A cross-sectional study was conducted between January 1st and February 30th, 2020, in which front-line members of medical staff who took part in the care and treatment of patients with COVID-19 were enrolled. Epidemiological and demographic data between infected and uninfected groups were collected and compared. Social network analysis (SNA) was used to establish socio-metric social links between influencing factors.

FINDINGS

A total of 92 medical staff were enrolled. In all participant groups, the super-factor identified by the network was wearing a medical protective mask or surgical mask correctly (degree: 572; closeness: 25; betweenness centrality: 3.23). Touching the cheek, nose, and mouth while working was the super-factor in the infected group. This was the biggest node in the network and had the strongest influence (degree: 370; closeness: 29; betweenness centrality: 0.37). Self-protection score was the super-factor in the uninfected group but was the isolated factor in the infected group (degree: 201; closeness: 28; betweenness centrality: 5.64). For family members, the exposure history to Huanan Seafood Wholesale Market and the contact history to wild animals were two isolated nodes.

CONCLUSION

High self-protection score was the main factor that prevented medical staff from contracting COVID-19 infection. The main factor contributing to COVID-19 infections among medical staff was touching the cheek, nose, and mouth while working.

A single-view field filter device for rare tumor cell filtration and enumeration

In this work, we demonstrate a single-view field filter (SVFF) device for the efficient filtration and enumeration of rare tumor cells in the blood. In our device, the track-etched membrane is integrated within a low-cost polymer-film microfluidic chip, and multiplex microfiltration chambers are designed. Our device permits the performing of multiple sample tests on a single membrane and the dynamical observation of the entire filtration process in a single field of view. To characterize the device performance, our device is first tested using tumor cells, and three different cell behaviors are observed during the filtration process. Finally, we successfully apply our device for the separation of rare tumor cells from the lysed blood samples at various flow rates. The recovery rates of 93.3, 87.6, and 84.1% can be respectively achieved at the throughputs of 50, 100, and 150 μL/min. Our single-view field filter (SVFF) device offers the advantages of label-free filtration, efficient enumeration, easy integration, and low cost, and holds the potential to be used as an efficient tool for the filtration and enumeration of rare cells.

A 3D porous graphene aerogel@GOx based microfluidic biosensor for electrochemical glucose detection

As a chronic disease, diabetes may result in serious complications that endanger the health and life of patients. Accurate and real-time detection of blood sugar levels is of great significance for the prevention and treatment of diabetes. In this paper, an enzymatic electrochemical microfluidic biosensor for glucose detection was developed based on a three-dimensional (3D) porous graphene aerogel and glucose oxidase (GOx). A graphene aerogel was prepared by freeze-drying a graphene hydrogel and has a high electrical conductivity, the 3D porous structure provided a good near-biological condition for GOx and the increased specific surface area allowed more GOx to be immobilized on the graphene aerogel. The microfluidic system greatly reduced the consumption of samples during tests. Amperometric measurements were carried out to test glucose concentrations, and the enzyme biosensor showed a linear range from 1 mM to 18 mM (R² = 0.991). The limit of detection (LOD) was 0.87 mM (S/N = 3) and the sensor showed excellent selectivity and stability. Finally, monitoring glucose in serum samples was achieved by the proposed sensor and good recoveries were obtained. Due to its excellent performance, the proposed biosensor has a favorable application prospect in the prevention and clinical diagnosis of diabetes. Furthermore, our method, which is used to prepare a graphene aerogel modified electrode in a microfluidic chip, can be widely used in various electrochemical sensors.