High CO2 permeation using a new Ce0.85Gd0.15O2-δ-LaNiO3 composite ceramic-carbonate dual-phase membrane

This work shows the synthesis, characterization and evaluation of dense-ceramic membranes made of Ce0.85Gd0.15O2-δ-LaNiO3 (CG-LN) composites, where the fluorite-perovskite ratio (CG:LN) was varied as follows: 75:25, 80:20 and 85:15 wt.%. Supports were initially characterized by XRD, SEM and electrical conductivity (using vacuum and oxygen atmospheres), to determine the composition, microstructural and ionic-electronic conductivity properties. Later, supports were infiltrated with an eutectic carbonates mixture, producing the corresponding dense dual-phase membranes, in which CO2 permeation tests were conducted. Here, CO2 permeation experiments were performed from 900 to 700°C, in the presence and absence of oxygen (flowed in the sweep membrane side). Results showed that these composites possess high CO2 permeation properties, where the O2 addition significantly improves the ionic conduction on the sweep membrane side. Specifically, the GC80-LN20 composition presented the best results due to the following physicochemical characteristics: high electronic and ionic conductivity, appropriate porosity, interconnected porous channels, as well as thermal and chemical stabilities between the composite support and carbonate phases.

Fluids and body composition during anesthesia in children and adolescents: A pilot study

The purpose of this study is to evaluate the intracellular and extracellular volume before and after anesthesia in order to ascertain their variations and determine the potential utility of this information in optimizing intraoperative fluid administration practices. A bioimpedance spectroscopy device (body composition monitor, BCM) was used to measure total body fluid volume, extracellular volume, and intracellular volume. BCM measurements were performed before and after general anesthesia in unselected healthy children and adolescents visiting the Pediatric Institute of Southern Switzerland for low-risk surgical procedures hydrated with an isotonic solution. In 100 children and adolescents aged 7.0 (4.8-11) years (median and interquartile range), the average total body water increased perioperatively with a delta value of 182 (0-383) mL/m2 from pre- to postoperatively, as well as the extracellular water content, which had a similar increase with a delta value of 169 (19-307) mL/m2. The changes in total body water and extracellular water content significantly correlated with the amount of fluids administered. The intracellular water content did not significantly change.   Conclusion: Intraoperative administration of isotonic solutions results in a significant fluid accumulation in low-risk schoolchildren during general anesthesia. The results suggest that children without major health problems undergoing short procedures do not need any perioperative intravenous fluid therapy, because they are allowed to take clear fluids up to 1 h prior anesthesia. In future studies, the use of BCM measurements has the potential to be valuable in guiding intraoperative fluid therapy. What is Known: • Most children who undergo common surgical interventions or investigations requiring anesthesia are nowadays hydrated at a rate of 1700 mL/m2/day with an isotonic solution. • The use bioimpedance spectroscopy for the assessment of fluid status in healthy children has already been successfully validated. • The bioimpedance spectroscopy is already currently widely used in various nephrological settings to calculate fluid overload and determine patient's optimal fluid status. What is New: • Routine intraoperative fluid administration results in a significant fluid accumulation during general anesthesia in low-risk surgical procedures. • This observation might be relevant for children and adolescents with conditions predisposing to fluid retention. • In future studies, the use of BCM measurements has the potential to be valuable in guiding intraoperative fluid therapy.

Furosemide drug as a corrosion inhibitor for carbon steel in 1.0 M hydrochloric acid

Furosemide (4-chloro-2-furan-2-ylmethylamino-5-sulfamoylbenzoic acid) was examined as an inhibitor for the corrosion of carbon steel (CS) in 1.0 M HCl. The investigation included mass loss (ML) and electrochemical techniques: potentiodynamic polarization (PP), electrochemical impedance spectroscopy (EIS), and electrochemical frequency modulation (EFM). The efficiency of inhibition rises with increasing Furosemide concentration and temperature. This compound follows the Temkin isotherm with good fit. The presence of varying quantities influences both anodic metal dissolution and cathodic hydrogen evolution. Scanning electron microscopy (SEM), atomic force microscopy (AFM), X-ray photoelectron spectroscopy (XPS), and Fourier transform infrared spectroscopy (FT-IR) were used to detect the effect of the compound on the CS surface. The molecular inhibitory effect of Furosemide was demonstrated using quantum chemical calculations, and the molecular simulation results demonstrated the adsorption on the carbon steel surface.

ECG signal quality in intermittent long-term dry electrode recordings with controlled motion artifacts

Wearable long-term monitoring applications are becoming more and more popular in both the consumer and the medical market. In wearable ECG monitoring, the data quality depends on the properties of the electrodes and on how they interface with the skin. Dry electrodes do not require any action from the user. They usually do not irritate the skin, and they provide sufficiently high-quality data for ECG monitoring purposes during low-intensity user activity. We investigated prospective motion artifact-resistant dry electrode materials for wearable ECG monitoring. The tested materials were (1) porous: conductive polymer, conductive silver fabric; and (2) solid: stainless steel, silver, and platinum. ECG was acquired from test subjects in a 10-min continuous settling test and in a 48-h intermittent long-term test. In the settling test, the electrodes were stationary, whereas both stationary and controlled motion artifact tests were included in the long-term test. The signal-to-noise ratio (SNR) was used as the figure of merit to quantify the results. Skin-electrode interface impedance was measured to quantify its effect on the ECG, as well as to leverage the dry electrode ECG amplifier design. The SNR of all electrode types increased during the settling test. In the long-term test, the SNR was generally elevated further. The introduction of electrode movement reduced the SNR markedly. Solid electrodes had a higher SNR and lower skin-electrode impedance than porous electrodes. In the stationary testing, stainless steel showed the highest SNR, followed by platinum, silver, conductive polymer, and conductive fabric. In the movement testing, the order was platinum, stainless steel, silver, conductive polymer, and conductive fabric.

A Quick Method to Assess Airway Distensibility in Mice

Airway distensibility is defined as the ease whereby airways are dilating in response to inflating lung pressure. If measured swiftly and accurately, airway distensibility would be a useful readout to parse the various elements contributing to airway wall stiffening, such as smooth muscle contraction, surface tension, and airway remodeling. The goal of the present study was to develop a method for measuring airway distensibility in mice. Lungs of BALB/c and C57BL/6 mice from either sex were subjected to stepwise changes in pressure. At each pressure step, an oscillometric perturbation was used to measure the impedance spectrum, on which the constant-phase model was fitted to deduce a surrogate for airway caliber called Newtonian conductance (GN). The change in GN over the change in pressure was subsequently used as an index of airway distensibility. An additional group of mice was infused with methacholine to confirm that smooth muscle contraction changes airway distensibility. GN increased with increasing steps in pressure, suggesting that the extent to which this occurs can be used as an index of airway distensibility. Airway distensibility was greater in BALB/c than C57BL/6 mice, and its variation by sex was mouse strain dependent, being greater in female than male in BALB/c mice with an inverse trend in C57BL/6 mice. Airway distensibility was also decreased by methacholine. This novel method swiftly measures airway distensibility in mice. Airway distensibility was also shown to vary with sex and mouse strain and to be sensitive to the contraction of smooth muscle.

Local environment in yeast-based impedance biodosimeters strongly influences the measurable dose

This work investigates the feasibility of yeast-based impedance measurements for retrospective dosimetry applications. The local environment around yeast cells in a previously developed film-badge was modeled using Geant4. A greater dose response was observed when yeast cells were surrounded by an aluminum-polymer structure, which acted as a conversion layer. Bench-top experiments were conducted using a jar-based dosimeter design that directly combined a finely-ground aluminum conversion medium with yeast powder. It was shown when irradiated in the presence of aluminum grains, yeast cells yielded a higher impedance signal, thereby indicating greater radiation-induced damage. Finally, in separate irradiation experiments, lead and aluminum sheets were placed behind yeast samples and the dosimeters were irradiated to 1 Gy. A 2-fold increase in the impedance signal was shown when samples were positioned in close contact with the lead sheet compared to the aluminum sheet. In all experiments, it was shown that the local environment significantly influences radiative energy deposition in yeast cells.

Impedimetric detection of gut-derived metabolites using 2D Germanene-based materials

Apart from the extensively researched graphene under the Group 14 2D materials, monolayered germanene and its derivatives have been gaining interest lately as alternative class of 2D materials owing to their facile synthesis, and attractive electronic and optical properties. Herein, three different functionalized germanene-based nanomaterials, namely Ge-H, Ge-CH3 and Ge-C3-CN were investigated on their novel incorporation in impedimetric immunosensors for the detection of gut-derived metabolites associated with neurological diseases, such as kynurenic acid (KA) and quinolinic acid (QA). The designed germanene-based immunosensor relies on an indirect competitive mechanism using disposable electrode printed chips. The competition for a fixed binding site of a primary antibody occurs between the bovine serum albumin-conjugated antigens on the electrode surface and the free antigens in the solution. Among the three materials, Ge-H displayed superior bioanalytical performance in KA and QA detection. Lower limits of detection of 5.07-11.38 ng/mL (26.79-68.11 nM) were attained for KA and QA with a faster reaction time than previously reported methods. Also, minimal cross-reactivity with interfering compounds, good reproducibility in impedimetric responses (RSD = 2.43-7.51 %) and long-term stability up to a month at 4 °C were the other attributes that the proposed Ge-H competitive impedimetric immunosensor has accomplished. The application of the developed Ge-H immunosensor to serum samples allowed an accurate KA and QA quantification at physiologically relevant levels. This work serves as a stepping-stone in the development of germanene-based nanomaterials for their implementation into cost-effective, miniaturized, portable and rapid impedimetric immunosensors, which are highly desirable for point-of-care testing in clinical settings.

Monitoring Intestinal Organoid-Derived Monolayer Barrier Functions with Electric Cell-Substrate Impedance Sensing (ECIS)

The measurement of transepithelial electrical resistance across confluent cell monolayer systems is the most commonly used technique to study intestinal barrier development and integrity. Electric cell substrate impedance sensing (ECIS) is a real-time, label-free, impedance-based method used to study various cell behaviors such as cell growth, viability, migration, and barrier function in vitro. So far, the ECIS technology has exclusively been performed on cell lines. Organoids, however, are cultured from tissue-specific stem cells, which better recapitulate cell functions and the heterogeneity of the parent tissue than cell lines and are therefore more physiologically relevant for research and modeling of human diseases. In this protocol paper, we demonstrate that ECIS technology can be successfully applied on 2D monolayers generated from patient-derived intestinal organoids. Key features • We present a protocol that allows the assessment of various cell functions, such as proliferation and barrier formation, with ECIS on organoid-derived monolayers. • The protocol facilitates intestinal barrier research on patient tissue-derived organoids, providing a valuable tool for disease modeling.

Antibacterial activity and dielectric properties of the PVA/cellulose nanocrystal composite using the synergistic effect of rGO@CuNPs

This work aims to enhance the performance of the polyvinyl alcohol (PVA) composite by using cellulose nanocrystal (CNC) as reinforcement and copper nanoparticles (CuNPs)/reduced graphene oxide (rGO) as conducting and antimicrobial reagents. Firstly, rGO was loaded onto CuNPs using an eco-friendly microwave method. Different techniques characterized the components and prepared composites, which indicated the incorporation of cellulose nanocrystals and rGO@CuNPs within the polyvinyl alcohol matrix. Utilizing the clear zone of inhibition, the antibacterial test was quantified. Compared to the neat composite, the rGO@CuNPs loaded polyvinyl alcohol/ cellulose nanocrystal composites exhibited no bacterial growth against S. aureus, E. coli, and C. albicans. However, all composites did not have antifungal activity against A. niger. The combination of conductivity and interfacial polarization is the reason for the abrupt increase of permittivity with decreasing frequency. Besides, adding rGO@CuNPs improved the electrical conductivity. DC-Conductivity increased about a decade after adding cellulose nanocrystal to polyvinyl alcohol, then another decade after adding CuONPs. The electric loss modulus representation shows a systematic shift in the peak position towards higher frequencies, decreasing the so-called conductivity relaxation time. This is the main reason for the enhancement of conductivity. The systematic attenuation of peaks' height with increasing conductivity is still unclear.

Impedance-based polymer microneedle patch sensor for continuous interstitial fluid glucose monitoring

Early detection and effective blood glucose control are critical for preventing and managing diabetes-related complications. Conventional glucometers provide point-in-time measurements but are painful and cannot facilitate continuous monitoring. Continuous glucose monitoring systems are comfortable but face challenges in terms of accuracy, cost, and sensor lifespan. This study aimed to develop a microneedle-based sensor patch for minimally invasive, painless, and continuous glucose monitoring in the interstitial fluid to address these limitations. Experimental results confirm painless and minimally invasive penetration of the skin tissue with cylindrical microneedles (3 × 3 array) to a depth of approximately 520 μm with minimal loading. The microneedle sensors fabricated with precision using the complementary metal-oxide semiconductor process were immobilized with glucose oxidase, as confirmed through phase angle analysis. Long-term tests confirmed the effective operation of the sensor for up to seven days. Glucose concentrations determined from the fitted concentration-impedance curves correlated well with those measured using commercial glucometers, indicating the reliability and precision of the microneedle sensor. The flexible and minimally invasive sensor developed in this study facilitates painless and continuous glucose monitoring.

Defibrillation threshold in elective subcutaneous implantable defibrillator generator replacements: Time to reduce the size of the pulse generator?

INTRODUCTION

The first step-down defibrillation studies in the subcutaneous implantable cardioverter-defibrillator (S-ICD) described a defibrillation threshold (DFT) of 32.5 ± 17.0 J and 36.6 ± 19.8 J. Therefore, the default shock output of the S-ICD was set at 80 J. In de novo implants, the DFT is lower in optimally positioned S-ICDs. However, a retrospective analysis raised concerns about a high DFT in S-ICD replacements, possibly related to fibrosis.

OBJECTIVE

We aimed to find the DFT in patients undergoing S-ICD generator replacement.

METHODS

This prospective study enrolled patients who underwent S-ICD generator replacement with subsequent defibrillation testing. A pre-specified defibrillation testing protocol was used to determine the DFT, defined as the lowest shock output that effectively terminated the induced ventricular arrhythmia.

RESULTS

A total of 45 patients were enrolled, 6.0 ± 2.1 years after initial implant. Mean DFT during replacement in the total cohort was 27.4 ± 14.3 J. In patients with a body mass index (BMI) 18.5-25 kg/m2 (N = 22, BMI 22.5 ± 1.6), median DFT was 20 J (IQR 17.5-30). In 18/22 patients, the DFT was ≤30 J and 5/22 patients were successfully defibrillated at 10 J. One patient with hypertrophic cardiomyopathy had a DFT of 65 J. In patients with a BMI >25 kg/m2 (N = 23, BMI 29.5 ± 4.2), median DFT was 30 J (IQR 20-40). In 15/23 patients, the DFT was ≤30 J and 4/23 patients had a successful defibrillation test at 10 J.

CONCLUSIONS

This study eases concerns about a high DFT after S-ICD generator replacement. The majority of patients had a DFT ≤30 J, regardless of BMI, suggesting that the shock output of the S-ICD could be safely reduced.

Development of an impedance-based biosensor for determination of IgG galactosylation levels

The glycan profile of immunoglobulin G (IgG) molecule and its changes are associated with a number of different diseases. Galactosylation of IgG was recently suggested as a potential biomarker for rheumatoid arthritis, inflammatory bowel disease and many cancers. In this paper, we propose a portable impedance-based biosensor that utilizes lectin array technology to detect glycans in IgG. Biotinylated Griffonia simplicifolia (GSL II) and Ricinus communis agglutinin I (RCA I) lectins were used in our biosensor design for determination of the ratio of N-acetyl glucosamine (GlcNAc) to galactose (Gal) respectively, which is termed agalactosylation factor (AF). Streptavidin gold nanoparticles (GNP) were conjugated to biotinylated lectin bonded to the carbohydrate in the glycoprotein to magnify the change in impedance signal and enhance detection sensitivity. The method was successfully applied to differentiation of the galactosylation levels in human and rat IgG. In addition, we present proof of concept use of our biosensor for differentiation of COVID-19 positive patient samples from negative patients. Consequently, the sensor can be useful in future applications to distinguish between glycan profiles of IgG from healthy and patient samples in disease studies. Our biosensor permits analysis of human serum without conventional time-consuming IgG purification steps or pretreatment using enzyme digestion to cut the sugars from the glycoprotein molecule. The results suggest that the proposed point of care (POC) biosensor can be used for evaluating disease progression and treatment efficacy via monitoring changes in the galactosylation profiles of IgG in patients.

Simple Formula for pH/Impedance Probe Positioning in Children-Time to Update Standard Practice?

OBJECTIVE

To develop a novel formula for pH probe placement with adequate accuracy.

METHODS

Children (3-18 y) undergoing pH-metry were prospectively evaluated. Their height and corrected pH probe position under X-ray (2 vertebrae above the diaphragm) was recorded and the linear-regression analysis was performed to derive a novel formula. Its accuracy was checked on an additional group of prospectively included children. The success rate of a newly developed formula was estimated and compared to the performance of previously used formulae. The difference in the suggested placement of the probe (cm from nostrils) was calculated.

RESULTS

Based on 670 children with pH probe placed under X-ray, the following formula was developed using the linear-regression analysis: L = 0.184x + 4.4 (cm) (L = probe placement depth, x = body height). Its accuracy was confirmed on additional 111 children resulting in almost 85% success rate. The formula showed significant difference in the suggested placement from formulae used previously: +4.9 ± 0.8 cm, +2.4 ± 0.1 cm, +0.7 ± 0.6 cm, +1.1 ± 0.4 cm, +1.8 ± 0.3 cm, +2.2 ± 0.5 cm from the one by the Strobel, Moreau, Wilson, Nowak, Staiano-Clouse formulae, and the GOSH table with the calculated success rates of 1.8%, 43.2%, 65.8%, 77.5%, 65.8% and 54.1%, respectively. A table suggesting placement depth based on the body height was developed.

CONCLUSION

The present formula provides 85% success of pH probe placement in children ≥ 3 y suggesting its use in routine practice. More data are needed to confirm that probe adjustment under X-ray is unnecessary.

Electrochemical techniques for label-free and early detection of growing microbial cells and biofilms

Over the past decades, the misuse or abuse of antimicrobial agents to prevent and/or control infections has led to increased resistance of microbes to treatments, and antimicrobial resistance is now a subject of major global concern. In some cases, microbes possess the capacity to attach to biotic or abiotic surfaces, and to produce a protective polymeric matrix, forming biofilms of higher resistance and virulence compared to planktonic forms. To avoid further excessive and inappropriate use of antimicrobials, and to propose new effective treatments, it is very important to detect planktonic microbes and microbial biofilms in their early growth stage and at the point of need. In this review, we provide an overview of currently available electrochemical techniques, in particular impedimetric and voltamperometric methods, highlighting recent advances in the field and illustrating with examples in antibiotic susceptibility testing and microbial biofilm monitoring.

Bioelectrical impedance analysis as a clinical marker of health status in adult patients with benign gastrointestinal disease: A systematic review

BACKGROUND

Body composition reflects nutritional status, disease status and progression, and treatment responses. Mounting evidence supports the use of bioelectrical impedance analysis (BIA) as a non-invasive tool to assess body composition. Patients with benign gastrointestinal (GI) disease experience disease-related alterations in their body composition, and bioimpedance outcomes in patients with benign GI diseases have not previously been summarized. We aimed to evaluate BIA as a clinical body composition marker for benign GI diseases and describe its association with physical health status.

METHODS

We systematically searched PubMed, Scopus, Web of Science, Embase, and CINAHL from inception to October 2023 (PROSPERO registration: CRD42021265866). Of 971 screened studies, 26 studies were included in the final analysis, comprising a total of 2398 adult patients with benign GI disease. The main outcome was raw impedance data.

RESULTS

The most frequently reported BIA outcome was phase angle (PhA) (reported in 18 of 26 studies), followed by fat-free-mass (FFM) (reported in 13 of 26 studies). The consensus view of the included studies illustrates that BIA can be a useful tool for evaluating body composition in patients with benign GI diseases, and low PhA and FFM were associated with increased nutritional risk, abnormal physical characteristics, and increased mortality risk.

CONCLUSION

To fully utilize BIA as a clinical marker of health in patients with benign GI disease, standardized protocols specific to this population are needed and prospective studies testing cut-offs and ranges, accuracy, and other raw BIA parameters for classifying disease status.

Usefulness of pepsin saliva measurement for the detection of primary burning mouth syndrome related to reflux

OBJECTIVES

To study the diagnostic value of salivary pepsin tests for detecting laryngopharyngeal reflux (LPR) in patients with primary burning mouth syndrome (BMS).

METHODS

Patients with BMS and asymptomatic individuals were consecutively recruited from September 2018 to June 2023. Patients underwent hypopharyngeal-esophageal impedance pH-monitoring (HEMII-pH) and saliva collections to measure pepsin. Stomatology evaluation was carried out to exclude other causes of BMS. Oral, pharyngeal and laryngeal signs and symptoms were evaluated with Reflux Sign Assessment (RSA) and Reflux Symptom Score (RSS). Sensitivity, specificity, positive (PPV) and negative (NPV) predictive values of pepsin test were calculated considering the highest values of pepsin tests at ≥ 16, ≥ 36, and ≥ 100 ng/mL cutoffs. Receiver operating characteristic curve (ROC) was evaluated.

RESULTS

Forty-nine patients with both BMS and LPR at the HEMII-pH and 21 asymptomatic individuals were recruited. Pepsin test was 83.7%, 79.6%, and 71.4% sensitive at cutoffs ≥ 16, ≥ 36, and ≥ 100 ng/mL, respectively. The ROC analysis reported that a threshold of ≥ 21.5 ng/mL was associated with sensitivity, specificity, PPV and NPV of 81.6%, 81.0%, 90.1% and 65.4%, respectively. The severity score of burning mouth symptom was significantly associated with the saliva pepsin concentration (rs = 0.263; p = 0.029) and the oral RSA (rs = 0.474; p = 0.007).

CONCLUSION

Pepsin test is a valuable diagnostic approach for detecting LPR in patients with BMS. Patients with high level of saliva pepsin reported more severe burning mouth symptoms. Future studies are needed to confirm the role of LPR in the primary BMS.

Increased electrode impedance as an indicator for early detection of deep brain stimulation (DBS) hardware Infection: Clinical experience and in vitro study

BACKGROUND

When deep brain stimulation (DBS) infections are identified, they are often too advanced to treat without complete hardware removal. New objective markers to promptly identify DBS infections are needed. We present a patient with GPi (globus pallidus interna) DBS for dystonia, where the electrode impedance unexpectedly increased 3-months post-operatively, followed by serologic and hematologic markers of inflammation at 6-months, prompting explantation surgery. We recreated these conditions in a laboratory environment to analyze the pattern of changing of electrical impedance across the contacts of a DBS lead following Staphylococcus biofilm formation.

METHODS

A stainless-steel culture chamber containing 1 % brain heart infusion agar was used. A DBS electrode was dipped in peptone water containing a strain of S. aureus and subsequently introduced into the chamber. The apparatus was incubated at 37 °C for 6 days. Impedance was measured at 24hr intervals. A control experiment without S. Aureus inoculation was used to determine changes in impedance over a period of 6-days.

RESULTS

The mean monopolar impedance on day-1 was 751.8 ± 23.8 Ω and on day-3 was 1004.8 ± 68.7 Ω, a 33.7 % rise (p = 0.007). A faint biofilm formation could be seen around the DBS lead by day-2 and florid growth by day-3. After addition of the linezolid solution, a 15.9 % decrease in monopolar impedance was observed from day 3-6 (p = 0.003).

CONCLUSION

This study gives insight into impedance trends following a hardware infection in DBS. Increased impedance outside expected norms may be valuable for early prediction of infection. Furthermore, timely management using antibiotics might reduce the frequency of infection-related explant surgeries.

Interpretation of Impedance Data on High-resolution Impedance Manometry Studies-A Worldwide Survey

Background/Aims

Esophageal manometry is the gold standard for esophageal motility evaluation. High-resolution esophageal manometry with impedance (HRIM) allows concurrent assessment of bolus transit and manometry. Inconsistencies between concomitant impedance and manometry data pose a clinical dilemma and has not yet been addressed. We aim to assess interpretation trends of HRIM data among gastroenterologists worldwide.

Methods

A cross-sectional study using an anonymous survey was conducted among gastroenterologists worldwide. Statistical analysis was performed to compare responses between providers.

Results

We received responses from 107 gastroenterologists (26 countries). Most were adult providers (69, 64.5%), and most (77, 72.0%) had > 5 years of experience. Impedance was found to be helpful by 83 (77.6%) participants, but over 30% reported inconsistencies between impedance and manometry data. With incomplete bolus clearance and normal manometry 41 (38.7%) recommended observation, 41 (38.7%) recommended 24-hours pH-impedance, and 16 (15.1%) recommended prokinetics. With abnormal manometry and complete bolus clearance, 60 (57.1%) recommended observation while 18 (17.1%) recommended 24-hours pH impedance and 15 (14.3%) recommended prokinetics. A significant difference was found between providers from different continents in treating cases with discrepancy between impedance and manometry findings (P < 0.001). No significant differences were seen in responses between adult versus pediatric providers and between providers with different years of experience.

Conclusions

There is no consensus on interpreting HRIM data. Providers' approaches to studies with inconsistencies between manometry and impedance data vary. There is an unmet need for guidelines on interpreting impedance data in HRIM studies.

Early fitting in cochlear implant surgery: preliminary results

PURPOSE

Cochlear implants are usually activated 3-5 weeks after surgery; to date, no universal protocol exists regarding switch on and fitting of these devices. The aim of the study was to assess safety and functional results of activation and fitting of cochlear implant within 24 h following surgery.

METHODS

In this retrospective case-control study, 15 adult patients who underwent cochlear implant surgery, for a total of 20 cochlear implant procedures were analyzed. In particular, clinical safety and feasibility were investigated by examinating patients at activation and at each follow-up. Values of electrodes' impedance and most comfortable loudness (MCL) were analyzed from the time of surgery to 12 months after activation. Free-field pure tone average (PTA) was also recorded.

RESULTS

No major or minor complications were reported and all patients could perform the early fitting. Activation modality influenced impedance values only in the short term but the differences were not statistically significant (p > 0.05). Mean MCL values in the early fitting group were lower than MCL of the late fitting in all follow-up sessions, and the difference was statistically significant (p < 0.05). The mean PTA was lower in the early fitting group but the difference was not statistically significant (p < 0.05).

CONCLUSIONS

Early fitting of cochlear implants is safe, allows for an early rehabilitation and can have possible beneficial effects on stimulation levels and dynamic range.

The mediating role of the left ventricular mass index on the relationship between the fluid balance and left ventricular diastolic function in patients with chronic kidney disease

BACKGROUND

The pathophysiological mechanism of cardiovascular disease in patients with chronic kidney disease (CKD) is complicated. Mediation analysis is an important statistical tool for gaining insight into the complex mechanisms of exposure-outcome effects. We investigated the potential mediating role of the left ventricular mass index (LVMI) on the association between fluid balance (overhydration/extracellular water, OH/ECW) and left ventricular diastolic function (E/e´ ratio) in patients with CKD not yet on dialysis.

METHODS

Bioimpedance spectroscopy, echocardiography, and laboratory evaluations were performed on 425 consecutive patients on the same day. The patients were classified into two groups according to the estimated glomerular filtration rate corresponding to CKD stages 3 and 5. Mediation analysis was performed using the PROCESS macro and bootstrapping methods.

RESULTS

OH/ECW and LVMI were positively correlated with the E/e´ ratio in both the CKD stages 3 and five groups. In CKD stage 5, there was a statistically significant association between OH/ECW and LVMI, whereas no correlation was observed in CKD stage 3. In the mediation analysis, LVMI positively mediated the relationship between OH/ECW and E/e´ ratio when controlling for confounders in patients with CKD stage 5 (B = 2.602; Boot 95% confidence interval, 1.313-4.076).

CONCLUSION

In our analysis, the indirect effect of mediators was significant in patients with advanced CKD. Therefore, our study suggests that further research on several other risk factors may be needed to determine the underlying mechanisms of association between the associated factors in all CKD stages.

Quantifying Trophoblast Function Using the xCELLigence System

Analyses of trophoblast behavior in vitro are widely used to investigate and understand the trophoblast dysfunction associated with pregnancy pathologies. Key behaviors critical for trophoblast function include adhesion, proliferation, migration, and invasion. Traditionally, these behaviors have been measured using time-consuming single timepoint or endpoint assays. xCELLigence is a breakthrough technology that utilizes gold electrodes embedded in cell culture plates to collect electrical impedance measurements and monitor cell attachment, spreading, movement, and growth. It enables trophoblast functions to be quantitatively monitored in real-time, providing new insights into trophoblast behavior.

Superiority of the Combination of Input and Output Parameters to the Single Parameter for Lesion Size Estimation

BACKGROUND

For lesion size prediction, each input parameter, including ablation energy (AE), and output parameter, such as impedance, is individually used. We hypothesize that using both parameters simultaneously may be more optimal.Methods and Results: Radiofrequency applications at a range of power (30-50 W), contact force (10 g and 20 g), duration (10-60 s), and catheter orientation with normal saline (NS)- or half-normal saline (HNS)-irrigation were performed in excised porcine hearts. The correlations, with lesion size of AE, absolute impedance drop (∆Imp-drop), relative impedance drop (%Imp-drop), and AE*%Imp-drop were examined. Lesion size was analyzed in 283 of 288 lesions (NS-irrigation, n=142; HNS-irrigation, n=141) without steam pops. AE*%Imp-drop consistently showed the strongest correlations with lesion maximum depth (NS-irrigation, ρ=0.91; HNS-irrigation, ρ=0.94), surface area (NS-irrigation, ρ=0.87; HNS-irrigation, ρ=0.86), and volume (NS-irrigation, ρ=0.94; HNS-irrigation, ρ=0.94) compared with the other parameters. Moreover, compared with AE alone, AE*%Imp-drop significantly improved the strength of correlation with lesion maximum depth (AE vs. AE*%Imp-drop, ρ=0.83 vs. 0.91, P<0.01), surface area (ρ=0.73 vs. 0.87, P<0.01), and volume (ρ=0.84 vs. 0.94, P<0.01) with NS-irrigation. This tendency was also observed with HNS-irrigation. Parallel catheter orientation showed a better correlation with lesion depth and volume using ∆Imp-drop, %Imp-drop, and AE*%Imp-drop than perpendicular orientation.

CONCLUSIONS

The combination of input and output parameters is more optimal than each single parameter for lesion prediction.

Influence of Zn-substitution on structural, magnetic, dielectric, and electric properties of Li-Ni-Cu ferrites

The polycrystalline Li0.15Ni0.6-xZnxCu0.1Fe2.15O4 ferrites are fabricated by the method of conventional solid-state reaction technique. The X-ray diffraction (XRD) confirms that the structure of the composition is a single-phase cubic spinel structure for all samples. The particle size of the compositions is varied from 36 to 52 nm. The lattice parameter and densities are found to increase with enhancing Zn content, as the ionic radius and atomic weight of Zn are greater than Ni. The porosity exhibits a decreasing trend. The average grain size determined using Field Emission Scanning Microscopy (FESEM) increases until x = 0.40, then declines. The Energy-Dispersive Spectroscopy (EDS) examination revealed that the percentage of obtained elements is well matched with the stoichiometric elements. The addition of Zn content acts as an accelerator for enhancing the value of the real part of initial permeability and the highest value is obtained (μi' = 276) for the x = 0.40 sample, as well as the highest relative quality factor (RQF) of around 3000. The loss factor for the Zn substituted composition is nine times lower than for the parent composition. The optimum saturation magnetization of around 77.49 emu/g is found for the x = 0.40 sample. The maximum dielectric constant (ε' = 2.85 × 103) is found for x = 0.10 samples at 10 kHz. Further, from impedance studies, the non-Debye type dielectric relaxation is seen for the Zn-substituted samples. The observed region of the imaginary electric modulus peak signifies the transition of charge carrier mobility from a larger range to a short-range distance. The phenomenon of ac conductivity is attributed to the process of the small polaron hopping mechanism.

In vitro assays to evaluate CAR-T cell cytotoxicity

This chapter introduces four commonly used in vitro chimeric antigen receptor (CAR)-T cell cytotoxicity assays (lactate dehydrogenase release assay, 51Cr release assay, IncuCyte live cell killing assay, and xCELLigence real-time analysis) and provides a detailed protocol for xCELLigence real-time analysis. Focusing on in vitro assays, this chapter starts with explaining the mechanisms and discussing the utilization of each assay to quantify T-cell-induced cytotoxicity. Due to the high-throughput quantification and straightforward workflow of xCELLigence real-time analysis, a protocol entailing reagents and equipment, a 3-day step-by-step procedure, and instructions for data analysis are provided.

LiPo batteries dataset: Capacity, electrochemical impedance spectra, and fit of equivalent circuit model at various states-of-charge and states-of-health

This dataset contains experimental data of capacity and electrochemical impedance of five Lithium Polymer (LiPo) batteries (model LP-503562-IS-3 manufactured by BAK Technology). All batteries have been subjected to hundreds of charge-discharge cycles to obtain their characteristics at different states-of-health. Capacities have been measured under both standard and stress conditions. At fixed intervals (45 cycles in most cases) batteries have been subjected to partial discharge cycles to measure impedance spectra at different values of the state-of-charge. Impedance spectra have been fitted by using an equivalent circuit model; estimated circuit parameters are included in the dataset.

Is empiric proton pump inhibition in patients with symptoms of extraesophageal gastroesophageal reflux justified?

BACKGROUND

The prevalence of gastroesophageal reflux disease (GERD) has had a marked increase in Western countries with a paralleling interest in extraesophageal (EE) manifestations of GERD, including laryngopharyngeal reflux (LPR). There are considerable differences in clinical practice between gastroenterologists, otolaryngologists and pulmonologists.

METHODS

In this narrative review we address some of these controversies concerning EE manifestations of GERD and LPR.

RESULTS

It is disputed whether there is causal relationship between reflux and the numerous symptoms and conditions suggested to be EE manifestations of GERD. Similarly, the pathophysiology is uncertain and there are disagreements concerning diagnostic criteria. Consequently, it is challenging to provide evidence-based treatment recommendations. A significant number of patients are given a trial course with a proton pump inhibitor (PPI) for several months before symptoms are evaluated. In randomized controlled trials (RCTs) and meta-analyses of RCTs PPI treatment does not seem to be advantageous over placebo, and the evidence supporting that patients without verified GERD have any benefit of PPI treatment is negligible. There is a large increase in both over the counter and prescribed PPI use in several countries and a significant proportion of this use is without any symptomatic benefit for the patients. Whereas short-term treatment has few side effects, there is concern about side-effects after long-term use. Although empiric PPI treatment for suspected EE manifestations of GERD instead of prior esophageal 24-hour pH and impedance monitoring is included in several guidelines by various societies, this practice contributes to overtreatment with PPI.

CONCLUSION

We argue that the current knowledge suggests that diagnostic testing with pH and impedance monitoring rather than empiric PPI treatment should be chosen in a higher proportion of patients presenting with symptoms possibly attributable to EE reflux.

Enhancing the functional maturity of hiPSC-derived cardiomyocytes to assess inotropic compounds

Human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) present an attractive in vitro platform to model safety and toxicity assessments-notably screening pro-arrhythmic compounds. The utility of the platform is stymied by a hiPSC-CM contractile apparatus and calcium handling mechanism akin to fetal phenotypes, evidenced by a negative force-frequency relationship. As such, hiPSC-CMs are limited in their ability to assess compounds that modulate contraction mediated by ionotropic compounds (Robertson, Tran, & George, 2013). To address this limitation, we utilize Agilent's xCELLigence Real-Time Cell Analyzer ePacer (RTCA ePacer) to enhance hiPSC-CM functional maturity. A continuous, progressive increase of electrical pacing is applied to hiPSC-CMs for up to 15 days. Contraction and viability are recorded by measurement of impedance using the RTCA ePacer. Our data confirms hiPSC-CMs inherently demonstrate a negative impedance amplitude frequency that is reversed after long-term electrical pacing. The data also indicate positive inotropic compounds increase the contractility of paced cardiomyocytes and calcium handling machinery is improved. Increased expression of genes critical to cardiomyocyte maturation further underscores the maturity of paced cells. In summary, our data suggest the application of continuous electrical pacing can functionally mature hiPSC-CMs, enhancing cellular response to positive inotropic compounds and improving calcium handling. SUMMARY: Long-term electrical stimulation of hiPSC-CM leads to functional maturation enabling predictive assessment of inotropic compounds.

A potent anticoagulant hybrid of snake venom derived FIX-binding protein and anti-factor IX RNA aptamer: Assessed by in-silico and electrochemical analyses

Anticoagulant therapies are crucial in the management of surgical complications as well as the prophylaxis of thrombosis. Many studies are being conducted on the Habu snake-venom anticoagulant, FIX-binding protein (FIX-Bp), for its greater potency and strong affinity to FIX clotting factor. On the other hand, the capacity to promptly reverse such acute anticoagulation is equally important. Combining a reversible anticoagulant with FIX-Bp may be advantageous in maintaining the balance between adequate anticoagulation and repealing when necessary. In this study, authors integrated FIX-Bp and RNA aptamer-based anticoagulants into a single target, FIX clotting factor, in order to achieve a robust anticoagulant effect. An in-silico and electrochemical approach were used to investigate the combination of FIX-Bp and RNA aptamers as a bivalent anticoagulant and to verify the competing or predominant binding sites of each anticoagulant. The in-silico analysis discovered that both the venom- and aptamer-anticoagulant had a strong affinity for the FIX protein at the Gla-domain and EGF-1 domain by holding 9 conventional hydrogen bonds with the binding energy of -34.859 kcal/mol. The electrochemical technique verified that both anticoagulants had different binding sites. The impedance load upon RNA aptamer binding to FIX protein was 14 %, whereas the addition of FIX-Bp caused a significant impedance rise of 37 %. This indicates that the addition of aptamers prior to FIX-Bp is a promising strategy for the conception of a hybrid anticoagulant.

An impedance based microfluidic sensor for evaluation of individual red blood cell solute permeability

-In this paper, we investigate a microfluidic based sensing device for cell membrane permeability measurements in real time with applications in rapid assessment of red blood cell (RBC) quality at the individual cell level. The microfluidic chip was designed with unique abilities to line up the RBCs in the centerline of the microchannel using positive dielectrophoresis (p-DEP) forces, rapid mixing of RBCs with various media (e.g. containing permeating or nonpermeating solutes) injected from different inlets to achieve high mixing efficiency. The chip detects the impedance values of the RBCs within 0.19 s from the start of mixing with other media, at ten electrodes along the length of the channel and enables time series measurements of volume change of individual cell caused by cell osmosis in anisosmotic fluids over a 0.8 s postmixing timespan. This technique enables estimating water permeability of individual cell accurately. Here we first present confirmation of a linear voltage-diameter relationship in polystyrene bead standards. Next, we show that under equilibrium conditions, the voltage-volume relationship in rat red blood cells (RBCs) is linear, corresponding to previously published Boyle van 't Hoff plots. Using rat cells as a model for human, we present the first measurement of water permeability in individual red blood cells and confirm that these data align with previously published population level values for human RBC. Finally, we present preliminary evidence for possible application of our device to identify individual RBCs infected with Plasmodium falciparum malaria parasites. Future developments using this device will address the use of whole blood with non-homogenous cell populations, a task currently performed by clinical Coulter counters.

Successful defibrillation testing in patients undergoing elective subcutaneous implantable cardioverter-defibrillator generator replacement

AIMS

After implantation of a subcutaneous implantable cardioverter-defibrillator (S-ICD), a defibrillation test (DFT) is performed to ensure that the device can effectively detect and terminate the induced ventricular arrhythmia. Data on DFT efficacy at generator replacement are scarce with a limited number of patients and conflicting results. This study evaluates conversion efficacy during DFT at elective S-ICD generator replacement in a large cohort from our tertiary centre.

METHODS AND RESULTS

Retrospective data of patients who underwent an S-ICD generator replacement for battery depletion with subsequent DFT between February 2015 and June 2022 were collected. Defibrillation test data were collected from both implant and replacement procedures. PRAETORIAN scores at implant were calculated. Defibrillation test was defined unsuccessful when two conversions at 65 J failed. A total of 121 patients were included. The defibrillation test was successful in 95% after the first and 98% after two consecutive tests. This was comparable with success rates at implant, despite a significant rise in shock impedance (73 ± 23 vs. 83 ± 24 Ω, P < 0.001). Both patients with an unsuccessful DFT at 65 J successfully converted with 80 J.

CONCLUSION

This study shows a high DFT conversion rate at elective S-ICD generator replacement, which is comparable to conversion rates at implant, despite a rise in shock impedance. Evaluating device position before generator replacement may be recommended to optimize defibrillation success at generator replacement.

Non-linear properties of the Achilles tendon determine ankle impedance over a broad range of activations in humans

Regulating ankle mechanics is essential for controlled interactions with the environment and rejecting unexpected disturbances. Ankle mechanics can be quantified by impedance, the dynamic relationship between an imposed displacement and the torque generated in response. Ankle impedance in the sagittal plane depends strongly on the triceps surae and Achilles tendon, but their relative contributions remain unknown. It is commonly assumed that ankle impedance is controlled by changing muscle activation and, thereby, muscle impedance, but this ignores that tendon impedance also changes with activation-induced loading. Thus, we sought to determine the relative contributions from the triceps surae and Achilles tendon during conditions relevant to postural control. We used a novel technique that combines B-mode ultrasound imaging with joint-level perturbations to quantify ankle, muscle, and tendon impedance simultaneously across activation levels from 0 - 30% of maximum voluntary contraction. We found that muscle and tendon stiffness, the static component of impedance, increased with voluntary plantarflexion contractions, but that muscle stiffness exceeded tendon stiffness at very low loads (21±7 N). Above these loads, corresponding to 1.3% of maximal strength for an average participant in our study, ankle stiffness was determined predominately by Achilles tendon stiffness. At approximately 20% MVC for an average participant, ankle stiffness was four times more sensitive to changes in tendon stiffness than muscle stiffness. We provide the first empirical evidence demonstrating that the nervous system, through changes in muscle activations, leverages the non-linear properties of the Achilles tendon to increase ankle stiffness during postural conditions.

Foldamer Nanotubes Mediated Label-Free Detection of Protein-Small Molecule Interactions

Development of miniaturized lab-on-chip devices for the detection of rapid and specific small molecule-protein binding interactions at very low concentrations holds significant importance in drug discovery and biomedical applications. Here, we are reporting the label-free detection of small molecule-protein interactions on the surface functionalizable nanotubes of α,γ-hybrid peptide helical foldamers using nanoscale capacitance and impedance spectroscopy. The 12-helix conformation of the α,γ-hybrid peptide observed in the single crystals, self-assembled into nanotubes in an aqueous environment with exposed cysteine thiols for small molecule conjugation. The binding of streptavidin to the covalently linked biotin on the surface of nanotubes was detected at the picomolar concentrations. No change in the capacitance and impedance were observed in the absence of either immobilized biotin or protein streptavidin. The functionalizable hybrid peptide nanotubes reported here pave the way for the label-free detection of various small molecule protein interactions at very low concentrations.

Optimizing Aerodynamic Vocal Parameters by Varying Supraglottic Pressure Using "Controlled Supraglottic Pressure Phonation" in Healthy Subjects

OBJECTIVE

The objective of this study is to introduce a novel method for semi-occluded vocal tract (SOVT) therapy called "controlled supraglottic pressure phonation," determine the mechanism by which supraglottic pressure contributes to lowering impedance during SOVT therapy, and provide the optimal supraglottic pressure range for SOVT exercises.

METHODS

Twenty-five human subjects were assigned to one of five supraglottic pressure levels, 0, 2, 4, 6, and 8 cmH2O, which were controlled through a continuous positive airway pressure device. Subjects were asked to phonate during both a short- and long-duration task, in which vocal properties were measured before and after. At the end of each task, the subjects reported the levels of discomfort and phonation difficulty on a 0-10 scale to assess the subjective improvement of vocal economy.

RESULTS

Significant differences were observed between pre- and post-task measurements for phonation threshold pressure for both the short-duration and long-duration tasks. Phonation threshold flow and frequency measurements were found to have no statistically significant differences. The subjective measures showed elevated discomfort in the higher pressure inputs for both tasks relative to no air.

CONCLUSION

Higher supraglottic pressure levels will improve ease of phonation, but the treatment discomfort needs to be considered as well, yielding an optimal supraglottic pressure range of 4-6 cmH2O. "Controlled supraglottic pressure phonation" serves as an alternative to straw phonation that may produce additional benefits.

Label free impedance based acetylcholinesterase enzymatic biosensors for the detection of acetylcholine

Realtime monitoring of neurotransmitters is of great interest for understanding their fundamental role in a wide range of biological processes in the central and peripheral nervous system, as well as their role, in several degenerative brain diseases. The measurement of acetylcholine in the brain is particularly challenging due to the complex environment of the brain and the low concentration and short lifetime of acetylcholine. In this paper, we demonstrated a novel, label-free biosensor for the detection of Ach using a single enzyme, acetylcholinesterase (ACHE), and electrochemical impedance spectroscopy (EIS). Acetylcholinesterase was covalently immobilized onto the surface of gold microelectrodes through an amine-reactive crosslinker dithiobis(succinimidyl propionate) (DSP). Passivation of the gold electrode with SuperBlock eliminated or reduced any non-specific response to other major interfering neurotransmitter molecules such as dopamine (DA), norepinephrine (NE) and epinephrine (EH). The sensors were able to detect acetylcholine over a wide concentration range (5.5-550 μM) in sample volumes as small as 300 μL by applying a 10 mV AC voltage at a frequency of 500 Hz. The sensors showed a linear relationship between Ach concentration and ΔZmod(R2 = 0.99) in PBS. The sensor responded to acetylcholine not only when evaluated in a simple buffer (PBS buffer) but in several more complex environments such as rat brain slurry and rat whole blood. The sensor remained responsive to acetylcholine after being implanted ex vivo in rat brain tissue. These results bode well for the future application of these novel sensors for real time in vivo monitoring of acetylcholine.

Polymer nanofiber network reinforced gold electrode array for neural activity recording

Flexible and stretchable neural electrodes are promising tools for high-fidelity interfacing with soft and curvilinear brain surface. Here, we describe a flexible and stretchable neural electrode array that consists of polyacrylonitrile (PAN) nanofiber network reinforced gold (Au) film electrodes. Under stretching, the interweaving PAN nanofibers effectively terminate the formation of propagating cracks in the Au films and thus enable the formation of a dynamically stable electrode-tissue interface. Moreover, the PAN nanofibers increase the surface roughness and active surface areas of the Au electrodes, leading to reduced electrochemical impedance and improved signal-to-noise ratio. As a result, PAN nanofiber network reinforced Au electrode arrays can allow for reliable in vivo multichannel recording of epileptiform activities in rats.

Supplementary Information

The online version contains supplementary material available at 10.1007/s13534-022-00257-5.

Optimization design of interdigitated microelectrodes with an insulation layer on the connection tracks to enhance efficiency of assessment of the cell viability

BACKGROUND

Microelectrical Impedance Spectroscopy (µEIS) is a tiny device that utilizes fluid as a working medium in combination with biological cells to extract various electrical parameters. Dielectric parameters of biological cells are essential parameters that can be extracted using µEIS. µEIS has many advantages, such as portability, disposable sensors, and high-precision results.

RESULTS

The paper compares different configurations of interdigitated microelectrodes with and without a passivation layer on the cell contact tracks. The influence of the number of electrodes on the enhancement of the extracted impedance for different types of cells was provided and discussed. Different types of cells are experimentally tested, such as viable and non-viable MCF7, along with different buffer solutions. This study confirms the importance of µEIS for in vivo and in vitro applications. An essential application of µEIS is to differentiate between the cells' sizes based on the measured capacitance, which is indirectly related to the cells' size. The extracted statistical values reveal the capability and sensitivity of the system to distinguish between two clusters of cells based on viability and size.

CONCLUSION

A completely portable and easy-to-use system, including different sensor configurations, was designed, fabricated, and experimentally tested. The system was used to extract the dielectric parameters of the Microbeads and MCF7 cells immersed in different buffer solutions. The high sensitivity of the readout circuit, which enables it to extract the difference between the viable and non-viable cells, was provided and discussed. The proposed system can extract and differentiate between different types of cells based on cells' sizes; two other polystyrene microbeads with different sizes are tested. Contamination that may happen was avoided using a Microfluidic chamber. The study shows a good match between the experiment and simulation results. The study also shows the optimum number of interdigitated electrodes that can be used to extract the variation in the dielectric parameters of the cells without leakage current or parasitic capacitance.

Multiplex sensing of IL-10 and CRP towards predicting critical illness in COVID-19 infections

Here we present a sensitive method for the detection and quantification of two (IL -10 and CRP) immuno-responsive biomarkers in various biofluids. The significance of these immune response biomarkers lies in them displaying elevated levels in critically ill COVID -19 patients. The developed electrochemical sensor contains a gold film electrode with ZnO nanoparticles deposited on its surface to increase the surface area of the working electrode while integrating antibody-antigen interactions into the detection system. This multiplex biosensor has a wide linear range from 0.01 μg/mL to 100 μg/mL and 0.1 pg/mL to 1000 pg/mL for CRP and IL10, respectively. The cross-reactivity of this multiplex sensor platform was evaluated between these two proteins and was <20%. Recovery studies were performed by spiking known concentrations in serum and urine samples. The recovery was calculated and ranged from 80% to 100%, confirming clinical applicability. This electrochemical sensing platform can aid in the early screening of COVID -19 patients to monitor for the development of more serious and potentially lethal symptoms.

Covalent organic framework: A state-of-the-art review of electrochemical sensing applications

Covalent organic framework (COF), a kind of porous polymer with crystalline properties, is a periodic porous framework material with precise regulation at atomic level, which can be formed by the orderly connection of pre-designed organic construction units through covalent bonds. Compared with metal-organic frameworks, COFs exhibit unique performance, including tailor-made functions, stronger load ability, structural diversity, ordered porosity, intrinsic stability and excellent adsorption features, are more conducive to the expansion of electrochemical sensing applications and the universality of applications. In addition, COFs can accurately integrate organic structural units with atomic precision into ordered structures, so that the structural diversity and application of COFs can be greatly enriched by designing new construction units and adopting reasonable functional strategies. In this review, we mainly summarized state-of-the-art recent advances of the classification and synthesis strategy of COFs, the design of functionalized COF for electrochemical sensors and COFs-based electrochemical sensing. Then, an overview of the considerable recent advances made in applying outstanding COFs to establish electrochemical sensing platform, including electrochemical sensor based on voltammetry, amperometry, electrochemical impedance spectroscopy, electrochemiluminescence, photoelectrochemical sensor and others. Finally, we discussed the positive outlooks, critical challenges and bright directions of COFs-based electrochemical sensing in the field of disease diagnosis, environmental monitoring, food safety, drug analysis, etc.

Comparison Between the Effect of Intra-Scalar Methylprednisolone and Sodium Hyaluronate in Impedance and Electrically Evoked Compound Action Potentials in Cochlear Implant Patients

To evaluate and compare the effect of intra-scalar methylprednisolone and sodium hyaluronate on cochlear implants' impedance and electrically evoked compound action potentials thresholds. In a prospective randomized clinical trial, 103 children with pre-lingual hearing loss candidates for cochlear implantation at a tertiary hospital were divided into three groups based on intervention. Intraoperatively, one group received intra-scalar methylprednisolone, the second sodium hyaluronate, and the third group was the control group. Impedance and electrically evoked compound action potentials (e-ECAP) thresholds on long-term follow-up were evaluated and compared in these three groups. Significant decrease in impedance and e-ECAP thresholds were observed in all groups in a 4-year follow-up. No statistically significant difference was observed among all mentioned groups. Impedance and e-ECAP thresholds decrease in the long term, and using topical intra-scalar Healon or methylprednisolone may not significantly affect these parameters.

RGO-PANI composite Au microelectrodes for sensitive ECIS analysis of human gastric (MKN-1) cancer cells

Microelectrode-based cell chip studies for cellular responses often require improved adhesion and growth conditions for efficient cellular diagnosis and high throughput screening in drug discovery. Cell-chip studies are often performed on gold electrodes due to their biocompatibility, and stability, but the electrode-electrolyte interfacial capacitance is the main drawback to the overall sensitivity of the detection system. Thus, here, we developed reduced graphene oxide-polyaniline-modified gold microelectrodes for real-time impedance-based monitoring of human gastric adenocarcinoma cancer (MKN-1) cells. The impedance characterization on modified electrodes showed 28-fold enhanced conductivity than the bare electrodes, and the spectra were modeled with proper equivalent circuits to extrapolate the values of circuit elements. The impedance of both time-and frequency-dependent measurements of cell-covered modified electrodes with equivalent model circuits was analyzed to achieve cellular behavior, such as adhesion, spreading, proliferation, and influence of anti-cancer agents. The normalized impedance at 41.5 kHz (|Z|_{norm 41 kHz}) was selected to monitor the cell growth analysis, which was found linear with the proliferation of adherent cells along with the influence of the anticancer drug agent on the MKN-1 cells. The synergistic effects and biocompatible nature of PANI-RGO modifications improved the overall sensitivity for the cell-growth studies of MKN-1 cells.

Sensitive Detection of BVDV Using Gold Nanoparticle-Modified Few-Layer Black Phosphorus with Affinity Peptide-Based Electrochemical Sensor

The lethality of the bovine viral diarrhea virus (BVDV) in cattle involves inapparent infection and various, typically subclinical, syndromes. Cattle of all ages are vulnerable to infection with the virus. It also causes considerable economic losses, primarily due to reduced reproductive performance. In the absence of treatment that can completely cure infected animals, detection of BVDV relies on highly sensitive and selective diagnosis methods. In this study, an electrochemical detection system was developed as a useful and sensitive system for the detection of BVDV to suggest the direction of diagnostic technology through the development of conductive nanoparticle synthesis. As a countermeasure, a more sensitive and rapid BVDV detection system was developed using the synthesis of electroconductive nanomaterials black phosphorus (BP) and gold nanoparticle (AuNP). To increase the conductivity effect, AuNP was synthesized on the BP surface, and the stability of BP was improved by using dopamine self-polymerization. Moreover, its characterizations, electrical conductivity, selectivity, and sensitivity toward BVDV also have been investigated. The BP@AuNP-peptide-based BVDV electrochemical sensor exhibited a low detection limit of 0.59 copies mL^-1 with high selectivity and long-term stability (retaining 95% of its initial performance over 30 days).

Aptamer-functionalized capacitive biosensors

The growing use of aptamers as target recognition elements in label-free biosensing necessitates corresponding transducers that can be used in relevant environments. While popular in many fields, capacitive sensors have seen relatively little, but growing use in conjunction with aptamers for sensing diverse targets. Few reports have shown physiologically relevant sensitivity in laboratory conditions and a cohesive picture on how target capture modifies the measured capacitance has been lacking. In this review, we assess the current state of the field in three areas: small molecule, protein, and cell sensing. We critically analyze the proposed hypotheses on how aptamer-target capture modifies the capacitance, as many mechanistic postulations appear to conflict between published works. As the field matures, we encourage future works to investigate individual aptamer-target interactions and to interrogate the physical mechanisms leading to measured changes in capacitance. To this point, we provide recommendations on best practices for developing aptasensors with a particular focus on considerations for biosensing in clinical settings.

ELISA-Based Biosensors

Enzyme-linked immunosorbent assay (ELISA) is by definition a biosensor. However, not all immuno-biosensors involve the use of enzymes, while other biosensors incorporate ELISA as a key signaling component. In this chapter, we review the role of ELISA in signal amplification, integration with microfluidic systems, digital labeling, and electrochemical detection.

Feasibility of bioelectrical impedance analysis in routine clinical care to assess body composition in geriatric rehabilitation inpatients: RESORT

BACKGROUND

Sarcopenia is prevalent in 20-50% of geriatric rehabilitation inpatients, but it is often undiagnosed.

AIMS

The aim of the study is to evaluate the feasibility of bioelectric impedance analysis (BIA) to measure muscle mass in routine clinical care in a cohort of geriatric rehabilitation inpatients.

METHODS

REStORing Health of acutely unwell adulTs (RESORT) is an observational, longitudinal inception cohort of geriatric rehabilitation inpatients. BIA was implemented at admission and discharge as routine care performed by nursing staff. BIA feasibility was defined as completion rate (low ≤ 25%, moderate > 25- ≤ 50%, good > 50- ≤ 75%, excellent > 75%), reasons for non-completion and need for remeasurement. Clinical characteristics associated with BIA completion and remeasurements were assessed.

RESULTS

Patients (n = 1890, 56% females) had a median age of 83.4 years (interquartile range: [77.6-88.4]). Of the total cohort, 5.7% had a contraindication (pacemaker/other electronic medical device) for BIA at admission and 4.5% at discharge. BIA was completed in 77.1% of patients eligible for BIA at admission and 63.2% at discharge indicating good feasibility; remeasurement was required in 7.4 and 6.9%, respectively; 5.9% had a medical reason preventing BIA completion at admission and 3.7% at discharge. Refusal and technical issues occurred in 1.6 and 0.7% at admission and 2.1 and 1.8% at discharge. Reason for non-completion was unknown/missing in 14.7% at admission and 28.6% at discharge. Worse functional and physical performance was associated with BIA non-completion and remeasurement.

CONCLUSIONS

BIA in routine clinical care in geriatric rehabilitation inpatients is feasible; completion rates may be enhanced further by reviewing barriers and enablers.

Reflux definitions in esophageal multi-channel intraluminal impedance

Aim

In this study, we aim to propose consensus-based interpretations to enhance both automatic, and manual analysis and then present our recommendations about reflux-related variables to enhance Multichannel Intraluminal (MII) measurements.

Background

Multichannel Intraluminal Impedance-pH (MII-pH) monitoring is the most sensible option to evaluate Gastroesophageal Reflux Disease (GERD), specifically for the patients with normal endoscopy findings, and persistent symptoms without response to Proton Pomp Inhibitor therapy. There were only a few studies on the interpretation of reflux events in MII tracings.

Methods

Several 200 episodes of reflux events were reviewed during several meetings in five steps, to discuss and categorize unresolved issues within existing interpretations, and propose technical principles for accurate characterization of reflux events.

Results

In this study, we show that baseline impedance is determined using a moving average procedure to the impedance data of each channel with a time window of 60 seconds based on this finding; a liquid reflux event is defined as a retrograde 50% drop in baseline impedance, gas reflux event is defined as a rapid increase in impedance greater than 5 kΩ, Mixed liquid-gas reflux is defined as gas reflux occurring immediately before or during liquid reflux.

Conclusion

The reliability of final diagnosis is significantly dependent on the accurate detection of reflux events, which is currently confronting technical limitations. A pathological reflux event propagates to at least three of the impedance sites, according to the literature. We think that taking three impedance locations into account might be too strict.

Single-Response Electronic Tongue and Machine Learning Enable the Multidetermination of Extracellular Vesicle Biomarkers for Cancer Diagnostics Without Recognition Elements

Platforms based on impedimetric electronic tongue (nonselective sensor) and machine learning are promising to bring disease screening biosensors into mainstream use toward straightforward, fast, and accurate analyses at the point-of-care, thus contributing to rationalize and decentralize laboratory tests with social and economic impacts being achieved. By combining a low-cost and scalable electronic tongue with machine learning, in this chapter, we describe the simultaneous determination of two extracellular vesicle (EV) biomarkers, i.e., the concentrations of EV and carried proteins, in mice blood with Ehrlich tumor from a single impedance spectrum without using biorecognizing elements. This tumor shows primary features of mammary tumor cells. Pencil HB core electrodes are integrated into polydimethylsiloxane (PDMS) microfluidic chip. The platform shows the highest throughput in comparison with the methods addressed in the literature to determine EV biomarkers.

Analyses of the Effects of Electrolyte and Electrode Thickness on High Temperature Proton Exchange Membrane Fuel Cell (H-TPEMFC) Quality

Researchers have been striving to minimize proton exchange membrane fuel cell components thickness. This is believed to reduce the losses (active losses, ohmic losses and mass transfer losses) associated with this cell. In this study, we numerically analyze the electrodes and electrolyte thickness effects on high-temperature proton exchange membrane fuel cell (H-TPEMFC) performance. COMSOL Multiphysics is adopted to model both the impedance spectroscopy and polarization of the cell. Increased cell catalyst layer (thick electrode) improves the overall cell performance by ±10%, because of the improved reaction rate. It presents 0.89 mol m^-3 lesser oxygen compared to that of the thin electrode cell. On the contrary, thick cell electrodes come with increased mass transport loss. The high reaction rate is also confirmed by the high amount of generated water, which is 0.42 mol m^-3 higher than that of thin electrode cell. The experiment used to set the modeling parameter renders results with only less than 5% discrepancy to the modeling results. Also revealed is that over a limited range, electrolytes thickness variation has negligible effects on H-TPEMFC performance.

Components of impedance in a cochlear implant animal model with TGFβ1-accelerated fibrosis

Outcomes of cochlear implantation are likely influenced by the biological state of the cochlea. Fibrosis is a pathological change frequently seen in implanted ears. The goal of this work was to investigate the relationship between fibrosis and impedance. To that end, we employed an animal model of extensive fibrosis and tested whether aspects of impedance differed from controls. Specifically, an adenovirus with a TGF-β1 gene insert (Ad.TGF-β1) was injected into guinea pig scala tympani to elicit rapid onset fibrosis and investigate the relation between fibrosis and impedance. We found a significant correlation between treatment and rate of impedance increase. A physical circuit model of impedance was used to separate the effect of fibrosis from other confounding factors. Supported by preliminary, yet nonconclusive, electron microscopy data, this modeling suggested that deposits on the electrode surface are an important contributor to impedance change over time.

Joint mechanical properties estimation with a novel EMG-based knee rehabilitation robot: A machine learning approach

Joint dynamic properties play essential roles in a wide range of biomechanical movement control. This paper develops a device with a novel mechatronic design to apply small-amplitude perturbations to the human knee. Surface Electromyography is employed to record such information; at the same time, force and position sensors collect measurements to be sent to identify human joint dynamics. For classification and estimation of force, support vector machine and support vector regression techniques are applied, respectively. We devise a genetic algorithm for parameter optimization and feature extraction within the proposed methods to improve the estimation accuracy. These are then analyzed and compared to the output of our estimation model to provide a reliable comparison. Our extensive experimental results reveal a high estimation accuracy for lower limb muscles to regulate robot impedance parameters. Although the identification method sounds similar to traditional ones, knee joint properties can be estimated by the machine learning approach from the surface Electromyography without perturbations.