In-situ fabrication of 3D interior hotspots templated with a protein@Au core-shell structure for label-free and on-site SERS detection of viral diseases

Nanoscale plasmonic hotspots play a critical role in the enhancement of molecular Raman signals, enabling the sensitive and reliable trace analysis of biomedical molecules via surface-enhanced Raman spectroscopy (SERS). However, effective and label-free SERS diagnoses in practical fields remain challenging because of clinical samples' random adsorption and size mismatch with the nanoscale hotspots. Herein, we suggest a novel SERS strategy for interior hotspots templated with protein@Au core-shell nanostructures prepared via electrochemical one-pot Au deposition. The cytochrome c and lysates of SARS-CoV-2 (SLs) embedded in the interior hotspots were successfully functionalized to confine the electric fields and generate their optical fingerprint signals, respectively. Highly linear quantitative sensitivity was observed with the limit-of-detection value of 10-1 PFU/ mL. The feasibility of detecting the targets in a bodily fluidic environment was also confirmed using the proposed templates with SLs in human saliva and nasopharyngeal swabs. These interior hotspots templated with the target analytes are highly desirable for early and on-site SERS diagnoses of infectious diseases without any labeling processes.

3D interior hotspots embedded with viral lysates for rapid and label-free identification of infectious diseases

In recent decades, biomedical sensors based on surface-enhanced Raman spectroscopy (SERS), which reveals unique spectral features corresponding to individual molecular vibrational states, have attracted intensive attention. However, the lack of a system for precisely guiding biomolecules to active hotspot regions has impeded the broad application of SERS techniques. Herein, we demonstrate the irreversible active engineering of three-dimensional (3D) interior organo-hotspots via electrochemical (EC) deposition onto metal nanodimple (ECOMD) platforms with viral lysates. This approach enables organic seed-programmable Au growth and the spontaneous bottom-up formation of 3D interior organo-hotspots simultaneously. Because of the net charge effect on the participation rate of viral lysates, the number of interior organo-hotspots in the ECOMDs increases with increasingly positive polarity. The viral lysates embedded in the ECOMDs function as both a dielectric medium for field confinement and an analyte, enabling the highly specific and sensitive detection of SARS-CoV-2 lysates (SLs) at concentrations as low as 10-2 plaque forming unit/mL. The ECOMD platform was used to trace and detect the SLs in human saliva and diagnose of the delta-type SARS-CoV-2 in clinical environments;the results indicate that the proposed platform can provide point-of-care diagnoses of infectious diseases.

AN INITIATIVE TO DECREASE 30-DAY HOSPITAL READMISSION RATES AT AN URBAN ACADEMIC SAFETY-NET HOSPITAL THROUGH A RESIDENT-LED TRANSITIONS-OF-CARE CLINIC

STATEMENT OF PROBLEM/QUESTION: The transition between hospital discharge and primary care follow-up is a vulnerable period for patients that can result in adverse health outcomes and preventable hospital readmissions. The COVID-19 pandemic has exacerbated this transitional period, as many patients have forgone their routine healthcare visits, lost touch with their primary care providers (PCPs), and lacked a point of contact for their health needs after leaving the hospital. DESCRIPTION OF PROGRAM/INTERVENTION: We launched a postdischarge Transitions in Care Management (TCM) clinic to serve patients discharged from NYU Langone Hospital Brooklyn, an urban safety net academic hospital that serves a racially diverse and socioeconomically vulnerable population in Southwest Brooklyn. From October 2020 to October 2021, TCM visits were offered to patients prior to discharge from the general medicine service at NYU Langone Brooklyn who did not have a primary care provider or who could not get an appointment with their PCP within 10 days of discharge. Patients were given the option of in-person visits or virtual visits. TCM visits were scheduled with residents within 2 weeks of patient discharge. Questions at the TCM visit focused on scheduled speciality appointments, any discrepancy in medications prescribed at discharge, or if the patient was connected to additional community resources. MEASURES OF SUCCESS: The primary outcome was the 30-day readmission rate for patients referred to TCM compared to all patients discharged from the general medicine unit. FINDINGS TO DATE: From October 2020 through October 2021, there were a total of 357 TCM visits out of a total 806 referrals placed (44% completion rate). There was a reduction in 30-day hospital readmission rate for patients who completed a TCM visit compared with those who were not referred (5% vs 15.9%;p < 0.001). There was also a reduction in readmission rate for those who were referred but did not complete their TCM visit compared to those who were not referred (8.4% vs. 15.9%;p < 0.001). Of the completed visits, 172 were in-person, 138 were virtual, and 47 were over the telephone. Patients were also more likely to show up to their virtual visits than their in-person visits (30% no-show rate for in-person vs. 12% no-show rate for virtual). KEY LESSONS FOR DISSEMINATION: Thirty-day hospital readmission rate was lower for patients seen as part of the resident-run TCM clinic at a safety net academic medical center. Interestingly, patients referred but who did not complete TCM visits still had a decreased readmission rate compared to those who were not referred, suggesting that there may be an inherent difference in these two patient groups. Future studies will examine the differences between these groups, and analyze the factors that influence TCM referral and visit completion. Future studies will also analyze how the medium of visit (virtual vs. in-person) and specific interventions during the TCM visits (medication reconciliation, specialty appointments, community resources) influenced patients' transition in care.

Covid-19 detection using disease monitoring systems based on vital-signs from smartwatch

Real-Time vital-sign from patients are important information that implies the current health status and behavior of patients. Recently, Mishra et al. [1] have shown that COVID-19 can be detected by analyzing the patient's vital signs and behaviors, i.e., heart rates and steps, using anomaly detection techniques. This paper presents a medical IoT platform, called MiT Eco-platform, which is designed to gather patient's physiological data through a smartwatch and to increase the efficiency of data labeling for building an AI model for medical diagnosis and treatment. Furthermore, we present a real-time COVID-19 detection approach advanced from the approach of using anomaly detection Mishra et al. [1] that will be run on MiT Eco-platform. As a result, we show performance evaluation results of preemptively detecting the COVID-19 infection for the same samples of the COVID-19 infected ones of Mishra et al.[1], comparing with the anomaly detection approach of Mishra et al.[1]. We expect that physiological data through smartwatches on daily life can be continuously gathered and effectively labeled by the MiT Eco-platform for various studies in medical area. © 2021 Korean Institute of Electrical Engineers. All rights reserved.

Determination of aircraft cruise altitude with minimum fuel consumption and time-to-climb: An approach with terminal residual analysis

A pandemic situation of COVID-19 has made a cost-minimization strategy one of the ut-most priorities for commercial airliners. A relevant scheme may involve the minimization of both the fuel-and time-related costs, and the climb trajectories of both objectives were optimized to determine the optimum aircraft cruise altitude. The Hermite-Simpson method among the direct collocation methods was employed to discretize the problem domain. Novel approaches of terminal residual analysis (TRA), and a modified version, m-σ TRA, were proposed to determine the goals. The multi-objective cruise altitude (MOCA) was different by 2.5%, compared to the one statistically calculated from the commercial airliner data. The present methods, TRA and m-σ TRA were powerful tools in finding a solution to this complex problem. The value σ also worked as a transition criterion between a single-and multi-objective climb path to the cruise altitude. The exemplary MOCA was determined to be 10.91 and 11.97 km at σ = 1.1 and 2.0, respectively. The cost index (CI) varied during a flight, a more realistic approach than the one with constant CI. With validated results in this study, TRA and m-σ TRA may also be effective solutions to determine the multi-objective solutions in other complex fields. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.