ABSTRACT
Bimetallic surface plasmon resonance (SPR) sensors have the potential to overcome the drawbacks of individual metals, but the effect of the configuration of the two metallic layers on the performance of the sensors has not been explored. This study examines the influence of different positions of a thin layer of silver in relation to a copper layer on the sensitivity of such a bimetallic SPR sensor. The design of this configuration aims to improve the SPR reflectance curve and strengthen the evanescent electric field to improve the sensor efficiency. Our findings indicate that, by optimizing the architectures of SPR sensors and using a silver-copper bimetallic structure, we can achieve superior performance compared to devices that utilize only silver or copper. The optimized Ag (5 nm)/Cu (55 nm) sensor design, with the best sensitivity of 299.09° RIU-1, can detect a change of 0.43°/(g dl-1) for hemoglobin in blood, 0.35°/(g dl-1) for glucose in urine, and 0.1°/(%) for methanol in ethanol. We also demonstrate the importance of signal quality by introducing two new parameters that offer a better quantitative indication of the efficiency of a sensor than is obtained by using only sensitivity.
ABSTRACT
OBJECTIVE: The aim of this study was to evaluate the efficacy and safety of intraoperative neuromonitoring (IONM) in surgery for tethered cord in infants. MATERIALS AND METHODS: The study included 87 infants who underwent surgery for closed spinal dysraphism under IONM. Their preoperative neurological and urological statuses were compared with postoperative status clinically. The study design was prospective, and the study's duration was from January 2011 to February 2020. IONM was performed (TcMEP and direct mapping) with an Xltek Protektor 32 IOM system, Natus Neurology/medical Inc., Middleton, USA. Statistical analysis in the form of χ2 is conducted using SPSS. RESULTS: Overall, among 87 patients, clinical improvement was seen in 28 (28/29) patients with motor deficits, 17 (17/24) with bladder deficits, and 18 (18/24) with bowel deficits. The monitorability for motor and sphincter was 97.3% and 90.7%, respectively. The sensitivity of IONM in predicting new motor deficit was 100%, whereas the specificity was 100%. The negative predictive value of predicting motor deficit was 100%, with a diagnostic accuracy of 100%. There were no complications in this cohort related to the IONM. CONCLUSIONS: The study has highlighted that the use of IONM is sensitive in identifying motor injury in infants with reliable outcome correlation. Assessment, monitoring, and outcome correlation of bladder and sphincteric functions are a challenge in this cohort.
