Surface-enhanced Raman sensor with molecularly imprinted nanoparticles as highly sensitive recognition material for cancer marker amino acids.

Surface-enhanced Raman scattering (SERS) is a powerful technique primarily due to its high sensitivity and signal-enhancing properties, which enable the identification of unique vibrational fingerprints. These fingerprints can be used for the diagnosis and monitoring of diseases such as cancer. It is crucial to selectively identify cancer biomarkers for early diagnosis. A correlation has been established between the reduction in the concentration of specific amino acids and the stage of the disease, particularly tryptophan (TPP) and tyrosine (TRS) in individuals diagnosed with prostate cancer. In this work, we present a strategy to analyze TPP and TRS amino acids using molecularly imprinted polymer nanoparticles (nanoMIPs), which selectively detect target molecules in a SERS sensor. NanoMIPs are synthesized using the solid-phase molecular imprinting method with TPP and TRS as templates. These are then immobilized on a SERS substrate with gold nanoparticles to measure samples prepared from tryptophan and tyrosine in phosphate-buffered saline. The detection and quantification limits of the designed sensor are 7.13 µM and 23.75 µM for TPP, and 22.11 µM and 73.72 µM for TRS, respectively. Our study lays the groundwork for future investigations utilizing nanoMIPs in SERS assessments of TPP and TRS as potential biomarkers for prostate cancer detection.

Development of a novel hybrid securing actuator for a self-securing soft robotic hand exoskeleton.

The development of soft robotic hand exoskeletons for rehabilitation has been well-reported in the literature, whereby the emphasis was placed on the development of soft actuators for flexion and extension. Little attention was focused on developing the glove interface and attachments of actuators to the hand. As these hand exoskeletons are largely developed for personnel with impaired hand function for rehabilitation, it may be tedious to aid the patients in donning and doffing the glove, given that patients usually have stiff fingers exhibiting high muscle tone. To address this issue, a hybrid securing actuator was developed and powered pneumatically to allow for rapid securing and release of a body segment. As a proof of concept, the actuator was further adapted into a self-securing glove mechanism and assembled into a complete self-securing soft robotic hand exoskeleton with the attachment of bidirectional actuators. Our validation tests show that the self-wearing soft robotic hand exoskeleton can easily conform and secure onto the human hand and assist with manipulation tasks.

Molecularly imprinted nanoparticle-based assay (MINA) for microcystin-LR detection in water.

Microcystins (MCs) are highly toxic peptides produced by cyanobacteria during algal blooms. Microcystin-leucine-arginine (MC-LR) is the most toxic and common MC variant with major effects on human and animal health upon exposure. MC-LR detection has become critical to ensure water safety, therefore robust and reliable analytical methods are needed. This work reports the development of a simple and optimized Molecularly Imprinted Nanoparticle-Based Assay (MINA) for MC-LR detection in water. Molecularly Imprinted Nanoparticles (MINs) were prepared by solid-phase polymerization on glass beads conjugated to MC-LR through (3-aminopropyl) triethoxysilane (APTES) via amide bonding. APTES-modified glass beads were obtained under optimized conditions to maximize the density of surface amino groups available for MC-LR conjugation. Two quinary mixtures of acrylic monomers differing in charge, polarity, and functionality were selected from molecular docking calculations and used to obtain MINs for MC-LR recognition using N,N'-methylene-bis-acrylamide (BIS) as the crosslinking agent. MINs were immobilized by physical adsorption onto 96-well polystyrene microplate and evaluated as per their rebinding capacity toward the analyte by using a covalent conjugate between MC-LR and the enzyme horseradish peroxidase (HRP). Experimental conditions for the MINs immobilization protocol, HRP-MC-LR concentration, and composition of the blocking solution were set to maximize the colorimetric response of the MINs compared to non-treated wells. Optimized conditions were then applied to conduct competitive MINAs with the HRP-MC-LR conjugate and the free analyte, which confirmed the preferential binding of MC-LR to the immobilized MINs for analyte concentrations ranging from 1 × 10-5 nmol L-1 to 100 nmol L-1. The best competitive MINA showed a limit of detection of 2.49 × 10-4 nmol L-1 and coefficients of variation less than 10% (n = 6), which are auspicious for the use of MINs as analytical tools for MC-LR detection below the permissible limits issued by WHO for safe water consumption (1.00 nmol L-1). This assay also proved to be selective to the analyte in cross-reactivity studies with two analogous microcystins (MC-RR and MC-YR). Analyses of lagoon and drinking water samples enriched with MC-LR revealed strong matrix effects that reduce the MINA response to the analyte, thus suggesting the need for sample pretreatment methods in future development in this subject.

A Wearable Soft Robotic Exoskeleton for Hip Flexion Rehabilitation.

Leg motion is essential to everyday tasks, yet many face a daily struggle due to leg motion impairment. Traditional robotic solutions for lower limb rehabilitation have arisen, but they may bare some limitations due to their cost. Soft robotics utilizes soft, pliable materials which may afford a less costly robotic solution. This work presents a soft-pneumatic-actuator-driven exoskeleton for hip flexion rehabilitation. An array of soft pneumatic rotary actuators is used for torque generation. An analytical model of the actuators is validated and used to determine actuator parameters for the target application of hip flexion. The performance of the assembly is assessed, and it is found capable of the target torque for hip flexion, 19.8 Nm at 30°, requiring 86 kPa to reach that torque output. The assembly exhibits a maximum torque of 31 Nm under the conditions tested. The full exoskeleton assembly is then assessed with healthy human subjects as they perform a set of lower limb motions. For one motion, the Leg Raise, a muscle signal reduction of 43.5% is observed during device assistance, as compared to not wearing the device. This reduction in muscle effort indicates that the device is effective in providing hip flexion assistance and suggests that pneumatic-rotary-actuator-driven exoskeletons are a viable solution to realize more accessible options for those who suffer from lower limb immobility.

Molecularly imprinted nanoparticle-based assay (MINA): Potential application for the detection of the neurotoxin domoic acid.

Domoic acid (DA) is a natural amino acid and water-soluble neurotoxic biotoxin primarily produced by the microalgae Pseudo-nitzschia. DA can cause poisoning in humans and a wide variety of marine species. In this work, a molecularly imprinted nanoparticle-based assay (MINA) was developed as an alternative to enzyme-linked immunosorbent assay (ELISA) for selective detection of DA. In contrast with ELISA, MINA uses molecularly imprinted polymer nanoparticles (nanoMIPs) as plastic antibodies due to its higher stability and lower production costs. In this work, dihydrokainic acid (DKA) was used as a dummy template because this molecule is structurally similar to DA but less toxic. The developed MINA had a high linear response for DKA and DA, showing detection limits of 2.12 nmol L-1 and 4.32 nmol L-1, respectively. Additionally, q-RMN studies demonstrated that DKA - nanoMIPs were selective for DKA, since they presented the best association parameters with a high loading load capacity of 175% and an association efficiency of 18%. No cross-reactivity towards 1, 3, 5 - pentanetricarboxylic acid was observed. These results suggest that MINA could be a more robust, more sensitive, and less expensive alternative to ELISA. The assay developed with DKA - nanoMIPs has strong potential for the detection of domoic acid in real samples of red tide.

Gastrointestinal endoscopy during the coronavirus pandemic in the New York area: results from a multi-institutional survey.

Background and study aims The coronavirus disease 2019 (COVID-19), and measures taken to mitigate its impact, have profoundly affected the clinical care of gastroenterology patients and the work of endoscopy units. We aimed to describe the clinical care delivered by gastroenterologists and the type of procedures performed during the early to peak period of the pandemic. Methods Endoscopy leaders in the New York region were invited to participate in an electronic survey describing operations and clinical service. Surveys were distributed on April 7, 2020 and responses were collected over the following week. A follow-up survey was distributed on April 20, 2020. Participants were asked to report procedure volumes and patient characteristics, as well protocols for staffing and testing for COVID-19. Results Eleven large academic endoscopy units in the New York City region responded to the survey, representing every major hospital system. COVID patients occupied an average of 54.5 % (18 - 84 %) of hospital beds at the time of survey completion, with 14.5 % (2 %-23 %) of COVID patients requiring intensive care. Endoscopy procedure volume and the number of physicians performing procedures declined by 90 % (66 %-98 %) and 84.5 % (50 %-97 %) respectively following introduction of restricted practice. During this period the most common procedures were EGDs (7.9/unit/week; 88 % for bleeding; the remainder for foreign body and feeding tube placement); ERCPs (5/unit/week; for cholangitis in 67 % and obstructive jaundice in 20 %); Colonoscopies (4/unit/week for bleeding in 77 % or colitis in 23 %) and least common were EUS (3/unit/week for tumor biopsies). Of the sites, 44 % performed pre-procedure COVID testing and the proportion of COVID-positive patients undergoing procedures was 4.6 % in the first 2 weeks and up to 19.6 % in the subsequent 2 weeks. The majority of COVID-positive patients undergoing procedures underwent EGD (30.6 % COVID +) and ERCP (10.2 % COVID +). Conclusions COVID-19 has profoundly impacted the operation of endoscopy units in the New York region. Our data show the impact of a restricted emergency practice on endoscopy volumes and the proportion of expected COVID positive cases during the peak time of the pandemic.

Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large U.S. Cohort.

BACKGROUND AND AIMS: Coronavirus disease 2019 (COVID-19) has been associated with acute liver injury (ALI) manifested by increased liver enzymes in reports worldwide. Prevalence of liver injury and associated clinical characteristics are not well defined. We aim to identify the prevalence of and risk factors for development of COVID-19-associated ALI in a large cohort in the United States. APPROACH AND RESULTS: In this retrospective cohort study, all patients who underwent SARS-CoV-2 testing at three hospitals in the NewYork-Presbyterian network were assessed. Of 3,381 patients, 2,273 tested positive and had higher initial and peak alanine aminotransferase (ALT) than those who tested negative. ALI was categorized as mild if ALT was greater than the upper limit of normal (ULN) but <2 times ULN, moderate if ALT was between 2 and 5 times the ULN, and severe if ALT was >5 times the ULN. Among patients who tested positive, 45% had mild, 21% moderate, and 6.4% severe liver injury (SLI). In multivariable analysis, severe ALI was significantly associated with elevated inflammatory markers, including ferritin (odds ratio [OR], 2.40; P < 0.001) and interleukin-6 (OR, 1.45; P = 0.009). Patients with SLI had a more severe clinical course, including higher rates of intensive care unit admission (69%), intubation (65%), renal replacement therapy (RRT; 33%), and mortality (42%). In multivariable analysis, peak ALT was significantly associated with death or discharge to hospice (OR, 1.14; P = 0.044), controlling for age, body mass index, diabetes, hypertension, intubation, and RRT. CONCLUSIONS: ALI is common in patients who test positive for SARS-CoV-2, but is most often mild. However, among the 6.4% of patients with SLI, a severe disease course should be anticipated.

Quality improvement initiative increases total paracentesis and early paracentesis rates in hospitalised cirrhotics with ascites.

OBJECTIVE: Early paracentesis (EP) for rapid diagnosis of spontaneous bacterial peritonitis is considered best practice in the care of admitted patients with cirrhosis and ascites, but inpatient paracentesis is frequently not performed or delayed. We developed a quality improvement (QI) initiative aimed at increasing the proportion of admitted patients with cirrhosis who undergo paracentesis and EP. DESIGN: Pre-post study of a QI initiative. SETTING: A tertiary care hospital in a major metropolitan area. PATIENTS: Hospitalised patients with cirrhosis and ascites. INTERVENTIONS: We targeted care providers in the emergency department (ED) by raising awareness of the importance of EP, developing criteria to identify patients at highest risk of SBP who were prioritised for EP by ED providers and restructuring the ED environment to enable timely paracentesis. RESULTS: 76 patients meeting inclusion criteria were admitted during the postintervention 9-month study period. Of these, 91% (69/76) underwent paracentesis during admission versus 71 % (77/109) preintervention (p=0.001). 81% (56/69) underwent EP within 12 hours of presentation or after a predefined acceptable reason for delay versus 48% (37/77) preintervention (p=0.001). There were no significant differences in in-hospital mortality or length of stay before and after intervention. CONCLUSION: A multidisciplinary QI intervention targeting care in the ED successfully increased the proportion of patients with cirrhosis and ascites undergoing diagnostic paracentesis during admission and EP within 12 hours of presentation.

The Biomechanics of Character Types in Javanese Dance.

The aim of this study was to describe and compare the different character sub-types of Javanese dance from a biomechanical perspective. One professional dancer was asked to repeat a basic motion (standing-up) according to the movement rules that pertain to six character sub-types (humble-refined, proud-refined, humble-strong, proud-strong, monkey, and bird). A motion capture system consisting of seven infrared cameras with a sample rate of 100 Hz and two force plates with a sample rate of 1,000 Hz were used to capture kinematics and kinetics. There were significant differences in the bio-mechanical values we calculated for each character sub-type: range of motion, angular velocity, and ground reaction forces. The refined sub-types (humble-refined and proud-refined) showed the lowest values at the knee joint for range of motion and the lowest ankle, shoulder, and wrist angular velocities. This result suggests that low values in these measurements are related to the smooth movements of refined sub-types. These measurements help describe and contrast the motion patterns of Javanese dance, contributing both to the scientific analysis of Javanese dance and the application of biomechanics to the study of dance more generally.

Cytotoxicity and in vivo plasma kinetic behavior of surface-functionalized PAMAM dendrimers.

Understanding the molecular features responsible for the plasma kinetics of surface-modified polyamido amine (PAMAM) dendrimers is critical to explore novel biomedical applications for these nanomaterials. In this report, polyethylene glycol (PEG) and folic acid (FA) were employed to obtain partially-substituted PAMAM dendrimers as model biocompatible nanomaterials with different size, charge and surface functionality. Cytotoxicity assays on HEK cells at 1-500 µM concentration confirmed that PEG and FA incorporation increased the cell viability of PAMAM-based nanomaterials. Measurements of plasma kinetics in vivo revealed that PEG-PAMAM has an extended circulation time in mice blood (71.7 min) over native PAMAM (53.3 min) and FA-PAMAM (41.8 min). Molecular dynamics simulations revealed a direct relationship between circulation time and dendrimer size, thus providing valuable evidence to increase understanding about the modulation of functional properties of PAMAM-based systems through surface modification, and to guide future efforts on the rational design of novel biomedical nanomaterials.

Association of Methotrexate with Native and PEGylated PAMAM-G4 Dendrimers: Effect of the PEGylation Degree on the Drug-Loading Capacity and Preferential Binding Sites.

PEGylated PAMAM dendrimers (PEG-PAMAM) have been extensively studied as versatile vehicles for drug delivery. Nevertheless, little information has been reported regarding the effect of the PEGylation degree on the drug-loading properties of these systems, aimed at maximizing their performance as drug carrier nanocarrriers. In this work, fully atomistic molecular dynamics (MD) simulations were employed to examine the association of methotrexate (MTX) with native and diversely PEGylated PAMAM-G4 dendrimers, using 2 kDa PEG chains with substitution degrees from 25 to 100% and 100:1 drug:dendrimer ratios to mimic experimental conditions of drug excess in saturated solution. MD results regarding complex stoichiometries and preferential binding sites were compared to experimental data retrieved from aqueous solubility profiles and 2D-NOESY experiments showing an outstanding level of agreement. The maximum theoretical drug loading capacity was achieved by the system with 34% PEGylation (42:1) through the simultaneous complexation of MTX within internal PAMAM-G4 branches and external PEG chains. On the other hand, higher PEGylation degrees were found to be detrimental for drug complexation due to PEG chains crowding on the dendrimer surface. These results provide valuable information to design more efficient PAMAM-based drug nanocarriers and explain the positive effect that partial PEGylation exerts on the drug-loading capacity of PAMAM-G4 over native and fully PEGylated systems.

Differential timing of granule cell production during cerebellum development underlies generation of the foliation pattern.

BACKGROUND: The mouse cerebellum (Cb) has a remarkably complex foliated three-dimensional (3D) structure, but a stereotypical cytoarchitecture and local circuitry. Little is known of the cellular behaviors and genes that function during development to determine the foliation pattern. In the anteroposterior axis the mammalian cerebellum is divided by lobules with distinct sizes, and the foliation pattern differs along the mediolateral axis defining a medial vermis and two lateral hemispheres. In the vermis, lobules are further grouped into four anteroposterior zones (anterior, central, posterior and nodular zones) based on genetic criteria, and each has distinct lobules. Since each cerebellar afferent group projects to particular lobules and zones, it is critical to understand how the 3D structure of the Cb is acquired. During cerebellar development, the production of granule cells (gcs), the most numerous cell type in the brain, is required for foliation. We hypothesized that the timing of gc accumulation is different in the four vermal zones during development and contributes to the distinct lobule morphologies. METHODS AND RESULTS: In order to test this idea, we used genetic inducible fate mapping to quantify accumulation of gcs in each lobule during the first two postnatal weeks in mice. The timing of gc production was found to be particular to each lobule, and delayed in the central zone lobules relative to the other zones. Quantification of gc proliferation and differentiation at three time-points in lobules representing different zones, revealed the delay involves a later onset of maximum differentiation and prolonged proliferation of gc progenitors in the central zone. Similar experiments in Engrailed mutants (En1 (-/+) ;En2 (-/-) ), which have a smaller Cb and altered foliation pattern preferentially outside the central zone, showed that gc production, proliferation and differentiation are altered such that the differences between zones are attenuated compared to wild-type mice. CONCLUSIONS: Our results reveal that gc production is differentially regulated in each zone of the cerebellar vermis, and our mutant analysis indicates that the dynamics of gc production plays a role in determining the 3D structure of the Cb.

The biomechanics of ACL injury: progresses toward prophylactic strategies.

Anterior cruciate ligament (ACL) injuries are highly prevalent during sporting activities. These injuries often are associated with maneuvers involving landing or sudden change in direction, which are thought to "destabilize" the knee joint and cause ACL rupture. ACL injuries can affect one's mobility and quality of life because of abnormal locomotion and consequent knee pain. This review presents key findings from prior biomechanics studies that aimed to understand ACL injury mechanisms. These studies, ranging from motion analyses and in vitro impact tests to knee finite element simulations and multibody dynamics musculoskeletal simulations, have collectively revealed the multifactorial nature of ACL injury mechanisms. Therefore, the second part of this review addresses the strong need to develop prophylactic strategies that can attenuate the factors involved in ACL injury mechanisms, such that the knee joint can be protected from ACL injuries. Previous studies have emphasized strategies such as knee bracing and strength training of important muscle groups. Although these strategies were intended to mitigate ACL injury-causing factors, their clinical outcomes remain controversial. Given the rapid progress of technologies in this area, however, the current state of uncertainty will gradually lead to prospective biomechanics research that can adopt a multifactorial approach toward protecting the ACL from injury.

The engrailed homeobox genes are required in multiple cell lineages to coordinate sequential formation of fissures and growth of the cerebellum.

The layered cortex of the cerebellum is folded along the anterior-posterior axis into lobules separated by fissures, allowing the large number of cells needed for advanced cerebellar functions to be packed into a small volume. During development, the cerebellum begins as a smooth ovoid structure with two progenitor zones, the ventricular zone and upper rhombic lip, which give rise to distinct cell types in the mature cerebellum. Initially, the cerebellar primordium is divided into five cardinal lobes, which are subsequently further subdivided by fissures. The cellular processes and genes that regulate the formation of a normal pattern of fissures are poorly understood. The engrailed genes (En1 and En2) are expressed in all cerebellar cell types and are critical for regulating formation of specific fissures. However, the cerebellar cell types that En1 and En2 act in to control growth and/or patterning of fissures has not been determined. We conditionally eliminated En2 or En1 and En2 either in both progenitor zones and their descendents or in the two complementary sets of cells derived from each progenitor zone. En2 was found to be required only transiently in the progenitor zones and their immediate descendents to regulate formation of three fissures and for general growth of the cerebellum. In contrast, En1 and En2 have overlapping functions in the cells derived from each progenitor zone in regulating formation of additional fissures and for extensive cerebellar growth. Furthermore, En1/2 function in ventricular zone-derived cells plays a more significant role in determining the timing of initiation and positioning of fissures, whereas in upper rhombic lip-derived cells the genes are more important in regulating cerebellar growth. Our studies reveal the complex manner in which the En genes control cerebellar growth and foliation in distinct cell types.