SARS-CoV-2 multi-variant graphene biosensor based on engineered dimeric ACE2 receptor

Fast, reliable and point-of-care systems to detect the SARS-CoV-2 infection are crucial to contain viral spreading and to adopt timely clinical treatments. Many of the rapid detection tests currently in use are based on antibodies that bind viral proteins. However, newly appearing virus variants accumulate mutations in their RNA sequence and produce proteins, such as Spike, that may show reduced binding affinity to these diagnostic antibodies, resulting in less reliable tests and in the need for continuous update of the sensing systems. Here we propose a graphene field-effect transistor (gFET) biosensor which exploits the key interaction between the Spike protein and the human ACE2 receptor. This interaction is one of the determinants of host infections and indeed recently evolved Spike variants were shown to increase affinity for this receptor. Through extensive computational analyses we show that a chimeric ACE2-Fc construct mimics the ACE2 dimer, normally present on host cells membranes, better than its soluble truncated form. We demonstrate that ACE2-Fc functionalized gFET is effective for in vitro detection of Spike and outperforms the same chip functionalized with either a diagnostic antibody or the soluble ACE2. Our sensor is implemented in a portable, wireless, point-of-care device and successfully detected both alpha and gamma virus variants in patient clinical samples. As incomplete immunization, due to vaccine roll-out, may offer new selective grounds for antibody-escaping virus variants, our biosensor opens to a class of highly sensitive and variant-robust SARS-CoV-2 detection systems.

Cybersecurity and Privacy Risk Assessment of Point-of-Care Systems in Healthcare—A Use Case Approach

Point-of-care systems are generally used in healthcare to respond rapidly and prevent critical health conditions. Hence, POC systems often handle personal health information; and consequently, their cybersecurity and privacy requirements are of crucial importance. While, assessing these requirements is a significant task. In this work, we propose a use case approach to assess specifications of cybersecurity and privacy requirements of POC systems in a structured and self-contained form. Such an approach is appropriate since use cases are one of the most common means adopted by developers to derive requirements. As a result, we detail a use case approach in the framework of a real-based healthcare IT infrastructure that includes a health information system, integration engines, application servers, web services, medical devices, smartphone apps and medical modalities (all data simulated) together with the interaction with participants. Since our use case also sustains the analysis of cybersecurity and privacy risks in different threat scenarios, it also supports decision making and the analysis of compliance considerations.

Variability of three activated clotting time point-of-care systems in cardiac surgery: reinforcing available evidence

Background: Cardiac surgery with extracorporeal circulation (ECC) requires the administration of anticoagulant drugs to maintain ACT ranges 400–600 seconds, which requires exhaustive coagulation monitoring for which various point-of-care devices are available. However, there is variability between them, so we aimed to compare the values in ACT measurement. Methods: Simultaneous ACT measurements were performed with the Hemochron Response®, Hemostasis Management System Plus® (HMS Plus®) and Hemochron Signature® systems. Results: A total of 255 simultaneous measurements were taken, the mean and standard deviation (SD) of each device were: Hemochron Signature® 361.1 seconds (SD: 156.9), HMS Plus® 412.8 seconds (SD: 180.9) and Hemochron Response® 422.8 seconds (SD: 187.9), being these differences statistically significant (Fridman’s test p < 0.01). For comparisons the Bland–Altman method was used, resulting the Hemochron Response® has 61.7 seconds higher mean values than the Hemochron Signature®, the Hemochron Response® 10 seconds higher than the HMS Plus® and the HMS Plus® 51.7 seconds higher than the Hemochron Signature®. Conclusion: The differences found in comparisons are considered to be clinically relevant, which is why it is considered important to make the variability of the different monitoring systems known and to take them into account for optimal control of this parameter and its clinical repercussions.

The Iranian Integrated Care Electronic Health Record

E-health plays a crucial role in E-government by proposing healthcare services based on information technology. However, the way to administer these services by using E-health solutions is one of the challenging issues. One of these significant challenges is how one integrates heterogeneous healthcare information of the different point of care systems. This paper introduces the Iranian integrated care electronic health record using the information gathered from several point-of-care systems in healthcare enterprises in Iran. This service-oriented architecture has a remarkable characteristic – its accessibility to medical knowledge and medical concepts through archetypes and ontology, respectively. The Ministry of Health and Medical Education of the Islamic Republic of Iran has designed and implemented this national architecture.

A Novel Platform Using RNA Signatures To Accelerate Antimicrobial Susceptibility Testing in Neisseria gonorrhoeae

ABSTRACT The rise of antimicrobial-resistant pathogens can be attributed to the lack of a rapid pathogen identification (ID) or antimicrobial susceptibility testing (AST), resulting in delayed therapeutic decisions at the point of care. Gonorrhea is usually empirically treated, with no AST results available before treatment, thus contributing to the rapid rise in drug resistance. Here, we present a rapid AST platform using RNA signatures for Neisseria gonorrhoeae. Transcriptome sequencing (RNA-seq) followed by bioinformatic tools was applied to explore potential markers in the transcriptome profile of N. gonorrhoeae upon minutes of azithromycin exposure. Validation of candidate markers using quantitative real-time PCR (qRT-PCR) showed that two markers (arsR [NGO1562] and rpsO) can deliver accurate AST results across 14 tested isolates. Further validation of our susceptibility threshold in comparison to MIC across 64 more isolates confirmed the reliability of our platform. Our RNA markers combined with emerging molecular point-of-care systems has the potential to greatly accelerate both ID and AST to inform treatment.

A novel platform to accelerate antimicrobial susceptibility testing in Neisseria gonorrhoeae using RNA signatures

The rise of antimicrobial-resistant pathogens can be attributed to the lack of a rapid pathogen identification (ID) or antimicrobial susceptibility testing (AST), resulting in delayed therapeutic decisions at the point of care. Gonorrhea is usually empirically treated with no AST results available before treatment, thus contributing to the rapid rise in drug resistance. Herein we present a rapid AST platform using RNA signatures for Neisseria gonorrhoeae (NG). RNA-seq followed by bioinformatic tools were applied to explore potential markers in the transcriptome profile of NG upon minutes of azithromycin exposure. Validation of candidate markers using PCR showed that two markers (arsR (NGO1562) and rpsO) can deliver accurate AST results across 14 tested isolates. Further validation of our cutoff in comparison to MIC across 64 more isolates confirmed the reliability of our platform. Our RNA markers combined with emerging molecular point-of-care systems has the potential to greatly accelerate both ID and AST to inform treatment.