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Diagnostics, Volume 9, Issue 1 (March 2019)

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Cover Story (view full-size image) The field of wound care is challenged by bacteria harboured within the wounds, which delay wound [...] Read more.
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Open AccessArticle Very Early Response Evaluation by PET/MR in Patients with Lung Cancer—Timing and Feasibility
Diagnostics 2019, 9(1), 35; https://doi.org/10.3390/diagnostics9010035
Received: 18 January 2019 / Revised: 17 March 2019 / Accepted: 22 March 2019 / Published: 26 March 2019
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Abstract
Purpose: With the increasing number of therapy options available for patients with lung cancer, early response evaluation is needed. We performed this pilot study to assess the feasibility of early, repeated Positron emission tomography-magnetic resonance (PET/MR), the impact of timing and the capability [...] Read more.
Purpose: With the increasing number of therapy options available for patients with lung cancer, early response evaluation is needed. We performed this pilot study to assess the feasibility of early, repeated Positron emission tomography-magnetic resonance (PET/MR), the impact of timing and the capability for response prediction in lung tumors during chemotherapy. Methods: Patients with stage IV non-small cell lung cancer referred for chemotherapy were prospectively recruited. Fluorine-18-Fluorodeoxyglucose(18F-FDG)-PET/MR scans were performed prior to, during and after the first or second cycle of chemotherapy. Primary tumors were defined on all scans and size, FDG-uptake and apparent diffusion coefficient (ADC) were measured. Early response was described over time and a Standard Linear Mixed Model was applied to analyze changes over time. Results: 45 FDG-PET/MR scans were performed in 11 patients. Whereas the overall changes measured by ADC did not change significantly, there was an overall significant decrease in FDG-uptake from pre to post treatment scans. There was no difference in the FDG-uptake measured 1 or 3 weeks after therapy, but uptake measured 2 weeks after therapy differed from measurements at week 3. Changes measured in patients scanned during the first treatment cycle appeared more pronounced than during the second cycle. Conclusions: This pilot study indicates that response evaluation shortly after initiation of chemotherapy appears concordant with later evaluation and probably more reliable than evaluation midway between cycles. Responses during or after the first cycle of chemotherapy rather than during subsequent cycles are likely to be more readily measured. Full article
(This article belongs to the Special Issue Imaging of Early Response in Cancer Management 2019)
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Open AccessArticle Active Matrix Metalloproteinase-8 Point-of-Care (PoC)/Chairside Mouthrinse Test vs. Bleeding on Probing in Diagnosing Subclinical Periodontitis in Adolescents
Diagnostics 2019, 9(1), 34; https://doi.org/10.3390/diagnostics9010034
Received: 26 February 2019 / Revised: 16 March 2019 / Accepted: 21 March 2019 / Published: 23 March 2019
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Abstract
This cross-sectional study compares the effectiveness of an active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test to the conventional bleeding on probing (BOP) (cutoff 20%) test in detecting subclinical periodontitis/pre-periodontitis in Finnish adolescents. The study was carried out at the Kotka Health Center, Finland. [...] Read more.
This cross-sectional study compares the effectiveness of an active MMP-8 (aMMP-8) point-of-care (PoC)/chairside mouthrinse test to the conventional bleeding on probing (BOP) (cutoff 20%) test in detecting subclinical periodontitis/pre-periodontitis in Finnish adolescents. The study was carried out at the Kotka Health Center, Finland. A total of 47 adolescents (30 boys/17 girls) aged 15–17 were first tested with the aMMP-8 PoC test, followed by a full-mouth evaluation of clinical parameters of oral health including periodontal, oral mucosal, and caries assessment. A periodontist performed these clinical examinations. The aMMP-8 PoC test result had much stronger association with subclinical periodontitis than the BOP 20% test (2.8–5.3 times stronger in terms of odds ratio). The aMMP-8 PoC test had ≥2 times higher sensitivity than the BOP 20% test with, generally, the same specificity. Further, the aMMP-8 PoC test had generally better accuracy and lower false negative percentages. The aMMP-8 PoC test seemed to be more effective than the conventional BOP test in detecting subclinical periodontitis/pre-periodontitis in adolescents reducing the risk of their undertreatment. However, the sample size may be a limiting factor, and more studies are needed to confirm our results for both adolescents and adults. Full article
(This article belongs to the Special Issue New Era of Testing: Salivary Diagnostics)
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Open AccessArticle Predicting Pulmonary Function Testing from Quantified Computed Tomography Using Machine Learning Algorithms in Patients with COPD
Diagnostics 2019, 9(1), 33; https://doi.org/10.3390/diagnostics9010033
Received: 2 March 2019 / Revised: 17 March 2019 / Accepted: 18 March 2019 / Published: 21 March 2019
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Abstract
Introduction: Quantitative computed tomography (qCT) is an emergent technique for diagnostics and research in patients with chronic obstructive pulmonary disease (COPD). qCT parameters demonstrate a correlation with pulmonary function tests and symptoms. However, qCT only provides anatomical, not functional, information. We evaluated five [...] Read more.
Introduction: Quantitative computed tomography (qCT) is an emergent technique for diagnostics and research in patients with chronic obstructive pulmonary disease (COPD). qCT parameters demonstrate a correlation with pulmonary function tests and symptoms. However, qCT only provides anatomical, not functional, information. We evaluated five distinct, partial-machine learning-based mathematical models to predict lung function parameters from qCT values in comparison with pulmonary function tests. Methods: 75 patients with diagnosed COPD underwent body plethysmography and a dose-optimized qCT examination on a third-generation, dual-source CT with inspiration and expiration. Delta values (inspiration—expiration) were calculated afterwards. Four parameters were quantified: mean lung density, lung volume low-attenuated volume, and full width at half maximum. Five models were evaluated for best prediction: average prediction, median prediction, k-nearest neighbours (kNN), gradient boosting, and multilayer perceptron. Results: The lowest mean relative error (MRE) was calculated for the kNN model with 16%. Similar low MREs were found for polynomial regression as well as gradient boosting-based prediction. Other models led to higher MREs and thereby worse predictive performance. Beyond the sole MRE, distinct differences in prediction performance, dependent on the initial dataset (expiration, inspiration, delta), were found. Conclusion: Different, partially machine learning-based models allow the prediction of lung function values from static qCT parameters within a reasonable margin of error. Therefore, qCT parameters may contain more information than we currently utilize and can potentially augment standard functional lung testing. Full article
(This article belongs to the Section Medical Imaging)
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Open AccessArticle Link-Level Functional Connectivity Neuroalterations in Autism Spectrum Disorder: A Developmental Resting-State fMRI Study
Diagnostics 2019, 9(1), 32; https://doi.org/10.3390/diagnostics9010032
Received: 23 January 2019 / Revised: 4 March 2019 / Accepted: 8 March 2019 / Published: 21 March 2019
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Abstract
Autism spectrum disorder (ASD) is a neurological and developmental disorder whose late diagnosis is based on subjective tests. In seeking for earlier diagnosis, we aimed to find objective biomarkers via analysis of resting-state functional MRI (rs-fMRI) images obtained from the Autism Brain Image [...] Read more.
Autism spectrum disorder (ASD) is a neurological and developmental disorder whose late diagnosis is based on subjective tests. In seeking for earlier diagnosis, we aimed to find objective biomarkers via analysis of resting-state functional MRI (rs-fMRI) images obtained from the Autism Brain Image Data Exchange (ABIDE) database. Thus, we estimated brain functional connectivity (FC) between pairs of regions as the statistical dependence between their neural-related blood-oxygen-level-dependent (BOLD) signals. We compared FC of individuals with ASD and healthy controls, matched by age and intelligence quotient (IQ), and split into three age groups (50 children, 98 adolescents, and 32 adults), from a developmental perspective. After estimating the correlation, we observed hypoconnectivities in children and adolescents with ASD between regions belonging to the default mode network (DMN). Concretely, in children, FC decreased between the left middle temporal gyrus and right frontal pole (p = 0.0080), and between the left orbitofrontal cortex and right superior frontal gyrus (p = 0.0144). In adolescents, this decrease was observed between bilateral postcentral gyri (p = 0.0012), and between the right precuneus and right middle temporal gyrus (p = 0.0236). These results help to gain a better understanding of the involved regions on autism and its connection with the affected superior cognitive brain functions. Full article
(This article belongs to the Special Issue Brain Imaging)
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Open AccessReview Current Diabetes Technology: Striving for the Artificial Pancreas
Diagnostics 2019, 9(1), 31; https://doi.org/10.3390/diagnostics9010031
Received: 6 February 2019 / Revised: 11 March 2019 / Accepted: 12 March 2019 / Published: 15 March 2019
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Abstract
Diabetes technology has continually evolved over the years to improve quality of life and ease of care for affected patients. Frequent blood glucose (BG) checks and multiple daily insulin injections have become standard of care in Type 1 diabetes (T1DM) management. Continuous glucose [...] Read more.
Diabetes technology has continually evolved over the years to improve quality of life and ease of care for affected patients. Frequent blood glucose (BG) checks and multiple daily insulin injections have become standard of care in Type 1 diabetes (T1DM) management. Continuous glucose monitors (CGM) allow patients to observe and discern trends in their glycemic control. These devices improve quality of life for parents and caregivers with preset alerts for hypoglycemia. Insulin pumps have continued to improve and innovate since their emergence into the market. Hybrid closed-loop systems have harnessed the data gathered with CGM use to aid in basal insulin dosing and hypoglycemia prevention. As technology continues to progress, patients will likely have to enter less and less information into their pump system manually. In the future, we will likely see a system that requires no manual patient input and allows users to eat throughout the day without counting carbohydrates or entering in any blood sugars. As technology continues to advance, endocrinologists and diabetes providers need to stay current to better guide their patients in optimal use of emerging management tools. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)
Open AccessReview Roles of ERCP in the Early Diagnosis of Pancreatic Cancer
Diagnostics 2019, 9(1), 30; https://doi.org/10.3390/diagnostics9010030
Received: 18 January 2019 / Revised: 4 March 2019 / Accepted: 5 March 2019 / Published: 7 March 2019
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Abstract
It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small [...] Read more.
It has been reported that endoscopic retrograde cholangiopancreatography (ERCP) is of value in evaluating precise pancreatograms of the pancreatic duct (PD). Recently, institutions have tended to perform magnetic resonance cholangiopancreatography (MRCP) for the diagnosis of PD due to post-ERCP pancreatitis (PEP). In small pancreatic cancer (PC), including PC in situ (PCIS) which is undetectable on cross sectional images, endoscopic ultrasonography (EUS) and MRCP serve important roles in detecting local irregular stenosis of the PD or small cystic lesions. Subsequently, ERCP and associated serial pancreatic juice aspiration cytologic examination (SPACE) obtained by endoscopic nasopancreatic drainage (ENPD) may be useful in the diagnosis of very early-stage PC. Further prospective multicenter studies are required to establish a standard method of SPACE for the early diagnosis of PC. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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Open AccessReview Automatic Pulmonary Nodule Detection Applying Deep Learning or Machine Learning Algorithms to the LIDC-IDRI Database: A Systematic Review
Diagnostics 2019, 9(1), 29; https://doi.org/10.3390/diagnostics9010029
Received: 20 December 2018 / Revised: 29 January 2019 / Accepted: 19 February 2019 / Published: 7 March 2019
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Abstract
The aim of this study was to provide an overview of the literature available on machine learning (ML) algorithms applied to the Lung Image Database Consortium Image Collection (LIDC-IDRI) database as a tool for the optimization of detecting lung nodules in thoracic CT [...] Read more.
The aim of this study was to provide an overview of the literature available on machine learning (ML) algorithms applied to the Lung Image Database Consortium Image Collection (LIDC-IDRI) database as a tool for the optimization of detecting lung nodules in thoracic CT scans. This systematic review was compiled according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Only original research articles concerning algorithms applied to the LIDC-IDRI database were included. The initial search yielded 1972 publications after removing duplicates, and 41 of these articles were included in this study. The articles were divided into two subcategories describing their overall architecture. The majority of feature-based algorithms achieved an accuracy >90% compared to the deep learning (DL) algorithms that achieved an accuracy in the range of 82.2%–97.6%. In conclusion, ML and DL algorithms are able to detect lung nodules with a high level of accuracy, sensitivity, and specificity using ML, when applied to an annotated archive of CT scans of the lung. However, there is no consensus on the method applied to determine the efficiency of ML algorithms. Full article
(This article belongs to the Section Medical Imaging)
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Open AccessArticle 4-Pyridoxic Acid/Pyridoxine Ratio in Patients with Type 2 Diabetes is Related to Global Cardiovascular Risk Scores
Diagnostics 2019, 9(1), 28; https://doi.org/10.3390/diagnostics9010028
Received: 29 January 2019 / Revised: 27 February 2019 / Accepted: 28 February 2019 / Published: 6 March 2019
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Abstract
Background: Vascular diseases are multifactorial and several risk factors may have synergetic effect on the global vascular risk. Among patients with diabetes, we investigated whether vitamin B6 species differ according to global cardiovascular risk. Methods: The present observational study included 122 patients with [...] Read more.
Background: Vascular diseases are multifactorial and several risk factors may have synergetic effect on the global vascular risk. Among patients with diabetes, we investigated whether vitamin B6 species differ according to global cardiovascular risk. Methods: The present observational study included 122 patients with type 2 diabetes (mean (SD) age = 69.9 (9.1) years; 50% men). Concentrations of vitamin B6 vitamers were measured. Classical blood biomarkers and risk factors were used to compute a multivariate risk score. Results: Plasma concentrations of 4-pyridoxic acid were higher in patients with high risk versus those with low risk scores (48.2 (63.7) vs. 31.9 (15.0) nmol/L; p = 0.031). Plasma pyridoxine was significantly lowered in patients at high risk (2.8 (28.4) vs. 38.1 (127.8) nmol/L; p = 0.003). PAr index (4-pyridoxic acid/pyridoxal + pyridoxal 5′-phosphate) (1.05 (0.07) vs. 0.84 (0.06); p = 0.017) and the ratio of 4-pyridoxic acid/pyridoxine (7.0 (4.8) vs. 3.9 (3.2); p < 0.001) were higher in patients at high risk. After adjustment for cystatin C and C-reactive protein, only pyridoxine and 4-pyridoxic acid/pyridoxine ratio remained significantly different according to vascular risk scores. 4-Pyridoxic acid/pyridoxine ratio was the best marker to discriminate between patients according to their risk scores—area under the curve (AUC) (95% confidence intervals (CI)) = 0.72 (0.62–0.81). 4-Pyridoxic acid/pyridoxine ratio was directly related to plasma levels of soluble vascular cell adhesion molecule 1. Conclusion: Vitamin B6 metabolism was shifted in patients with multiple vascular risk factors. The catabolism to 4-pyridoxic acid was enhanced, whereas the catabolism to pyridoxine was lowered. High 4-Pyridoxic acid/pyridoxine ratio is independently associated with global cardiovascular risk. Full article
(This article belongs to the Section Novel Diagnostic Technologies and Devices)
Open AccessArticle Acquisition of Quasi-Monochromatic Dual-Energy in a Microfocus X-ray Generator and Development of Applied Technology
Diagnostics 2019, 9(1), 27; https://doi.org/10.3390/diagnostics9010027
Received: 31 January 2019 / Revised: 27 February 2019 / Accepted: 27 February 2019 / Published: 4 March 2019
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Abstract
In regenerative medicine, evaluation of bone mineral density using a microfocus X-ray generator could eventually be used to determine the degree of bone tissue regeneration. To evaluate bone mineral density against regenerated bone material, two low-energy X-rays are necessary. Herein, the acquisition of [...] Read more.
In regenerative medicine, evaluation of bone mineral density using a microfocus X-ray generator could eventually be used to determine the degree of bone tissue regeneration. To evaluate bone mineral density against regenerated bone material, two low-energy X-rays are necessary. Herein, the acquisition of quasi-monochromatic, dual-energy soft X-ray and the subsequent medical application were examined using the K-absorption edges of two types of metal filters (i.e., zirconium and tin) in a microfocus X-ray generator. Investigation of the optimal tube voltage and filter thickness to form a quasi-monochromatic energy spectrum with a single filter revealed that a filter thickness of 0.3 mm results in an optimal monochromatization state. When a dual filter was used, the required filter thickness was 0.3 mm for tin and 0.2 mm for zirconium at a tube voltage of 35 kV. For the medical application, we measured quasi-monochromatic, dual-energy X-rays to evaluate the measurement accuracy of bone mineral density. Using aluminum as a simulated bone sample, a relative error of ≤5% was consistent within the aluminum thickness range of 1–3 mm. These data suggest that a bone mineral density indicator of recycled bone material can be easily obtained with the quasi-monochromatic X-ray technique using a microfocus X-ray generator. Full article
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Open AccessArticle Assessment of Post-Exertional Malaise (PEM) in Patients with Myalgic Encephalomyelitis (ME) and Chronic Fatigue Syndrome (CFS): A Patient-Driven Survey
Diagnostics 2019, 9(1), 26; https://doi.org/10.3390/diagnostics9010026
Received: 1 February 2019 / Revised: 25 February 2019 / Accepted: 26 February 2019 / Published: 2 March 2019
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Abstract
Considerable controversy has existed with efforts to assess post-exertional malaise (PEM), which is one of the defining features of myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). While a number of self-report questionnaires have been developed to assess this symptom, none have been [...] Read more.
Considerable controversy has existed with efforts to assess post-exertional malaise (PEM), which is one of the defining features of myalgic encephalomyelitis (ME) and chronic fatigue syndrome (CFS). While a number of self-report questionnaires have been developed to assess this symptom, none have been comprehensive, and a recent federal government report has recommended the development of a new PEM measure. The current study involved a community-based participatory research process in an effort to develop a comprehensive PEM instrument, with critical patient input shaping the item selection and overall design of the tool. A survey was ultimately developed and was subsequently completed by 1534 members of the patient community. The findings of this survey suggest that there are key domains of this symptom, including triggers, symptom onset, and duration, which have often not been comprehensively assessed in a previous PEM instrument. This study indicates that there are unique benefits that can be derived from patients collaborating with researchers in the measurement of key symptoms defining ME and CFS. Full article
(This article belongs to the Special Issue Biomedical Insights that Inform the Diagnosis of ME/CFS)
Open AccessInteresting Images Disseminated Bartonella henselae Infection Visualized by [18F]FDG-PET/CT and MRI
Diagnostics 2019, 9(1), 25; https://doi.org/10.3390/diagnostics9010025
Received: 24 February 2019 / Accepted: 26 February 2019 / Published: 1 March 2019
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Abstract
We describe the clinical course of a 24-year old male with Crohn’s disease in immunosuppressive therapy admitted with a 6-week history of fever, weight loss, night sweat, and general malaise. The patient received extensive workup for a fever of unknown origin and received [...] Read more.
We describe the clinical course of a 24-year old male with Crohn’s disease in immunosuppressive therapy admitted with a 6-week history of fever, weight loss, night sweat, and general malaise. The patient received extensive workup for a fever of unknown origin and received empiric antibiotics. Workup with Fluorine-18 fluoro-2-deoxy-d-glucose ([18F]FDG) positron-emission tomography (PET/CT), and magnetic resonance imaging (MRI) with intravenous contrast showed multifocal ostitis of the columna and os sacrum, as well as abscesses in m. iliopsoas and m. iliacus and affection of the retroperitoneum, liver, and spleen. Initially, malignancy was suspected, but a subsequent liver biopsy showed necrotizing granulomatous inflammation and a later polymerase chain reaction (PCR) showed Bartonella henselae. The patient had relevant exposure from housecats. He was treated with Doxycycline and Rifampicin for 12 weeks resulting in complete recovery. This case is, to our knowledge, a rare example of disseminated infection with Bartonella henselae visualized on both [18F]FDG-PET/CT and MRI. Full article
(This article belongs to the Section Medical Imaging)
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Open AccessReview Clinicopathological Spectrum of Bilirubin Encephalopathy/Kernicterus
Diagnostics 2019, 9(1), 24; https://doi.org/10.3390/diagnostics9010024
Received: 2 February 2019 / Revised: 17 February 2019 / Accepted: 25 February 2019 / Published: 28 February 2019
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Abstract
Bilirubin encephalopathy/kernicterus is relatively rare, but continues to occur despite universal newborn screening. What is more interesting is the spectrum of clinical and even neuropathological findings that have been reported in the literature to be associated with bilirubin encephalopathy and kernicterus. In this [...] Read more.
Bilirubin encephalopathy/kernicterus is relatively rare, but continues to occur despite universal newborn screening. What is more interesting is the spectrum of clinical and even neuropathological findings that have been reported in the literature to be associated with bilirubin encephalopathy and kernicterus. In this review, the authors discuss the array of clinicopathological findings reported in the context of bilirubin encephalopathy and kernicterus, as well as the types of diagnostic testing used in patients suspected of having bilirubin encephalopathy or kernicterus. The authors aim to raise the awareness of these features among both pediatric neurologists and neuropathologists. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)
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Open AccessReview A Brief Overview of Medical Fiber Optic Biosensors and Techniques in the Modification for Enhanced Sensing Ability
Diagnostics 2019, 9(1), 23; https://doi.org/10.3390/diagnostics9010023
Received: 12 February 2019 / Revised: 23 February 2019 / Accepted: 24 February 2019 / Published: 27 February 2019
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In this paper, we provide a brief overview of fiber optic biosensors for use in MedTech, specifically to aid in the diagnoses and treatment of those with chronic medical conditions. Fiber optic cables as components of biological sensors make them especially effective in [...] Read more.
In this paper, we provide a brief overview of fiber optic biosensors for use in MedTech, specifically to aid in the diagnoses and treatment of those with chronic medical conditions. Fiber optic cables as components of biological sensors make them especially effective in biological systems that may require ultra-sensitive detection of low-frequency signals in hard to reach areas. This systematic review focuses on the differentiating factors of fiber-optic biosensors, which are tailored to apply the sensor to specific health needs. The main components of FOBS (fiber optic biosensors) such as biosensing elements, fiber optic cables, optical element enhancements, transducers, sensing strategies, photodetectors, and signal processing are covered in detail by showcasing the recent developments in modifications to these components. This paper pays particular attention to the alterations made in biosensing elements including pH elements, enzymatic elements, as well as those sensors utilizing antibodies and whole-cell bacteria. This paper reviews and discusses several published examples in the research stage of development to give the reader an overall scope of the field. The need for research on biosensing equipment is increasing, as the number of individuals with chronic diseases and the geriatric population require more effective, accurate, and mobile sensing ability and reduced invasiveness. FOBS offer a sensing solution that is accurate, tailorable to almost any clinical need, has abundant and relatively cheap material requirements, and a well-established technological base in fiber optic technology. This small price tag and large market potential make FOBS a desirable research area. Full article
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Open AccessTutorial Understanding Real-Time Fluorescence Signals from Bacteria and Wound Tissues Observed with the MolecuLight i:XTM
Diagnostics 2019, 9(1), 22; https://doi.org/10.3390/diagnostics9010022
Received: 31 January 2019 / Revised: 20 February 2019 / Accepted: 20 February 2019 / Published: 26 February 2019
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The persistent presence of pathogenic bacteria is one of the main obstacles to wound healing. Detection of wound bacteria relies on sampling methods, which delay confirmation by several days. However, a novel handheld fluorescence imaging device has recently enabled real-time detection of bacteria [...] Read more.
The persistent presence of pathogenic bacteria is one of the main obstacles to wound healing. Detection of wound bacteria relies on sampling methods, which delay confirmation by several days. However, a novel handheld fluorescence imaging device has recently enabled real-time detection of bacteria in wounds based on their intrinsic fluorescence characteristics, which differ from those of background tissues. This device illuminates the wound with violet (405 nm) light, causing tissues and bacteria to produce endogenous, characteristic fluorescence signals that are filtered and displayed on the device screen in real-time. The resulting images allow for rapid assessment and documentation of the presence, location, and extent of fluorescent bacteria at moderate-to-heavy loads. This information has been shown to assist in wound assessment and guide patient-specific treatment plans. However, proper image interpretation is essential to assessing this information. To properly identify regions of bacterial fluorescence, users must understand: (1) Fluorescence signals from tissues (e.g., wound tissues, tendon, bone) and fluids (e.g., blood, pus); (2) fluorescence signals from bacteria (red or cyan); (3) the rationale for varying hues of both tissue and bacterial fluorescence; (4) image artifacts that can occur; and (5) some potentially confounding signals from non-biological materials (e.g., fluorescent cleansing solutions). Therefore, this tutorial provides clinicians with a rationale for identifying common wound fluorescence characteristics. Clinical examples are intended to help clinicians with image interpretation—with a focus on image artifacts and potential confounders of image interpretation—and suggestions of how to overcome such challenges when imaging wounds in clinical practice. Full article
(This article belongs to the Special Issue Diagnosis of Bacterial Pathogens)
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Open AccessReview Metabolomics Biomarkers of Prostate Cancer: A Systematic Review
Diagnostics 2019, 9(1), 21; https://doi.org/10.3390/diagnostics9010021
Received: 23 January 2019 / Revised: 13 February 2019 / Accepted: 14 February 2019 / Published: 19 February 2019
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Abstract
Prostate cancer (PCa) diagnosis with current biomarkers is difficult and often results in unnecessary invasive procedures as well as over-diagnosis and over-treatment, highlighting the need for novel biomarkers. The aim of this review is to provide a summary of available metabolomics PCa biomarkers, [...] Read more.
Prostate cancer (PCa) diagnosis with current biomarkers is difficult and often results in unnecessary invasive procedures as well as over-diagnosis and over-treatment, highlighting the need for novel biomarkers. The aim of this review is to provide a summary of available metabolomics PCa biomarkers, particularly for clinically significant disease. A systematic search was conducted on PubMed for publications from July 2008 to July 2018 in accordance with PRISMA guidelines to report biomarkers with respect to their application in PCa diagnosis, progression, aggressiveness, recurrence, and treatment response. The vast majority of studies report biomarkers with the ability to distinguish malignant from benign prostate tissue with a few studies investigating biomarkers associated with disease progression, treatment response or tumour recurrence. In general, these studies report high dimensional datasets and the number of analysed metabolites often significantly exceeded the number of available samples. Hence, observed multivariate differences between case and control samples in the datasets might potentially also be associated with pre-analytical, technical, statistical and confounding factors. Giving the technical and methodological hurdles, there are nevertheless a number of metabolites and pathways repeatedly reported across various technical approaches, cohorts and sample types that appear to play a predominant role in PCa tumour biology, progression and recurrence. Full article
(This article belongs to the Special Issue Diagnostic Biomarkers in Prostate Cancer)
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Open AccessArticle Machine-Learning-Based Laboratory Developed Test for the Diagnosis of Sepsis in High-Risk Patients
Diagnostics 2019, 9(1), 20; https://doi.org/10.3390/diagnostics9010020
Received: 25 January 2019 / Revised: 6 February 2019 / Accepted: 11 February 2019 / Published: 13 February 2019
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Abstract
Sepsis, a dysregulated host response to infection, is a major health burden in terms of both mortality and cost. The difficulties clinicians face in diagnosing sepsis, alongside the insufficiencies of diagnostic biomarkers, motivate the present study. This work develops a machine-learning-based sepsis diagnostic [...] Read more.
Sepsis, a dysregulated host response to infection, is a major health burden in terms of both mortality and cost. The difficulties clinicians face in diagnosing sepsis, alongside the insufficiencies of diagnostic biomarkers, motivate the present study. This work develops a machine-learning-based sepsis diagnostic for a high-risk patient group, using a geographically and institutionally diverse collection of nearly 500,000 patient health records. Using only a minimal set of clinical variables, our diagnostics outperform common severity scoring systems and sepsis biomarkers and benefit from being available immediately upon ordering. Full article
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Open AccessEditorial Introduction to Special Issue on “Electromagnetic Technologies for Medical Diagnostics: Fundamental Issues, Clinical Applications and Perspectives”
Diagnostics 2019, 9(1), 19; https://doi.org/10.3390/diagnostics9010019
Received: 6 February 2019 / Accepted: 11 February 2019 / Published: 13 February 2019
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Abstract
The application of microwave technologies in medical imaging and diagnostics is an emerging topic within the electromagnetic (EM) engineering community [...] Full article
Open AccessReview Advances in Early Detection of Pancreatic Cancer
Diagnostics 2019, 9(1), 18; https://doi.org/10.3390/diagnostics9010018
Received: 10 January 2019 / Revised: 24 January 2019 / Accepted: 28 January 2019 / Published: 5 February 2019
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Abstract
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. PDAC is the fourth leading cause of death in the United States and Japan based on epidemiological data. Early detection of PDAC is very important to improve the prognosis of PDAC. Early detection of pancreatic [...] Read more.
Pancreatic ductal adenocarcinoma (PDAC) is a lethal disease. PDAC is the fourth leading cause of death in the United States and Japan based on epidemiological data. Early detection of PDAC is very important to improve the prognosis of PDAC. Early detection of pancreatic ductal adenocarcinoma (PDAC) requires further examination after selecting cases with risk factors for the condition, such as family history, hereditary pancreatic carcinoma syndrome, intraductal papillary mucinous neoplasms, or chronic pancreatitis. The Japan Study Group on the Early Detection of Pancreatic Cancer has investigated and clarified the clinicopathological features for the early diagnosis of PDAC. In Japan, an algorithm for the early diagnosis of PDAC, which utilized the cooperation of local clinics and regional general hospitals, has been a breakthrough in the detection of early-stage PDAC. Further approaches for the early diagnosis of PDAC are warranted. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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Open AccessArticle Evaluation of the Performance of 18F-Fluorothymidine Positron Emission Tomography/Computed Tomography (18F-FLT-PET/CT) in Metastatic Brain Lesions
Diagnostics 2019, 9(1), 17; https://doi.org/10.3390/diagnostics9010017
Received: 24 December 2018 / Revised: 19 January 2019 / Accepted: 23 January 2019 / Published: 26 January 2019
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Abstract
18F-fluorothymidine (18F-FLT) is a radiolabeled thymidine analog that has been reported to help monitor tumor proliferation and has been studied in primary brain tumors; however, knowledge about 18F-FLT positron emission tomography/computed tomography (PET/CT) in metastatic brain lesions is limited. The purpose of this [...] Read more.
18F-fluorothymidine (18F-FLT) is a radiolabeled thymidine analog that has been reported to help monitor tumor proliferation and has been studied in primary brain tumors; however, knowledge about 18F-FLT positron emission tomography/computed tomography (PET/CT) in metastatic brain lesions is limited. The purpose of this study is to evaluate the performance of 18F-FLT-PET/CT in metastatic brain lesions. A total of 20 PET/CT examinations (33 lesions) were included in the study. Semiquantitative analysis was performed: standard uptake value (SUV) with the utilization of SUVmax, tumor-to-background ratio (T/B), SUVpeak, SUV1cm3, SUV0.5cm3, SUV50%, SUV75%, PV50% (volume × SUV50%), and PV75% (volume × SUV75%) were calculated. Sensitivity, specificity, and accuracy for each parameter were calculated. Optimal cutoff values for each parameter were obtained. Using a receiver operating characteristic (ROC) curve analysis, the optimal cutoff values of SUVmax, T/B, and SUVpeak for discriminating active from non-active lesions were found to be 0.615, 4.21, and 0.425, respectively. In an ROC curve analysis, the area under the curve (AUC) is higher for SUVmax (p-value 0.017) compared to the rest of the parameters, while using optimal cutoff T/B shows the highest sensitivity and accuracy. PVs (proliferation × volumes) did not show any significance in discriminating positive from negative lesions. 18F-FLT-PET/CT can detect active metastatic brain lesions and may be used as a complementary tool. Further investigation should be performed. Full article
(This article belongs to the Special Issue Brain Imaging)
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Open AccessArticle Can 3D RVEF be Prognostic for the Non-Ischemic Cardiomyopathy Patient but Not the Ischemic Cardiomyopathy Patient? A Cardiovascular MRI Study
Diagnostics 2019, 9(1), 16; https://doi.org/10.3390/diagnostics9010016
Received: 12 December 2018 / Revised: 10 January 2019 / Accepted: 20 January 2019 / Published: 23 January 2019
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Abstract
Background: While left ventricular ejection fraction (LVEF) has been shown to have prognostic value in ischemic cardiomyopathy (ICMX) patients, right ventricular ejection fraction (RVEF) has not been systematically evaluated in either ICMX or non-ischemic cardiomyopathy (NICMX) patients. Moreover, an accurate estimation of RVEF [...] Read more.
Background: While left ventricular ejection fraction (LVEF) has been shown to have prognostic value in ischemic cardiomyopathy (ICMX) patients, right ventricular ejection fraction (RVEF) has not been systematically evaluated in either ICMX or non-ischemic cardiomyopathy (NICMX) patients. Moreover, an accurate estimation of RVEF is problematic due to the geometry of the right ventricle (RV). Over the years, there have been improvements in the resolution, image acquisition and post-processing software for cardiac magnetic resonance imaging (CMR), such that CMR has become the “gold standard” for measuring RV volumetrics and RVEF. We hypothesize that CMR defines RVEF more so than LVEF and might have prognostic capabilities in ischemic and non-ischemic cardiomyopathy patients (ICMX and NICMX). Methods: Patients that underwent CMR at our institution between January 2005 and October 2012 were retrospectively selected if three-dimensional (3D) LVEF < 35%. Patients were further divided into ICMX and NICMX groups. The electronic medical record (EMR) database inquiry determined all-cause mortality and major adverse cardiovascular events (MACE). Additionally, a Social Security Death Index (SSI) database inquiry was performed to determine all-cause mortality in patients who were lost to follow-up. Patients were further sub-grouped on the basis of 3D RVEF ≥ 20%. Separately, patients were sub-grouped by LVEF ≥ 20% in both ICMX and NICMX cases. A cut-off of ≥20% was chosen for the RVEF based on the results of prior studies showing significance based on Kaplan–Meier (KM) survival curves. Cumulative event rates were estimated for each subgroup using the KM analysis and were compared using the log-rank test. The 3D RV/LVEFs were compared to all-cause mortality and MACE. ICMX patients were defined using the World Health Organization (WHO) criteria. Results: From a 7000-patient CMR database, 753 heart failure patients were selected. Eighty-seven patients met WHO definition of ICMX and NICMX (43 ICMX and 44 NICMX). The study patients were followed for a median of 3 years (Interquartile range or IQR 1.5–6.5 years). The mean age of patients was 58 ± 13 years; 79% were male. In ICMX, mean 3D LVEF was 21% ± 6% and mean 3D RVEF was 38% ± 14%, while for NICMX, mean 3D LVEF was 16% ± 6% and mean 3D RVEF was 30% ± 14% (p < 0.005 for intra- and inter-group comparison). It should be noted that LVEF < RVEF in both groups and the ejection fraction (EF) in NICMX was less than the corresponding EF in ICMX. Overall mortality was higher in ICMX than NICMX (12/40, 30% vs. 7/43, 16%; p < 0.05). Patients were stratified based on both RVEF and LVEF with a threshold of EF ≥ 20% separately. RVEF but not LVEF was a significant predictor of death for NICMX (χ2 = 8; p < 0.005), while LVEF did not predict death in ICMX (χ2 = 2, p = not significant). Similarly, time to MACE was predicted by RVEF for NICMX (χ2 = 9; p < 0.005) but not by LVEF in ICMX (χ2 = 1; p = NS). Importantly, RVEF, while predictive of NICMX MACE, did not emerge as a predictor of survival or MACE in ICMX. Conclusions: Via 3D CMR in non-ischemic CMX patients, RVEF has important value in predicting death and time to first MACE while 3D LVEF is far less predictive. Full article
(This article belongs to the Special Issue Hot Topics in Cardiopulmonary Imaging)
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Open AccessArticle Proposal for Endoscopic Ultrasonography Classification for Small Pancreatic Cancer
Diagnostics 2019, 9(1), 15; https://doi.org/10.3390/diagnostics9010015
Received: 28 November 2018 / Revised: 18 January 2019 / Accepted: 18 January 2019 / Published: 23 January 2019
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Abstract
Backgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. Materials and Methods: Six patients with [...] Read more.
Backgrounds: Endoscopic ultrasonography (EUS) is used to observe the stricture of the main pancreatic duct (MPD) and in diagnosing pancreatic cancer (PC). We investigate the findings on EUS by referring to the histopathological findings of resected specimens. Materials and Methods: Six patients with carcinoma in situ (CIS) and 30 patients with invasive carcinoma of 20 mm or less were included. The preoperative EUS findings were classified as follows. A1: Simple stricture type—no findings around the stricture; A2: Hypoecho stricture type—localized hypoechoic area without demarcation around the stricture; A3: Tumor stricture type—tumor on the stricture; B: Dilation type—the dilation of the pancreatic duct without a downstream stricture; C: Parenchymal tumor type—tumor located apart from the MPD. Results: Classes A1 and A2 consisted of 2 CISs, and 4 invasive carcinomas included two cases smaller than 5 mm in diameter. Most of the cancers classified as A3 or C were of invasive carcinoma larger than 5 mm in diameter. All cancers classified as B involved CIS. Serial pancreatic-juice aspiration cytologic examination (SPACE) was selected for all types of cases, with a sensitivity of 92.0%, while EUS-guided fine needle aspiration cytology (EUS-FNA) was only useful for invasive carcinoma, and its sensitivity was 66.7%. Conclusions: Stricture without a tumor could be a finding for invasive PC and pancreatic duct dilation without a downstream stricture could be a finding indicative of CIS. Carcinoma smaller than 5 mm in diameter could not be recognized by EUS. SPACE had a high sensitivity for diagnosing small PC. Full article
(This article belongs to the Special Issue Early Diagnosis of Pancreatic Cancer)
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Open AccessArticle The Effect of Microdialysis Catheter Insertion on Glutamate and Serotonin Levels in Masseter Muscle in Patients with Myofascial Temporomandibular Disorders and Healthy Controls
Diagnostics 2019, 9(1), 14; https://doi.org/10.3390/diagnostics9010014
Received: 5 December 2018 / Revised: 9 January 2019 / Accepted: 19 January 2019 / Published: 22 January 2019
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Abstract
Myofascial temporomandibular disorders (TMD) are the most common cause of chronic pain in the orofacial region. Microdialysis has been used to study metabolic changes in the human masseter muscle. The insertion of the microdialysis probe causes acute tissue trauma that could affect the [...] Read more.
Myofascial temporomandibular disorders (TMD) are the most common cause of chronic pain in the orofacial region. Microdialysis has been used to study metabolic changes in the human masseter muscle. The insertion of the microdialysis probe causes acute tissue trauma that could affect the metabolic milieu and thereby influence the results when comparing healthy subjects to those with TMD. This study aimed to investigate the levels of serotonin and glutamate during the acute tissue trauma period in healthy subjects and in patients with TMD. Microdialysis was carried out in 15 patients with TMD and 15 controls, and samples were collected every 20 min during a period of 140 min. No significant alterations of serotonin or glutamate were observed over the 2 h period for the healthy subjects. For the TMD group, a significant decrease in serotonin was observed over time (p < 0.001), followed by a significant increase between 120 and 140 min (p < 0.001). For glutamate, a significant reduction was observed at 40 min compared to baseline. The results showed that there was a spontaneous increase of serotonin 2 h after the insertion of the catheter in patients with TMD. In conclusion, the results showed that there are differences in the masseter muscle levels of serotonin and glutamate during acute nociception in patients with myofascial TMD compared to healthy subjects. Full article
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Open AccessArticle Cost-Efficient and Easy to Perform PCR-Based Assay to Identify Met Exon 14 Skipping in Formalin-Fixed Paraffin-Embedded (FFPE) Non-Small Cell Lung Cancer (NSCLC) Samples
Diagnostics 2019, 9(1), 13; https://doi.org/10.3390/diagnostics9010013
Received: 23 November 2018 / Revised: 10 January 2019 / Accepted: 14 January 2019 / Published: 18 January 2019
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Abstract
MET is a receptor tyrosine kinase (RTK) that plays important roles in carcinogenesis. Despite being frequently overexpressed in cancer, clinical responses to targeting this receptor have been limited. Recently novel splicing mutations involving the loss of exon 14 (called METex14 skipping) have emerged [...] Read more.
MET is a receptor tyrosine kinase (RTK) that plays important roles in carcinogenesis. Despite being frequently overexpressed in cancer, clinical responses to targeting this receptor have been limited. Recently novel splicing mutations involving the loss of exon 14 (called METex14 skipping) have emerged as potential biomarkers to predict for responsiveness to targeted therapies with Met inhibitors in non-small cell lung cancer (NSCLC). Currently, the diverse genomic alterations responsible for METex14 skipping pose a challenge for routine clinical diagnostic testing. In this report, we examine three different methodologies to detect METex14 and assess their potential utility for use as a diagnostic assay for both the identification of METex14 and intra-tumoural distribution in NSCLC. Full article
(This article belongs to the Section Novel Diagnostic Technologies and Devices)
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Open AccessReview Sentinel Lymph Node Evaluation: What the Radiologist Needs to Know
Diagnostics 2019, 9(1), 12; https://doi.org/10.3390/diagnostics9010012
Received: 26 November 2018 / Revised: 5 January 2019 / Accepted: 5 January 2019 / Published: 17 January 2019
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Abstract
Axillary lymph node status is the single most important prognostic indicator in patients with breast cancer. Axillary lymph node dissection, the traditional method of staging breast cancer, is associated with significant morbidity. Sentinel lymph node biopsy has become standard in patients being treated [...] Read more.
Axillary lymph node status is the single most important prognostic indicator in patients with breast cancer. Axillary lymph node dissection, the traditional method of staging breast cancer, is associated with significant morbidity. Sentinel lymph node biopsy has become standard in patients being treated for breast cancer with clinically negative lymph nodes. There is considerable variation in the medical literature regarding technical approaches to sentinel lymph node biopsy in patients with breast cancer. The purpose of this article is to describe our preferred approaches to sentinel lymph node biopsy with a review of the literature. Full article
(This article belongs to the Special Issue Breast Imaging)
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Open AccessCase Report Subcutaneous and Mediastinal Emphysema Followed by Group A Beta-Hemolytic Streptococci Mediastinitis. A Complicated Course after Adenotonsillectomy: Case Report
Diagnostics 2019, 9(1), 11; https://doi.org/10.3390/diagnostics9010011
Received: 11 November 2018 / Accepted: 4 December 2018 / Published: 15 January 2019
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Abstract
Tonsillectomy is a commonly performed surgery in the daily practice of an otorhinolaryngologist. For patients as well as health professionals, the best known complication is post-operative bleeding. Among the less noted, but potentially life-threatening, complications are the development of subcutaneous emphysema and the [...] Read more.
Tonsillectomy is a commonly performed surgery in the daily practice of an otorhinolaryngologist. For patients as well as health professionals, the best known complication is post-operative bleeding. Among the less noted, but potentially life-threatening, complications are the development of subcutaneous emphysema and the presence of bacteremia due to group A hemolytic streptococci. In this report, we describe a severely complicated clinical course after an uncomplicated adenotonsillectomy in a young boy. Increased awareness of relatively unknown complications after adenotonsillectomy amongst surgeons, pediatricians and anesthesiologists is desirable to facilitate rapid diagnosis and adequate treatment in order to prevent life-threatening situations. Full article
(This article belongs to the Special Issue Diagnosis and Management of Pediatric Diseases)
Open AccessArticle Genotyping of Single Nucleotide Polymorphisms Using Allele-Specific qPCR Producing Amplicons of Small Sizes Directly from Crude Serum Isolated from Capillary Blood by a Hand-Powered Paper Centrifuge
Received: 15 November 2018 / Revised: 27 December 2018 / Accepted: 29 December 2018 / Published: 11 January 2019
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Abstract
The cell-free genomic DNA (gDNA) concentration in serum ranges from 1500 to 7500 copies/mL within 2 h after phlebotomy (6–24 times the concentration observed in plasma). Here, we aimed to evaluate the gDNA size distribution in serum with time after coagulation and to [...] Read more.
The cell-free genomic DNA (gDNA) concentration in serum ranges from 1500 to 7500 copies/mL within 2 h after phlebotomy (6–24 times the concentration observed in plasma). Here, we aimed to evaluate the gDNA size distribution in serum with time after coagulation and to test if crude serum can be directly used as a source of gDNA for qPCR. Next, we investigated if single nucleotide polymorphisms (SNPs) could be genotyped directly from the crude serum isolated from capillary blood using a hand-powered paper centrifuge. All tested PCR targets (65, 100, 202 and 688 base pairs) could be successfully amplified from DNA extracted from serum, irrespective of their amplicon size. The observed qPCR quantitation cycles suggested that the genomic DNA yield increased in serum with incubation at room temperature. Additionally, only 65 and 101 base pair qPCR targets could be amplified from crude serum soon after the coagulation. Incubation for 4 days at room temperature was necessary for the amplification of PCR targets of 202 base pairs. The 688 base pair qPCR target could not be amplified from serum directly. Lastly, serum was successfully separated from capillary blood using the proposed paper centrifuge and the genotypes were assigned by testing the crude serum using allele-specific qPCR, producing small amplicon sizes in complete agreement with the genotypes assigned by testing the DNA extracted from whole blood. The serum can be used directly as the template in qPCR for SNP genotyping, especially if small amplicon sizes are applied. This shortcut in the SNP genotyping process could further molecular point-of-care diagnostics due to elimination of the DNA extraction step. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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Open AccessArticle Defining System Requirements for Simplified Blood Culture to Enable Widespread Use in Resource-Limited Settings
Diagnostics 2019, 9(1), 10; https://doi.org/10.3390/diagnostics9010010
Received: 15 October 2018 / Revised: 20 December 2018 / Accepted: 26 December 2018 / Published: 11 January 2019
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Abstract
Bacterial blood stream infections (BSI) are a common cause of mortality and morbidity globally. As the causative agents and the resulting treatment decisions vary, near-patient testing and surveillance tools are necessary to monitor bacterial causes and resistance to antimicrobial agents. The gold standard [...] Read more.
Bacterial blood stream infections (BSI) are a common cause of mortality and morbidity globally. As the causative agents and the resulting treatment decisions vary, near-patient testing and surveillance tools are necessary to monitor bacterial causes and resistance to antimicrobial agents. The gold standard to identify BSIs is blood culture (BC), a methodology not widely available in resource-limited settings. The aim of the study was to map out a target product profile of a simplified BC system (SBCS) to inform product development efforts. To identify the desired characteristics of a SBCS, we enlisted a small group of specialists working in Africa and Asia. Questions were used to understand challenges and how these constraints inform system requirements. The specialists were infectious disease physicians, public health/clinical microbiologists, clinical researchers, and technology experts with different geographical backgrounds. All suggested that BC should ideally be available at the district hospital level. Many of the same operational challenges, such as limited availability of culture bottles, electricity and internet connectivity, profuse dust, the lack of ambient temperature control, and human capacity constraints were identified across the different regions. BCs, although the accepted gold standard for diagnosis of BSIs, are not widely available outside of reference/research centers in Africa and Asia. To extend the reach of this important tool, it is crucial to engage product developers and academic research partners to develop accessible alternatives. Full article
(This article belongs to the Special Issue Diagnosis of Bacterial Pathogens)
Open AccessArticle Feature Extraction in Motor Activity Signal: Towards a Depression Episodes Detection in Unipolar and Bipolar Patients
Received: 4 December 2018 / Revised: 27 December 2018 / Accepted: 7 January 2019 / Published: 10 January 2019
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Abstract
Depression is a mental disorder characterized by recurrent sadness and loss of interest in the enjoyment of the positive aspects of life, in addition to fatigue, causing inability to perform daily activities, which leads to a loss of quality of life. To monitor [...] Read more.
Depression is a mental disorder characterized by recurrent sadness and loss of interest in the enjoyment of the positive aspects of life, in addition to fatigue, causing inability to perform daily activities, which leads to a loss of quality of life. To monitor depression (unipolar and bipolar patients), traditional methods rely on reports from patients; nevertheless, bias is commonly present in them. To overcome this problem, Ecological Momentary Assessment (EMA) reports have been widely used, which include data of the behavior, feelings and other types of activities recorded almost in real time through the use of portable devices and smartphones containing motion sensors. In this work a methodology was proposed to detect depressive subjects from control subjects based in the data of their motor activity, recorded by a wearable device, obtained from the “Depresjon” database. From the motor activity signals, the extraction of statistical features was carried out to subsequently feed a random forest classifier. Results show a sensitivity value of 0.867, referring that those subjects with presence of depression have a degree of 86.7% of being correctly classified, while the specificity shows a value of 0.919, referring that those subjects with absence of depression have a degree of 91.9% of being classified with a correct response, using the motor activity signal provided from the wearable device. Based on these results, it is concluded that the motor activity allows distinguishing between the two classes, providing a preliminary and automated tool to specialists for the diagnosis of depression. Full article
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Open AccessEditorial Acknowledgement to Reviewers of Diagnostics in 2018
Published: 9 January 2019
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Abstract
igorous peer-review is the corner-stone of high-quality academic publishing [...] Full article
Open AccessReview Radio-Frequency and Microwave Techniques for Non-Invasive Measurement of Blood Glucose Levels
Received: 27 November 2018 / Revised: 13 December 2018 / Accepted: 21 December 2018 / Published: 8 January 2019
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Abstract
This paper reviews non-invasive blood glucose measurements via dielectric spectroscopy at microwave frequencies presented in the literature. The intent is to clarify the key challenges that must be overcome if this approach is to work, to suggest some possible ways towards addressing these [...] Read more.
This paper reviews non-invasive blood glucose measurements via dielectric spectroscopy at microwave frequencies presented in the literature. The intent is to clarify the key challenges that must be overcome if this approach is to work, to suggest some possible ways towards addressing these challenges and to contribute towards prevention of unnecessary ‘reinvention of the wheel’. Full article
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