Clinical Diagnosis Research Articles

Cerebral fat embolism following autologous fat injection in facial reconstruction: A case report

BACKGROUND Autologous fat injection in facial reconstruction is a common cosmetic surgery. Although cerebral fat embolism (CFE) as a complication is rare, it carries serious health risks. CASE SUMMARY We present a case of a 29-year-old female patient who developed acute CFE following facial fat filling surgery. After the surgery, the patient experienced symptoms including headache, nausea, vomiting, and difficulty breathing, which was followed by neurological symptoms such as slurred speech and left-sided weakness. Comprehensive physical examination and auxiliary investigations, including blood tests, head and neck computed tomography angiography, and cranial magnetic resonance diffusion-weighted imaging, were performed upon admission. The clinical diagnosis was acute cerebral embolism following facial fat filling surgery. Treatment included measures to improve cerebral circulation, dehydration for intracranial pressure reduction, nutritional support, and rehabilitation therapy for left limb function. The patient showed a significant improvement in symptoms after 2 weeks of treatment. She recovered left limb muscle strength to grade 5, had clear speech, and experienced complete relief of headache. CONCLUSION Our case highlights the potential occurrence of severe complications in patients undergoing fat injection in facial reconstruction. To prevent these complications, plastic surgeons should enhance their professional knowledge and skills.

Diabetes complications in people with alcohol use disorder and type 2 diabetes

BackgroundPeople living with alcohol use disorder (AUD) who develop Type 2 Diabetes (T2DM) may be at higher risk of diabetes-complications.AimOur aims were to compare diabetes-monitoring and incidence of diabetes-complications between people with and without AUD prior to T2DM diagnosis attending primary care in England.Design & settingWe used the Clinical Practice Research Datalink (CPRD) Aurum linked with Hospital Episode Statistics (HES) and Office for National Statistics (ONS) mortality data. The target population was people with incident T2DM diagnosed between 2004-2019.MethodWe defined AUD from codes indicating i) clinical diagnosis; ii) alcohol withdrawal; or iii) chronic alcohol-related harm. Outcomes were end stage renal disease (ESRD), lower limb amputation, myocardial infarction (MI), stroke, cardiovascular disease (CVD) mortality and all-cause mortality. We compared yearly HbA1c, creatinine and cholesterol monitoring activities for the first 5 years post T2DM diagnosis.ResultsThe study population was 543,509 people, of whom 15 237(2.8%) had a code for AUD. Adjusting for measured confounders, people with AUD had higher rates of ESRD (IRR 1.95 95% CI 1.71, 2.23), lower limb amputation (IRR 1.78 95% CI 1.50, 2.21), stroke (IRR 1.35 95% CI 1.25, 1.46), CVD mortality (IRR 1.74 95% 1.63, 1.86) and all-cause mortality (IRR 2.10 95% CI 2.04, 2.17) but not MI (IRR 0.91 95% CI 0.82, 1.00) compared with people without AUD. Laboratory diabetes-monitoring was high in people with (83.5-91.1%) and without (83.7-92.4%) AUD.ConclusionPeople with AUD had nearly double the rates of most of the diabetes-complications investigated than people without AUD.

Synthetic [18F]FET-PET Generation and Hotspot Prediction Via Preoperative MRI Fusion of Glioma Lacking Radiographic High-Grade Characteristics

Abstract Background Limited amino acid availability for Positron Emission Tomography (PET) imaging hinders therapeutic decision-making for gliomas without typical high-grade imaging features. To address this gap, we evaluated a generative artificial intelligence (AI) approach for creating synthetic [18F]FET-PET and predicting high [18F]FET-uptake from magnetic resonance imaging (MRI). Methods We trained a deep learning (DL)-based model to segment tumors in MRI and extracted radiomic features using the pyradiomics package and classification with a Random Forest classifier. To generate [18F]FET-PET images, we employed a Generative Adversarial Network (GAN) framework and utilized a split-input fusion module for processing different MRI sequences through feature extraction, concatenation, and self-attention. Results We included MR and PET images from 215 studies for the hotspot classification and 211 studies for the synthetic PET generation task. The top-performing radiomic features achieved 80% accuracy for hotspot prediction. From the synthetic [18F]FET-PET, 85% were classified as clinically useful by senior physicians. Peak Signal-to-Noise Ratio analysis indicated high signal fidelity with a peak at 40 dB, while Structural Similarity Index values showed structural congruence. Root Mean Square Error analysis demonstrated lower values below 5.6. Most Visual Information Fidelity scores ranged between 0.6 and 0.7. This indicates that synthetic PET images retain the essential information required for clinical assessment and diagnosis. Conclusion For the first time, we demonstrate that predicting high [18F]FET-uptake and generating synthetic PET images from preoperative MRI in LGG and HGG is feasible. Advanced MRI modalities and other generative AI models will be used to improve the algorithm further in future studies.

Two Cases of Maxillofacial Vascular Malformations Associated with Blue Rubber Bleb Nevus Syndrome And Literature Review

Blue Rubber Bleb Nevus Syndrome (BRBNS) is a rare systemic vascular malformation-related disorder that primarily affects the skin, gastrointestinal tract, and central nervous system. Approximately 55.9% of patients have lesions involving the oral and maxillofacial region. Due to the potential risks of gastrointestinal hemorrhage and intracerebral hemorrhage, it is crucial for dental practitioners to promptly identify and refer such cases to relevant departments to improve patient prognosis and enhance quality of life. This paper reports two cases of BRBNS associated with maxillofacial vascular malformations treated at the Oral and Maxillofacial Surgery Department of Henan Provincial People's Hospital. In conjunction with a literature review, this study discusses the clinical features, diagnosis, and treatment strategies of BRBNS, aiming to raise awareness among dental practitioners to avoid missed or incorrect diagnoses.

Comprehensive care processes for substance use disorders in adult mental health services: A systematic review

Background and Objectives: Assessment and care of substance use disorder within mental health services are essential due to the high prevalence and harms associated with comorbidity. Substance use disorder assessment and care are routinely recommended in clinical guidelines; however, processes are not agreed. This systematic review of routine clinical practice in relation to substance use disorders in adult mental health service aims to identify routine assessment and diagnosis processes, the proportion of patients and service episodes in which they occur and their outputs. Methods: We searched MEDLINE, PsycINFO, Embase and relevant Cochrane databases for articles until July 2024 reporting on substance use assessment, diagnosis or treatment in adults receiving routine mental health service and locating additional articles by snowballing. Variables including setting, study method, period, cohort, substances, clinical assessment type, diagnosis and care pathways were compared. Results: In 137 heterogeneous studies reporting routine practice within a wide variety of adult mental health service from 29 nations, 44 (32%) expected or reported on substance use assessment in domains of pattern or impact. However, 23 studies (17%) reported structured approaches to substance use disorder assessment, while 67 (49%) reported a diagnostic structure, including classification system. Diagnostic prevalence varied markedly. Treatment was reported in 16 studies (12%) and no substance use disorder outcomes were reported. Conclusion: This systematic review shows marked variation in routine practice in mental health service across a range of substance use disorder assessment and diagnosis processes. To better identify substance use disorder, enhance its care and reduce associated morbidity, adult mental health service may benefit from standardising expectations and systematically monitoring the performance of substance use assessment and diagnosis.

Magnetic resonance imaging evaluation and nuclear receptor binding SET domain protein 1 mutation in the Sotos syndrome with attention-deficit/hyperactivity disorder

Sotos syndrome is characterized by overgrowth features and is caused by alterations in the nuclear receptor binding SET domain protein 1 gene. Attention-deficit/hyperactivity disorder (ADHD) is considered a neurodevelopment and psychiatric disorder in childhood. Genetic characteristics and clinical presentation could play an important role in the diagnosis of Sotos syndrome and ADHD. Magnetic resonance imaging (MRI) has been used to assess medical images in Sotos syndrome and ADHD. The images process is considered to display in MRI while wavelet fusion has been used to integrate distinct images for achieving more complete information in single image in this editorial. In the future, genetic mechanisms and artificial intelligence related to medical images could be used in the clinical diagnosis of Sotos syndrome and ADHD.

Comparative Analysis of Viral Load Quantification Using Reverse Transcription Polymerase Chain Reaction and Digital Droplet Polymerase Chain Reaction

In the year 2019, a highly virulent coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged, precipitating the outbreak of the illness known as coronavirus disease 2019 (COVID-19). The commonly employed reverse transcription polymerase chain reaction (RT-qPCR) methodology serves to estimate the viral load in each patient’s sample by employing a standard curve. However, it is imperative to recognize that this technique exhibits limitations with respect to clinical diagnosis and therapeutic applications, since an advancement of the conventional polymerase chain reaction methods, digital polymerase chain reaction (digital PCR or DDPCR), enables the direct quantification and clonal amplification of nucleic acid strands. The primary divergence between dPCR and traditional PCR resides in their approaches to measuring nucleic acid quantities. In this study, we investigated the viral loads of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) within 461 participants. By employing both RT-qPCR and DDPCR techniques, we established a comparison between the quantification methodologies of the two approaches. Our findings illustrate that the quantification through DDPCR affords a superior means of monitoring viral load within lower respiratory tract samples, thus enhancing the assessment of disease progression, particularly in scenarios characterized by low viral loads.

An ARFID case report assessment with 18F-FDG PET/MRI and treatment with olanzapine, escitalopram and fluoxetine in adult

BackgroundAvoidant/restrictive food intake disorder (ARFID), a DSM-5-introduced eating disorder, is increasingly prevalent and challenging to treat, primarily affecting children and adolescents, with limited adult case reports. This rarity in adults leads to misdiagnosis or underdiagnosis, and treatment experiences are scarce.Case presentationThis report details an adult ARFID case, where the patient’s fear of food intake followed gastric damage from corn ingestion, resulting in a restrictive diet of rice porridge due to gastric pain. The behavior is driven by fear of eating-related adverse effects.ResultBased on clinical symptoms assessment, semi-structured interviews, and comprehensive testing, including PET/MRI scans to exclude secondary conditions, a diagnosis of ARFID was confirmed. ARFID, a newly introduced diagnosis in the DSM-5, is uncommon in adults with sparse case data. Differentiating it from gastrointestinal diseases and other psychiatric conditions is crucial for precise diagnosis and focused treatment.ConclusionIn this paper, we report on the clinical diagnosis, imaging manifestations, treatment, and follow-up of an adult ARFID case, highlighting the utility of neuroimaging in diagnosis and differentiation. It also assesses the therapeutic efficacy of olanzapine, escitalopram oxalate, and fluoxetine hydrobromide, offering clinical guidance for diagnosing and managing ARFID.

Incarcerated Women and Mental Illness: An Interpretative Phenomenological Analysis (IPA)

A significant number of incarcerated women experience severe and persistence mental illness. Even though a sizable body of research finds that mental health can be significantly worsened during periods of incarceration, surprisingly few studies to date have explored how incarcerated women negotiate, manage, and process their clinical diagnoses while in custody. To address this research void, the current study conducted an interpretative phenomenological analysis of ( n = 15) women with mental illness incarcerated in a medium-maximum security, state prison located in the Southeastern United States. Respondents cited six themes associated with these experiences: (1) Coming to terms with a diagnosis; (2) Managing mental illness; (3) The value of communication; (4) Negative impacts of mental illness; (5) Stigmatization and labeling; and (6) Isolation. Findings are discussed with reference to policy initiatives aimed at improving the mental and physical welfare of justice-involved women.

Construction of a multifunctional bio-probe based on lanthanides for UCL/MR/CT multimodal imaging in vivo

Multimodal bioimaging is beneficial for clinical diagnosis and research due to the provision of comprehensive diagnostic information. However, the design of multifunctional bio-probes aggregating multiple bioimaging functions is greatly challenging. In this study, a multifunctional bio-probe based on lanthanide-based nanomaterials Sr2GdF7: Yb3+/Er3+/Tm3+(abbreviated as SGF) was developed forin vivomultimodal imaging by co-adopting apropos lanthanides and tuning their molar ratio. The experimental results indicate that SGF incorporates multiple excellent properties, such as 10 nm small size, optimal red-NIR region emissions, strong paramagnetism, excellent x-ray absorption ability and high biological safety. More importantly, SGF successfully realizedin vivomultimodal imaging of upconversion luminescence, magnetic resonance and x-ray computed tomography at the animal level. Thus, SGF is expected to become a multifunctional bio-probe for clinical research/diagnosis. This research would promote the application and transformation of lanthanide fluorides nanomaterials in the field of clinical diagnosis to a certain extent.

Phenotypes linked to duplication upstream of SOX9: New insights into presentation and diagnosis.

Duplications occurring upstream of the SOX9 gene have been identified in a limited subset of patients with 46,XX testicular/ovotesticular differences/disorders of sex development (DSD). However, comprehensive understanding regarding their clinical presentation and diagnosis is limited. To gain further insight into the diagnosis of a large cohort of 46,XX individuals with duplications upstream of SOX9. We retrospectively analyzed data of 46,XX/SRY-negative individuals with SOX9 upstream duplications. Clinical data were recorded, and genetic etiologies were investigated using karyotyping, fluorescence in situ hybridization (FISH) for SRY analysis, microarray analysis, multiplex ligation-dependent probe amplification (MLPA) and next generation sequencing panels including whole genome sequencing. We analyzed twelve 46,XX individuals with heterozygous duplications upstream of SOX9, ranging from 107-941 kb. Ages at diagnosis ranged from 0.1 to 55 years. Seven (58%) had testicular/ovotesticular DSD, while five (41%) were asymptomatic carriers detected through family screening. There was no significant correlation between duplication size and genital/gonadal phenotype. The duplication was inherited from the father (n=3) or an asymptomatic mother (n=2). In one family, a duplication missed by the 300K microarray was detected by MLPA and confirmed with the 750K microarray. 46,XX individuals with SOX9 upstream duplications may exhibit no symptoms, but thorough family screening is crucial due to the potential inheritance and testicular/ovotesticular DSD risk in subsequent generations. We emphasize the effectiveness of high-resolution microarray analysis (>500K) as the primary diagnostic tool for 46,XX/SRY-negative testicular/ovotesticular DSD individuals, enabling thorough genome-wide assessment of copy number variations and detecting small alterations.

Evaluating Lichen Sclerosus in Phimosis: Insights From a Multidisciplinary Retrospective Study.

This study aimed to evaluate the prevalence of lichen sclerosus (LS) in male patients undergoing circumcision for phimosis, emphasising the significance of a multidisciplinary approach in the early diagnosis and management of this condition. A retrospective analysis was performed on 841 male patients who underwent circumcision at a high-volume medical centre between 2001 and 2023. Data were collected on clinical diagnoses made by both dermatologists and urologists, along with the corresponding histological findings. Logistic regression models were utilised to assess diagnostic accuracy and the relationship between clinical suspicion and histological confirmation. Histological confirmation of LS was identified in 30.6% of the cases. Dermatologists demonstrated a diagnostic accuracy of 81.8%, whereas urologists showed an accuracy of 46.1%. The evaluations conducted by dermatologists exhibited a significant correlation with histological confirmation of LS (odds ratio 4.81; 95% confidence interval: 1.96-11.80; p = 0.001). This study elucidates the differences in diagnostic accuracy between dermatologists and urologists in identifying LS in patients undergoing circumcision for phimosis, highlighting the necessity of a multidisciplinary approach to improve the diagnostic process. Furthermore, the epidemiological data obtained from this research offer valuable insights into the prevalence of LS and the associated diagnostic challenges within a substantial patient cohort.

VEGFA, MYC, and JUN are abnormally elevated in the synovial tissue of patients with advanced osteoarthritis

Osteoarthritis (OA), affecting > 500 million people worldwide, profoundly affects the quality of life and ability to work. The mitogen-activated protein kinase (MAPK) signaling pathway plays an essential role in OA. To address the lack of studies focused on synovial cells in OA, we evaluated the expression patterns and roles of the MAPK signaling pathway components in OA synovial tissues using bioinformatics. The JUN, MYC, and VEGFA expression levels were significantly higher in the synovial tissues of patients with OA than in control tissues. These loci were closely related to abnormal proliferation, inflammation, and angiogenesis in the synovial tissues of patients with OA. We speculate that Myc and VEGFA activate the p38-MAPK signaling pathway to further activate Jun, thereby promoting abnormal inflammation, proliferation, and angiogenesis in OA synovial tissue. The high MYC, JUN, and VEGFA expression was positively correlated with the patients’ K-L score, pain time, and synovial score. Furthermore, the high p38-MAPK and P-p38-MAPK expression confirmed that the abnormal expression and activation of the MAPK signaling pathway occurred in the synovial tissue of patients with OA. Our findings may provide a new direction for the clinical diagnosis and treatment of OA and insights into its pathogenesis.

Development and evaluation of optimized PCR and indirect ELISA for the detection of Morganella morganii in dairy cows

IntroductionMorganella morganii (M. morganii) is a Gram-negative opportunistic pathogen, whose increasing virulence and antibiotic resistance negatively impact dairy cow health and productivity, raising concerns in livestock health management. To mitigate this risk, rapid and reliable diagnostic methods for detection are essential. Currently, detection methods for M. morganii are underdeveloped, prompting us to develop both pathogenic and serological detection methods, including an optimized PCR technique and an indirect enzyme-linked immunosorbent assay (I-ELISA).MethodsThe optimized PCR method utilized bacterial suspensions directly as templates, bypassing the need for DNA extraction and thereby allowing the direct detection of M. morganii in fecal samples. Primer concentrations and annealing temperatures were optimized to minimize primer dimer formation, ensuring high specificity. Clinical evaluation was conducted using 771 fecal and nasal fluid samples collected from dairy farms in five regions. The I-ELISA method was developed using M. morganii lipoprotein (LPP) antigen. Parameters such as antigen coating, blocking conditions, and antibody dilution were optimized to improve specificity. Stability and reproducibility were validated through intra- and inter-assay tests. A total of 476 serum samples from dairy cows were tested to assess the method’s clinical applicability.ResultsThe optimized PCR method demonstrated high sensitivity and specificity, achieving a detection threshold of 0.2 CFU/μL. Clinical testing revealed a positivity rate of 1.4% among 771 fecal and nasal fluid samples. The I-ELISA method showed excellent stability and reproducibility, confirmed through intra- and inter-assay consistency. In testing 476 dairy cow serum samples, the positivity rate for M. morganii was 5.9%. These results indicate the utility of I-ELISA as a reliable serological diagnostic tool.DiscussionThe PCR and I-ELISA methods collectively offer practical solutions for the early clinical diagnosis of M. morganii infections in dairy cows. The PCR technique’s efficiency and sensitivity make it ideal for pathogen detection in fecal samples, while the I-ELISA method provides a robust platform for serological analysis. Together, these tools enable timely intervention, contributing to improved livestock health management and mitigating the negative impacts of M. morganii on dairy cow productivity. Future research may focus on further refining these techniques and exploring their applications in broader livestock management contexts.

Clinical expression of radiographic axial spondyloarthritis and its association with HLA-B27 in European and Ibero-American populations

ObjectiveTo compare the clinical and sociodemographic characteristics of Ibero-American patients with radiographic axial spondyloarthritis (r-axSpA) to those of European patients, with a particular focus on the influence of HLA-B27.MethodsThis was an observational, cross-sectional, and multicentre study of patients who fulfilled the European Spondyloarthropathy Study Group (ESSG) criteria for SpA from the REGISPONSER and RESPONDIA registries. Univariate and multivariate analyses between European and Ibero-American populations stratified by HLA-B27 status were conducted. Race stratification (White, Black American, and Indian American) was also performed to evaluate clinical differences according to HLA-B27.ResultsA total of 2592 patients with a clinical diagnosis of r-axSpA were included in the analysis: 1083 (41.8%) Ibero-American patients and 1509 (58.2%) European patients. Among the HLA-B27-positive patients, Ibero-American status was independently associated with conventional synthetic disease-modifying antirheumatic drugs (csDMARD) intake (OR: 4.21), arthritis (OR: 2.36), enthesitis (OR: 6.01), dactylitis (OR: 6.10), severe structural damage (BASRI) (OR: 1.12) and poor functionality (BASFI) (OR: 1.40). Multivariate analysis of HLAB27-negative patients revealed that Ibero-American status was independently associated with enthesitis (OR: 11.67), csDMARDs (OR: 15.51) and total BASRI (OR: 1.34). Clinical manifestations also varied across racial groups, with differences noted in the prevalence of peripheral joint manifestations such as more arthritis and enthesitis in American Indian patients than in White and Black American patients.ConclusionIbero-American r-axSpA patients in our study exhibit more peripheral manifestations, more structural damage, and worse functionality than European patients, regardless of the presence of HLA-B27.

Diagnosis of hereditary ataxias: a real-world single center experience.

This study aims to evaluate our experience in the diagnosis of hereditary ataxias (HAs), to analyze data from a real-world scenario. This is a retrospective, cross-sectional, descriptive study conducted at a single Italian adult neurogenetic outpatient clinic, in 147 patients affected by ataxia with a suspicion of hereditary forms, recruited from November 1999 to February 2024. A stepwise approach for molecular diagnostics was applied: targeted gene panel (TP) next-generation sequencing (NGS) and/or clinical exome sequencing (CES) were performed in the case of inconclusive first-line genetic testing, such as short tandem repeat expansions (TREs) testing for most common spinocerebellar ataxias (SCA1-3, 6-8,12,17, DRPLA), other forms [Fragile X-associated tremor/ataxia syndrome (FXTAS), Friedreich ataxia (FRDA) and mitochondrial DNA-related ataxia, RFC1-related ataxia/CANVAS] or inconclusive phenotype-guided specific single gene sequencing. A definitive diagnosis was reached in 36.7% of the cases. TREs testing was diagnostic in 30.4% of patients. The three most common TREs ataxias were FRDA (36.1%), SCA2 (27.8%), and RFC1-related ataxia/CANVAS (11.1%). In five patients, the molecular diagnosis was achieved by single gene sequencing and causative mutations were identified in POLG (2), SACS (1), DARS2 (1), MT-ATP6 (1). Of 94 patients with a suspicion of HAs of indeterminate genetic origin, 68 underwent new molecular evaluation using the NGS approach. In 28 of these cases, CES was performed after the TP sequencing resulted negative. In 13 patients, the diagnosis was achieved by NGS approach. In 7 of these 13 patients, the diagnosis was made by CES. Genes mutations identified as causative of HAs were found in SPG7 (4), SACS (1), CACNA1A (1), CACNA1G (1), EEF2 (1), PRKCG (1), KCNC3 (1), ADCK3 (1), SYNE1 (1), ITPR1 (1). A positive family history of ataxia and early onset of symptoms were associated with a higher likelihood of obtaining a definite diagnosis. The molecular diagnosis of HAs remains a significant challenge for neurologists. Our data indicate that, in most cases, a diagnosis of HA can be established through first line genetic testing, particularly TREs testing. However, for patients with a clinical diagnosis of HA who do not achieve a molecular diagnosis through initial genetic tests, the use of NGS proves to be a valuable tool, providing a definitive diagnosis in approximately 20% of cases. Therefore, when feasible in clinical practice, integrating NGS testing, especially exome sequencing, into the diagnostic decision-making process for unsolved cases is crucial.

Next-Generation Potentiometric Sensors: A Review of Flexible and Wearable Technologies

In recent years, the field of wearable sensors has undergone significant evolution, emerging as a pivotal topic of research due to the capacity of such sensors to gather physiological data during various human activities. Transitioning from basic fitness trackers, these sensors are continuously being improved, with the ultimate objective to make compact, sophisticated, highly integrated, and adaptable multi-functional devices that seamlessly connect to clothing or the body, and continuously monitor bodily signals without impeding the wearer’s comfort or well-being. Potentiometric sensors, leveraging a range of different solid contact materials, have emerged as a preferred choice for wearable chemical or biological sensors. Nanomaterials play a pivotal role, offering unique properties, such as high conductivity and surface-to-volume ratios. This article provides a review of recent advancements in wearable potentiometric sensors utilizing various solid contacts, with a particular emphasis on nanomaterials. These sensors are employed for precise ion concentration determinations, notably sodium, potassium, calcium, magnesium, ammonium, and chloride, in human biological fluids. This review highlights two primary applications, that is, (1) the enhancement of athletic performance by continuous monitoring of ion levels in sweat to gauge the athlete’s health status, and (2) the facilitation of clinical diagnosis and preventive healthcare by monitoring the health status of patients, in particular to detect early signs of dehydration, fatigue, and muscle spasms.

A Dual-Cycle Isothermal Amplification Method for microRNA Detection: Combination of a Duplex-Specific Nuclease Enzyme-Driven DNA Walker with Improved Catalytic Hairpin Assembly

The association between microRNAs and various diseases, especially cancer, has been established in recent years, indicating that miRNAs can potentially serve as biomarkers for these diseases. Determining miRNA concentrations in biological samples is crucial for disease diagnosis. Nevertheless, the stem-loop reverse transcription quantitative PCR method, the gold standard for detecting miRNA, has great challenges in terms of high costs and enzyme limitations when applied to clinical biological samples. In this study, an isothermal signal amplification method based on a duplex-specific nuclease (DSN) enzyme-driven DNA walker and an improved catalytic hairpin assembly (CHA) was designed for miRNA detection. First, biotin–triethylene glycol-modified trigger-releasable DNA probes were conjugated to the streptavidin-coated magnetic beads for recognizing the target miRNA. The DSN enzyme specifically hydrolyzes DNA strands when the DNA probe hybridizes with the targeted miRNA. This recycling process converts the input miRNA into short trigger fragments (catalysts). Finally, three hairpins of improved CHA are driven by this catalyst, resulting in the three-armed CHA products and a fluorescence signal as the output. This dual-cycle biosensor shows a good linear relationship in the detection of miR-21 and miR-141 over the final concentration range of 250 fM to 50 nM, presenting an excellent limit of detection (2.95 amol). This system was used to detect miR-21 and miR-141 in MCF-7 and 22RV1 cells, as well as in 1% human serum. This system can be used to evaluate the expression levels of miRNAs in different biological matrices for the clinical diagnosis and prognosis of different cancers.

Smart Flow Micro‐Reaction Device Integrated with Oxygen Reduction Catalysts for Gaseous Electrochemiluminescence Sensing

AbstractThe sensitive detection of low‐concentration gases has significant implications for environmental monitoring, clinical diagnosis, and other fields of scientific inquiry. Electrochemiluminescence (ECL) is a widely accepted analytical technique known for its high sensitivity, precision, and minimal background interference. Nevertheless, it has rarely been documented in the context of gas‐oriented sensing. This study presents an innovative paradigm for gas sensing, which integrates oxygen reduction reactions (ORR) and a gas diffusion electrode (GDE) into a gas flow micro‐reaction device. The integration aims to optimize mass transfer, ensure adequate electrochemical contact, facilitate efficient electron transfer, and ultimately enhance ECL emission. The viability of this effective in situ gas sensing strategy under mild conditions without pre‐treatments is substantiated by experimental and model calculation evidence. This homemade micro‐reaction device enables the efficient quantification of formaldehyde with a limit of determination (LOD) as low as 12.7 ppb and paves the way for universal gaseous ECL sensing.

Effectively preventing pneumococcal diseases in the elderly and the young

Pneumococcal disease (PD) caused by Streptococcus pneumoniae (Sp) is a global public health concern. Children younger than 5 years and elderly over 60 years, due to immature development of the immune system early in life or the gradual decline of immune function with age, are high-risk groups for pneumococcal infections, which makes the disease burden particularly serious and the situation of prevention and control grim. Vaccination is the most effective measure to prevent PD and reduce pneumococcal antimicrobial resistance. Improving health consciousness and vaccination rates are particularly necessary and urgent for the prevention and control of PD. Based on the disease burden, this article discusses the problems and challenges of PD in China regarding surveillance, laboratory testing, antimicrobial resistance, and vaccination. Recommended strategies concerning the surveillance system, clinical diagnosis and treatment, vaccination, and health promotion were made to increase the vaccination rate of pneumococcal vaccine among the elderly and young and to improve the level of PD prevention and control.