Improved Bacterial and Viral Recoveries from 'Complex' Samples using Electrophoretically Assisted Acoustic Focusing

Automated front-end sample preparation technologies can significantly enhance the sensitivity and reliability of biodetection assays [1]. We are developing advanced sample preparation technologies for biowarfare detection and medical point-of-care diagnostics using microfluidic systems with continuous sample processing capabilities. Here we report an electrophoretically assisted acoustic focusing technique to rapidly extract and enrich viral and bacterial loads from 'complex samples', applied in this case to human nasopharyngeal samples as well as simplified surrogates. The acoustic forces capture and remove large particles (> 2 {micro}m) such as host cells, debris, dust, and pollen from the sample. We simultaneously apply an electric field transverse to the flow direction to transport small ({le} 2 {micro}m), negatively-charged analytes into a separate purified recovery fluid using a modified H-filter configuration [Micronics US Patent 5,716,852]. Hunter and O'Brien combined transverse electrophoresis and acoustic focusing to measure the surface charge on large particles, [2] but to our knowledge, our work is the first demonstration combining these two techniques in a continuous flow device. Marina et al. demonstrated superimposed dielectrophoresis (DEP) and acoustic focusing for enhanced separations [3], but these devices have limited throughput due to the rapid decay of DEP forces. Both acoustic standing waves and electric fields exert significant forces over the entire fluid volume in microchannels, thus allowing channels with larger dimensions (> 100 {micro}m) and high throughputs (10-100 {micro}L/min) necessary to process real-world volumes (1 mL). Previous work demonstrated acoustic focusing of microbeads [4] and biological species [5] in various geometries. We experimentally characterized our device by determining the biological size-cutoff where acoustic radiation pressure forces no longer transport biological particles. Figure 1 shows images of E.Coli ({approx}1 {micro}m) and yeast ({approx}4-5 {micro}m) flowing in a microchannel (200 {micro}m deep, 500 {micro}m wide) at a flow rate of 10 {micro}L/min. The E.Coli does not focus in the acoustic field while the yeast focuses at the channel centerline. This result suggests the acoustic size-cutoff for biological particles in our device lies between 2 and 3 {micro}m. Transverse electrophoresis has been explored extensively in electric field flow fractionation [6] and isoelectric focusing devices [7]. We demonstrated transverse electrophoretic transport of a wide variety of negatively-charged species, including fluorophores, beads, viruses, E.Coli, and yeast. Figure 2 shows the electromigration of a fluorescently labeled RNA virus (MS2) from the lower half of the channel to the upper half region with continuous flow. We demonstrated the effectiveness of our electrophoretically assisted acoustic focusing device by separating virus-like particles (40 nm fluorescent beads, selected to aid in visualization) from a high background concentration of yeast contaminants (see Figure 3). Our device allows for the efficient recovery of virus into a pre-selected purified buffer while background contaminants are acoustically captured and removed. We also tested the device using clinical nasopharyngeal samples, both washes and lavages, and demonstrated removal of unknown particulates (>2 ?m size) from the sample. Our future research direction includes spiking known amounts of bacteria and viruses into clinical samples and performing quantitative off-chip analysis (real-time PCR and flow cytometry)

Separation of Yeast Cells from MS2 Viruses Using Acoustic Radiation Force

We report a rapid and robust separation of Saccharomyces cerevisiae and MS2 bacteriophage using acoustic focusing in a microfluidic device. A piezoelectric transducer (PZT) generates acoustic standing waves in the microchannel. These standing waves induce acoustic radiation force fields that direct microparticles towards the nodes (i.e., pressure minima) or the anti-nodes (i.e., pressure maxima) of the standing waves depending on the relative compressidensity between the particle and the suspending liquid.[1] For particles larger than 2 {micro}m, the transverse velocities generated by these force fields enable continuous, high throughput separation. Extensive work in the last decade [2-4] has demonstrated acoustic focusing for manipulating microparticles or biological samples in microfluidic devices. This prior work has primarily focused on experimental realization of acoustic focusing without modeling or with limited one-dimensional modeling estimates. We recently developed a finite element modeling tool to predict the two-dimensional acoustic radiation force field perpendicular to the flow direction in microfluidic devices.[1] Here we compare results from this model with experimental parametric studies including variations of the PZT driving frequencies and voltages as well as various particle sizes and compressidensities. These experimental parametric studies also provide insight into the development of an adjustable 'virtual' pore-size filter as well as optimal operating conditions for various microparticle sizes. Figure 1 shows a typical experimental acoustic focusing result for microparticles (diameter = 2.0 {micro}m) in a 500 {micro}m wide by 200 {micro}m deep microchannel. In this case, the PZT driving frequency and voltage are, respectively, 1.459 MHz and 6.6 V. The microparticles tightly focus (full width half maximum (FWHM) {approx}30 {micro}m) less than 30 s after the initiation of the acoustic field. We simulated the same geometry and operating conditions for comparison. The surface plot in Figure 2 illustrates the two-dimensional pressure field orthogonal to the flow direction (x-direction) from the simulation. The superimposed vector plot shows the acoustic radiation force in this plane. The dark regions and the light regions respectively represent the nodes and anti-nodes of the acoustic pressure field. The corresponding force field predicts acoustic focusing at the center of the microchannel, which is confirmed by the experimental results shown in Figure 1. We demonstrated the separation of Saccharomyces cerevisiae (typical cell size of 4-6 {micro}m depending on the cell growth stage, measured using a Coulter counter) and MS2 bacteriophage (typical diameter {approx}30 nm [5]) using acoustic focusing (Figure 3). A mixture of S. cerevisiae and MS2 labeled with Ribogreen was prepared and injected into one inlet of the microchip (i.e., half of the microchannel was filled with the sample). We varied driving voltages from 1.96 to 4.76 V, while fixing the driving frequency at 1.459 MHz and flow rate at 20 {micro}l/min. The acoustic radiation force did not affect the MS2 viruses, and their concentration profile remained unchanged. Increased driving voltages enhanced the acoustic focusing of the yeast cells thereby achieving good separation. We are able to achieve yields of > 80% and sample purities of > 90% in this continuous-flow sample preparation device

The role of the social sciences and economics in understanding and informing tree biosecurity policy and planning: a global summary and synthesis

Increased global biosecurity threats to trees, woods and forests have been strongly linked to the upsurge in worldwide trade and the expansion of tourism. A whole range of social, economic and political actors are implicated and affected by the movement of pests and diseases along these international pathways. A number of factors affect the actions of stakeholders, and wider public, including their values and motivations, how risks are perceived and acted upon, their ability to act, as well as the existing regulatory and economic environment. Understanding these factors is key to any future attempts to improve biosecurity policy and practice, and we present available evidence on six key dimension: (1) the role of different stakeholders and the broader public within tree health; (2) levels of knowledge and awareness of tree pests and diseases amongst the variety of end-user ‘stakeholder’ groups, and influences on their attitudes and practices; (3) social acceptability of management approaches; (4) the impact of formal and informal governance arrangements; (5) risk communication; (6) economic analyses on the impact of tree pests. We conclude by identifying evidence gaps and emphasising the need for better integration within the social sciences and between the social and natural sciences to promote effective interdisciplinary and policy-relevant contributions to tree health

Trocar-guided total tension-free vaginal mesh repair of post-hysterectomy vaginal vault prolapse

Contains fulltext : 81076.pdf (publisher's version ) (Closed access)INTRODUCTION AND HYPOTHESIS: The objective of this study was to report 1 year anatomical and functional outcomes of trocar-guided total tension-free vaginal mesh (Prolift) repair for post-hysterectomy vaginal vault prolapse with one continuous piece of polypropylene mesh. METHODS: We conducted a prospective observational cohort study of 46 patients. A minimum sample size of 35 patients was needed to detect a recurrence rate of less than 20% at 12 months. Instruments of measurement used were pelvic organ prolapse quantification and validated questionnaires. RESULTS: Overall anatomical success was 91% (95% confidence interval 83-99), with significant improvement in experienced bother and quality of life. Mesh exposure occurred in seven patients (15%). No adverse effects on sexual function could be detected. CONCLUSIONS: Trocar-guided total tension-free vaginal mesh (Prolift) repair with one continuous piece of mesh for post-hysterectomy vaginal vault prolapse is well tolerated and anatomically and functionally highly effective. Results of controlled trials will determine its position in the operative armamentarium

Association between early sexual initiation and sexually transmitted infections among Peruvian reproductive-age women

BackgroundSexually transmitted infections (STIs) are a serious public health problem worldwide, especially among reproductive-age women. The early sexual onset of sexual intercourse (EOSI) has been suggested as a risk factor, although there is no data at the national level.ObjectiveTo evaluate the association between EOSI and STIs in Peruvian women of childbearing age.MethodsAnalytical cross-sectional study with secondary data analyzes of the Peruvian Demographic and Family Health Survey 2018. The outcome was the presence of STIs in the last 12 months and the exposure variable was EOSI (age < 15 years at the time of their first sexual experience). To evaluate the association of interest, crude and adjusted prevalence ratios (aPRs) were calculated using generalized linear models with Poisson family and logarithmic link function.ResultsWe analyzed data from 31,028 women of childbearing age. The 11.3% reported having STIs in the last 12 months and 20.2% of the participants had an EOSI. After adjusting for potential confounders, we found that EOSI was associated with STIs (aPR: 1.27; 95% CI: 1.08–1.50; p = 0.005). When conducting stratified analysis by area of residence and number of sexual partners, this association was maintained in women living in urban areas (aPR: 1.36; 95% CI: 1.11–1.66; p = 0.003) those who did not report having a history of multiple sexual partners (aPR: 1.27; 95% CI: 1.08–1.51; p = 0.005), and those in the middle (aPR: 1.42; 95% CI: 1.03–1.97; p = 0.034) and highest (aPR: 2.12; 95% CI: 1.33–3.39; p = 0.002) wealth quintiles.ConclusionAmong reproductive-age women from Peru, EOSI was associated with STIs, especially in women living in urban areas, with no history of multiple sexual partners, and belonging to the middle to higher wealth index. The implementation of measures to prevent EOSI and fostering appropriate sexual health counseling for women with EOSI is advised

Randomized Clinical Trial on Ivermectin versus Thiabendazole for the Treatment of Strongyloidiasis

Strongyloidiasis is the infection caused by the worm Strongyloides stercoralis. Due to its peculiar life cycle Strongyloides may remain indefinitely in the host, if not effectively cured. Although the disease is usually mild, in case of weakening of the host's immune defenses the worm may invade virtually all organs and tissues (disseminated strongyloidiasis, almost invariably fatal). The treatment must then reach the goal of the complete elimination of the parasite. Small size clinical trials showed similar, high efficacy of the two drugs ivermectin (used as a single dose) and thiabendazole (used twice daily for two consecutive days). All trials used as the criterion for cure the absence of larvae in stool exams. The latter however may easily miss the infection, falsely suggesting that the infection has been cured. This trial, using a test detecting specific Strongyloides antibodies as an additional and more sensitive diagnostic tool, confirms previous reports: the two drugs have similar efficacy but ivermectin is better tolerated and is therefore the first choice. However the cure rate was lower than 70% for the standard, single dose. The authors then conclude that a larger, multi center trial is needed to find the optimal dose schedule of ivermectin

Predictive factors for overactive bladder symptoms after pelvic organ prolapse surgery

Contains fulltext : 89696.pdf (publisher's version ) (Closed access)INTRODUCTION AND HYPOTHESIS: This study focussed on the factors which predict the presence of symptoms of overactive bladder (OAB) after surgery for pelvic organ prolapse (POP). METHODS: Consecutive women who underwent POP surgery with or without the use of vaginal mesh materials in the years 2004-2007 were included. Assessments were made preoperatively and at follow-up, including physical examination (POP-Q) and standardised questionnaires (IIQ, UDI and DDI). RESULTS: Five hundred and five patients were included with a median follow-up of 12.7 (6-35) months. Bothersome OAB symptoms decreased after POP surgery. De novo bothersome OAB symptoms appeared in 5-6% of the women. Frequency and urgency were more likely to improve as compared with urge incontinence and nocturia. The best predictor for the absence of postoperative symptoms was the absence of preoperative bothersome OAB symptoms. CONCLUSION: The absence of bothersome OAB symptoms preoperatively was the best predictor for the absence of postoperative symptoms.1 september 201