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Climatic changes and interannual variability in the Mediterranean overturning circulation are crucially linked to dense water formation in the Levantine Sea, namely the Levantine Intermediate Water whose formation zone, comprising multiple and intermittent sources, extends over fluctuating pathways. To probe into the variability of this water formation and spreading, a unique dataset was collected during the winter of 2019 in the western Levantine Sea, via oceanographic cruises, profiling floats and a glider, at a spatio-temporal distribution suited to resolve mesoscale circulation features and intermittent convection events. This study highlights the competition between two source regions, the Cretan Sea and the Rhodes Cyclonic Gyre, to supply the Mediterranean overturning circulation in Levantine Intermediate Water. The Cretan source was estimated as the most abundant, supported by increasingly saltier water masses coming from the Levantine Sea under the pumping effect of a water deficit caused by strong western outflow toward the Ionian Sea. [ABSTRACT FROM AUTHOR]

Electrochemically reduced graphene oxide/zinc oxide (ERGO/ZnO) nanocomposite was simultaneously co-electrodeposited based on a one-step electrodeposition approach at room temperature on an indium tin oxide (ITO) electrode from an aqueous solution without using specific reducing agents. The electrochemical fabricated ITO-ERGO/ZnO electrode was characterized using field emission scanning electron microscopy (FESEM), X-ray diffraction spectroscopy (XRD), X-ray photoelectron spectroscopy (XPS), Raman spectroscopy, and electrochemical impedance spectroscopy (EIS) techniques. The biosensor properties of the ITO-ERGO/ZnO electrodes were investigated in terms of their response toward uric acid (UA) sensing via enzyme-free amperometry. The linear current response for UA on the ITO-ERGO/ZnO electrode in the concentration range of $1- 400\,\,\mu \text{M}$ with a sensitivity of $150.7 ~\mu \text{A}$ cm−2 mM−1 was obtained. The main advantage of the ITO-ERGO/ZnO electrode was a relatively low detection limit for estimating UA, high selectivity, good repeatability, and long-term stability. In addition, the fabrication procedure of the designed biosensor was straightforward, practicable, and inexpensive. [ABSTRACT FROM AUTHOR]

Hemophilia A is an x-linked recessive disorder characterized by an absent or reduced factor VIII (FVIII). It is a genetic deficiency that causes increased bleeding. It can be challenging for anesthesiologists to discover it in the perioperative management. This case report represents the successful management of a 25-year-old male patient having severe hemophilia A. We managed a 25-year-old man, 89 kg, 180 cm, with a recurring history of perianal abscesses. Previously at 13 years old, he experienced prolonged and excessive bleeding after a minor cut and injury. Following clinical and laboratory investigation, he was diagnosed with severe hemophilia A. Ever since, he used to take antihemophilic factor (AHF) VIII transfusion therapy and revealed severe disease with a positive inhibitor. No other coexisting disease was revealed during history-taking. We managed this case with general anesthesia because of the fact that he was hemophilic. We administered 2000 International Unit (IU) of recombinant Factor VIII (rFVIII) preoperatively as per the hematologist’s recommendation. We continued with 2000 IU of AHF FVIII transfusion after the surgery, but unfortunately, he redeveloped the abscess again. Another careful anesthesia and surgery were then conducted with a satisfactory result. The multidisciplinary team approach was provided to a positive outcome in these patients. Perioperative transfusion of AHF FVIII is essential for patients with hemophilia.

We define statistical logarithmic summability of strongly measurable fuzzy valued functions and we give slowly decreasing type Tauberian conditions under which statistical limit at infinity and statistical logarithmic summability of strongly measurable fuzzy valued functions imply ordinary limit at infinity in one dimensional fuzzy number space $E^1$. Besides, we give slowly oscillating type Tauberian conditions for statistical limit and statistical logarithmic summability of strongly measurable fuzzy valued functions in $n-$dimensional fuzzy number space $E^n$.

Aims This study aims to identify a high level exopolysaccharide ( EPS) producer thermophile that in turn could be used as a model organism to study the biological mechanisms and whole genome organization of EPS-producing thermophilic bacteria. Methods and Results Thermophilic isolates were screened, and then growth and EPS production of the best producer Brevibacillus thermoruber strain 423 were investigated under different carbon and nitrogen sources, temperature, pH and agitation rates. Rheological characterization revealed that the EPS behaved like a typical Newtonian fluid and viscosity of the EPS solution increased with increasing Ca2+ ion concentration. Chemical characterization by TLC, GC- MS, FT- IR and NMR suggested a heteropolymer structure with glucose as major monomer unit. High biocompatibility of pure EPS fractions suggested their potential use in biomedical applications. Conclusions This study reports on the comprehensive description of microbial production conditions as well as chemical, rheological and biological characterization of the EPS produced by B. thermoruber strain 423. The bioreactor cultures were found to reach two times higher yields and three times higher productivities when compared with literature. Significance and Impact of the Study Brevibacillus thermoruber strain 423 combined the advantages of its nonpathogenicity with the advantages of fast productivity and hence proved to be a very promising model organism and cell factory for microbial EPS production. [ABSTRACT FROM AUTHOR]

A combined dataset of near real time multi-satellite observations and in situ measurements from a high-resolution survey, is used for characterizing physical- biogeochemical properties of a patch stretching from the coast to the open sea in the Levantine basin of the Eastern Mediterranean. Spatial analysis of the combined dataset indicates that the patch is a semi-enclosed system, bounded within the mixed layer and separated from ambient waters by transport barriers induced by horizontal stirring. As such, the patch is characterized by physical-biogeochemical properties that significantly differ from those of the waters surrounding it, with lower salinity, higher temperatures, higher concentrations of silicic acid and chlorophyll a, and higher abundance of Synechococcus and Picoeukaryotes cells. Based on estimates of patch dimensions (~40 km width and ~25m depth) and propagation speed (~ 0.09ms-1), the volume flux associated with the patch is found to be in the order of 0.1 Sv. Our observations suggest that horizontal stirring by surface currents is likely to have an important impact on the ultra-oligotrophic Levantine basin ecosystem, through (1) transport of nutrients and coastal derived material, and (2) formation of local, dynamically isolated, niches. In addition, this work provides a satellite-based framework for planning and executing high resolution sampling strategies in the interface between coast and the open sea. [ABSTRACT FROM AUTHOR]

Thermal and electrical conductivity of unsaturated polyester resin with copper filler composite material are investigated both theoretically and experimentally. In the experiments, polyester matrix is combined with dendrite-shape copper to determine the effects of both filler size and content on thermal and electrical conductivity, respectively. It is observed that the increase in the concentration causes the thermal and electrical conductivity of composite mixture to grow up. It has also been observed that the both thermal and electrical conductivity increase with increasing filler particle size.

We introduce the slowly decreasing condition for sequences of fuzzy numbers. We prove that this is a Tauberian condition for the statistical convergence and the Cesáro convergence of a sequence of fuzzy numbers.

Introduction. Infectious diseases may present with atypical presentations in the geriatric patients. While fever is an important finding of infections, it may also be a sign of noninfectious etiology. Methods. Geriatric patients who were hospitalized for acute fever in our infectious diseases unit were included. Acute fever was defined as presentation within the first week of fever above 37.3∘C. Results. 185 patients were included (82 males and 103 females). Mean age was 69.7±7.5 years. The cause of fever was an infectious disease in 135 and noninfectious disease in 32 and unknown in 18 of the patients. The most common infectious etiologies were respiratory tract infections (𝑛=46), urinary tract infections (𝑛=26), and skin and soft tissue infections (𝑛=23). Noninfectious causes of fever were rheumatic diseases (𝑛=8), solid tumors (𝑛=7), hematological diseases (𝑛=10), and vasculitis (𝑛=7). A noninfectious cause of fever was present in one patient with no underlying diseases and in 31 of 130 patients with underlying diseases. Conclusion. Geriatric patients with no underlying diseases generally had infectious causes of fever while noninfectious causes were responsible from fever in an important proportion of patients with underlying diseases.

Background: The emergence of COVID-19 has amplified the importance of efficient patient transfer, leading to the idea of inter-hospital ECMO transport programs. However, there are limited studies on ECMO transfer protocols and experiences during COVID pandemic. This study aimed to evaluate the effectiveness our transport program and provide insights into establishing and maintaining ECMO programs., Methods: Over the period from April 2020 to December 2021, 76 patients with severe hypoxic COVID-19 ARDS were transferred to our center under a veno-venous ECMO support. The transfers were performed by the experienced transport ECMO-team, covering both intracity and intercity transports from various hospitals in Istanbul and the Marmara Region., Results: Mean age was 44 (34-54) years. Time until ECMO initiation was 6 (3-11.2) days. The average transport distance was 36.6 ± 58.7 km. Average intracity and intercity transport distance were 17.5 ± 15.7 and 121 ± 96.6 km, respectively. ECMO wean rate was 40.7% and survival to discharge (home) was 38.1%. No major adverse events occurred during the transfer process. In one transport, the oxygen tank was instantly replenished on the road due to the decrease in the oxygen level in the tank., Conclusion: In conclusion, this study contributed to the knowledge surrounding ECMO transport programs during pandemics, emphasized the importance of expert coordination and careful patient management with demonstrating feasibility of mobile ECMO program ., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The similar transmission patterns and early symptoms of respiratory viral infections, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza (H1N1), and respiratory syncytial virus (RSV), pose substantial challenges in the diagnosis, therapeutic management, and handling of these infectious diseases. Multiplexed point-of-care testing for detection is urgently needed for prompt and efficient disease management. Here, we introduce an electrochemical paper-based analytical device (ePAD) platform for multiplexed and label-free detection of SARS-CoV-2, H1N1, and RSV infection using immobilized pyrrolidinyl peptide nucleic acid probes. Hybridization between the probes and viral nucleic acid targets causes changes in the electrochemical response. The resulting sensor offers high sensitivity and low detection limits of 0.12, 0.35, and 0.36 pM for SARS-CoV-2 (N gene), H1N1, and RSV, respectively, without showing any cross-reactivities. The amplification-free detection of extracted RNA from 42 nasopharyngeal swab samples was successfully demonstrated and validated against reverse-transcription polymerase chain reaction (range of cycle threshold values: 17.43-25.89). The proposed platform showed excellent clinical sensitivity (100 %) and specificity (≥97 %) to achieve excellent agreement (κ ≥ 0.914) with the standard assay, thereby demonstrating its applicability for the screening and diagnosis of these respiratory diseases., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

A novel approach for simultaneous detection of iron and potassium via a smartphone-based potentiometric method is proposed in this study. The screen printed electrodes were modified with carbon black nanomaterial and ion selective membrane including zinc (II) phtalocyanine as the ionophore. The developed Fe 3+ -selective electrode and K + -selective electrode exhibited detection limits of 1.0 × 10 -6  M and 1.0 × 10 -5  M for Fe 3+ and K + ions, respectively. The electrodes were used to simultaneously detect Fe 3+ and K + ions in apple juice, skim milk, soybean and coconut water samples with recovery values between 90%-100.5%, and validated against inductively coupled plasma-optical emission spectrometry. Due to the advantageous characteristics of the sensors and the portability of Near Field Communication potentiometer supported with a smartphone application, the proposed method offers sensitive and selective detection of iron and potassium ions in food and beverage samples at the point of need., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Tugba Ozer reports financial support was provided by TUBITAK under project number 122Z721. Tugba Ozer reports a relationship with TUBITAK that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Ltd.)

Objective: This study aims to evaluate outcomes in nutcracker syndrome patients with tolerable symptoms and treated conservatively without invasive interventions., Methods: This prospective study included patients treated conservatively. Promoting weight gain, the endpoint of the study was spontaneous resolution of symptoms., Results: Sixteen patients (75% female and mean age 24.4 ± 3.5 years) underwent conservative management. Over a mean follow-up of 27.3 months [13-42, interquartile range (IQR)], the diameter ratio (5.5 [5-6.5, IQR] vs 4.3 [4.1-6], p = NS), the peak velocity ratio (6 [5-7, IQR] vs 4.8 [4.8-5.8], p = NS), beak angle (27° [24-30, IQR] vs 29° [24-32]; p = NS), and aortomesenteric angle (26° [23-29, IQR] vs 28° [24-30]; p = NS) exhibited no statistically significant changes. Complete resolution and improvement of symptoms were 28.5% and 31.4%, respectively, while 68.5% remained unchanged., Conclusions: This study shows that a conservative approach contributes to the spontaneous improvement or complete resolution in young adult patients with mild symptoms., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

The COVID-19 pandemic underlines the need for effective strategies for controlling virus spread and ensuring sensitive detection of SARS-CoV-2. This review presents the potential of nanomaterial-enabled optical biosensors for rapid and low-cost detection of SARS-CoV-2 biomarkers, demonstrating a comprehensive analysis including colorimetric, fluorescence, surface-enhanced Raman scattering, and surface plasmon resonance detection methods. Nanomaterials including metal-based nanomaterials, metal-organic frame-based nanoparticles, nanorods, nanoporous materials, nanoshell materials, and magnetic nanoparticles employed in the production of optical biosensors are presented in detail. This review also discusses the detection principles, fabrication methods, nanomaterial synthesis, and their applications for the detection of SARS-CoV-2 in four categories: antibody-based, antigen-based, nucleic acid-based, and aptamer-based biosensors. This critical review includes reports published in the literature between the years 2021 and 2024. In addition, the review offers critical insights into optical nanobiosensors for the diagnosis of COVID-19. The integration of artificial intelligence and machine learning technologies with optical nanomaterial-enabled biosensors is proposed to improve the efficiency of optical diagnostic systems for future pandemic scenarios., (© 2024. The Author(s).)

Background: Nutcracker syndrome is a rare condition that occurs as a result of the entrapment of the left renal vein (LRV) between the aorta and the superior mesenteric artery. It is typically associated with symptoms such as left flank pain, hematuria, proteinuria, and pelvic congestion. The current treatment approach may be conservative in the presence of tolerable symptoms, and surgical or hybrid and stenting procedures in the order of priority in the presence of intolerable symptoms. The aim of this study is to review our experiences to evaluate the results of both methods in this series in which we have a greater tendency toward surgery instead of stenting., Methods: The clinical data of consecutive patients with nutcracker syndrome who underwent LRV transposition and LRV stenting between July 2019 and October 2023 were retrospectively reviewed. The patients were divided into 2 groups based on the methods of treatment: surgical and stenting. For procedure selection, LRV transposition was primarily recommended, with stenting offered to those who declined. Primary end points were morbidity and mortality. Secondary end points included late complications, patency, freedom from reintervention, and resolution of symptoms. Standard basic statistics and survival analysis methods were employed., Results: Nineteen patients with nutcracker syndrome (female: 100%) were treated with LRV stentings (n = 5) and LRV transposition (n = 14). The mean age was 24 (20-27, interquartile range [IQR]) years. The mean follow-up was 23 (9-32, IQR) months. There were no major complications and mortality after both procedures. The most frequent sign and symptom associated with LRV entrapment were left flank pain 100% (n = 19), proteinuria 88% (n = 15), and hematuria 47% (n = 9). The mean peak velocity ratio on Doppler ultrasound was 6.13 (6-6.44, IQR). Aortomesenteric angle, beak angle (beak sign), and mean diameter ratio on computed tomography were 26° (22.6-28.5, IQR), 25° (23.9-28, IQR), and 5.3 (5-6, IQR), respectively. Venous pressure measurements were only used to confirm the diagnosis in 5 patients in the stenting group. The measured renocaval gradient was 4 (3.9-4.4, IQR) mm Hg. After both procedures, the classical symptoms, including left flank pain, proteinuria, and hematuria, resolved in 89.5% (n = 17), 57.8% (n = 11), and 82.3% (n = 15) of the cases, respectively. A total of 4 patients required reintervention, 3 patients after LRV transposition (occlusion, n = 2; stenosis, n = 1), and 1 patient after stenting (occlusion, n = 1). The 1-year and 3-year primary patency for the 19 patients was 87% and 80%, respectively. Three-year primary-assisted patency was 100%. Similarly, the 1-year and 3-year freedom from reintervention rate was 83% and 72%, respectively. Additionally, the 1-year and 3-year primary patency for the surgical group was 91% and 81%, respectively, and the 1-year and 3-year primary patency for the stenting group was 75%., Conclusions: Nutcracker syndrome should be kept in mind in cases where flank pain and hematuria cannot be associated with kidney diseases. Radiographic evidence must be accompanied by serious symptoms to initiate the treatment of nutcracker syndrome with LRV transposition and endovascular stenting procedures. Both procedures, along with their respective advantages and disadvantages, can be preferred as primary treatments for nutcracker syndrome. Our study demonstrates that both procedures can be safely and effectively performed, yielding good outcomes., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: In this study, we shared our experience with the minimal invasive extracorporeal circulation system for coronary artery bypass grafting patients., Methods: A total of 163 patients were included in the retrospective study, with 83 patients (63 males, 20 females; mean age: 61.9±8.9 years; range, 35 to 81 years) undergoing coronary artery bypass grafting with minimal invasive extracorporeal circulation and 80 patients (65 males, 15 females; mean age: 60.5±8.8 years; range, 43 to 82 years) undergoing coronary artery bypass grafting with conventional cardiopulmonary bypass between July 2021 and April 2023. Elective coronary bypass performed by same surgical team were included in the study. Mortality, major adverse cardiac and cerebrovascular event, hospital stays and transfusion requirements were evaluated., Results: There were no significant differences in sex distribution, age, comorbidities, and blood values between the two groups. Intraoperatively, the minimal invasive extracorporeal circulation group had a slightly higher number of distal anastomoses and comparable times for aortic cross-clamp and cardiopulmonary bypass. Postoperative outcomes such as tamponade, bleeding, atrial fibrillation, left ventricular ejection fraction improvement or reduction, and postoperative drainage were similar between the two groups. However, the minimal invasive extracorporeal circulation group had fewer transfusions of packed red blood cells and fresh frozen plasma and a shorter length of stay in the intensive care unit., Conclusion: The minimal invasive extracorporeal circulation system effectively preserves blood, works with lower activated clotting time values without additional complications in coronary artery bypass grafting, and could present a better option for patients with anemia or patients with a relatively high risk for high-dose heparinization., Competing Interests: Conflict of Interest: The authors declared no conflicts of interest with respect to the authorship and/or publication of this article., (Copyright © 2024, Turkish Society of Cardiovascular Surgery.)

Low-power and smart sensing systems for iron detection are necessary for in situ monitoring of water quality. Here, a potentiometric Fe 2+ -selective electrode (ISE) was fabricated based on cyanomethyl N -methyl- N -phenyl dithiocarbamate for the first time as an ionophore. Under optimal conditions, the ISE showed a Nernstian slope of 29.76 ± 0.6 mV per decade for Fe 2+ ions over a wide concentration range from 1.0 × 10 -1 to 1.0 × 10 -5 M with a lower detection limit (LOD) of 1.0 × 10 -6 M. The ISE interference of various cations on the potentiometric response was also investigated. The ISE had a response time less than 3 s and the lifetime was two months. Also, an automated, long-range (LoRa), wireless enabled sampling microfluidic device powered with a solar panel as an autonomous power source was developed for a continuous sampling and sensing process. The sensing platform was employed in the determination of Fe 2+ in acid mine drainage and spiked water samples with an average recovery of 100.7%. This simple, inexpensive (below $350), portable sensing platform will allow for rapid real-time monitoring of ground-, drinking-, and industrial waters contaminated with iron.

Background: Thoracofemoral bypass has been applied mostly secondary to previous procedures in the treatment of aortoiliac occlusive disease. However, its application as an initial treatment is less common, and long-term outcomes remain uncertain. The aim of this analysis was to review the 16-year experience and long-term outcomes of 31 consecutive patients who underwent thoracofemoral bypass as the primary procedure., Methods: All patients who underwent thoracofemoral bypass for severe aortoiliac occlusive disease between 2005 and 2021 were retrospectively analyzed. The occlusion and calcified plaques of the abdominal aorta at the renal level were common characteristics of all patients. The patients were divided into 2 groups: severe claudication group (Rutherford III group) and chronic limb-threatening ischemia group (Rutherford IV-V). Chi-square test or Fisher's exact test was used to compare categorical variables between the groups, and t-test or Mann-Whitney U-tests were used to compare continuous variables according to their distributions. The Kaplan-Meier curve was used to depict the time-to-event data., Results: Thirty-one patients [age: 62 (56-67.5); male: 87%] underwent thoracofemoral bypass. Among the 31 patients, 21 (67.7%) belonged to the severe claudication group (Rutherford III), while 10 (32.3%) were in the chronic limb-threatening ischemia (Rutherford IV-V). Twenty-two patients (83.8%) remained asymptomatic after thoracofemoral bypass. The mean follow-up duration was 79 ± 32 months. The 30-day mortality rate was 3.2% (n = 1). Major complications were observed in 9.6% of patients (n = 3; respiratory: 6.4%, retroperitoneal hematoma: 3.2%). No significant difference was found between the claudication and chronic limb-threatening ischemia groups regarding major complications (3.2% vs. 6.4%, P = NS). Minor complications occurred in 41.9% of patients, including pleural effusion 9.6% (n = 3), acute kidney injury 9.6% (n = 3), gastrointestinal bleeding 3.2% (n = 1), paralytic ileus 6.4% (n = 2), and superficial skin infection 12.9% (n = 4). The rate of postoperative superficial skin infection was higher in the chronic limb-threatening ischemia group compared to the claudication group (4 [40%] vs. 0 [0%], P: 0.007). The univariable Cox regression analysis revealed that hypertension and diabetes mellitus were not related to primary patency of the thoracofemoral bypass graft. The 5-year Kaplan-Meier estimated primary patency for the entire study was 96% ± 7% (95% confidence interval [CI]: 88.6-100), and the secondary patency was 96.3% ± 6% (95% CI: 89.4-100). The 5-year Kaplan-Meier estimated survival rate after thoracofemoral bypass was 93.4% ± 3 (95% CI: 91-100)., Conclusions: We demonstrated in this study that thoracofemoral bypass can yield good outcomes when preferred as the initial treatment in selected patients with juxtarenal total aortic occlusion. Despite being a complex surgical technique, thoracofemoral bypass has shown to have safe, acceptable mortality and morbidity rates, as well as excellent long-term follow-up results in selected patients., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background:  Surgical incisional approach to the ascending aorta is the main strategic step during valvular and/or subvalvular aortic interventions. Classic aortotomy incisions (transverse or oblique) can be challenging and can cause suboptimal exposure of the aortic root especially for the patients with small aortic annulus or for redo coronary artery bypass patients with patent proximal grafts interposed to the ascending aorta., Methods:  The Kırali incision was used in 91 patients (including 13 reoperations) who underwent an aortic intervention for valvular and subvalvular pathologies. Aortic root was exposed by forming inverted "U" shape incision starting from approximately 3 cm above the right coronary ostium toward the center of the noncoronary annulus and the top of the left-right commissure like a tongue., Results:  The aortic valve was replaced with a mechanical prosthesis in 45 patients and with a bioprosthesis in 39 patients including 14 sutureless and 16 stentless prostheses. A total of 29 patients received a concomitant procedure per the following: coronary artery bypass grafting on 8 patients and left ventricular assist device on 7 patients. There was no any problem related to aortotomy incision technique such as bleeding, rupture, dehiscence, or laceration perioperatively. There was no complication related to the procedure during 5-year follow-up., Conclusion:  This new aortotomy incision technique is a safe procedure that provides good exposure for all kinds of aortic valve interventions and protects grafts and can facilitate aortic root enlargement or aortoplasty easily. This incision has the potential to be an alternative to traditional techniques., Competing Interests: None declared., (Thieme. All rights reserved.)

An individual's therapeutic drug exposure level is directly linked to corresponding clinical effects. Rapid, sensitive, inexpensive, portable and reliable devices are needed for diagnosis related to drug exposure, treatment, and prognosis of diseases. Electrochemical sensors are useful for drug monitoring due to their high sensitivity and fast response time. Also, they can be combined with portable signal read-out devices for point-of-care applications. In recent years, nanomaterials such as carbon-based, carbon-metal nanocomposites, noble nanomaterials have been widely used to modify electrode surfaces due to their outstanding features including catalytic abilities, conductivity, chemical stability, biocompatibility for development of electrochemical sensors. This review paper presents the most recent advances about nanomaterials-based electrochemical sensors including the use of green assessment approach for detection of drugs including anticancer, antiviral, anti-inflammatory, and antibiotics covering the period from 2019 to 2023. The sensor characteristics such as analyte interactions, fabrication, sensitivity, and selectivity are also discussed. In addition, the current challenges and potential future directions of the field are highlighted., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

A significant bottleneck exists for mass-production of ion-selective electrodes despite recent developments in manufacturing technologies. Here, we present a fully-automated system for large-scale production of ISEs. Three materials, including polyvinyl chloride, polyethylene terephthalate and polyimide, were used as substrates for fabricating ion-selective electrodes (ISEs) using stencil printing, screen-printing and laser engraving, respectively. We compared sensitivities of the ISEs to determine the best material for the fabrication process of the ISEs. The electrode surfaces were modified with various carbon nanomaterials including multi-walled carbon nanotubes, graphene, carbon black, and their mixed suspensions as the intermediate layer to enhance sensitivities of the electrodes. An automated 3D-printed robot was used for the drop-cast procedure during ISE fabrication to eliminate manual steps. The sensor array was optimized, and the detection limits were 10 -5  M, 10 -5  M and 10 -4  M for detection of K + , Na + and Ca 2+ ions, respectively. The sensor array integrated with a portable wireless potentiometer was used to detect K + , Na + and Ca 2+ in real urine and simulated sweat samples and results obtained were in agreement with ICP-OES with good recoveries. The developed sensing platform offers low-cost detection of electrolytes for point-of-care applications., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

The COVID-19 pandemic has significantly increased the development of the development of point-of-care (POC) diagnostic tools because they can serve as useful tools for detecting and controlling spread of the disease. Most current methods require sophisticated laboratory instruments and specialists to provide reliable, cost-effective, specific, and sensitive POC testing for COVID-19 diagnosis. Here, a smartphone-assisted Sensit Smart potentiostat (PalmSens) was integrated with a paper-based electrochemical sensor to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A disposable paper-based device was fabricated, and the working electrode directly modified with a pyrrolidinyl peptide nucleic acid (acpcPNA) as the biological recognition element to capture the target complementary DNA (cDNA). In the presence of the target cDNA, hybridization with acpcPNA probe blocks the redox conversion of a redox reporter, leading to a decrease in electrochemical response correlating to SARS-CoV-2 concentration. Under optimal conditions, a linear range from 0.1 to 200 nM and a detection limit of 1.0 pM were obtained. The PNA-based electrochemical paper-based analytical device (PNA-based ePAD) offers high specificity toward SARS-CoV-2 N gene because of the highly selective PNA-DNA binding. The developed sensor was used for amplification-free SARS-CoV-2 detection in 10 nasopharyngeal swab samples (7 SARS-CoV-2 positive and 3 SARS-CoV-2 negative), giving a 100% agreement result with RT-PCR., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

While food safety issues are attracting public concern due to their detrimental effects on human health, monitoring livestock health is urgently needed to diagnose animal diseases at an early stage by applying proper treatments, controlling, and preventing outbreaks, particularly in resource- limited countries. In addition, unhealthy farms are not only a threat to livestock but also to human lives. The available diagnostic techniques for the detection of key health threats within both the food and livestock sectors require labor-intensive and time-consuming experimental procedures and sophisticated and expensive instruments. To tackle this issue, optical biosensing strategies have been incorporated into point-of-care (POC) systems, offering real-time monitoring, field-deployable, and low-cost devices, which help make on-the-spot decisions. This review aims to discuss the recent cutting-edge research on POC optical biosensing platforms for on-farm diagnosis of animal diseases and on-site detection of animal-derived food-borne contaminants, including pathogens, antibiotics, and mycotoxins. Moreover, this review briefly presents the basic knowledge of various types of optical biosensors and their development using various recent strategies, including nanomaterial combinations, to enhance their performance in POC tests. This review is expected to help scientists to understand the evolution and challenges in the development of point-of-care biosensors for the food and livestock industry, benefiting global healthcare., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Here, we developed a microfluidic paper device by combining ion-selective electrodes (ISE) and a distance-based paper device (dPAD) for simultaneous potentiometric and colorimetric detection of urine electrolytes including K + , Na + and Cl - . The working and reference electrode zones were coated with polystyrene as a non-ionic polymer to improve hydrophobic properties on the paper surface for fabrication of K + -ISE and Na + -ISE. The layer of polymer coating was optimized to enhance the sensitivity of the ISEs. Under optimized conditions, the electrode surfaces were modified with carbon black to improve the electrochemical characteristics of the ISEs. The ISEs showed good performance with sensitivities of 54.14 ± 3.94 mV per decade and 55.08 ± 1.15 mV per decade for K + and Na + within the linear concentration range 0.100 mM-100 mM K + and 5 mM-1 M Na + , respectively. The limits of detection (LOD) were 0.05 mM and 1.36 mM for K + and Na + , respectively. The linear working range of Cl - was 0.50 to 50 mM and the LOD and limit of quantification (LOQ) were found to be 0.16 ± 0.05 mM (3SD) and 0.53 ± 0.05 mM (10SD), respectively. The dual-mode ISE-dPAD was validated in human urine and recoveries were obtained as 90-108%, 94-105%, and 90-96% for K + , Na + , and Cl - , respectively, showing successful application of the developed device in a complex matrix. The ISE-dPAD has advantages including low-cost ($ 0.33 per test), eco-friendly, portability, simple operation, the need of low sample volume (100 μL), and simultaneous analysis on a single device.

At home electrolyte analysis is of growing interest due to the importance for early diagnosis for various diseases. This work presents the first device that integrates a potentiometric ion-selective electrode (ISE) with distance-based colorimetric detection for the simultaneous analysis of K + and Cl - ions at the point of care (POC). This hybrid sensing device was designed in a two-dimensional configuration using a plastic transparency sheet containing a stencil printed K + -ISE and a paper substrate for distance-based colorimetric detection of Cl - . K + quantification was performed using a low-cost (<$25) lab-made Wi-Fi supported potentiometer with a custom smartphone application while Cl - ions were quantified with an instrument-free distance-based paper analytical device (dPAD). The total analysis time is 5 min once the sample is added. The K + -ISE showed a sensitivity of 55.89 ± 2.52 mV/decade from 0.1 to 100 mM with a limit of detection (LOD) of 0.01 mM. The linear working range for Cl - detection was 0.5-50 mM whereas the LOD was 0.16 ± 0.05 mM. The proof-of-concept application of the sensing hybrid device was demonstrated in human urine and artificial sweat samples containing K + and Cl - ions at physiologically relevant ranges. The recoveries were found to be 88-108% for K + and 90-104% for Cl - , showing the potential use of the proposed device for low-cost routine analysis of biological samples at POC., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Here, a smartphone-based portable sensing system is developed for real-time detection of Ca 2+ ions in a variety of biofluids. A solid-contact calcium-selective electrode (Ca 2+ -ISE) consisting of an ion-selective membrane (ISM), carbon black nanomaterial and polystyrene-graphite nanoplatelets as a solid contact was fabricated. The polyvinylchloride (PVC)-based ISM was optimized using different plasticizers and ion-exchangers. Under optimized conditions, the solid contacts were electrochemically characterized by electrochemical impedance spectroscopy (EIS), chronopotentiometric and potentiometric measurements. The Ca 2+ -ISE showed a Nernst response with a slope of 31.2 ± 0.6 mV/decade in the concentration range from 0.1 M to 10 -4  M Ca 2+ with a limit of detection (LOD) of 1.0 × 10 -5  M. In addition, the ISEs exhibited good selectivity to Ca 2+ ions over various interfering electrolytes and metabolites. The Ca 2+ -ISEs were applied in human urine and, artificial serum and cerebrospinal fluid samples. The ISEs showed good recoveries between 90 and 105%, indicating potential applicability of these electrodes in biological fluids. The portable lab-made potentiometer provides wireless data signaling and transmission to a smartphone and final Ca 2+ concentration display due to its customized software. Therefore, the developed smartphone-based sensing platform offers low cost (< $25), rapid, user-friendly detection of Ca 2+ especially in resource-limited areas., (© 2022. The Author(s), under exclusive licence to The Japan Society for Analytical Chemistry.)

We report automated fabrication of solid-contact sodium-selective (Na + -ISEs) and potassium-selective electrodes (K + -ISEs) using a 3D printed liquid handling robot controlled with Internet of Things (IoT) technology. The printing system is affordable and can be customized for the use with micropipettes for applications such as drop-casting, biological assays, sample preparation, rinsing, cell culture, and online analyte monitoring using multi-well plates. The robot is more compact (25 × 30 × 35 cm) and user-friendly than commercially available systems and does not require mechatronic experience. For fabrication of ion-selective electrodes, a carbon black intermediate layer and ion-selective membrane were successively drop-cast on the surface of stencil-printed carbon electrode using the dispensing robot. The 3D-printed robot increased ISE robustness while decreasing the modification time by eliminating manual steps. The Na + -ISEs and K + -ISEs were characterized for their potentiometric responses using a custom-made, low-cost (<$25) multi-channel smartphone-based potentiometer capable of signal processing and wireless data transmission. The electrodes showed Nernstian responses of 58.2 ± 2.6 mV decade -1 and 56.1 ± 0.7 mV decade -1 for Na + and K + , respectively with an LOD of 1.0 × 10 -5  M. We successfully applied the ISEs for multiplexed detection of Na + and K + in urine and artificial sweat samples at clinically relevant concentration ranges. The 3D-printed pipetting robot cost $100 and will pave the way for more accessible mass production of ISEs for those who cannot afford the expensive commercial robots., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Background: Dysphagia is a geriatric syndrome. Changes in the whole body that occur with aging also affect swallowing functions and cause presbyphagia. This condition may progress to oropharyngeal and/or esophageal dysphagia in the presence of secondary causes that increase in incidence with aging. However, no study has been published that provides recommendations for use in clinical practice that addresses in detail all aspects of the management of dysphagia in geriatric individuals. This study aimed to answer almost all potential questions and problems in the management of geriatric dysphagia in clinical practice., Methods: A multidisciplinary team created this recommendation guide using the seven-step and three-round modified Delphi method via e-mail. The study included 39 experts from 29 centers in 14 cities., Results: Based on the 5W and 1H method, we developed 216 detailed recommendations for older adults from the perspective of different disciplines dealing with older people., Conclusion: This consensus-based recommendation is a useful guide to address practical clinical questions in the diagnosis, rehabilitation, and follow-up for the management of geriatric dysphagia and also contains detailed commentary on these issues.

A microfluidic paper-based thermoplastic electrode (TPE) array has been developed for point-of-care detection of Na + and K + ions using a custom-made portable potentiometer. TPEs were fabricated using polystyrene as the binder and two different types of graphite to compare the electrode performance. The newly designed TPE array embedded in a polymethyl methacrylate chip consists of two working electrodes modified with carbon black nanomaterial and an ion-selective membrane, and an all-solid-state reference electrode modified with Ag/AgCl ink and poly(butyl methacrylate-co-methyl methacrylate) membrane via drop-casting. Ion-selective membrane compositions and conditioning steps were optimized. Under optimized conditions, ion-selective TPEs demonstrated fast response time (4 s) and good stability. The TPE array demonstrated a Nernstian behavior for K + with a sensitivity of 59.2 ± 0.2 mV decade -1 and near-Nernstian response for Na + with a sensitivity of 54.0 ± 1.1 mV decade -1 in the range 10 -1  - 10 -4  M and 1 -  10 -3  M, respectively. The detection limits were 1 × 10 -5  M and 1 × 10 -4  M for K + and Na + , respectively. In addition, a K + and Na + selective microfluidic paper-based analytical device (µPAD) was applied to artificial serum analysis and found in good agreement with average recoveries of 101.3% and 99.7%, respectively, suggesting that the developed ISE array is suitable for detection of sodium and potassium in complex matrix., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.)

Objective In this study, we aimed to analyze the laboratory and clinical results of cytokine hemadsorption as an immunomodulation therapy in ICU patients diagnosed with sepsis or septic shock. Methods The levels of procalcitonin (PCT) and C-reactive protein (CRP), determined to be indicators of infection/sepsis, and the levels of interleukins (IL-6, IL-8, and IL-10) and tumor necrosis factor α (TNFα), deemed as indicators of the cytokine storm, were compared among 32 patients before and after the hemadsorption procedure. Results The hemadsorption significantly reduced the levels of IL-6, IL-8, IL-10, TNFα, PCT, CRP, Acute Physiology and Chronic Health Evaluation (APACHE) scores, mortality rate, and Sequential Organ Failure Assessment (SOFA) scores (p<0.05). APACHE scores and the mean predicted mortality rate (PMR) of the non-survivors measured before the procedure was significantly higher than those of survivors (p=0.002 for both). IL-10, APACHE scores, and the mortality rates determined before the hemadsorption procedure were deemed significant parameters to predict the mortality among all ICU patients (p<0.05). IL-10 levels ≤125.3 ng/L, APACHE score >30, and PMR >70.33 were significantly associated with the mortality rates of all patients, indicating that these three parameters determined before the hemadsorption may be good predictors of mortality among ICU patients with sepsis. Conclusion The progression of sepsis in ICU patients may be prevented with cytokine hemadsorption applied as an immunomodulator therapy., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Koc et al.)

Objectives and Background: In this study we assessed the prognostic value of main pulmonary artery diameter and its ratio to ascending aorta diameter (P/Ao ratio) in advanced heart failure patients., Methods: Patients with advanced heart failure who were candidates for heart transplantation were retrospectively evaluated. The clinical information, cardiac catheterisation results, and computed tomography images were gathered from institutional database system. The observed and predicted probabilities for survival were analysed in a nomogram., Results: The P/Ao ratio was found to be a strong predictor for MACE both in traditional multivariable Cox proportional hazard regression modelling (increase in P/Ao ratio per 2 SD, HR:2.72, 95% CI 1.14-6.48, p  = 0.024) and ridge regression analysis (increase in P/Ao ratio per 2SD, HR:3.45, 95% CI 1.53-7.74, p  = 0.003). Prediction model showed statistically significant correlation between the observed and predicted probabilities for 1-year survival., Conclusion: In patients with advanced heart failure, computed tomography derived P/Ao ratio might be a prognostic predictor during follow up.

For electrochemical immunosensors, inexpensive electrodes with fast redox kinetics, and simple stable methods of electrode functionalization are vital. However, many inexpensive and easy to fabricate electrodes suffer from poor redox kinetics, and functionalization can often be difficult and/or unstable. Diazonium tosylates are particularly stable soluble salts that can be useful for electrode functionalization. Recently developed thermoplastic electrodes (TPEs) have been inexpensive, moldable, and highly electroactive carbon composite materials. Herein, the synthesis and grafting of diazonium tosylate salts were optimized for modification of TPEs and used to develop the first TPE immunosensors. With diazonium tosylates, TPEs were amine functionalized either directly through grafting of p -aminophenyl diazonium salt or indirectly through grafting p -nitrophenyl diazonium salt followed by electrochemical reduction to an amine. Diazonium tosylates were synthesized in situ as a paste in 6 min. Once the reaction paste was spread over the electrodes, near monolayer coverage (1.0 ± 0.2 nmol cm -2 ) was achieved for p -nitrophenyl diazonium salt within 5 min. Amine functionalized electrodes were conjugated to C-reactive protein (CRP) antibodies. Antibody-modified TPEs were applied for the sensitive detection of CRP, a biomarker of cardiovascular disease using electrochemical enzyme-linked immunosorbent assays (ELISA). LODs were determined to be 2 ng mL -1 in buffer, with high selectivity against interfering species for both functionalization methods. The direct p -aminophenyl modification method had the highest sensitivity to CRP and was further tested in spiked serum with an LOD of 10 ng mL -1 . This low-cost and robust TPE immunosensor platform can be easily adapted for other analytes and multiplexed detection.

The importance of user-friendly, inexpensive, sensitive, and selective detection of viruses has been highlighted again due to the recent Coronavirus disease 2019 (COVID-19) pandemic. Among the analytical tools, paper-based devices (PADs) have become a leading alternative for point-of-care (POC) testing. In this review, we discuss the recent development strategies and applications in nucleic acid-based, antibody/antigen-based and other affinity-based PADs using optical and electrochemical detection methods for sensing viruses. In addition, advantages and drawbacks of presented PADs are identified. Current state and insights towards future perspectives are presented regarding developing POC diagnosis platform for COVID-19. This review considers state-of-the-art technologies for further development and improvement in PADs performance for virus detection., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 Elsevier B.V. All rights reserved.)

Microfluidic paper-based analytical devices (μPADs) have garnered significant interest as a promising analytical platform in the past decade. Compared with traditional microfluidics, μPADs present unique advantages, such as easy fabrication using established patterning methods, economical cost, ability to drive and manipulate flow without equipment, and capability of storing reagents for various applications. This Review aims to provide a comprehensive review of the field, highlighting fabrication methods available to date with their respective advantages and drawbacks, device designs and modifications to accommodate different assay needs, detection strategies, and the growing applications of μPADs. Finally, we discuss how the field needs to continue moving forward to realize its full potential.