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18January 2021

New Covid Antibody Test Gets Results in 10 Seconds Using 3D Printing

In the ongoing global efforts to contain the Covid-19 virus, the ability to conduct rapid mass testing is proving critical to success. It is also an area where many countries are facing major challenges. Researchers at Carnegie Mellon University and the University of Pittsburgh have just developed a test that may help overcome this challenge.

Created by a joint team of engineers and virologists, the test enables Covid antibodies, the blood-borne protein that attacks the coronavirus, to be detected in 10 seconds. The presence of these antibodies in a person’s blood indicates that they were previously infected by the virus. Pinpointing who within a population has Covid antibodies helps track the virus’ progress, including by identifying who may have developed immunity.

Micro 3D printing technology lies at the heart of this research innovation. Dr. Rahul Panat, Associate Professor of Mechanical Engineering at Carnegie Mellon University, whose group developed the test, explained:

“Micro 3D printing allows you to produce new shapes in devices and new combinations of materials. The progress we are making today in biomedical devices is inherently tied to the progress in microfabrication.”

The device is made using trademarked Aerosol Jet 3D electronics printers developed and patented by Optomec, a U.S.-based company specializing in additive manufacturing technology. About the size of a U.S. quarter coin, the device is formed by printing gold micropillars onto a substrate, coating them with reduced graphene oxide, then attaching Covid antigens, the markers of the virus. A pinprick of blood is obtained from the person being tested, and if the sample has any Covid antibodies they latch on to the antigen, creating an electrochemical reaction.

Unlike other manufacturing processes that create a smooth surface finish, the Optomec aerosol jet printer produces a rough surface on the gold micropillars. This trademark ‘stickiness’ allows the antigen to easily load onto the micropillar resulting in it being able to detect even very small amounts of antibodies. A single device costs in the range of tens of dollars to make.

Like a Home Glucose Test

The device gets connected to a dongle that has a small electrochemical analyzer, which confirms the presence of antibodies. The dongle connects to a smartphone that reads the result on a custom app. Both interfaces—the dongle and smartphone app—are already widely available on the market. One advantage of choosing such interfaces, according to Dr. Panat, is that:

“It lowers the technical expertise needed to take a reading. It can be like a glucose test you do at home.”

After a test is performed, the device gets washed with formic acid and another test can be done in a minute. While at least 10 tests can be done with complete accuracy, the detection capability weakens after that and the device needs to be replaced. The research team published its preliminary data in September, with larger-scale trials underway at the University of Pittsburgh Medical Center.

With parts of the world getting battered by a new wave of Covid infections and a vaccine very likely still months away, testing is set to remain an indispensable part of nations’ Covid mitigation strategies. For example, when China, which had been doing very well at containing Covid-19 over the summer, experienced an outbreak in October in the eastern city of Qingdao, it managed to stave off a resurgence by testing all of Qingdao’s 10 million residents in a few days. Dr. Panat said:

“Rapid mass testing can help us eradicate the virus by effectively isolating patients. If a test takes 24 or 48 hours to get results—or even 20 minutes—that is simply too long.”

25June 2020

Study details first AI tool to help labs rule-out COVID-19

Hospital-based laboratories and doctors at the front line of the COVID-19 pandemic might soon add artificial intelligence to their testing toolkit. A recent study conducted with collaborators from the University of Vermont and Cedars-Sinai describes the performance of Biocogniv’s new AI-COVID™ software.

The team found high accuracy in predicting the probability of COVID-19 infection using routine blood tests, which can help hospitals reduce the number of patients referred for scarce PCR testing.

“Nine months into this pandemic, we now have a better understanding of how to care for patients with COVID-19,” says lead author and University of Vermont Assistant Professor Timothy Plante, M.D., M.H.S., “but there’s still a big bottleneck in COVID-19 diagnosis with PCR testing.”

PCR testing is the current standard diagnostic for COVID-19, and requires specific sampling, like a nasal swab, and specialized laboratory equipment to run.

Biocogniv Chief Operating Officer Tanya Kanigan, Ph.D., says, “According to data from over 100 US hospitals, the national average turnaround time for COVID-19 tests ordered in emergency rooms is above 24 hours, far from the targeted one-hour turnaround.”

Complete Blood Count and Complete Metabolic Panels are common laboratory tests ordered by emergency departments and have a rapid turnaround time. These tests provide insight into the immune system, electrolytes, kidney, and liver. The researchers were able to train a model that analyzes changes in these routine tests and assigns a probability of the patient being COVID-19 negative with high accuracy.

“AI-COVID takes seconds to generate its informative result once these blood tests return, which can then be incorporated by the laboratory into its own test interpretation,” says Jennifer Joe, M.D., an emergency physician in Boston, Mass. and Biocogniv’s Chief Medical Officer. “In an efficient emergency department that prioritizes these routine blood tests, the door-to-result time could be under an hour.”

Cedars-Sinai pulmonary and internal medicine specialist Victor Tapson, M.D., says such assistive tools that help physicians rule out possible diagnoses are familiar in emergency medicine. “For example, a low D-dimer blood test can help us rule out clots in certain patients, allowing providers to skip expensive, often time-consuming diagnostics such as chest CT scans,” says Tapson.

The Biocogniv team believes a secondary benefit of laboratories incorporating AI-COVID might be reduced time for traditional PCR results. “With the help of AI-COVID, laboratories might relieve some of the testing bottleneck by helping providers better allocate rapid PCR testing for patients who really need it,” says Joe.

The AI-COVID model was validated on real world data from Cedars-Sinai as well as on data from geographically and demographically diverse patient encounters from 22 U.S. hospitals, achieving an area under the curve (or AUC) of 0.91 out of 1.00.

“This enables the model to achieve a high sensitivity of 95% while maintaining moderate specificity of 49%, which is very similar to the performance of other commonly used rule-out tests,” says Biocogniv Chief Scientific Officer George Hauser, MD, a pathologist.

Biocogniv CEO Artur Adib, Ph.D., says, “I’m honored to have such an impressive team of medical scientists from the University of Vermont and Cedars-Sinai as collaborators in validating this timely model. AI has progressed considerably; the time is now to leverage this powerful tool for new healthcare breakthroughs, and we’re glad to direct it to help hospital laboratories and providers combat the current COVID-19 crisis.”

25June 2020

VR could be key to helping recovered COVID-19 patients get therapy, according to experts

Authors of an article published in BMJ Open Sport Exercise Medicine say the technology could help with rehab therapies, with social distancing.

Virtual reality could be key to COVID-19 rehabilitation, according to a new paper published in BMJ Open Sport Exercise Medicine. Specifically, the authors of the publication pitch tailor-made rehabilitation services that can be administered remotely via a VR experience.

The authors explain that many COVID-19 patients who were critically ill continue to have Post-Intensive Care Syndrome, even after the infection is gone, leaving a potential risk for physical, psychological and cognitive impairment.

“Traditional PICS treatments also do not account for the additional emotional and societal side-effects of this particular crisis, such as social distancing, limitation of family members’ visits and consultations by primary caregivers when patients are discharged,” authors of the study wrote. “VR provides healthcare practitioners with the means to administer fast, temporary and tailor-made rehabilitation services at a distance, and offers a solution to address the impending surge of demand for PICS-COV therapy.”

VR could help patients not just with physical rehab but could also help with psychological support for patients who have overcome COVID-19.

Authors noted that the technology is well suited to today’s environment as it lets therapy be delivered at a distance and allows therapists, who may be in high demand, to treat patients simultaneously. VR differs from traditional telemedicine, the paper says, because of its ability to put patients into a 3D environment.

However, VR also presents new sets of challenges, according to the article. Those challenges include creating a new toolkit for physical, mental and cognitive therapy. The risk of falls is another potential issue in the technology. Authors of the paper suggested that patients should sit when doing cognitive and mental health-related therapy. Proper patient education was also suggested.

WHY IT MATTERS

According to a paper published in Heart Lung, 50% of all patients admitted to the ICU that go onto a ventilator develop PICS. The paper goes on to note that there is no difference in PICS risk between ICU patients with morbidities such as diabetes, hypertension, asthma, and chronic obstructive pulmonary and those admitted to the ICU who do not have a morbidity.

THE LARGER TREND

Virtual reality is growing in popularity in the healthcare space. In Italy one hospital is supplying VR therapy to its workers to help reduce the stress and anxiety associated with treated coronavirus patients.

Virtual reality is also growing in the rehabilitation space, in stroke care in particular. In February a use-of-concept study found that stroke patients given virtual reality therapy were consistent in completing the therapy, and preferred a version that let them connect to others.

In 2018, a rehabilitation research group from the Kessler Foundation and immersive interactive technologies company Virtualware announced the two organizations are teaming up to develop a VR-based treatment for spatial neglect in stroke patients.

1April 2020

An IoMT Device That Can Detect Disease Through the Toilet Bowl

Technology featured in a science fiction movie has inspired a new device that could end up saving hundreds of thousands of lives and offering early warnings of future pandemics.

Israeli company OutSense has developed an IoT device which attaches to a toilet bowl and scans excretions for signs of disease.

OutSense CEO Yfat Scialom explained:

“The initial idea was born when Ishay Attar, our founder, was watching The Island, where people live in a futuristic utopian facility that continually monitors the inhabitants’ toilet activity. It came together when, by total coincidence, a relative was saved due to early detection of colon cancer.”

Established in 2016, OutSense was born with the aim of developing a technology to screen for hidden blood—an early sign of colorectal cancer. Additionally, however, Ms Scialom said, the resulting system can monitor dehydration, urinary tract infections, constipation, and diarrhea.

“The device utilizes a patented technology based on multispectral optical sensors. In general, we can literally see (by computer vision) what’s going on in the toilet bowl in three dimensions—time, space and spectrum.”

The device, which is currently at the research and development stage, employs multi-spectral optical sensors, an illumination module, and has an autonomous controller with a wifi receiver. It monitors the frequency of toilet visits, together with volumes, texture and opacity, as well as molecular composition and substances the human eye has no perception for.

Curing Through Connectivity

Results are delivered to the cloud, where real-time analysis is conducted using OutSense’s proprietary computer vision algorithms and AI. The sensor connects to the smartphone of the caregiver or user, and the system sends notifications and results immediately if an abnormality is detected.

Colorectal cancer is a leading cause of death worldwide, with 700,000 fatalities every year, and it costs healthcare systems an estimated US $30 billion annually, said Ms Scialom.

“We believe our technology will be adopted widely and will revolutionize the way colorectal cancer is screened worldwide. In addition, it will dramatically improve quality of care in elderly facilities and will play an essential role in allowing older people to age at home.”

Becoming Standard

Expected to be launched on the market in September 2021, the device does not require any infrastructure other than connectivity. She explained:

“Costs will be different based on the various features available on different markets. We designed the product with an affordable price target, in the range of a few hundred USD, which will be divided into a one-time hardware fee and a monthly subscription.”

The hope is that the product might eventually be integrated into every standard toilet seat. Once widely deployed, it could potentially flag outbreaks of other diseases, based on the detection of specific antigens or general gut issues in specific locations.

“OutSense aims to create the world’s first and largest database of human waste. The initial market for the new technology will be the elderly care market, but this will eventually be expanded, and we will add more diseases to the detection list. Eventually, the technology could be used to detect the onset of an epidemic like Covid-19 as well as for personalized care, biofeedback, fine tuning of drug dosage and even personalized nutrition for weight control.”