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MicroRNAs (miRNAs) have been widely investigated as potential biomarkers for early clinical diagnosis of cancer. Developing an miRNA detection platform with high specificity, sensitivity, and exploitability is always necessary. Electrochemiluminescence (ECL) is an electrogenerated chemiluminescence technology that greatly decreases background noise and improves detection sensitivity. The development of a paper‐based ECL biosensor further makes ECL suitable for point‐of‐care detection. Recently, clustered regularly interspaced short palindromic repeats (CRISPR)/Cas13a as high‐fidelity, efficient, and programmable CRISPR RNA (crRNA) guided RNase has brought a next‐generation biosensing technology. However, existing CRISPR/Cas13a based detection often faces a trade‐off between sensitivity and specificity. In this research, a CRISPR/Cas13a powered portable ECL chip (PECL‐CRISPR) is constructed. Wherein target miRNA activates Cas13a to cleave a well‐designed preprimer, and triggers the subsequent exponential amplification and ECL detection. Under optimized conditions, a limit‐of‐detection of 1 × 10−15 m for miR‐17 is achieved. Through rationally designing the crRNA, the platform can provide single nucleotide resolution to dramatically distinguish miRNA target from its highly homologous family members. Moreover, the introduction of “light‐switch” molecule [Ru(phen)2dppz]2+ allows the platform to avoid tedious electrode modification and washing processes, thereby simplifying the experimental procedure and lower testing cost. Analysis results of miRNA from tumor cells also demonstrate the PECL‐CRISPR platform holds a promising potential for molecular diagnosis. A clustered regularly interspaced short palindromic repeats (CRISPR)/Cas13a powered portable pBPE‐ECL chip (PECL‐CRISPR) is developed, which combines the high‐fidelity and trans‐cleavage of Cas13a, high efficiency of exponential amplification, high sensitivity and low background noise of electrochemiluminescence technology, and the simplicity of “light‐switch” [Ru(phen)2dppz]2+, thereby enabling ultrasensitive, highly‐specific, convenient, and low‐cost detection of miRNA.

Dual‐mode readout platforms with colorimetric and electrochemiluminescence (ECL) signal enhancement are proposed for the ultrasensitive and flexible detection of the monkeypox virus (MPXV) in different scenes. A new nanotag, Ru@U6‐Ru/Pt NPs is constructed for dual‐mode platforms by integrating double‐layered ECL luminophores and the nanozyme using Zr‐MOF (UiO‐66‐NH2) as the carrier, which not only generates enhanced ECL and colorimetric signals but also provide greater stability than that of commonly used nanotags. Dual‐mode platforms are used within 15 min from the “sample in” to the “result out” steps, without nucleic acid amplification. The colorimetric mode allows the screening of MPXV with the visual limit of detection (vLOD) of 0.1 pM (6 × 108 copies µL−1) and the ECL mode supports quantitative detection of MPXV with an LOD as low as 10 aM (6 copies·µL−1), resulting in a broad sensing range of 60 to 3 × 1011 copies·µL−1 (10 orders of magnitude). Validation is conducted using 50 clinical samples, which is 100% concordant to those of quantitative polymerase chain reaction (qPCR), indicating that Ru@U6‐Ru/Pt NPs‐based dual‐mode sensing platforms showed great promise as rapid, sensitive, and accurate tools for diagnosis of the nucleic acid of MPXV and other infectious pathogens. A new nanotag, Ru@U6‐Ru/Pt NPs is constructed for dual‐mode platforms by integrating double‐layered electrochemiluminescence luminophores and the nanozyme using Zr‐MOF as the carrier. This dual‐mode sensing platform shows great promise as a rapid, sensitive, and accurate tool for point‐of‐care testing and clinical diagnosis of nucleic acids of monkeypox virus and other infectious pathogens.

Veno-arterial extracorporeal membrane oxygenation (V-A ECMO) is an increasingly adopted life-saving mechanical circulatory support for a number of potentially reversible or treatable cardiac diseases. It is also started as a bridge-to-transplantation/ventricular assist device in the case of unrecoverable cardiac or cardio-respiratory illness. In recent years, principally for non-post-cardiotomy shock, peripheral cannulation using the femoral vessels has been the approach of choice because it does not need the chest opening, can be quickly established, can be applied percutaneously, and is less likely to cause bleeding and infections than central cannulation. Peripheral ECMO, however, is characterized by a higher rate of vascular complications. The mechanisms of such adverse events are often multifactorial, including suboptimal arterial perfusion and hemodynamic instability due to the underlying disease, peripheral vascular disease, and placement of cannulas that nearly occlude the vessel. The effect of femoral artery damage and/or significant reduced limb perfusion can be devastating because limb ischemia can lead to compartment syndrome, requiring fasciotomy and, occasionally, even limb amputation, thereby negatively impacting hospital stay, long-term functional outcomes, and survival. Data on this topic are highly fragmentary, and there are no clear-cut recommendations. Accordingly, the strategies adopted to cope with this complication vary a great deal, ranging from preventive placement of antegrade distal perfusion cannulas to rescue interventions and vascular surgery after the complication has manifested. This review aims to provide a comprehensive overview of limb ischemia during femoral cannulation for VA-ECMO in adults, focusing on incidence, tools for early diagnosis, risk factors, and preventive and treating strategies.

Background Extracorporeal carbon dioxide removal (ECCO 2 R) uses an extracorporeal circuit to directly remove carbon dioxide from the blood either in lieu of mechanical ventilation or in combination with it. While the potential benefits of the technology are leading to increasing use, there are very real risks associated with it. Several studies demonstrated major bleeding and clotting complications, often associated with hemolysis and poorer outcomes in patients receiving ECCO 2 R. A better understanding of the risks originating specifically from the rotary blood pump component of the circuit is urgently needed. Methods High-resolution computational fluid dynamics was used to calculate the hemodynamics and hemocompatibility of three current rotary blood pumps for various pump flow rates. Results The hydraulic efficiency dramatically decreases to 5–10% if operating at blood flow rates below 1 L/min, the pump internal flow recirculation rate increases 6–12-fold in these flow ranges, and adverse effects are increased due to multiple exposures to high shear stress. The deleterious consequences include a steep increase in hemolysis and destruction of platelets. Conclusions The role of blood pumps in contributing to adverse effects at the lower blood flow rates used during ECCO 2 R is shown here to be significant. Current rotary blood pumps should be used with caution if operated at blood flow rates below 2 L/min, because of significant and high recirculation, shear stress, and hemolysis. There is a clear and urgent need to design dedicated blood pumps which are optimized for blood flow rates in the range of 0.5–1.5 L/min.

Background Venoarterial extracorporeal membrane oxygenation (VA-ECMO) support under extracorporeal cardiopulmonary resuscitation (eCPR) is the last option and may be offered to selected patients. Several factors predict outcome in these patients, including initial heart rhythm, comorbidities, and bystander cardiopulmonary resuscitation (CPR). We evaluated outcomes of all VA-ECMO patients treated within the last 5 years at our center in respect to low-flow duration during CPR. Methods We report retrospective registry data on all patients with eCPR treated at a university hospital between October 2010 and May 2016. Results A total of 133 patients (mean age 58.7 ± 2.6 years, Simplified Acute Physiology Score II score at admission 48.1 ± 3.4) were included in the analysis. The indication for eCPR was either in-hospital or out-of-hospital cardiac arrest without return of spontaneous circulation ( n  = 74 and 59, respectively). There was a significant difference in survival rates between groups (eCPR in-hospital cardiac arrest [IHCA] 18.9%, eCPR out-of-hospital cardiac arrest [OHCA] 8.5%; p  < 0.042). Mean low-flow duration (i.e., duration of mechanical CPR until VA-ECMO support) was 59.6 ± 5.0 minutes in all patients and significantly shorter in IHCA patients than in OHCA patients (49.6 ± 5.9 vs. 72.2 ± 7.4 minutes, p  = 0.001). Low-flow time strongly correlated with survival ( p  < 0.001) and was an independent predictor of mortality. Conclusions Time to full support is an important and alterable predictor of patient survival in eCPR, suggesting that VA-ECMO therapy should be established as fast as possible in the selected patients destined for eCPR.

Very recently, there is a great research interest in electrochemiluminescence (ECL) featuring thermally activated delayed fluorescence (TADF) properties, i.e., TADF-ECL. It is appealing since the earlier reports in this topic well-confirmed that this strategy has a great potential in achieving all-exciton-harvesting ECL efficiency under electrochemical excitation, which is a breakthrough in the topic of organic ECL. However, organic phase electrochemistry and ECL studies surrounding TADF-ECL are still extremely rare. Especially, the ECL spectra of previous reported TADF emitters are still very different from their PL spectra. In this work, we systematically measure and discuss the liquid electrochemistry and ECL behavior of two typical TADF molecules in organic medium. Most importantly, we verify for the first time that the ECL spectra of them (coreactant ECL mode) are identical to their PL spectra counterparts, which confirms the effectiveness of TADF photophysical properties in the coreactant ECL mode in practice.

Gastric cancer is still an important disease causing many deaths worldwide, although there has been a marked reduction in prevalence during the last few decades. The decline in gastric cancer prevalence is due to a reduction in Helicobacter pylori infection which has occurred for at least 50 years. The most probable mechanism for the carcinogenic effect of H. pylori is hypergastrinemia since H. pylori infected individuals do not have increased risk of gastric cancer before the development of oxyntic atrophy. When atrophy has developed, the carcinogenic process continues independent of H. pylori. Autoimmune gastritis also induces oxyntic atrophy leading to marked hypergastrinemia and development of ECL cell neoplasia as well as adenocarcinoma. Similarly, long-term treatment with efficient inhibitors of acid secretion like the proton pump inhibitors (PPIs) predisposes to ECL cell neoplasia of a different degree of malignancy. Contrasting the colon where most cancers develop from polyps, most polyps in the stomach have a low malignant potential. Nevertheless, gastric polyps may also give rise to cancer and have some risk factors and mechanisms in common with gastric cancer. In this overview the most common gastric polyps, i.e., hyperplastic polyps, adenomatous polyps and fundic gland polyps will be discussed with respect to etiology and particularly use of PPIs and relation to gastric carcinogenesis.

Extracorporeal life support (ECLS) is increasingly used in the management of patients with severe cardiopulmonary disease. Infections are frequently the etiologies underlying the respiratory, and occasionally cardiac, failure that necessitates ECLS. Just as importantly, infections are among the most commonly reported adverse events during ECLS. Infections in this setting may be the sequelae of prolonged critical illness or of underlying immune dysregulation; they may be hospital-acquired infections, and they may or may not be attributable to the presence of ECLS itself, the latter being an aspect that can be difficult to determine. Current registry data and evidence from the literature offer some insights, but also leave open many questions regarding the nature and significance of infections reported both before and during ECLS, including the question of any causal link between ECLS and the development of infections. An ongoing lack of consistency in the identification, diagnosis, management, and prevention of infections during ECLS is limiting our ability to interpret literature data and thus highlighting the need for more rigorous investigation and standardization of definitions. This review aims to characterize the current understanding of infections associated with the use of ECLS, taking into account data from the updated Extracorporeal Life Support Organization Registry, which provides important context for understanding the epidemiology and outcomes of these patients.

Mammalian cell analysis is essential in the context of both fundamental studies and clinical applications. Among the various techniques available for cell analysis, electrochemiluminescence (ECL) has attracted significant attention due to its integration of both electrochemical and spectroscopic methods. In this review, we summarize recent advances in the ECL-based systems developed for mammalian cell analysis. The review begins with a summary of the developments in luminophores that opened the door to ECL applications for biological samples. Secondly, ECL-based imaging systems are introduced as an emerging technique to visualize single-cell morphologies and intracellular molecules. In the subsequent section, the ECL sensors developed in the past decade are summarized, the use of which made the highly sensitive detection of cell-derived molecules possible. Although ECL immunoassays are well developed in terms of commercial use, the sensing of biomolecules at a single-cell level remains a challenge. Emphasis is therefore placed on ECL sensors that directly detect cellular molecules from small portions of cells or even single cells. Finally, the development of bipolar electrode devices for ECL cell assays is introduced. To conclude, the direction of research in this field and its application prospects are described.

We report a molecularly imprinted polymer electrochemiluminescence (MIP-ECL) sensor with dual recognition effects on dopamine (DA). Boric-acid-functionalized carbon dots (B-CDs) with good ECL performance at − 2.0 V (vs. Ag/AgCl) were prepared and immobilized on a glassy carbon electrode (GCE). The MIP was then introduced via electropolymerization using o-phenylenediamine (OPD) as a functional monomer and DA as a template molecule to fabricate the MIP-ECL sensor. The cavities in the MIP after elution were used to capture the target molecular DA. The affinity of boric acid of B-CDs to the cis-diol of DA, as well as the special recognition of MIP, provides dual recognition effects on DA. The selective readsorption of DA onto the sensor leads to the ECL quenching of B-CDs. The quenching effect was used to detect DA from 1.0 × 10 −9 to 1.0 × 10 −5  mol·L −1 with a detection limit of 2.1 × 10 −10  mol·L −1 . The dual recognition caused the MIP-ECL sensor exhibiting excellent selectivity and sensitivity toward  DA. The sensor was successfully used to determine DA in real samples. Graphical abstract