A current challenge regarding microfluidic paper-based analytical devices (µPAD) for blood plasma separation (BPS) and electrochemical immunodetection of protein biomarkers is how to achieve a µPAD that yields enough plasma to retain the biomarker for affinity biosensing in a functionalized electrode system. This paper describes the development of a BPS µPAD to detect and quantify the S100B biomarker from peripheral whole blood. The device uses NaCl functionalized VF2 filter paper as a sample collection pad, an MF1 filter paper for plasma retention, and an optimized microfluidic channel geometry. An inverted light microscope, scanning electron microscope (SEM), and image processing software were used for visualizing BPS efficiency. A design of experiments (DOE) assessed the device’s efficacy using an S100B ELISA Kit to measure clinically relevant S100B concentrations in plasma. The BPS device obtained 50 μL of plasma from 300 μL of whole blood after 3.5 min. The statistical correlation of S100B concentrations obtained using plasma from standard centrifugation and the BPS device was 0.98. The BPS device provides a simple manufacturing protocol, short fabrication time, and is capable of S100B detection using ELISA, making one step towards the integration of technologies aimed at low-cost POC testing of clinically relevant biomarkers.

Neuronal damage secondary to traumatic brain injury (TBI) is a rapidly evolving condition, which requires therapeutic decisions based on the timely identification of clinical deterioration. Changes in S100B biomarker levels are associated with TBI severity and patient outcome. The S100B quantification is often difficult since standard immunoassays are time-consuming, costly, and require extensive expertise. A zero-length cross-linking approach on a cysteamine self-assembled monolayer (SAM) was performed to immobilize anti-S100B monoclonal antibodies onto both planar (AuEs) and interdigitated (AuIDEs) gold electrodes via carbonyl-bond. Surface characterization was performed by atomic force microscopy (AFM) and specular-reflectance FTIR for each functionalization step. Biosensor response was studied using the change in charge-transfer resistance (Rct) from electrochemical impedance spectroscopy (EIS) in potassium ferrocyanide, with [S100B] ranging 10–1000 pg/mL. A single-frequency analysis for capacitances was also performed in AuIDEs. Full factorial designs were applied to assess biosensor sensitivity, specificity, and limit-of-detection (LOD). Higher Rct values were found with increased S100B concentration in both platforms. LODs were 18 pg/mL(AuES) and 6 pg/mL(AuIDEs). AuIDEs provide a simpler manufacturing protocol, with reduced fabrication time and possibly costs, simpler electrochemical response analysis, and could be used for single-frequency analysis for monitoring capacitance changes related to S100B levels.

Introduction: Traumatic brain injury is a leading worldwide cause of death and disability in young people. Severity classification is based on the Glasgow Coma Scale. However, the neurological worsening in an acute setting does not always correspond to the initial severity suggesting an underestimation of the real magnitude of the injury.Objective: To study the correlation between the initial severity according to the Glasgow Coma Scale and the patient outcome in the context of different clinical and tomography variables.Materials and methods: We analyzed a retrospective cohort of 490 patients with closed traumatic brain injury requiring a stay in the intensive care unit of two third-level hospitals in Barranquilla. The risk was estimated by calculating the OR (95% CI). The significance level was established at an alpha value of 0.05.Results: Forty-one percent of all patients required orotracheal intubation; 51.2% were initially classified with moderate trauma and 6,0% as mild. The delay in the aggressive management of the traumas affected mainly those patients with traumas classified as moderate in whom lethality increased to 100% when there was delay in the detection of the neurological worsening and in the establishment of the aggressive treatment beyond 4 to 8 hours while the lethality in patients who received this treatment within the first hour reduced to <20%.Conclusions: The risk of lethality in traumatic brain injury increases with the delayed detection of neurological worsening in an acute setting, especially when aggressive management is performed after the first hour post-trauma. Introducción. El trauma craneoencefálico es una de las principales causas de muerte y discapacidad en adultos jóvenes. Su gravedad se define según la escala de coma de Glasgow. Sin embargo, el deterioro neurológico agudo no siempre concuerda con la gravedad inicial indicada por la escala, lo que implica una subestimación de la magnitud real de la lesión.Objetivo. Estudiar la correlación entre la gravedad inicial del trauma craneoencefálico según la escala de coma de Glasgow y la condición final del paciente, en el contexto de diferentes variables clínicas y de los hallazgos de la tomografía.Materiales y métodos. Se analizó una cohorte retrospectiva de 490 pacientes con trauma craneoencefálico cerrado que requirieron atención en la unidad de cuidados intensivos de dos centros de tercer nivel de Barranquilla. La estimación del riesgo se estableció con la razón de momios (odds ratio, OR) y un intervalo de confianza (IC) del 95 %. Se utilizó un alfa de 0,05 como nivel de significación.Resultados. El 41,0 % de los pacientes requirió intubación endotraqueal; el 51,2 % había presentado traumas inicialmente clasificados como moderados y, el 6,0 %, como leves. El retraso en la implementación de un tratamiento agresivo afectó principalmente a aquellos con trauma craneoencefálico moderado, en quienes la letalidad aumentó al 100 % cuando no se detectó a tiempo el deterioro neurológico y, por lo tanto, el tratamiento agresivo se demoró más de 4 a 8 horas. Por el contrario, la letalidad fue de menos de 20 % cuando se brindó el tratamiento agresivo en el curso de la primera hora después del trauma.Conclusiones. El riesgo de letalidad del trauma craneoencefálico aumentó cuando el deterioro neurológico se detectó tardíamente y el tratamiento agresivo se inició después de transcurrida la primera hora a partir del trauma.

The potential of early neurological inaccurate assessment of severity in patients with traumatic brain injury (TBI) has been highlighted; in some cases, for example, the severity of the injury is overestimated or underestimated. These findings have led to the search of biomarkers associated with early brain injury. Research in this field has exponentially increased over the past 20 years, with most publications on the subject in the last 10 years, whose results range from promising findings to other sometimes inconclusive one. An ideal biomarker should be able to demonstrate high sensitivity and specificity for brain injury, among other aspects. Literature has shown that there is not a single biomarker that predicts the patient’s clinical decline with high sensitivity and specificity. Instead, it is required to use a panel of markers that reflect different aspects of head trauma. This chapter gives a review of the most promising biomarkers studied as predictors of severity of TBI, with a special focus on their nature, location, basal concentrations, and methods by which they can be quantified in blood samples.

Empathy is considered a key factor in patient satisfaction, treatment adherence, clinical outcomes, and professional fulfillment. Consequently, training health sciences students in empathy has become a priority in universities worldwide. However, empathy-focused interventions have not achieved the desired success due to the complex nature of empathy. Both internal and external factors shape and influence empathy. Resilience has been proposed as one such factor, but the association between these two concepts is poorly understood. This study aims to evaluate the association between different dimensions of resilience and empathy in health science students. A Cross-sectional analysis evaluated the levels of empathy and resilience in 993 Medical, Nursing, and Dentistry students at Universidad del Norte using the Jefferson Scale of Empathy-Health Professions Students (JSE-HPS) and the Ecological, Engineering, Adaptation (EEA) Resilience Scale. Data were examined through univariate and multivariate normality analyses and descriptive statistics. To evaluate the theoretical structure of empathy and resilience, a confirmatory factor analysis (CFA) was performed on the three-dimensional models of each construct. Reliability was established using the Omega coefficient. Finally, structural equation modeling (SEM) with a robust maximum likelihood estimator was applied to analyze the association between resilience and empathy. The normal distribution assumptions were largely met for empathy scale data, its respective dimensions, and individual items. The theoretical model was well-supported for both constructs, and the data suggested acceptable reliability. SEM analysis revealed that the association between empathy and resilience dimensions vary. Ecological resilience was positively correlated with all empathy dimensions while engineering and adaptative resilience were negatively correlated with all three dimensions of empathy. There is no universal effect of resilience on empathy. Designers of empathy-focused educational interventions and researchers should consider the potential differential effects of different dimensions of resilience on different aspects of empathy. In particular, focusing on ecological resilience may create the conditions for achieved empathy to be expressed, while strategies to mitigate the potential negative impact of adaptive resilience on empathy should be further explored.