Detection of biomolecules at low abundances is crucial to the rapid diagnosis of disease. Impressive sensitivities, typically measured with small model analytes, have been obtained with a variety of nano- and microscale sensors. A remaining challenge, however, is the rapid detection of large native biomolecules in real biological samples. Here we develop and investigate a sensor system that directly addresses the source of this challenge: the slow diffusion of large biomolecules traveling through solution to fixed sensors, and inefficient complexation of target molecules with immobilized probes. We engineer arrayed sensors on two distinct length scales: a ∼100 μm length scale commensurable with the distance bacterial mRNA can travel in the 30 min sample-to-answer duration urgently required in point-of-need diagnostic applications; and the nanometer length scale we prove necessary for efficient target capture. We challenge the specificity of our hierarchical nanotextured microsensors using crude bacterial lysates and document the first electronic chip to sense trace levels of bacteria in under 30 min.

A chip‐based platform is reported that is able to detect as few as 10 cancer cells. By developing sub‐milliscale sensors that are able to capture slow moving biological targets with high efficiency (see picture; scale bar 50 μm), cancer‐specific sequences were detected in crude lysates of leukemia cells. This achievement relied on the development of a new type of molecular probe that improves the solubility and performance of neutral nucleic acids.

Objective: To compare the efficacy and safety of patient-controlled analgesia (PCA) to epidural analgesia in adults undergoing open hepatic resection. Background: Effective pain management in patients undergoing open hepatic resection is often achieved with epidural analgesia. However, associated risks have prompted investigation of alternative analgesic methods in this patient population. Methods: A comprehensive systematic literature review via Medline, Embase, and the Cochrane databases from inception until December 2, 2017 was conducted, followed by meta-analysis. Abstract and full-text screening, data extraction, and quality assessment were conducted by 2 investigators. Odds ratios (OR), mean differences (MD), and 95% confidence intervals were calculated using RevMan 5.3. Results: Four randomized controlled trials with 278 patients were identified. All studies compared the use of PCA to epidural, with differing regimens. Pooled MD and 95% confidence interval for pain score were higher for PCA at rest 24 hours postoperatively (0.59 [0.30, 0.88]), and with movement at 48 hours postoperatively (0.95 [0.31, 1.60]. Pooled MD for hospital length of stay was 1.23 days (−2.72, 5.19). Pooled OR was 0.68 (0.36, 1.3) and 0.24 (0.04, 1.36) for overall and analgesia-related complications, respectively. Need for blood transfusion had a pooled OR of 1.14 (0.31, 4.18). Conclusions: Epidural analgesia was observed to be superior to PCA for pain control in patients undergoing open hepatic resection, with no significant difference in hospital length of stay, complications, or transfusion requirements. Thus, epidural analgesia should be the preferred method for the management of postoperative pain in this patient population.

No abstract

No abstract

A chip‐based platform is reported that is able to detect as few as 10 cancer cells. By developing sub‐milliscale sensors that are able to capture slow moving biological targets with high efficiency (see picture; scale bar 50 μm), cancer‐specific sequences were detected in crude lysates of leukemia cells. This achievement relied on the development of a new type of molecular probe that improves the solubility and performance of neutral nucleic acids.

Background: Timely surgical resection in patients with suspected or diagnosed pancreas adenocarcinoma is an essential part of care. We hypothesized that longer surgical wait time was associated with worse oncologic outcomes.Methods: A retrospective cohort of patients (N = 144) with resectable pancreas adenocarcinoma was divided into four wait time groups (<4, 4-8, 8-12, and >12 weeks), defined from the time of diagnosis on cross-sectional imaging. Overall and recurrence-free survival were analyzed using the Kaplan-Meier method and Cox proportional hazards regression. A higher rate of conversion to palliative bypass in patients waiting over 4 weeks was observed and further analyzed using post-hoc multivariate regression.Results: On multivariable analysis, longer wait time was associated with improved overall (HR 0.49, 95% CI: 0.28-0.85) and recurrence-free survival (HR 0.29, 95% CI: 0.15-0.56) in >12 weeks compared to <4 weeks group. On post-hoc analysis, longer wait time over 8 weeks was positively associated with palliative bypass (OR 5.33,. Conclusion:Wait time over 8 weeks was associated with a higher rate of palliative bypass. There was an improvement in overall and recurrence-free survival in patients who waited over 12 weeks, likely due to selection bias.

No abstract