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Recent developments in microtechnologies for point-of-care testing
Philippe Renaud, EPFL
Thursday, Oct. 26, 2017 · 10:47 a.m. · 30m 44s
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morning session now
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a raw food director off to micro system uh
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microsystems laboratory at their federal institute of technology in los on
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and talk to us about recent developments micro technologies for point of care
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thank you very much thank you for the introduction and also thank
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you for the recogniser uh we invite me uh so uh
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the uh outline of my whole kind when i started to uh prepare
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my talk i realised that myself i don't do people see all
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so i thought okay you how to how to fit side splitting two parts the first part will be in the context of
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the new the new trends here to to address the question of what are the buyer markers and which what are
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the difficulties of of of having access to the site markers and then i will shoot show you some
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what i could not the plot device was that these devices which are which are are related to whereabouts
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and finally uh i uh i will switch to the the second part where we start to
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address the question of of the analytical work flow so what what happens when you do
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the the testing and show you an example i finally found an
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example in my lab uh where where we we we
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a bit work on the sample sample preparation in fact i will do i will give two examples
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so first point is when we talk about they the diagnostics uh we have two different
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shape the the the between the bottom markers and a bit on the physical
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side are interesting by mark or just a activity that body temperature or whatever which
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are important then you have the metaphor light pertains viruses by importance on
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and depending on respectable lights you have different access to this to this uh it
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to these uh parameters and a co op usually the physical parameters you access
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with the body booty movement but then uh if you if you go to uh to the they have a light
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there you you find them almost everywhere except in the body in the in the activity or very indirectly
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uh uh but then if you go down to the province for instance or
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hormones uh quickly you have to access to to be in the bill
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so now our if we see a uh in terms of
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what is the technology behind a off for the physical
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it's okay we have the sense physical sensors uh for the method politics
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mostly the analytical chemistry approach that is a that is there
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uh and uh and for the for the rest we have either the new could se testing which
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is extremely efficient for viruses microbes and that and parasites and and even oh i see
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so until now i have not said the anything and that will uh show you uh some
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uh_huh example because we talk about that a lot uh on on on where nobles
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and also when i talk with with our student the over the often
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say that it's the school day and it it ten years ago
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are we had no sensors in our mobile phone now we have twenty
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sensors yeah in every mobile phone so in ten years from
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now i will have twenty more sensors in in in this in the phone and the sensors will be everything for the half
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uh but uh of course the good question is the fire marker has access
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yeah you can't it's not enough to just to a patch your skin with the
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with the smart phone and to get to decker access to the promenade
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let's say that are still uh accessible parameters and the accessible parameters
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that are that are uh the metabolic seen unknown not lot
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system uh are you for instance with the straight to the to yours uh or to even begin to show
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interest issue for which which is accessible through this would this would also so now and uh uh
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give you one example it's extremely when when such example our our uh is released to the press
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it lays lots of expectation an infected this is the goal will uh a goodwill clara um
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lines where you can sense uh the glucose in the in the
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tears fantastic device in the technologies behind in fact there
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are not that complicated because the title of my talk is
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about technologies uh so it's it's about inferior technologies
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and the sense in principle which which is which is there say sense of the text because it yours
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in fact it's an electro chemical sensor a very classical one the one the
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same that you can find in in the in the goes straight
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the challenge your is really the the the integration the second challenge and to make the success of the
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sensors years that in fact when you most records in the years you don't measure the blog becomes
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so there is the lady there are there are there are there are there other parameters that ensures that
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and and i unfortunately nowadays it is compensated a lot
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by the signal processing uh but still it's not the direct measurement and you you should
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you place a part of the responsibility on the sensor and i on
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on the data processing and on the knowledge of the patient
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and we should also be careful uh on putting too much processing there because for instance if you make
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machine you don't need to put machine learning algorithm it might be that the the the the system five finally
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try to do if profile due to to well and and we reject some warning
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sign uh it and we have seen that's it so the technology there
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in fact we had developed technologies in the past uh what where there's
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no set a a few uh chemical sensing that physical sense in
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is exactly the same type of technology thing fumes uh r. f.
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i. these uh and in that case it's a physical sensor
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and that was the company sensing that already do it almost seems fifteen years ago uh do do we do in that
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uh it's either way much simpler because you don't have the
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electrochemical sensor but the concept to the chip is almost
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a senate was that you can yeah he's not the point of care centre but it's it's more it
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i it's more to make a it to to provide the the people and you can
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measure the uh the eye pressure over twenty four hours and get the profile of of the people and then uh
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advice for for giving the the the the the drops a eye drops to really to decrease the eye pressure
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uh we've seen also lately a lot of of uh of things on the to so
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called lab once clean and about skin is it means that you you bring
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uh the the microsystems right on the skin and what what do you measure on
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the skin you measure the the the the the this with this perspiration
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and in the in that you have you have you can measure lots of parameter in this example of one paper
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where uh they uh it's basic basically at actual chemical sensors that are embedded on this
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on the theme a sheet of plastic and you you put that it's a patch
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the technology itself again must be very simple because these are uh
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things that you throw away you use only one time it looks like
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that's then it's connected to some very simple electronics and it works
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oh the people if if proven that you can measure degree
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codes uh uh the the the line is somebody and
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and the reference point are outside that you can even run with these things
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and presses here they've put it at a series of runners measure the
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uh the the the the potassium and those we didn't uh drink
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enough data hydrate and there is a race uh of uh off to what extreme after a certain time of a friend uh
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no and and are you also company said like your uh in your by it you pay for the the company that is
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developing this kind of for sensors and try to to to address
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the to to make business uh out of out of that
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if you go one step b. only in in at the in in the yeah
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a skin sensors uh it recently we've seen the idea of tattoos
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about twelve course the tattoos are very popular i don't have homes menu but maybe in the future i will have four might have
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purpose of the i would hide them properly and so and and and
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the id there is that uh uh that just what here
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this is one example what he said that too but it's this one is not the truth that too so that's good i
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could i could use it it's a transcript that to you make distinctions you make your actual then and electro chemical sensors and
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then you you you you you really transparent onto the skin removed and you have destroyed the structure uh uh there and
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very simple again electro chemical sensors measuring lactate and works
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and and the last example i i'd like to show is also
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we sent a recent papers by by people at mit
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they use in fact classical coral metric for us and sensor in the the put that in inks the
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cut to uh and and then these things well you can read the the the the result
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uh just by reading that the two so you have to do is going to change court order according to your
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uh really level of glucose in the body that's like of i do you
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things of course that was of issues in terms of toxicity in terms of reliability
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in terms of a duration of the scene but it's nice to to see
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and the the have not yet don't happen humans these are the skin from big and and they show that a huge
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the change from a uh some some of the uh by mark those parameters in the skin you you see change of of core
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this is a bit science fiction is not much technology but but to h. and but i like to come back to do
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we were following a a a doctor so uh to the real needs and and
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the the real needs is is uh thinking of the analytical work flow
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and in the other legal work flow the ideal point of care test you
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mention very clearly you have to do everything in a very short time
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and of course have reliable data out of that so that's my idea of
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talk to stand in the in in in in a doctor's office except those
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you already have that you're not satisfied with the accuracy and and
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i think that that you usually take care of the sample collection to it and then transfer that goes into trance central lab
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and this and this is the job of the transference a lab to give you reliable
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data if they don't do that the we didn't deserve to be cautious central now
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uh so now if you if we go and we go for the i. ideal point of care
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if you measure reason you create a seat it is possible to do to do that and there are some
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at times already and here i show the example of a offer the accompanied by a card is which is making a cartridge
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it's a cartridge of these that that takes a and and that manage
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everything uh on site so it means that you can drop
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in this contract any type of sentence it could be lot could be biopsies could be an as a swap and so on
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and then this is processed in this cartridge they use your multiplex something pick implications don't and there is a reader
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you just forget this cartridge in the machine and twenty minutes later in the in the best case you
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get you get the results and it works but using the k. i. c. testing and it's relatively
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relative easy we read and and you're more about uh that uh later by by jean pocket presentation
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uh but if you go with other part uh uh
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parameters and and especially for the blood test uh
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what we see you can find on publications or
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on in internet the ideal up sorry uh
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idea idea plot point of care so it's a kind of the lab and shit
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and in the level chip you you've you drop a you brought some processing everything
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and then you have a smart phone and you read that and that's it that's what you need
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uh the the problem of course it is extremely demanding to have at the accuracy
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of the the the all the preprocessing step for the sample we is that
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it's feasible and not saying a it's visible but it is extremely difficult and if i
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go in my lab and we we do so so cool level in shape
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this is what we have is uh if it more in the chip in the lab and and i uh_huh
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and the phone is uh huh corey uh so uh so and what i i'm i'm i'm
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not saying that we cannot in into indy integrate but integrating all the steps uh
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and making analytical labs and this preparations that is a big big change and we are a bit
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i want i want say over selling the the the the level chip but is it really we can do many things proof of concept
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there are there are some limitations we'll see later in this day that the people succeed to to do
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that so in properties you have the right to test and they're happy to start extremely developed
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and we can do much more rapid test and process of white sites would probably yeah i mentioned things about that
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and i'm i'm extremely optimistic about revisiting the the the rapid tested that or should i say
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we squeeze we say we smart technologies and simple technologies
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uh because it was a bit overlooked at the beginning of of of the micro freaks uh area yeah
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because we were just saying this is all technology and would do something better i don't read
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it's it's it's hard to beat so let's go back to the analytical work flow so when you
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when you have a uh when you have the uh l. analytical work flow you
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can divide in the preclinical phase the analytical face in the post analytical face
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id id new point of care device is taking care of
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everything with the highest precision at ian's yeah it
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did this enterprise in the analogy clicks and the india
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result interpretation uh and when you start to follow
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what happens in this kinda classical analytical work flow and ah you and
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and you read the cease the uh as sources of of errors
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and what what you see often is not the analytic sit stuff that makes the the main which is the main concerns
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so that it's very well under control anything it is under control in the in the central not
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but it's often related to the sample collections of the centre prep is a critical so if you do
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wrong there whatever machine you have the i mean you're dead and one of that but that
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uh and and the post analytical face i've just exaggerating to it's related to
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according to be convincing i so i'm now but uh what we
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what we were thinking estate okay why don't we move i'm sorry that the red
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yellow uh is is not a though you have is to say if
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we can combine the sample collection and the same sample preparation
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and provide the very same there is stable known
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preconditions sample and then transfer to a to a the clinical lab then your not point of care but
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you almost point of course you have sort of part except time art some some uh some
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the the in some cases you needed to take the decision but in
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other cases you don't need to you you have the decision immediately
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uh and you can call back uh the paper or or just be a better place eh intervals afterwards
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so news the plot uh the the the good up sorry i'm just
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beats mixed up with my with the buttons you uh with the blood um a definitive
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because is nice because it's the least invasive way of of of taking broad
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we've seen that it's easy and painless it's the it's of course isn't is is more volume
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the jury is it is it is of course the the question and that was the the reason the
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questions uh working about the rounds for instance about the quality of of the the finger peak
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uh it's still you you have access to brought up the relatively low invest in this
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but then if you want to do uh in some analytical techniques for instance you want to know uh it
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really want to know versus text it most of the case people with century fig eight have a very clean plasma get rid of
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the cells or on the or otherwise it's just so you need
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some some some propriety few stripes start to do the separation
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on on on on micro freaks cell phones on paper on filter paper
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you see that there is a lot of analysis that means that the cells
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are blown and and went and and and you you you you lose
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really beats the you you which you're brought and and then you buy yes
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the uh the information it's not only the the only reason so
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in in our lab we we work to be able to say what have what can
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we do to improve the things and so to make it preparation of blood sample
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uh yeah and with this preparation of blood sample having a lot separation so this is used
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here we would have he brought a concentrated load and here very few class that
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and then having a section here where you can go and and meter very
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small quantities of of uh a lot a of lot plus my
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but but metered and this is their important uh in some analytical tools were instead of measuring
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just the uh concentration you you you need to make friends with the marker
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at the at the given concentration to mickey to make an analysis
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so practically the the the separation is usually don't buy fits into vacation
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are people doing that on micro freaks but the news continues flow and
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what we tried with it was to observe the sedimentation alone
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a microfiche and this is the cross section this is about two hundred micron high
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and what happens with the news channel of course this this elwood sediment
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but since there is not much distance to to to travel do is is not going to take a
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days as we would do that with a with with you so you big wins more reason advantage
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but still uh yea you how the the the the the the the plasma is
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going to be you see here this is it side view of the channel
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the plasma is starting to appear wheeze wheeze time is is that from the the the good front and at some point
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you get this imitation in sedimentation you have to to get three face you
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have to press my face you have concentrated lot and you have
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to just to know and there is a very clear interface i decided
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lactation because corresponds to the latest cells that have been a demented
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they prefer the folk refine is changing why because when you have the blowed which is
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uh which is a city venting they're concentrating you increase the viscosity a lot
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so the pro for five which is initially proper robotic because uh still do that
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and then if you go uh if you go next to ops yeah and and missing in animation here but it's okay
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when you go in the next step you see that here the maximum velocity still in the plot but at some point
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uh the the maximum velocity it up is is in the past so it means that the plasma will overcome the blood flow
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and then you will have a cure plasma flow in front of your of your thing
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and this is what happens here you have the plasma really flowing
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about this one slightly progressing because you add new cells
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but it is fully sit sediment it and this way you can uh you you you you you can go and an extra class
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for the metering is we were using some micro freak status things to related to surface tension
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to push here in the caddy and and put out of the of the chip
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and you see the real chip but not with real broad just score or inc
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a worry it has been so it's it's a flowing by just get ready
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then you beecher really no no leaders uh quantities of of of blood and then this
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just to to prove it it how it works you see this is the black
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the black part here is the plasma volume that you would you would observe
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there is at the beginning there's no class no up front the front is progressing does know plasma
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and suddenly you start to see plasma appearing and the plasma appears and crows crows crows
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uh and and and and this is related to do is is the distance so you can make nice jury to things and
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to validate the thing we have compared in clinical settings
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with real patients uh the uh some some are
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parameters multiple lights parameters compared with extraction of of the of the chip
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and with the uh with the central laboratory made also with the
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certification and prove that most in in in in most
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of the case we have extremely good correlation between uh what
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uh what the big so the quality of the plasma
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is very high and uses reported if you really want to be in high
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accuracy and to finish in two minutes i finished yeah i i go
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to something a bit different to speech is also related to to consent
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of collection so the idea here is that we we we want
00:21:05
to extract been playing for brain fried and see dynamic change in
00:21:09
some concentration of of multiple lights or or or other province
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or your transmitter in the great so what we do here if we collect but these things are very difficult to
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an ice so the uh uh the the the bay point here is that we call we we store
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is is restored we do we do with chemical recording which time in the computer it
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and the company can be as long as you as you want and you can store a
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and and it it's segmented sewed me we need stored in drop it and every droplet
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correspond to maybe once a control could correspond to one minute or to ten minutes and you can have thousands of drop
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and then you distort you can put that in the freezer and days later you got
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you going the analytical at the lab we up we we we we upload
00:21:55
the the chemistry the chemical recording you want to be kind of hard disk
00:22:00
uh and and then we use the i. c. p. m. s. analyses
00:22:04
to to uh analysis in so this way you can have
00:22:07
really it can uh i analysis of of your six
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uh in detail this is the micro technology so uh nothing nothing very special except that
00:22:16
we need to when it tries not to damage the brain of of the nice
00:22:20
and this is saying the protest you see the probe uh uh the capillary to be seen
00:22:24
here it's been stored and then what we have here is a is a that to
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well uh i did is it we don't see anything i'm sorry uh but uh
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uh we what we have done here we have put the intellectual stimulation on at some point
00:22:43
and what i should have your on top is the graph of the of the concentration uh
00:22:48
until now we were limited and because it's a really early results were limited to
00:22:53
very simple a bit about it says so it's a metal and
00:22:56
with our aims because the technologies yeas allowing that's easy
00:23:01
and what what we had done with be stimulated at
00:23:05
some point the sixty second every between every point
00:23:08
and if i would have the graph here you would you would see a nice increase of some of these uh
00:23:14
a buyer markers right eh related to the uh to to to be
00:23:17
addicted couples of course if you can do that reason your
00:23:20
transmitter would be also very very interesting that's what the what the
00:23:23
what the games it what's our aim here so in conclusion
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um i'd like to stress the the question of that notion
00:23:32
of the ideal point of care depends very much
00:23:36
on the type of buyer markers your that you one that you want to murder
00:23:41
but you could depends also very much on the accuracy of the of of uh or which is needed
00:23:47
and our doctor said before it maybe be prefer to
00:23:50
have a a good that negative productivity uh and
00:23:54
for the rest we can afford to make longer test so that's probably something uh uh important
00:24:01
uh so so that's that's why there is no ideal point of care testing in my opinion
00:24:06
and the wearable might be good enough for many applications um
00:24:11
that we have a new approach for them a couple nights a year for
00:24:15
the brought it's really access and integrity of the of the sample
00:24:20
and finally uh uh uh i promote also some orders not to
00:24:24
forget that we can have if we have a good sample
00:24:27
sample conditioning we can still use the central labs because
00:24:31
they are qualified diego and extremely uh extremely efficient
00:24:36
and not that expensive prototype points cost but at that
00:24:40
point even it was cheap technology remakes so uh
00:24:44
saying that i would like to thank you for your attention and that's eh i love my talk
00:24:50
hi
00:24:54
hi
00:25:04
ah but you you can use mine
00:25:07
yes okay
00:25:12
yeah
00:25:14
yeah
00:25:22
oh ah
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yes
00:25:31
ah
00:25:34
do i have a question on we'll let sam the last mile circulation
00:25:39
and um
00:25:41
one of the things you make a few my collie till they think it was in ten to fifteen minutes
00:25:48
and i was wondering if you have some ideas how to make it more volume and fast still
00:25:55
and that's the smaller totally passive device is it at the time passive
00:26:02
yes okay yes okay the question of the quantity is critical
00:26:08
because uh this works on the of small scale and one to increase the quantities and the flow
00:26:14
rate uh it it it basically faiths have nothing it's impossible but the thing is that
00:26:20
we've we've we've been reached with the maximum that we can probably improve
00:26:25
buy it if if the person something available but not a change my order of magnitude
00:26:30
so so that's that is then strictly related to uh
00:26:34
the i think the analytical technique behind but
00:26:38
this the analytical tools in in in the central labs how extreme the senses
00:26:43
and uh they are not simply made to handle small samples because
00:26:48
the receiver examples and they have to be and so on
00:26:51
you can easily revisit these these two sent to go with
00:26:54
very very small quantities and often in fact when we
00:26:58
had a we we had or someplace sent to the clinical labs they were they were did you see
00:27:03
because the centre was too small but the reader with the resolution was way good the enough so
00:27:10
you see that we we have room uh also because the machines are extremely efficient
00:27:16
and uh whether the question with the time yeah the time will come of the thing and
00:27:21
uh we should go for the planet with a higher uh aggravated to go faster
00:27:33
any any other question huh
00:27:43
just one more formal questions and only printed it might
00:27:47
recruit to to him the segmentation flew gradients
00:27:51
because we know that the pentagon might agree to we had to experience that uh on mm classical uh
00:27:58
filters can really room performance obviously so i'll always it because
00:28:02
this is the interesting from i'm just important you
00:28:05
we we consider this this and up from the it's
00:28:09
very with a little sensitive to have much recruit
00:28:12
because the way it is flowing with a decent constant compensated so if there is more i have not to quit you with
00:28:19
uh quickly reach the phase of separation either you
00:28:23
is so and that's it so in principle
00:28:26
and i'm not claiming is totally insensitive but that was not an issue
00:28:30
uh uh for especially was patients we had patients with different
00:28:34
uh because they were hospital patients uh in the controlling the mother
00:28:38
a clinical trial and they were quite different in terms also in amateur great and it was okay so
00:28:46
but the thing that we have solve the problem of
00:28:52
yes i have one question others very rational and even handed presentation thank you you
00:28:59
arrive at the idea i think that what is ultimately a very useful
00:29:02
um substrate retry agreements but if you look at the others that you mentioned guilt yours is one than urine
00:29:08
do you see any promise for when you lose in in serious clinical analysis or
00:29:14
are they always going to be second year even though they're non invasive
00:29:18
uh you want to hear the tools or was this statement yeah
00:29:25
uh i'm not expert enough but uh i have some doubts
00:29:28
uh that these these kind of test when we pass
00:29:32
uh will be even more than the cone for information uh his soul but this is personal view
00:29:38
and and and maybe uh that people would say something else and the problem is of course
00:29:44
euros the into tissues and presents on are in direct and
00:29:48
and and what circulates quickly and that the right
00:29:51
and and also we know the blood and the others is the process
00:29:55
if you exercise uh whether what you eat a further no fight
00:29:59
it's going to change the the the the decomposition of of these
00:30:03
uh for with the wrong i would to saliva is it
00:30:07
for some applications i've is good because it's renewed quickly uh but but
00:30:12
the very important is we we we should know what we want from since if if and that's that's what
00:30:17
is what is okay for viruses that's fine so it but you don't quantify you would pick the presence
00:30:27
no uh it because of the access
00:30:30
yeah but it's a good of course it's good
00:30:36
thank you very much
Conference Program
Welcome Note
Gaëtan Cherix, Director - School of Engineering
Oct. 26, 2017 · 10:08 a.m.
210 views
Welcome Note
Marc E. Pfeifer, Symposium Chair
Oct. 26, 2017 · 10:15 a.m.
564 views
Point-of-care Diagnostics: what are the real needs of general practioners?
Nicolas Senn, PMU, UNIL
Oct. 26, 2017 · 10:19 a.m.
157 views
Recent developments in microtechnologies for point-of-care testing
Philippe Renaud, EPFL
Oct. 26, 2017 · 10:47 a.m.
217 views
GenePOC, a breakthrough solution in molecular point-of-care testing
Patrice Allibert, GenePOC
Oct. 26, 2017 · 11:19 a.m.
273 views
mHealth in the therapy follow-up of chronic inflammatory diseases – a smartphone based self-monitoring tool
Jakob Weber, BÜHLMANN Laboratories
Oct. 26, 2017 · 11:47 a.m.
104 views
Reglementary aspects ruling the reimbursement of laboratory analyses in the context of the compulsory health insurance
Michèle A. Fleury-Siegenthaler, Federal Office of Public Health
Oct. 26, 2017 · 2:12 p.m.
166 views
The applied research programme "Diagnostic Biochips": novel technologies for point-of-care diagnostics
Jean-Manuel Segura, HES-SO Valais
Oct. 26, 2017 · 2:42 p.m.
198 views
From brain proteomics discovery to the use of a POCT: The translation to mild traumatic brain injury (mTBI)
Jean-Charles Sanchez, CMU, UNIGE
Oct. 26, 2017 · 3:25 p.m.
466 views
Recent advances in non-invasive diagnostics
Samantha Paoletti, CSEM
Oct. 26, 2017 · 3:53 p.m.
199 views
How nanofluidics bring diagnostics closer to the patient
Fabien Rebeaud, Abionic
Oct. 26, 2017 · 4:17 p.m.
224 views
Keynote Session introduction
Marc E. Pfeifer, Symposium Chair
Oct. 26, 2017 · 5:07 p.m.
Keynote session: Accessible Bioanalysis for the Developing World and the Point of Care
George M. Whitesides, Harvard University, Cambridge - USA
Oct. 26, 2017 · 5:09 p.m.
230 views
Conclusions
Marc E. Pfeifer, Symposium Chair
Oct. 26, 2017 · 6:25 p.m.
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