(i)
Technologies in Health
Background
The importance of technology in health has been recognised by the World Health Organisation who launched a call for
innovative technologies in 2009. The call was funded by the Bill and Melinda Gates Foundation within the framework of the
Global Initiative for Health Technologies that was launched in 2008 and was aimed at identifying and evaluating innovative
medical devices, either existing or under development, which address global health concerns and which are likely to be
accessible, appropriate and affordable for use in low- and middle-income countries.
Over the last decade, mobile phones have evolved from relatively simple communication devices to the most ubiquitous
computing and sensing platform on the planet. With mobile phone subscriptions close to 6 billion people, more people now
have access to a mobile phone than electricity (5.8 billion) or safe drinking water (4.5 billion). This unprecedented level of
technology penetration provides enormous opportunity for applications in global health (in both the developed and developing
world). In the developed world, there is now a very strong focus on the development of patient-centric models of healthcare
delivery as a means of reducing the economic burden of chronic disease. Within these models, mobile phones are considered
to play a critical role and may well become the technology platform of choice for healthcare delivery in the future. This view is
already reflected in both industry activity toward the development of mobile phone-based health technologies and in the
scientific literature. In particular, an area that will impact significantly on human health is the ability to perform biodiagnostic
tests using mobile phone technology. The focus is primarily on mobile phone technologies, but for many biodiagnostic assays
we also need easy-to-use, robust and low-cost cartridge with sample preparation and bio-sensitive elements that mobile phones
interfaces with.
(A) Current areas of research
Members are researching a variety of technologies that could address global health concerns including ;
Malaria vaccines
At RCSI, Prof. Sam McConkey leads a phase 1 clinical Malaria vaccine trial which aims to develop and test new vaccines
which would prevent the 1.2 million deaths from malaria in childhood. One study, funded by the European Vaccine Initiative,
has just completed enrolment, and is now in the follow-up stage.
A second technology under investigation is malaria surveillance funded by Irish Aid and HRB to set up and evaluate the malaria
surveillance system in The Gambia.
Diagnostic Technologies
Researchers in the BDI, at DCU, are focused on the development of next generation Point-of-Care (POC) diagnostic
technologies. Early diagnosis is a key driver for developing highly sensitive devices, which will identify ultra-low concentrations
of biomarkers during the early stages of diseases, for example cancer, infectious and cardiovascular disease. For the most part,
photoluminescence is the sensor transduction approach due to its high sensitivity compared to most other approaches e.g.,
colorimetry, refractometry and electrochemical sensing. The emphasis in the BDI has been on the development of enhanced
fluorescence-based diagnostic platforms with increased signal-to-background ratio (SBR) to facilitate improved limit of detection
(LOD) and resolution power. Among the signal enhancement strategies developed by CMD at the BDI are (i) plasmonic
enhancement and (ii) supercritical angle fluorescence (SAF). To date, significant signal enhancement and improved bioassay
performance for both protein and DNA-based assays have been achieved within the BDI using both these strategies.
Researchers are developing optical signal amplification strategies for enhanced optical biomedical sensor platforms for
applications in point-of-care diagnosis, for instance cancer and infectious disease. The work here has 3 strands (i) development
of ultra-bright silica nanoparticles for cell imaging and enhanced RNA assays (ii) Supercritical Angle fluorescence (SAF) based
enhanced light collection platforms for improved bioassays and (iii) metal-nanoparticle-based plasmonic platforms for
biomedical diagnostics.
Health Informatics
Dr Pamela Hussey is a lecturer in Health Informatics and nursing at DCU. Her research interests include Health care systems
and processes, particularly the Electronic Healthcare Record (EHR) and health informatics standards on concepts and
terminology. Current projects include working with public health nurses on population health tools using digital data entry
devices and the development of an online resource for education on EHR scope purpose. This resource is a collaborative
initiative between DCU , DIT and TCD and is scheduled for completion in November 2012.
At an international /european level she is engaged with a joint working group in CEN (WG1 and WG2) health informatics
standards harmonisation between core EHR standards EN13940 (Contsys) , EN13606 (EHRcom), EN12967 (HISA). The
purpose of this group is to
1. Describe the issues relating to concurrent use of these three
important standards for future EHR development
2. To map/ extend the 3 standards as required for future implementation
3. To create or faciliate implementation guides for future deliverables.
Engineering - ‘Sustainable Hand Pump Design’
A collaborative project between DCU and DkIT researching wear on hand-pump piston seals. Initial work highlights improved
wear characteristics for nitrile rubber piston seals using a diamond like coating. Field trials in Uganda are due to commence in
2012. The project is part of the bigger project 'Water Is Life: Amazzi Bulamu' which is a HEA/IrishAid funded partnership of Irish
Higher Education Institutions (NUIM, DCU, RCSI ,DkIT TCD, UCD, QUB, Makerere University Kampala, the Medical
Missionaries of Mary and various NGOs. The goal of the partnership, in support of the Government of Ireland's development
goals, is to build research capacity in Ireland and Africa and to conduct research that supports sustainable water resource
management as a catalyst for sustainable economic and social development in rural Uganda
(B) Proposed areas for future research and collaboration
Proposals for future research/collaboration are invited. The following is a list of proposals received to date.
Diagnostic Technologies
 development of microfluidic systems for water analysis
 the development/integration/miniaturisation of biodiagnostic technologies from JIGH partners and examine possible
intersections with mobile phone technology.
 research on the factors that influence the uptake and use of mobile phone-based health interventions, along with their
impact.
(C) New Initiative
- "Rapid, Low-Cost and Instrument-Free CD4+ Cell Counting for HIV Diagnostics in Resource-Poor Settings"
- The blend of technical expertise in diagnostic development, with the societal and population context provided by
social scientists has led to the design of novel instrumentation and subsequent success in publication.
Publications
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Charles E. Nwankire, Anita Venkatanarayanan, Thomas Glennon, Tia E. Keyes, Robert J. Forster, and Jens Ducrée.
Label-free electrochemical impedance detection of cancer cells from whole blood on an integrated centrifugal
microfluidic platform. Biosensors & Bioelectronics, 68:382–389, 2015, DOI:10.1016/j.bios.2014.12.049. status:
published online.
David Kinahan, Sinéad Kearney, Olivier Faneuil, Macdara Glynn, and Jens Ducrée. Paper imbibition for timing of
multi-step liquid handling protocols on event-triggered centrifugal microfluidic lab-on-a-disc platforms. RSC Advances,
5(3):1818–1826, 2015, DOI:10.1039/C4RA14887H.
Daniel Kirby, Macdara Glynn, Gregor Kijanka, and Jens Ducrée. Rapid and cost-efficient enumeration of rare cancer
cells from whole blood by low-loss centrifugo-magnetophoretic purification under stopped-flow conditions. Cytometry
Part A, 87(1):74–80, 2015, DOI:10.1002/cyto.a.22588.
Macdara Glynn, David Kinahan, and Jens Ducrée. Rapid, low-cost and instrument-free CD4+ cell counting for HIV
diagnostics in resource-poor settings. Lab on a Chip, 14(15):2844–2851, 2014, DOI:10.1039/c4lc00264d.
Charles Nwankire, Monika Czugala, Robert Burger, Kevin J. Fraser, Tríona M. O’Connell, Thomas Glennon, Blessing
E. Onwuliri, Isikaku E. Nduaguibe, Dermot Diamond, and Jens Ducrée. A portable centrifugal analyser for liver
function screening. Biosensors & Bioelectronics, 56:352–358, 2014, DOI:10.1016/j.bios.2014.01.031.
Macdara Glynn, Daniel Kirby, Danielle Chung, David J. Kinahan, Gregor Kijanka, and Jens Ducrée. Centrifugomagnetophoretic purification of CD4+ cells from whole blood towards future HIV/AIDS point-of-care applications.
Journal of Laboratory Automation, 19(3):285–296, 2014, DOI:10.1177/2211068213504759. Front Cover.
David J. Kinahan, Sinéad M. Kearney, Macdara T. Glynn, and Jens Ducrée. Spira mirabilis enhanced whole blood
processing in a lab-on-a-disk. Sensors & Actuators A – Physical, 215:71–76, 2014, DOI:10.1016/j.sna.2013.11.010.
Charles Nwankire, Di sien S. Chan, Jennifer Gaughran, Tríona O’Connell, Robert Burger, Robert Gorkin III, and Jens
Ducrée. Fluidic automation of nitrate and nitrite bioassays in whole blood by dissolvable-film based centrifugopneumatic actuation. Sensors, 13(9):11336–11349, 2013, DOI:10.3390/s130911336.
Macdara Glynn, David Kinahan, and Jens Ducrée. CD4 counting technologies for HIV therapy monitoring in resourcepoor settings: State-of-the-art and emerging microtechnologies. Lab on a Chip, 13(14):2731–2748, 2013,
DOI:10.1039/C3LC50213A.
Charles E. Nwankire, Gerard G. Donohoe, Xin Zhang, Jonathan Siegrist, Martin Somers, Dirk Kurzbuch, Ruairi
Monaghan, Maria Kitsara, Robert Burger, Stephen Hearty, Julie Murrell, Christopher Martin, Martha Rook, Louise
Barrett, Stephen Daniels, Colette McDonagh, Richard O’Kennedy, and Jens Ducrée. At-line bioprocess monitoring by
immunoassay with rotationally controlled serial siphoning and integrated supercritical angle fluorescence optics.
Analytica Chimica Acta, 781:54–62, 2013, DOI:10.1016/j.aca.2013.04.016.
Monika Czugala, Damian Maher, Fiachra Collins, Robert Burger, Frank Hopfgartner, Yang Yang, Jiang Zhaou, Jens
Ducrée, Alan Smeaton, Kevin J. Fraser, Fernando Benito-Lopez, and Dermot Diamond. CMAS: Fully integrated
portable centrifugal microfluidic analysis system for on-site colorimetric analysis. RSC Advances, 3(36):15928–15938,
2013, DOI:10.1039/C3RA42975J.