PFI:BIC - Pathtracker: A smartphone-based system for mobile infectious disease detection and epidemiology

这个创新伙伴关系：建设创新能力（PFI:BIC）项目将开发一种移动传感器技术，用于检测和识别病毒和细菌病原体。通过基于智能手机的检测仪器，结果与基于云的数据管理服务共享，这将使医生能够快速可视化传染病的地理和时间传播。当由社区医疗用户（如兽医或护理点临床医生）部署时，PathTracker系统将能够快速确定和报告传染病病例，从而为治疗和隔离反应提供信息，这是目前在中心实验室设施进行检测无法做到的。聚合酶链反应（PCR）和环介导等温扩增（LAMP）目前是鉴定病毒或细菌病原体最敏感和最特异性的方法，研究重点是将疾病特异性DNA序列扩增到易于测量的浓度的方案的小型化、加速和自动化。该计划是应用先前nsf资助的光子晶体增强荧光（PCEF）和智能手机荧光光谱的进展结果，在亚µl液体体积内实施PCR或LAMP测定，以减少测定扩增时间，以记录可测量的荧光信号。重要的是，该检测方法可以在芯片内实现10倍PCR（或LAMP）反应的多路复用，该芯片可以通过定制的手持检测仪器“刷卡”，该仪器与传统智能手机的后置摄像头接口，其方式类似于读取信用卡。移动设备软件应用程序将指导用户完成分析过程，解释检测结果（包括分析测量与芯片上实验控制的相关性），并将结果与用户提供的其他相关信息一起传达给基于云的数据管理系统。重要的是，该应用程序将使用户能够查看其他用户执行的测试结果，通过移动设备界面，可以简单地可视化位置，时间和阳性/阴性测试周围的情况。当用户网络内出现阳性检测时，该系统将使用户能够请求可定制的警报，并在常规实验室检测可以确认现场阳性检测结果时突出显示确诊的阳性病例。该应用程序将跟踪结果并报告系统性能的统计数据，包括检测的接收者操作特性。虽然该系统最初将部署在马传染病的背景下，这意味着有机会减轻与马业传染病相关的巨大经济损失，但开发的技术将同样适用于人类、食用动物和伴侣动物。考虑到埃博拉、艾滋病毒、结核病和疟疾对经济和健康的影响，当PathTracker在发展中国家全面部署时，该系统通过快速提供有效治疗、隔离感染患者和快速识别/报告新病例来拯救生命的潜力是巨大的。在项目启动之初，主要合作伙伴是牵头机构：伊利诺伊大学厄巴纳-香槟分校（电气与计算机工程系、生物工程系和国家超级计算应用中心）；华盛顿大学西雅图分校（学术机构）；Perkin Elmer，诊断研发部，（Waltham， MA）（大型企业）；摩托罗拉移动（芝加哥，伊利诺伊州）（大型企业）；大卫·纳什博士，医学博士。（莱克星顿，肯塔基州）（个体执业兽医）。

This Partnerships for Innovation: Building Innovation Capacity (PFI:BIC) project will develop a mobile sensor technology for performing detection and identification of viral and bacterial pathogens. By means of a smartphone-based detection instrument, the results are shared with a cloud-based data management service that will enable physicians to rapidly visualize the geographical and temporal spread of infectious disease. When deployed by a community of medical users (such as veterinarians or point-of-care clinicians), the PathTracker system will enable rapid determination and reporting of instances of infectious disease that can inform treatment and quarantine responses that are currently not possible with tests performed at central laboratory facilities. Polymerase Chain Reaction (PCR) and Loop-Mediated Isothermal Amplification (LAMP) currently represent the most sensitive and specific approaches for identification of viral or bacterial pathogens, with intense research focus directed towards miniaturization, acceleration, and automation of the protocol for amplifying disease-specific DNA sequences to easily-measured concentration. The plan is to apply the results of previously NSF-funded advances in photonic crystal enhanced fluorescence (PCEF) and smartphone fluorescence spectroscopy to implement PCR or LAMP assays within sub-µl liquid volumes for reduction in the assay amplification time to register a measurable fluorescent signal. Importantly, the detection approach enables 10x multiplexing of PCR (or LAMP) reactions within a chip that can be "swiped" through a custom handheld detection instrument that interfaces with the back-facing camera of a conventional smartphone in a manner that is similar to reading a credit card. A mobile device software application will guide the user through the assay process, interpret the results of the detection (including correlation of assay measurements with on-chip experimental controls), and communicate results to a cloud-based data management system along with other relevant information provided by the user. Importantly, the app will enable the user to view the results of tests performed by other users, with a mobile device interface that enables simple visualization of the locations, times, and circumstances surrounding positive/negative tests. The system will enable users to request customizable alerts when positive tests occur within the network of users, and to highlight confirmed positive cases when conventional laboratory tests can confirm results of positive field tests. The app will track outcomes and report statistics on system performance, including Receiver Operating Characteristic of assays. While the system will initially be deployed in the context of equine infectious disease representing an opportunity to mitigate enormous economic losses associated with infectious disease in the horse industry, the developed technology will be equally applicable to humans, food animals, and companion animals. Considering the economic and health impact of ebola, HIV, tuberculosis, and malaria, when PathTracker is fully deployed within developing nations, the potential of the system to save lives by rapid delivery effective treatment, quarantine of infectious patients, and rapid identification/reporting of new cases is enormous. At the inception of the project, the primary partners are the lead institution: University of Illinois at Urbana-Champaign (Department of Electrical and Computer Engineering, Department of Bioengineering, and National Center for Supercomputing Applications); University of Washington at Seattle (academic institution); Perkin Elmer, Diagnostics R&D Division, (Waltham, MA) (Large business); Motorola Mobility (Chicago, IL) (Large business);and Dr. David Nash, D.VM.(Lexington, KY) (Individual practitioner veterinarian).