International study led by researchers in Singapore reveals critical insights into timely interventions for maternal depression

Peer-Reviewed Publication

AGENCY FOR SCIENCE, TECHNOLOGY AND RESEARCH (A*STAR), SINGAPORE

SINGAPORE – A large-scale international study spanning three continents, led by researchers from A*STAR’s Translational Neuroscience Programme of the Singapore Institute for Clinical Sciences (SICS) in Singapore, has found that maternal depressive symptoms begin from early pregnancy and can last up to two years after childbirth.

While health professionals often emphasise the postpartum stage after childbirth as a high-risk period for the onset of depression, findings from this latest study reveal a different reality – that maternal depressive symptoms can appear from early pregnancy and therefore timely interventions during pregnancy are needed to better mitigate such symptoms for improved outcomes for both mother and child.

Previous findings from the Growing Up in Singapore Towards healthy Outcomes (GUSTO) project showed clearly that prenatal maternal mental health plays a significant role in the brain development and health of one’s offspring. Research shows that maternal depressive symptoms can negatively affect a child’s nutrition, physical health, cognitive functions, socioemotional development, academic achievement, and also increase the risk of ADHD and depression.

The study was published in the journal JAMA Network Open on 26 Oct 2023, titled “Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents”. It involved seven prospective observational cohorts across the United Kingdom, Canada, and Singapore. A*STAR researchers analysed the maternal depressive symptom trajectories of 11,563 pregnant women, spanning multiple decades in the largest such analysis to date.

Among the cohorts analysed were three from Singapore: Growing Up in Singapore Towards healthy Outcomes (GUSTO), Singapore PREconception Study of Long-Term Maternal and Child Outcomes (S-PRESTO) and Mapping Antenatal Maternal Stress (MAMS). Each cohort included depressive symptoms measured at multiple perinatal time points and analysed independently. The data was based on prospective maternal self-reports of depressive symptoms, eliminating the potential bias collected from retrospective reports.

The study showed three distinct clusters of mothers with stable low, mild, and high symptom levels over the perinatal period – the period from the beginning of pregnancy up to two years post-birth. The trajectories of depressive symptoms were present for all mothers.  This was true even those who met clinical cut-offs for probable depression indicating that more serious instances of depression in women begin prior to the birth of the child. 

With a more precise grasp of when depressive symptoms begin for mothers, the study underscores the importance of early interventions during pregnancy to mitigate maternal depressive symptoms and their impact on offspring. This paradigm shift has far-reaching implications for healthcare professionals, policymakers, and the general public.

“Several recent studies, including one conducted locally suggest that maternal depressive symptoms may begin before conception, which is why interventions, guidelines for care, and public health policies aimed at alleviating maternal depressive symptoms should target as early as preconception, at least during pregnancy, in addition to the postnatal period, for more effective outcomes,” says Dr Michelle Kee, Research Scientist at A*STAR’s SICS and first author of the paper.

Professor Michael Meaney, the Director of the Translational Neuroscience Programme at SICS, adds, “The medical media continues to refer to maternal depression as ‘postnatal depression’, implying that the onset of symptoms occurs following the birth of the child. This extensive analysis shows that the onset of symptoms is in the prenatal period and remains largely stable thereafter. This is true for women in the community as well as for those experiencing more severe symptom levels. The results of this study point to the early antenatal period as a crucial time point for the identification of stable trajectories of maternal depressive symptoms and emphasises the critical importance of prenatal intervention.”

Associate Professor Helen Chen, Senior Consultant Department of Psychological Medicine, KK Women's and Children's Hospital and Clinical Associate Professor of Duke-NUS Medical School shares, "This study provides strong evidence across populations that it is crucial to address depression during pregnancy so that mothers are well and ready to receive their babies, rather than to wait until the postnatal period, for postnatal depression has traditionally been the focus. Given what we know about the impact of perinatal depression on child development and health outcomes, the paper will help to inform healthcare systems to direct resources upstream to the antenatal period. This will benefit our mothers and their children, and population health of future generations."

---

JOURNAL

JAMA Network Open

DOI

10.1001/jamanetworkopen.2023.39942 

ARTICLE TITLE

Perinatal Trajectories of Maternal Depressive Symptoms in Prospective, Community-Based Cohorts Across 3 Continents

Singapore’s smoke-free law may have warded off 20,000 heart attacks in seniors

First such local study finds extension of smoking ban to communal areas of residential blocks and outdoor spaces linked to monthly fall in heart attack cases

Peer-Reviewed Publication

DUKE-NUS MEDICAL SCHOOL

An extension of the smoking ban to communal areas of residential blocks and other outdoor spaces in Singapore in 2013 may have prevented up to 20,000 heart attacks among those aged 65 and above. This is according to the first local study investigating the effects of expanding such laws to outdoor areas.

The research, published in the open access journal BMJ Global Health, was led by scientists from Duke-NUS Medical School. Their study showed that the extension of the smoking ban was associated with a monthly fall in the rate of heart attacks, with older people and men benefitting the most.

Second-hand smoke exposure is responsible for 1.3 million annual deaths around the globe, many of which are caused by heart attacks. But the existing evidence on the health benefits of comprehensive smoke-free laws, which many countries (67 since 2003) have implemented, is largely confined to indoor smoking bans rather than those for housing estates and outdoor spaces. 

“Residents would likely frequent common areas in housing estates as part of their daily routine or when meeting with their friends and neighbours. If there are smokers around, these residents may be exposed to tobacco smoke. Having smoking bans in these areas would reduce their exposure to the smoke and consequently, reduce their risk of heart attacks,” said Dr Joel Aik, an Adjunct Assistant Professor from the Health Services & Systems Research Programme at Duke-NUS and senior author of the study.

In 2013, Singapore extended smoke-free legislation to all communal areas of residential blocks, where 80 per cent of the population lives, as well as outdoor spaces, including covered linkways, overhead bridges and within 5 metres of bus stops. This was further extended to reservoirs and all residential parks in 2016, and to more educational institutions as well as more types of buses and taxis in 2017.

To assess the impact of the various pieces of legislation on heart attack rates, the researchers analysed monthly reports from the Singapore Myocardial Infarction Registry from January 2010 to December 2019. During this period, 133,868 heart attacks were reported, 87,763 (66 per cent) of which occurred among men and 80,597 (60 per cent) of which occurred among those aged 65 and above.

Before the 2013 extension, the rate of heart attacks among those aged 65 and above was around 10 times that of those under 65 years of age. The rate of cases among men was nearly double that of women. The overall number of heart attacks rose by a rate of 0.9 cases per million people every month before the 2013 extension. But afterwards, this rate fell to 0.6 cases per million people.

Seniors and men were the primary beneficiaries of the extended ban. The monthly fall in heart attack rate among those aged 65 and above was 5.9 cases per million people. This fall in the rate is almost 15 times greater than that in younger individuals, which stood at 0.4 cases per million people.

According to their calculations, the scientists also estimated that an additional 19,591 heart attacks might have occurred in those aged 65 and above, compared with 1,325 in the under-65s had the legislation not been enacted. Potentially, 4,748 cases were averted in men.

The impact was not as clear when studying the impact of legislation in subsequent years. From 2016, the extension of smoke-free laws to reservoirs and more parks was not associated with a significant reduction in the number of heart attacks. This could have been due to better diagnostic technology, which can detect more cases of heart attack.

While the 2017 legislation was not associated with a significant decline in overall heart attack incidence, the researchers found that the average decline in the rates following this prohibition extension to more universities and more types of buses and taxis was consistent among those of different age groups and among men and women. This consistency in findings suggests that the ban may well have been beneficial though more studies are required to validate this.

Professor Patrick Tan, Senior Vice-Dean for Research at Duke-NUS, said: “Smoking remains an unresolved epidemic in Asia, with majority of tobacco consumers being in the region. This study provides additional evidence for policy makers who are looking to expand their smoke-free laws to mitigate the adverse impact of exposure to tobacco smoke and reduce the health burden of heart diseases for their residents.”  

###

Reference: Ho, J.S. et al. (2023) ‘Association between the extension of smoke-free legislation and incident acute myocardial infarctions in Singapore from 2010 to 2019: An interrupted time-series analysis’, BMJ Global Health, 8(10). doi:10.1136/bmjgh-2023-012339.

---

JOURNAL

BMJ Global Health

DOI

10.1136/bmjgh-2023-012339 

METHOD OF RESEARCH

Meta-analysis

SUBJECT OF RESEARCH

People

ARTICLE TITLE

Association between the extension of smoke-free legislation and incident acute myocardial infarctions in Singapore from 2010 to 2019: an interrupted time-series analysis

 

Smart phone application to increase safety in liver surgery

Score for individualized risk assessment for patients prior to liver resection can be calculated using a smartphone app

Peer-Reviewed Publication

MEDICAL UNIVERSITY OF VIENNA

Surgical removal of parts of the liver remains the only curative approach for patients with liver-specific cancer. An international team led by Patrick Starlinger from MedUni Vienna has developed a score that provides an individualised risk assessment for patients prior to liver resection, which can significantly increase the safety of liver surgery. This score can be calculated using a simple smartphone app and, compared to standard preoperative tests, offers a cheaper and less invasive option with comparable or better predictive power for postoperative liver failure. The effectiveness of the score was confirmed in an international multicentre study with over 14,000 patients.

Normally, the liver can tolerate the surgical removal of up to 75 percent of its volume and can maintain its functions after surgery. However, depending on the underlying chronic liver disease, the type of cancer or the extent of resection, patients may be at higher risk of inadequate postoperative liver regeneration or even postoperative liver failure, the main cause of mortality after liver surgery. As there is no treatment for this, a risk assessment before surgery is essential. However, the established tests for preoperative liver function testing are often associated with considerable cost, time and invasiveness and are rarely directly compared.

APRI+ALBI score facilitates preoperative liver function assessment
A team from 10 different international liver surgery centres led by Patrick Starlinger (Medical University of Vienna/University Hospital Vienna and Mayo Clinic, Rochester, USA) has developed a multivariable model based on basic patient:in characteristics and a preoperative score, the APRI+ALBI score, which enables a standardised and easily accessible preoperative liver function assessment. The APRI+ALBI score is calculated using simple routine laboratory parameters (GOT, platelets, albumin, bilirubin). It has already been shown to be closely related to preoperative liver function and chemotherapy-induced liver injury, and has significant predictive potential for the development of postoperative liver failure. The APRI+ALBI score provides a comprehensive assessment of liver function, especially compared to classical liver function tests, which usually only assess the excretory capacity of the liver.

International multicentre study with more than 14,000 patients
The study included more than 14,000 patients from 10 different institutions and the National Surgery Quality Improvement Program (NSQIP), an algorithm-based database from the United States. The model showed significant predictive performance, which was validated in the international multicentre cohort. "We are very pleased with the strong predictive potential of our model, which documents the significant clinical utility of our score and the associated smart phone app," says Jonas Santol, first author of the manuscript, a surgical resident at Klinikum Favoriten and a doctoral student at MedUni Vienna's Center for Physiology and Pharmacology, who is currently on a research residency at the Mayo Clinic (Rochester, USA).

Freely available smartphone app
The multivariable model based on the APRI+ALBI score is easy to calculate using routine laboratory values and basic patient characteristics, and can be calculated using a freely available smartphone app. Compared to established liver function tests, it shows equivalent or improved prediction of liver failure at a fraction of the cost, time required and invasiveness. "We have taken an important step in translating this into clinical practice by developing a freely available smartphone application that allows us to calculate our score and thus individualise the risk assessment of patients before liver resection. This sets a new standard in preoperative risk assessment and will significantly increase the safety of liver surgery for our patients," says Patrick Starlinger from MedUni Vienna's Department of General Surgery of MedUni Vienna/University Hospital Vienna, who is currently based at the Mayo Clinic (Rochester, USA).

Participating centres were the Medical University of Vienna and the University Hospital Vienna, the Favoriten Clinic, the Landstraße Clinic, the Medical University of Innsbruck, the Wiener Neustadt Regional Hospital, the Mayo Clinic, Rochester (USA), the Karolinska University Hospital (Sweden), the Bern University Hospital (Switzerland), the Heidelberg University Hospital (Germany) and the University Medicine Mannheim (Germany).

Reference to the App:
iPhone: https://apps.apple.com/us/app/tellaprialbi/id1538815527
Android: https://play.google.com/store/apps/details?id=com.thirtysevenbinary.tellaprialbi&hl=de&gl=US

---

JOURNAL

Annals of Surgery

DOI

10.1097/SLA.0000000000006127 

ARTICLE TITLE

An APRI+ALBI Based Multivariable Model as Preoperative Predictor for Posthepatectomy Liver Failure

 

HKU remote-sensing and landscape scholars reveal an improved human greenspace exposure equality during 21st century urbanization

Peer-Reviewed Publication

THE UNIVERSITY OF HONG KONG

 

IMAGE: 

FROM LEFT TO RIGHT: DR BIN CHEN, DR SHENGBIAO WU, PROFESSOR CHRIS WEBSTER AND PROFESSOR PENG GONG.

view more 

CREDIT: THE UNIVERSITY OF HONG KONG

Over half of the global population currently resides in urban settings, experiencing an influx of nearly 200,000 individuals each day. An increasing body of evidence highlights the significance of urban green spaces, emphasizing their potential to boost psychological and physiological well-being, coupled with broader ecosystem service benefits. Consequently, ensuring universal access to public and green spaces is vital for achieving sustainable and healthy development goals.

The evolution of cities has left a profound impact on green space exposure. In initial urban development stages, extensive built-up areas supplanted green spaces. The subsequent rapid urban expansion led to the construction of significant artificial green landscapes, reshaping the nature of greenspace exposure in cities. However, the extent to which urbanization has affected human exposure to green space and related inequalities over time remains unclear.

Recent research conducted by researchers from The University of Hong Kong (HKU) in collaboration with colleagues from Tsinghua University has unveiled an improved human greenspace exposure equality among global large cities. This discovery underscores the positive impact of urbanization on the accessibility and benefits of greenspaces. This research represents the first global exploration of human exposure to greenspace exposure and its associated equality shifts, focusing on the first two decades of the 21st century urbanization. The findings have been published in Nature Communications (link), providing valuable insights that can help inform future city greening efforts.

The research team developed a methodology incorporating 30-meter-resolution Landsat satellite time-series greenspace mapping and a population-weighted exposure framework to quantify the changes in human exposure to greenspace and associated equality from 2000 to 2018. The team examined 1028 cities in the world and divided their sample into two main segments: Global South (developing countries) and Global North (developed countries) cities.

Global findings indicated a substantial increase in physical greenspace coverage and an improvement in human exposure to urban greenspace. This progress led to a marked reduction in greenspace exposure inequality over the past two decades. Nevertheless, there is a contrast in the rate of reduction in greenspace exposure inequality between cities in the Global South and North, with a much faster rate of reduction in the Global South, nearly four times that of the Global North. Delving deeper into the underlying drivers, the researchers found that greenspace coverage, as a measurement of greenspace supply, has dominantly promoted the improvement in the temporal change of greenspace exposure inequality.

Dr. Bin Chen, the project's principal investigator and Assistant Professor of Division of Landscape Architecture at HKU said： “This study is a timely thrust on our earlier work published in Nature Communications, which highlighted contrasting green space exposure inequalities between cities of the Global North and Global South (link). The current research offers a comprehensive, longitudinal view of how this exposure and its associated inequalities have evolved over time”.

Dr. Chen emphasized two important contributions from this study. The research findings reveal a trend toward equality in human exposure to greenspace, as reflected by a decline in inequality indices such as Gini, Atkinson, and Theil coefficients. Another key insight is that this study observes prominent spatial differences in urban greenspace trends in the contrast between Global North and Global South cities. Dr. Chen remarked: “These findings provide encouraging evidence, showcasing that cities globally are making positive progress in realizing the 11th sustainable development goal”.

“The study tells a broadly positive story of the opening decades of the urban century, and our analysis of trends, and subsequent studies of positive outliers in those trends, will help cities achieve better net outcomes when planning for balanced changes in urban greenspace loss and construction by incorporating multidimensional contexts of greening history, greenspace supply status quo, prioritized vulnerable hotspots and the underlying socio-economic factors”, said Professor Chris Webster, Chair Professor of Urban Planning and Development Economics, Dean of Faculty of Architecture, HKU.

Adding to the discourse, Professor Peng Gong, Chair Professor of Global Sustainability at Department of Geography and Department of Earth Sciences, Vice-President and Pro-Vice-Chancellor (Academic Development) of HKU, commented: “This research is timely and offers invaluable insights, serving as a beacon for government bodies, urban planners, and private sector developers. It emphasizes the adoption of comprehensive urban strategies to not only increase but also enhance the quality of green spaces, all in pursuit of the sustainable development goals.” Professor Gong further stressed HKU’s unwavering commitment to forwarding scientific research that aligns with the UN’s Sustainable Development Goals. As a testament to this commitment, he highlighted HKU's recent launch of two pioneering research hubs: the Urban Systems Institute (USI) and the Institute for Climate and Carbon Neutrality (ICCN).

The full paper can be accessed here: https://doi.org/10.1038/s41467-023-41620-z

Temporal change of greenspace exposure inequality measured by the Gini index for global 1028 cities from 2000 to 2018.

CREDIT

Nature Communications

About the research team
This research was led by Dr. Bin Chen, Director of Future Urbanity & Sustainable Environment (FUSE) Lab, Division of Landscape Architecture, Faculty of Architecture, Urban Systems Institute, and Musketeers Foundation Institute of Data Science, HKU. The collaborative team includes Dr. Shengbiao Wu, Research Assistant Professor, Division of Landscape Architecture, Faculty of Architecture, HKU; Professor Bing Xu, Department of Earth System Science, Tsinghua University; Professor Chris Webster, HKUrbanLabs, Faculty of Architecture, Urban Systems Institute, and Musketeers Foundation Institute of Data Science, HKU of Data Science, HKU; and Professor Peng Gong, Department of Geography, Department of Earth Sciences, Urban Systems Institute, and Institute for Climate and Carbon Neutrality, HKU.

This study is supported by The University of Hong Kong HKU-100 Scholars Fund, Seed Fund for Strategic Interdisciplinary Research Scheme Fund , the Research Grants Council of Hong Kong Early Career Scheme (No. HKU27600222) and General Research Fund (No. HKU17601423), National Key Research and Development Program of China (No. 2022YFB3903703), National Research and Development Program of China (No. 2022YFB3903703) Development Program of China (No. 2022YFB3903703), National Natural Science Foundation of China Young Scientists Fund (No. 42201373), the International Research Center of Big Data for Sustainable Development Goals (No. CBAS2022GSP04), the Croucher Foundation (No. CAS22902/CAS22HU01), and the Major Program of the National Natural Science Foundation of China (No. 2022YFB3903703). and the Major Program of the National Natural Science Foundation of China (No. 42090015).

About the FUSE Lab
FUSE Lab aims to leverage geospatial and remote sensing big data, data-model fusion, and advanced interdisciplinary approaches to investigate the interaction loops between urban environmental change, human activities, and public health, with the ultimate goal of contributing to sustainable and sustainable development. FUSE Lab aims to leverage geospatial and remote sensing big data, data-model fusion, and advanced interdisciplinary approaches to investigate the interaction loops between urban environmental change, human activities, and public health, with the ultimate goal of contributing to sustainable and FUSE lab's research focuses on four major directions: (1) Urban and Natural Environmental Changes; (2) Human- Environment Spatiotemporal Interaction; and (3) Healthy Cities. Environment Spatiotemporal Interaction; (3) Impact of Environment and Human activities on Public Health; and (4) Urban Environment Improvement Theory and Adaptation Pathway. Theory and Adaptation Pathways.

To promote knowledge exchange, more recent research activities can be viewed through https://fuselab.hku.hk/

JOURNAL

Nature Communications

DOI

10.1038/s41467-023-41620-z 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Improved human greenspace exposure equality during 21st century urbanization

 

Study: Underground car parks heat up groundwater

Peer-Reviewed Publication

MARTIN-LUTHER-UNIVERSITÄT HALLE-WITTENBERG

The heat given off by car engines warms up underground car parks in such a way that the heat passes through the ground into the groundwater. In Berlin alone, enough energy is transferred to the groundwater to supply 14,660 households with heat. This finding was made by a team from Martin Luther University Halle-Wittenberg (MLU), the Karlsruhe Institute of Technology, and the University of Basel. According to the researchers, this warming could have long-term effects on groundwater quality. In their study, published in the journal Science of The Total Environment, they also propose a solution. Using geothermal energy and heat pumps, the heat could be extracted from the ground and utilised.

The researchers examined temperatures in 31 underground car parks in various cities throughout Germany, Austria and Switzerland. In six of them, they were also able to measure the temperature of the groundwater in the immediate vicinity. This allowed a heat profile to be created for all locations. Their investigations showed that underground car parks heat up the groundwater throughout the year. The volume of traffic in the underground car parks, their proximity to the groundwater and ambient groundwater temperatures were the biggest influencing factors. "Public underground car parks heat up the groundwater more than private facilities as they are often deeper and the cars park there for shorter periods of time," explains Maximilian Noethen, a geoscientist from MLU. 

According to the team, geothermal energy and heat pumps could help utilise the excess heat in the ground. "This would have the advantage of extracting energy from the groundwater and thus cooling it down," says Noethen. Based on modelling for 5,040 underground car parks in Berlin, the team calculated groundwater warming from the underground car parks for the city. Since many underground car parks in the central districts of the capital are located in or near groundwater, a particularly large amount of heat is transferred to the groundwater there. According to their calculations, around 0.65 petajoules of energy are emitted annually in Berlin. This could theoretically supply around 14,660 households with heat. "Of course, heat from groundwater alone is not enough to cover the heating needs of a city like Berlin or even a country like Germany. Nor are the temperature levels of the groundwater near the surface high enough to provide heat without a heat pump. However, we do know from previous studies that the potential for geothermal energy goes well beyond this and that it could make a significant contribution to supplying sustainable heat," says Professor Peter Bayer from the Institute of Geosciences and Geography at MLU. 

Groundwater temperatures have been rising for decades as a result of global warming. In cities, this is exacerbated by dense urban development, soil sealing, lack of vegetation and heat radiating directly from tunnels and underground car parks. Since the organisms in the groundwater are adapted to constant temperatures, species composition could also change. "This could affect the quality of the groundwater from which we draw large parts of our drinking water. This development needs to be controlled through a variety of measures," concludes Bayer. 

The study was funded by the Deutsche Bundesstiftung Umwelt (DBU) and the Margarete von Wrangell Program of the Ministry of Science, Research and the Arts of the State of Baden-Württemberg.  

Study: Noethen M. et al. Thermal impact of underground car parks on urban groundwater. Science of The Total Environment (2023). doi: 10.1016/j.scitotenv.2023.166572

---

JOURNAL

Science of The Total Environment

DOI

10.1016/j.scitotenv.2023.166572 

METHOD OF RESEARCH

Data/statistical analysis

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

Thermal impact of underground car parks on urban groundwater

 

‘Lab on a chip’ genetic test device can identify viruses within three minutes with top-level accuracy

Compact genetic testing device created for Covid-19 could be used to detect a range of pathogens, or conditions including cancer

Peer-Reviewed Publication

UNIVERSITY OF BATH

 

IMAGE: 

DR DESPINA MOSCHOU WITH LOCKAMP REPLACEABLE LAB ON CHIP PRINTED CIRCUIT BOARD

view more 

CREDIT: UNIVERSITY OF BATH

‘Lab on a chip’ genetic test device can identify viruses within three minutes with top-level accuracy

Compact genetic testing device created for Covid-19 could be used to detect a range of pathogens, or conditions including cancer

 

A virus diagnosis device that gives lab-quality results within just three minutes has been invented by engineers at the University of Bath, who describe it as the ‘world’s fastest Covid test’.

The prototype LoCKAmp device uses innovative ‘lab on a chip’ technology and has been proven to provide rapid and low-cost detection of Covid-19 from nasal swabs. The research team, based at the University of Bath, say the technology could easily be adapted to detect other pathogens such as bacteria – or even conditions like cancer.

The device works by rapidly releasing and amplifying genetic material from a nasal swab sample by carrying out a chemical reaction to produce a result, which can be viewed on a smartphone app.

Unlike lateral flow assay tests, commonplace during the pandemic, the LoCKAmp employs the same ‘gold standard’ genetic-based testing techniques previously reserved for lab-based PCR (polymerase chain reaction) tests, thus enabling rapid testing at laboratory-scale standard for the first time.

As well as its accuracy, the speed of the LoCKAmp sets it apart. With results shown within three minutes, the research team say that to their knowledge this makes LoCKAmp the fastest Covid-19 test reported to date.

Made with off-the-shelf components and factory-manufactured printed circuit boards, the prototype device could be made on a mass scale quickly and at low cost, presenting care providers and public health bodies around the world with an effective new tool in virus detection. The research team says a commercial partner with the relevant design and manufacturing expertise could quickly redesigned the LoCKAmp into a small, portable device – with great potential for use in remote healthcare settings.

The research team is already engaging with academic and commercial partners, and would welcome further approaches, as it seeks to bring LoCKAmp into production.

The device and how it works is detailed in the research paper LoCKAmp: lab-on-PCB technology for <3 minute virus genetic detection, published in the journal Lab on a Chip.

Dr Despina Moschou, from Bath’s Centre for Bioengineering & Biomedical Technologies (CBio), led the research. She says: “We started researching and developing LoCKAmp during the second wave of Covid in the UK. We were confident we could create a portable, low-cost device that could carry out genetic identification of the virus, like a PCR test, within 10 minutes. We have done that, but found it can actually work within just three minutes.

“This is an amazing display of the possibilities of lab-on-a-chip technology, and given the low cost and adaptability of the technology to detect a range of conditions, a potentially highly valuable and unique tool for a range of healthcare settings.”

By using readily available printed circuit board technology and the associated mass manufacturing infrastructure, the team say the device can be produced quickly and cheaply at scale. LoCKAmp comprises a portable testing unit, and disposable cartridges, which are used for each test.

The testing unit is projected to cost as little as £50 when it reaches mass production, while the test cartridges, currently made for £2.50, could cost less than 50 pence.

How LoCKAmp works

LoCKAmp harnesses a process known as RT-LAMP (reverse transcription loop-mediated isothermal amplification) to multiply specific sequences of RNA, meaning it can quickly detect the particular virus it is looking for. The team says LAMP detection is preferable to PCR testing as it has higher sensitivity, is faster and more specific.

Crucially, processing takes place at a single stable temperature of 65°, instead of needing the three thermal cycles a PCR test requires. This means the device can be made easier at a portable size, and with lower power consumption. A further benefit of the design is that no pre-processing of the nasal swab samples is required.

Once a nasal swab sample is added to the device, the LoCKAmp pumps the liquid through tiny transparent ‘microfluidic’ channels layered onto the circuit board, above copper heaters just 0.017mm thick. These heat the sample, releasing the RNA genetic material from the virus. This is then further heated and treated with RT-LAMP chemicals to encourage multiplication.

If the specific virus RNA is present in the amplified sample, it fluoresces under light – this signal is then used to denote a positive test.

LoCKAmp has been developed by a team led at the University of Bath, including staff from its departments of Chemical Engineering, Chemistry and Life Sciences, as well as colleagues from the James Watt School of Engineering at the University of Glasgow and the John Innes Centre.

The device was tested with COVID-19 patient swabs collected by Bath’s Royal United Hospital Trusts, with which the University has a longstanding research partnership, during the third wave of the pandemic.

Despite the cessation of the pandemic, particularly in the public consciousness and legislative agenda, development continued, given the adaptability and potential of the device.

Scope to track outbreaks via wastewater

As well as proving the system’s capability in analysing nasal swab samples, the LoCKAmp could also be used to carry out anonymised community-level monitoring and detection of viruses like Covid, by testing wastewater.

This alternative use, which does require some pre-processing of wastewater samples, was arrived upon as the team took advantage of expertise in wastewater-based epidemiology within Bath’s Water Innovation Research Centre.

Using LoCKAmp to carry out ongoing, real-time analysis of wastewater could allow public health bodies to quickly detect the spread of viruses like Covid, or other infectious diseases. Doing this via wastewater can give a broader community-wide view, rather than relying on individuals to regularly test for a condition.

Professor Barbara Kasprzyk-Hordern, from Bath’s Department of Chemistry, is an expert in environmental epidemiology and contributed to the research. She says: 'With LoCKAmp technology providing both low cost and real time genetic target identification and quantification, we're getting ever closer to real time pathogen tracking. This opens exciting opportunities enabling the establishment of early warning systems utilising wastewater for pathogen surveillance in communities.”

The research was funded by the Global Challenges Research Fund (GCRF) QR – UK Research & Innovation and the Engineering and Physical Sciences Research Council Impact Acceleration Account. At the John Innes Centre, the work was supported by BBSRC (Grant BB/V009087/1), the Institute Strategic Programme Grant “Molecules from Nature—Enhanced Research Capacity” (BBS/E/J/000PR9794), and the John Innes Foundation. The authors at the Department of Biology & Biochemistry, University of Bath acknowledge financial support from the Academy of Medical Sciences (SBF006\1023). 

ENDS

Contact:

Will McManus, Media & PR Manager, wem25@bath.ac.uk / press@bath.ac.uk, +44 (0)1225 385 798

Images are available at: https://tinyurl.com/k3f34uxy

  

Prototype LoCKAmp device

CREDIT

University of Bath

The University of Bath 

 

The University of Bath is one of the UK's leading universities for high-impact research with a reputation for excellence in education, student experience and graduate prospects.

 

We are named ‘University of the Year’ in The Times and The Sunday Times Good University Guide 2023, and ranked among the world’s top 10% of universities, placing 148th in the QS World University Rankings 2024. We are ranked 5th in the UK in the Complete University Guide 2024, 6th in the Guardian University Guide 2024 and 8th in the The Times and Sunday Times Good University Guide 2024.

  

Bath is rated in the world’s top 10 universities for sport in the QS World University Ranking by Subject 2023. We produce some of the world’s most job-ready graduates and were named University of the Year for Graduate Jobs by the Daily Mail University Guide 2024, as well as ranking as one of the world’s top 90 universities for employer reputation according to the QS World University Rankings 2024. 

 

Research from Bath is helping to change the world for the better. Across the University’s three Faculties and School of Management, our research is making an impact in society, leading to low-carbon living, positive digital futures, and improved health and wellbeing. Find out all about our Research with Impact: https://www.bath.ac.uk/campaigns/research-with-impact/

---

JOURNAL

Lab on a Chip

DOI

10.1039/D3LC00441D 

METHOD OF RESEARCH

Experimental study

SUBJECT OF RESEARCH

Not applicable

ARTICLE TITLE

LoCKAmp: lab-on-PCB technology for <3 minute virus genetic detection