A bioluminescence DNA hybridization assay for the detection of Plasmodium falciparum, the most deadly species of malaria, using the photoprotein aequorin as a bioluminescent label has been developed. The current gold standard for the detection of malaria is light microscopy, which can detect down to ∼50 parasites/µL of blood, but has low-throughput, high costs, and requires high skill, which limit the applicability of the method, especially in the developing regions where malaria detection is mostly needed. The utilization of aequorin as a bioluminescence label offers the advantages of high signalto-noise ratio and reliable detection down to attomole levels, allowing for the development of highly sensitive and miniaturized high-throughput bioluminescence assays. Herein, we developed a DNA hybridization assay for the detection of P. falciparum based on the competition between the target DNA and the signal generating DNA streptavidin-aequorin for hybridization with the probe DNA. This bioluminescence hybridization assay demonstrated a detection limit of 3 pg/µL and was employed for the detection of target DNA in standard and spiked human serum samples. The DNA hybridization assay was developed in a microplate format without the need for sample PCR amplification, showing the potential suitability of this method in the parallel analysis of samples by low-trained personnel, such as that typically encountered in developing regions.

Objectives: Guidelines for appropriate use of telemetry recommend monitoring for specific patient populations; however, many hospitalized patients receive telemetry monitoring without an indication. Clinical data and outcomes associated with nonindicated monitoring are not well studied. The objectives of our study were to evaluate the impact of an education and an order entry intervention on telemetry overuse and to identify the diagnoses and telemetry-related outcomes of patients who receive telemetry monitoring without guidelines indication.Methods: A retrospective cohort study of hospitalized patients on internal medicine (IM) wards between 2015 and 2018 examining the effects of educational and order entry interventions at an academic urban medical center. A baseline cohort examining telemetry use was established. This was followed by the delivery of IM resident educational sessions regarding telemetry guidelines. In a subsequent intervention, the telemetry order entry system was modified with a constraint to require American Heart Association guidelines justification.Results: Across all of the cohorts, 51% (n = 141) of patients lacked a guidelines-specified indication. These patients had variable diagnoses. The educational intervention alone did not result in significant differences in telemetry use by IM residents. The order entry intervention resulted in a significant increase in the proportion of guidelines-indicated patients and a decrease in nonindicated patients on telemetry. No safety events were noted in any group.Conclusions: A telemetry order entry system modification implemented following an educational intervention is more likely to reduce telemetry use than an educational intervention alone in IM resident practice. A variety of patients are monitored without evidence of need; therefore, the clinical impact of telemetry reduction is unlikely to be harmful.

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