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Context: The purpose of this study was to compare short-term clinical outcomes between meniscus procedures performed with anterior cruciate ligament reconstruction (ACLR), ACLR (ACLR-only), ACLR with meniscectomy/resection (ACLR-resect), and ACLR with meniscal repair (ACLR-repair) for bone patellar tendon bone grafts (BPTB) and hamstring tendon grafts, separately. Design: This was a cross-sectional study conducted in a controlled laboratory setting as part of a large point-of-care collaborative research program. Methods: This study included 314 participants (168 females; mean [SD]: age, 19.7 [4.8]) with primary unilateral ACLR with a BPTB or hamstring tendon. Patients were divided into 3 groups depending on meniscal procedure (ACLR-only, ACLR-resect, and ACLR-repair). Postsurgical testing included: isokinetic assessment of knee extension and flexion, single-leg hop tests, and patient-reported outcomes. Multivariate analysis of covariance compared differences between meniscal procedures on the battery of tests, and for each statistically significant variable an analysis of covariance assessed the effect of meniscal procedure within each graft type. Chi-square analysis assessed the influence of meniscal procedure on tests' pass rates defined as 90% of limb symmetry index. Results: BPTB: ACLR-only had greater hamstring strength than ACLR-resect (P = .05) and ACLR-repair (P = .005). ACLR-only had the highest proportion of participants to pass the hamstring strength test (P=.02). amstring tendon: ACLR-only (P=.03) and ACLR-resect (P=.003) had higher International Knee Documentation Committee scale scores than ACLR-repair. There was a significant difference in the proportion of participants who scored >90% limb symmetry index on the timed hop test (P = .05). Conclusions: The influence of meniscal repair on clinical outcomes is dependent on the graft choice. Following an ACLR with BPTB and a meniscal procedure, hamstring function should be more closely monitored for optimal short-term recovery. [ABSTRACT FROM AUTHOR]

Background: Chest pain is a common reason patients are admitted to the hospital. The most clinically significant cases are those in which the pain is due to an immediate life-threatening condition, such as acute aortic dissection (AAD). A prompt and correct diagnosis is crucial to patient survival. This case report of a patient who presented with chest pain confirms the appropriateness of urgent imaging tests e.g. POCUS when AAD is suspected in high-risk patients, regardless of the results of additional laboratory tests such as the D-dimer (DD) assay. Case report: A 72-year-old female patient was brought by the emergency medical team to the emergency room due to fainting without loss of consciousness and severe chest pain. Owing to worsening hypotonia and recurrent chest pain, a thoracic computed tomography (CT scan) was performed and subsequently revealed aortic dissection within the ascending segment with bleeding into the pericardial sac. The results of previously ordered laboratory tests, including the DD assay, were unremarkable and were obtained only after the thoracic CT scan had been acquired. Despite prompt medical intervention, the patient died. Conclusion: Vigilance is required when diagnosing chest pain in high-risk patients who are suspected of having AAD. The case presented in this report confirms the importance of a thorough history and physical examination as well as prompt diagnostic imaging e.g. POCUS or CT scan. Dedicated laboratory tests such as the DD assay, while often helpful, may fail to reveal remarkable abnormalities in time for medical intervention. [ABSTRACT FROM AUTHOR]

The pathogenic oomycete Pythium insidiosum causes a fatal infectious illness known as pythiosis, impacting humans and certain animals in numerous countries in the tropics and subtropics. Delayed diagnosis is a primary factor contributing to the heightened morbidity and mortality associated with the disease. Several new serodiagnostic methods have been developed to improve the identification of pythiosis. However, these assays provide only indirect evidence of pythiosis and are not readily available in the commercial market. Here, we have developed an affordable point-of-care test (POCT) kit based on an immunochromatographic assay to detect P. insidiosum antigens directly. Our recent findings reveal that the lateral flow sandwich immunological testing cassette can accurately identify vascular pythiosis antigens using a small volume of patient's plasma, accomplishing diagnostic efficiency, with a limit of detection (LOD) of 8 ng/mL. This prototype cartridge represents a significant stride toward advancing enriched POCT for pythiosis serodiagnosis. [ABSTRACT FROM AUTHOR]

A novel hybridization chain reaction (HCR) powered optical fiber-embedded microfluidic biochip (HCR-FMB) has been constructed for ultrafast and sensitive detection of lethal-7a (let-7a) in serum. By integrating HCR, fluorescence energy resonant transfer, and evanescent wave fluorescence principle, the HCR-FMB enables detecting let-7a with satisfactory limit of detection of 100.0 pM within 6 min at room temperature, and demonstrates excellent specificity. The HCR-FMB can directly detect let-7a in serum with high sensitivity and without any pre-treatment, and good recoveries were observed for let-7a in serum samples, demonstrating their potential application to the analysis of serum samples. The HCR-FMB exhibits several advantages, including rapidity, enzyme-free, miniaturization, ease-of-operation, field-deployment applicability, minimal-equipment, and cost-effectiveness. The HCR-FMB can be considered a revolutionary detection device that rapidly adapts and deploys in various settings, especially in low medical resource regions. [ABSTRACT FROM AUTHOR]

Staphylococcus aureus, commonly referred to as S. aureus, is a type of bacteria that is often found on the skin and in the nasal passages of humans. Staphylococcus aureus is a common but potentially dangerous bacterium, notable for its role in various infections and its capacity for antibiotic resistance. In this situation, our motivation is to develop a photonic crystal fiber detector to detect these deadly gram-positive bacteria. In our study, we achieved a max Relative Sensitivity (RS) of 96.82% and 96.73% on the x and y poles, respectively, at an operating frequency equal to 3.2 THz. We further investigate several kinds of losses, such as loss of confinement (CL) and loss of effective material (EML). We achieve minimal CL that is 3.415 × 10–5 dB/m and 1.624 × 10–4 dB/m on the x and y poles, respectively. The lowest EMLs we achieve are 0.0062 cm−1, and 0.0085 cm−1 on the x and y poles, respectively. The small size and flexibility of the suggested PCF sensor make it suitable for miniaturized and portable sensing devices. This portability is advantageous for point-of-care diagnostics and field applications where rapid and on-site detection of Staphylococcus aureus is needed. [ABSTRACT FROM AUTHOR]

It is challenging to identify emergency department (ED) patients with sepsis who will require resources such as positive-pressure ventilation, vasopressors, or intensive care unit (ICU) admission. Describe the correlation of cardiopulmonary ultrasound (CPUS) with need for care escalation. Single center, prospective, observational study of adult patients with suspected sepsis. CPUS assessed left ventricular systolic function (LVF), right ventricular (RV) size and function, inferior vena cava (IVC) collapsibility, and thoracic B lines. The primary composite outcome was need for care escalation within 12 hours of ED presentation defined as: ICU admission or positive-pressure ventilation or vasopressor infusion. A total of 92 patients were enrolled; 18 (19.6%) required care escalation. A logistic regression model identified the presence of ≥4 thoracic B-lines as a statistically significant predictor of care escalation (OR 7.8, 95% CI [1.3–26.4], p = 0.002). Other features positively correlated with care escalation were: reduced LVF (OR 4.26, 95% CI [0.06–12.9], p = 0.14), and dilated RV size (OR 2.8, 95% CI [0.4–11.8], p = 0.16). A retrospective stepwise regression model incorporating these three variables to predict care escalation showed an AUROC = 0.75 (95% CI [0.63–0.88]). When 2 or more variables were abnormal the model showed excellent specificity of 95% (LR+ 6.2), but low sensitivity of 33% (LR- 0.7). In patients with concern for sepsis early findings of ≥4 B-lines is associated with care escalation. Combining this finding with LVF and RV size assessment improves the positive predictive power and may be useful in rapid identification of patients likely to require care escalation. [ABSTRACT FROM AUTHOR]

This study aimed to demonstrate the effectiveness of our new diagnostic chart using point of care ultrasound combined with CTS-6 for diagnosing idiopathic carpal tunnel syndrome. We conducted a retrospective analysis of the data of patients who visited our department and received point of care ultrasound combined with CTS-6 from 2020 to 2023. Data regarding age, sex, initial and final diagnosis, cross-sectional area of the median nerve, CTS-6 score, and electrodiagnostic severity were obtained and statistically analyzed. Of the 177 wrists included in our study, 138 (78 %) were diagnosed with carpal tunnel syndrome, while 39 (22 %) were not (non-carpal tunnel syndrome). With our diagnostic method, 127 wrists (72 %) were diagnosed initially with carpal tunnel syndrome, 23 wrists (13 %) with non-carpal tunnel syndrome, and the rest 27 wrists (15 %) as borderline. Our initial diagnoses of carpal tunnel syndrome and non-carpal tunnel syndrome were maintained in all cases except for two. Cross-sectional area, CTS-6 score, and electrodiagnostic severity showed a positive correlation. A post hoc analysis showed that the new scoring system (CTS-6 score + 2 × cross-sectional area) with a cutoff value of 31.25 points showed a sensitivity as high as 95 % and a specificity of 100 %. Our findings suggest that most suspected idiopathic carpal tunnel syndrome cases can be diagnosed correctly using the diagnostic chart. Although additional tools, including electrodiagnostic studies, may be needed for borderline cases, the use of point of care ultrasound combined with CTS-6 may be a recommendable first-line confirmatory test because point of care ultrasound and CTS-6 could be complementary tools, and this chart may be especially beneficial for atypical or outlier cases. Diagnostic III. [ABSTRACT FROM AUTHOR]

Objectives: Concurrent type 1 diabetes (T1D) and celiac disease (CeD) pose challenges in insulin dosage adjustments and gluten-free dietary adherence. Urine testing for gluten immunogenic peptides (GIP) is a new method to detect gluten exposure within the last 3–12 h. Our aims were to compare gluten-free dietary adherence between T1D + CeD and CeD individuals and evaluate urinary GIP testing in an outpatient setting. Materials and methods: This observational cross-sectional study included three adult groups: (1) T1D and CeD, (2) CeD only, and (3) T1D only. T1D participants were recruited from outpatient clinics, the CeD group via social media. One urine sample (12 pm–7 pm) was analyzed using a qualitative immunographic GIP test. CeD participants completed 'Celiac Dietary Adherence Test' (CDAT) and 'Celiac Symptom Index' (CSI) questionnaires. IgA anti-transglutaminase 2 (IgA-TG2) and IgG anti-deamidated gliadin (IgG-DGP) serology were also analyzed. Results: 197 participants, mean (SD) age 43 (15) years, were included. Female percentages were: CeD: 90%, T1D + CeD: 64%, and T1D: 47%. Positive urinary GIP was found in 15% (14/96) of T1D + CeD and 0% (0/50) of CeD (p = 0.002). As expected, most T1D only participants had positive urinary GIP (86%, 44/51). CDAT and CSI scores did not differ between T1D + CeD and CeD groups. Positive IgA-TG2 and/or IgG-DGP levels were found in 12% of T1D + CeD and 6% of CeD participants (p = 0.38). Conclusions: A single GIP urine test revealed higher gluten exposure in T1D + CeD versus CeD only, questioning dietary adherence in this population. Urinary GIP tests can be useful for clinical follow-up. Created with [ABSTRACT FROM AUTHOR]

The objective of this study is to evaluate the analytical and diagnostic performance of a high-sensitivity point-of-care (POC) cardiac troponin I assay, the Quidel TriageTrue™ (QuidelOrtho Inc, San Diego, USA), compared to central laboratory testing (CLT) in accelerated diagnostic protocols (ADP) in real time in a clinical environment. In a nested sub-study of a pragmatic randomised control trial, consecutive patients with suspected acute coronary syndrome (ACS) and chest pain <12 h duration were randomised to the ESC 0/1 and 0/3-h ADP. Subjects underwent sampling for Quidel TriageTrue POC hs-TnI whole blood and plasma, CLT hs-TnT Roche Elecsys and a validated, NICE approved CLT High sensitivity cardiac troponin I (hs-TnI) (Siemens Attellica) at each time point. Assay imprecision was assessed by repeat analysis of whole blood samples at three levels (low, near 10 % CV 5–10 ng/L, medium, approximating 99th percentile 15–25 ng/L and high, 3–5 times the 99th percentile, 60–100 ng/L). Final diagnosis was adjudicated at 6 weeks by Roche hs-TnT using the 4th universal definition of myocardial infarction (MI). A total of 1,157 patients consented and had both investigational POC whole blood and plasma and central lab hs-cTn available. The median age was 59, 47.2 % were female and 15 % had suffered a previous MI. Assay imprecision of whole blood POC TriageTrue revealed 10 % CV at 8.6 ng/L (>50 % lower than 99th percentile [20.5 ng/L]) and a 20 % CV at 1.2 ng/L. Receiver operator characteristics (ROC) curves were computed for each assay against adjudicated index type 1 MI to study clinical performance. At all-time points there were excellent performance for whole blood POC TriageTrue: area under the curve (AUC) 0.97 [95 % CI 0.94–098], 0.98 [95 % CI 0.97–1.00] and 0.95 [95 % CI 0.92–0.98] at time 0, 1 and 3 h respectively. There was statistical equivalence for performance of whole blood and plasma POC TriageTrue hs-TnI and laboratory Siemens Atellica hs-TnI. The whole blood POC TriageTrue hs-TnI assay demonstrates imprecision levels consistent with high sensitivity characteristics and has a clinical performance equivalent to an established, validated and NICE approved laboratory Siemens Atellica hs-TnI. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of sexually transmitted infections (STIs) has increased disproportionately to STI services. It is uncertain how many residents trained in STI services continue them. This study assessed the self-rated quality of training and attitudes about STI services amongst residents of Indian teaching hospitals. Materials and Methods: In this descriptive cross-sectional survey study, opinions from Indian postgraduate trainee residents were sought in three domains of STIs- institutional STI management practices, quality and satisfaction with training, and attitude towards STI services. Results: A total of 225 responses were included. There was no separate area for STI services at centers of 51.6% of residents, and among those with separate STI posting, the duration was ≤2 months for 34.7%, with 59.6% wishing for its increase. Easily available bedside tests were used regularly when indicated by only 41.8%. Only 58.2% of respondents strictly ensured contact tracing and partner treatment. Only 65.8% of centers had provision of benzathine penicillin. Under-confidence in managing STIs independently was reported by 19.6%. Inadequate training was the second reason for wishing to discontinue STI services upon completion of training; with 71.5% wishing to continue STI practice. In univariate analysis, frequent point-of-care testing (P < 0.001), and >2 months of separate STI posting (P = 0.018) were associated with good satisfaction with STI training. Frequent point-of-care testing (P < 0.001), and male gender (P < 0.001) were associated with good confidence in independently managing STIs. Male gender (P = 0.038), having less reluctance in dealing with STI patients (P = 0.003), and good confidence in independently managing STIs (P = 0.008), was associated with willingness to continue STI practice. Conclusions: STI care is associated with reluctance. Current STI training in Indian teaching hospitals is less than desired and can lead to unwillingness amongst residents to practice STI services in the future. Having >2 months of separate STI posting, frequent point-of-care tests, and efforts to reduce reluctance when dealing with STI patients are steps that can improve the STI training experience of residents. [ABSTRACT FROM AUTHOR]

The promise of artificial intelligence has generated enthusiasm among patients, health care professionals, and technology developers who seek to leverage its potential to enhance the diagnosis and management of an increasing number of chronic and acute conditions. Point-of-care testing increases access to care because it enables care outside of traditional medical settings. Collaboration among developers, clinicians, and end users is an effective best practice for solving clinical problems. A common set of clearly defined terms that are easily understood by research teams is a valuable tool that fosters these collaborations. [ABSTRACT FROM AUTHOR]

The article presents the statement by the American Society of Health-System Pharmacists (ASHP) on the community pharmacist's role in the care continuum. Topics include practice areas where community pharmacies are found, core clinical responsibilities of community pharmacists, and core operations of the community pharmacy that the pharmacist manages or supports.

Point-of-care testing (POCT) is becoming an increasingly popular way to perform laboratory tests closer to the patient. This option has several recognized advantages, such as accessibility, portability, speed, convenience, ease of use, ever-growing test panels, lower cumulative healthcare costs when used within appropriate clinical pathways, better patient empowerment and engagement, and reduction of certain pre-analytical errors, especially those related to specimen transportation. On the other hand, POCT also poses some limitations and risks, namely the risk of lower accuracy and reliability compared to traditional laboratory tests, quality control and connectivity issues, high dependence on operators (with varying levels of expertise or training), challenges related to patient data management, higher costs per individual test, regulatory and compliance issues such as the need for appropriate validation prior to clinical use (especially for rapid diagnostic tests; RDTs), as well as additional preanalytical sources of error that may remain undetected in this type of testing, which is usually based on whole blood samples (i.e., presence of interfering substances, clotting, hemolysis, etc.). There is no doubt that POCT is a breakthrough innovation in laboratory medicine, but the discussion on its appropriate use requires further debate and initiatives. This collective opinion paper, composed of abstracts of the lectures presented at the two-day expert meeting "Point-Of-Care-Testing: State of the Art and Perspective" (Venice, April 4–5, 2024), aims to provide a thoughtful overview of the state-of-the-art in POCT, its current applications, advantages and potential limitations, as well as some interesting reflections on the future perspectives of this particular field of laboratory medicine. [ABSTRACT FROM AUTHOR]

Cardamom mosaic virus causing mosaic/katte disease is the most destructive virus infecting cardamom. The development of effective diagnostic assays is essential for the production of virus-free plants, as the primary spread of the virus occurs through vegetative propagation. Currently used PCR-based assays are not suitable for Point-of-Care testing, require sophisticated equipment, and are time-consuming. Hence, in the present study, an assay based on reverse transcription-recombinase polymerase amplification (RT-RPA) combined with lateral flow assay (RT-RPA-LFA) was optimized for the specific, and sensitive detection of CdMV. The forward and reverse primers selected for RT-RPA were labeled with 6-carboxyfluorescein (FAM) and biotin respectively at the 5´end. The tedious total RNA preparation was avoided by using the crude extract as a template for the assay. A magnesium acetate concentration of 14 mM, 0.4 M betaine, temperature from 37 to 42 ℃, and 20 min of incubation time were found optimum for the assay. The entire RT-RPA-LFA from sample preparation to visualization of results could be completed within 40–50 min and the assay is suitable for Point-of-Care testing. The assay is specific for CdMV and could detect the virus up to 10–5 dilutions of the crude extract. The assay was validated using field samples collected from different cardamom-growing regions of Kerala and Karnataka, India. [ABSTRACT FROM AUTHOR]

miRNA-21 (miR-21) is a potential biomarker for the monitoring of diseases through its expression levels. Simple, portable and sensitive miR-21 detection of is advantageous for health monitoring in Point of Care Testing (POCT). Gold nanoparticles (AuNP) as excellent colorimetric sensors are widely used in the POCT. However, their low sensitivity is a limitation of their clinical use. Herein, we developed an AuNPs-based miR-21 assay with enzyme-assisted amplification reaction to construct the colorimetric platform capable of detecting as low as 0.1 nM. In this platform, template ssDNA as a signal molecule could hybridize with ssDNA-modified AuNPs to generate the color reaction. The target miR-21 specifically hybridized to the template ssDNA, which was then cleaved by exonuclease III (Exo III) to release the target miR-21. As a trigger, miR-21 catalyzed the degradation of the template ssDNA to amplify the signal by Exo III. By hybridizing miR-21 and template ssDNA in the presence of Exo III, R-21 induced a significant decrease in the level of template ssDNA to reduce the aggregation of AuNPs. There is a clear color difference in the presence/absence of miR-21 in the assay. In this assay, the optimal concentration of templated ssDNA and Exo III were 100 nM and 0.06 U/ μ L in a 100 μ L detection system. The LoD for UV–Vis spectrum and colorimetric reaction were 0.1 nM and 0.5 nM, respectively. The detection system has good selectivity and can be used to detect miR-21 in the simulated saliva. It has great potential for application in biomedical research as well as in clinical diagnostics. Gold nanoparticles (AuNPs)-based colorimetric methods have been widely used for biomolecules at the point-of-care. The AuNPs-based nucleic acid detection platform was developed using an enzyme-assisted amplification reaction. The detection limit can be as low as 0.1 nM. The detection system has good selectivity and can be used for the detection of nucleic acids in simulated saliva. It has a great deal of potential for use in biomedical research applications. [ABSTRACT FROM AUTHOR]

Background: Imaging both electrical and mechanical cardiac function can better characterize cardiac disease and improve patient care. Currently, there is no noninvasive technique that can simultaneously image both electrical and mechanical function of the whole heart at the point of care. Here, our aim is to demonstrate that high volume-rate echocardiography can simultaneously map cardiac electromechanical activation and end-systolic cardiac strain of the whole heart in a single heartbeat. Method: A 32x32 ultrasound matrix array connected to four synchronized ultrasound scanners were used for transthoracic high volume-rate imaging (840 volumes/s) in sixteen young volunteers (28.1±4.2 y.o.). An electromechanical activation map of the whole heart and volumetric end-systolic atrial and ventricular strain images were obtained. Results: The whole heart activation sequence was found to be consistent across volunteers and in agreement with previously reported normal electrical activation sequences. The mean electromechanical activation time was 72.6±15.2 ms in the atria, 132.4±19.7 ms in the ventricles and 154.5±19.6 ms in the whole heart. Volumetric right and left atrial as well as right and left ventricular strains were also consistent across all volunteers, with a mean end-systolic global longitudinal strain of 26.8±6.5% in the atria and -16.6±3.4% in the ventricles. Conclusions: This initial feasibility study demonstrates that noninvasive high-volume rate imaging of the heart in a single heartbeat is feasible and can provide electromechanical activation and systolic strains simultaneously in all four cardiac chambers. This technique can be further developed and used at the point of care to assist for screening, diagnosis, therapy guidance and follow-up of heart disease patients. [ABSTRACT FROM AUTHOR]

The risk of disease highlights the necessity of point‐of‐care testing. Here, a ternary hybrid (MAP) combining metal–organic frameworks (MOFs), aggregate‐induced emission luminogens, and Pt nanoparticles is introduced. MAP demonstrates a greater fluorescence quantum yield (62.1%) and greater anti‐photobleaching ability than conventional fluorescent MOFs and organic fluorophores, as well as a 2214‐fold and 16‐fold increase in catalytic capacity over those of horseradish peroxidase and Pt nanoparticles, respectively. The MAP exhibited a slight attenuation after 180 days at room temperature in signal intensity. Polydopamine‐coated polystyrene microsphere‐enabled microchips are economical, user‐friendly, and portable. The combination of MAP and microchips allows for determination using the fluorescence/colorimetric mode in different scenarios. Compared with the enzyme‐linked immunosorbent assay, the fluorescence mode exhibited a 41.9‐fold increase in sensitivity, a 94.2% decrease in time, and an 80.7% decrease in cost. The accuracy of clinical samples reached 100%, and the specificity is 96.2%. Chloramphenicol and enrofloxacin serve as small molecule targets, demonstrating the versatility of this strategy. [ABSTRACT FROM AUTHOR]

Infectious Agents and Cancer journal has recently launched a new collection of papers about "Point-of-Care (POC) for HPV-related genital cancers" putting together some interesting works on the accuracy of HPV tests for screening. This editorial initiative gave us the opportunity to reflect on the relations between accuracy measures, prevalence and characteristics of the tested population in the case of HPV-based screening. In screening test evaluation, we look at the clinical accuracy of the test as an intrinsic characteristic of the assay, which interacts with the characteristics of the population, the result being the screening performance. In the case of HPV testing, the clinical accuracy should be conceptualized in two steps, the analytical accuracy of the assay for HPV infection and the biological link between HPV infection and the target disease, i.e. the high-grade cervical intraepithelial neoplasia (hgCIN). This approach highlights that just a few false positive cases result from a lack of analytical specificity while most derive from women who have the infection but it did not progress to hgCIN. In addition, increasing prevalence of hgCIN results in relevant increases of PPV only if due or associated with exposures which increase the progression from infection to hgCIN or the duration of the latter; while an increase due to a higher prevalence of HPV infection would only marginally affect PPV. This approach may help in modelling the performance of HPV-based cervical screening. [ABSTRACT FROM AUTHOR]

Proximity‐orientation effects (POE) are essential for enzymes, as the spatial arrangement and orientation of catalytic sites strongly influence substrate binding and enhance catalysis. However, nanozymes often face limitations due to weak POE arising from uniform catalytic interfaces. Herein, Co atoms are incorporated into the lattice of Pt‐based nanozymes, exploiting differences in electron configuration and atomic radius between transition metals and noble metals. This integration induced lattice distortion formed new catalytic sites, and restricted the transport path, thereby enhancing the POE. Such transition metal‐doped alloy nanozyme (TANzyme) can be functioned as a self‐cascading nanozyme with artificial catalase‐oxidase activity. Density functional theory calculations demonstrated that the Pt site selectively decomposed H2O2 into H2O and O2, while the Co site specifically adsorbed O2 and conversed into superoxide anions, so an oxygen transfer path to connect dual‐active centers not only increased the POE but also improved catalytic specificity. Additionally, by leveraging the efficient catalytic property of TANzyme, a visual origami‐based sensing strategy is developed for the cascade detection of H2O2, nucleic acids, and marine toxins. This strategy highlighted the pivotal role of POE in enhancing the catalytic specificity of nanozymes, mimicking natural POE in enzymes, and providing a solution to design next‐generation nanozymes. [ABSTRACT FROM AUTHOR]

AFB1 (Aflatoxin B1) contamination is becoming a global concern issue due to its extraordinary occurrence, severe toxicity, as well as the great influence on the economic losses, food safety and environment. Therefore, it is desirable to develop novel analytical techniques for simple, rapid, accurate, and even point-of-care testing of AFB1. Fortunately, aptamer, considered as a new generation bioreceptor and even superior to classic antibody and enzyme, has been emerged remarkable application in food hazards detection. Correspondingly, aptasensors have been well-established toward AFB1 determination with outstanding performance. In this article, we first discuss and summarize the recent progress in optical and electrochemical aptasensors to monitor AFB1 over the past three years. In particular, the embedding of advanced nanomaterials for their improved analytical performance is highlighted. Furthermore, the critical analysis on various signal transduction strategies for aptasensors construction is discussed. Finally, we reveal the challenges and provide our opinion in future opportunities for aptasensor development. [ABSTRACT FROM AUTHOR]

Laboratory-based high-sensitivity cardiac troponin testing has been the pillar for emergency stratification of suspected acute coronary syndrome for well over a decade. Point-of-care troponin assays achieving the requisite analytical sensitivity have recently been developed and could accelerate such assessment. This review summarises the latest assays and describes their potential diverse clinical utility in the emergency department, community healthcare, pre-hospital, and other hospital settings. It outlines the current clinical data but also highlights the evidence gap, particularly the need for clinical trials using whole blood, that must be addressed for safe and successful implementation of point-of-care troponin analysis into daily practice. Additionally, how point-of-care troponin testing can be coupled with advances in biosensor technology, cardiovascular screening, and triage algorithms is discussed. [ABSTRACT FROM AUTHOR]

In this paper, a new label-free DNA nanosensor based on a top-gated (TG) metal–ferroelectric–metal (MFM) graphene nanoribbon field-effect transistor (TG-MFM GNRFET) is proposed through a simulation approach. The DNA sensing principle is founded on the dielectric modulation concept. The computational method employed to evaluate the proposed nanobiosensor relies on the coupled solutions of a rigorous quantum simulation with the Landau–Khalatnikov equation, considering ballistic transport conditions. The investigation analyzes the effects of DNA molecules on nanodevice behavior, encompassing potential distribution, ferroelectric-induced gate voltage amplification, transfer characteristics, subthreshold swing, and current ratio. It has been observed that the feature of ferroelectric-induced gate voltage amplification using the integrated MFM structure can significantly enhance the biosensor's sensitivity to DNA molecules, whether in terms of threshold voltage shift or drain current variation. Additionally, we propose the current ratio as a sensing metric due to its ability to consider all DNA-induced modulations of electrical parameters, specifically the increase in on-state current and the decrease in off-state current and subthreshold swing. The obtained results indicate that the proposed negative-capacitance GNRFET-based DNA nanosensor could be considered an intriguing option for advanced point-of-care testing. [ABSTRACT FROM AUTHOR]

Background/Objectives: Lupus nephritis (LN) is a serious complication of systemic lupus erythematosus (SLE), involving immune complex deposition in the kidneys. While renal biopsy is the diagnostic gold standard, its invasiveness limits frequent use, driving the need for non-invasive urinary biomarkers to monitor disease progression and response to treatment. This study aimed to identify and validate urinary biomarkers for LN. Methods: Data from 10 LN-related omics databases, including urine, PBMCs, and kidney tissue, were analyzed. Differentially expressed proteins (DEPs) and genes (DEGs) were identified, and candidate biomarkers were validated via ELISA in an independent cohort of 87 urine samples. Results: We identified 78 biomarkers, with 14 overlapping across transcriptomic categories. Novel urinary biomarkers, including SERPING1, SLPI, and CD48, were validated. Urinary CD163, VCAM1, and ALCAM levels showed significant differences between LN and healthy controls, while urinary immune complexes (ICx) demonstrated superior diagnostic performance, with urinary ALCAM-ICx and CCL21-ICx achieving the highest AUC values. Conclusions: Our findings highlight the potential of urinary immune complexes and antigens as non-invasive biomarkers for LN. ALCAM, CD163, and SERPING1-ICx, in particular, were found as promising candidates for a urinary biomarker panel to aid in the diagnosis and monitoring of LN. [ABSTRACT FROM AUTHOR]

Background: Zoonotic schistosomiasis, caused by Schistosoma japonicum, is prevalent in China, the Philippines and Indonesia. Rapid point-of-care (POC) diagnostics are attractive and promising tools for evaluating the efficacy of intervention strategies for schistosomiasis control. Methodology: The diagnostic potential of five recombinant antigens was tested by enzyme-linked immunosorbent assay (ELISA) using sera from individuals with positive Kato-Katz (KK) results for S. japonicum (n = 28) and non-endemic controls (n = 12). A latex microsphere (LM)-based lateral flow immunoassay (LFIA) incorporating the recombinant SjSAP4 (rSjSAP4) was developed for the diagnosis of schistosomiasis japonica. The test conditions including diluent, dilution factor and reaction time, were optimised for the developed LFIA. Under the optimised conditions, serum samples from individuals living in a barangay endemic for S. japonicum (n = 549) and non-endemic controls (n = 50) were tested with the established LFIA cassettes. The results were imaged by a smartphone and analysed by the ImageJ program. The intensity ratio of the test line to the control line (T/C ratio) was calculated for each cassette. Main findings: ELISA confirmed that rSjSAP4 was the optimal candidate for serological diagnosis of schistosomiasis japonica. Under optimal testing conditions, the developed LFIA strips had a sensitivity of 80.6% and a specificity of 98.0% at a cut-off T/C ratio of 0.1031. Moreover, the results of the LM-based LFIA was positively correlated with those obtained from the rSjSAP4-ELISA (r = 0.8270, 95% CI, 0.7990–0.8514; p < 0.0001). The schistosomiasis prevalence determined by the LFIA strips was about 1.8 times greater than that obtained with the 6-slide KK procedure performed on three stool samples. Conclusions/Significance: The developed LFIA represents a POC diagnostic tool that is suitable for onsite screening of human S. japonicum infection with minimal equipment needed. The established immunochromatographic assay complies with most of the WHO's ASSURED criteria for POC diagnostics. Author summary: Schistosomiasis remains a significant global public health concern, with over 230 million people affected. Integrated multicomponent interventions targeting the various aspects of schistosomiasis epidemiology represent promising efforts that may eventually lead to the disease elimination. Rapid and accurate point-of-care diagnostics (POCs) are crucial tools for informing the effective implementation of these elimination efforts. In this study, we developed a latex microsphere (LM)-based lateral flow immunoassay (LFIA) by incorporating rSjSAP4 for the rapid diagnosis of schistosomiasis japonica. Serum samples collected from subjects living in an area endemic for S. japonicum and non-endemic controls were tested with the established LFIA strips. In the individuals who tested positive by the Kato-Katz method, the LM-based LFIA cassette showed 80.6% sensitivity and 98.0% specificity. When the entire Philippines cohort was tested, the developed LFIA showed a high consistency with the rSjSAP4-ELISA. The schistosomiasis incidence deduced from the developed LFIA and rSjSAP4-ELISA was about 1.8 times higher than that determined with the KK procedure. The findings obtained here further indicate that the rSjSAP4-incorprated LFIA meets most of the ASSURED criteria set by the WHO for POC diagnostics, representing an effective diagnostic tool for the screening of S. japonicum infection in rural endemic areas with limited resources. [ABSTRACT FROM AUTHOR]

Emergency department (ED) crowding is a widespread problem that positions patients at risk. The desire to improve the ED throughput requires novel approaches. Point-of-care testing (POCT) has emerged as useful technology that could contribute to create more efficient patient flow and better timeliness in the ED. The main objective of our study is to demonstrate, in a multicenter study, that POCT benefits care timeliness in the ED.We conducted a multicenter and cluster randomized study. A total of 3,200 patients. We randomly assigned patients to a POCT group or Central Laboratory Group. The primary outcome was the ED time to clinical decision. The secondary outcome included the length of stay and the laboratory turnaround time. Readmission within the seven after discharge was also calculated.The primary finding of this study is a strategy based on POCT that aims to significantly improve care timeliness in the ED. We found significant reductions in all outcomes regardless of presentation reason, patient disposition or hospital type. Time to clinical decision decreased by 75.2 min (205–129.8), length of stay by 77.5 min (273.1–195.6) and laboratory turnaround time by 56.2 min (82.2–26) in the POCT group. No increase in readmission was found.Our strategy represents a good approach to optimize timeliness in the ED. It should be seen as a starting point for further operational research focusing on POCT for improving throughput and reducing crowding in the ED. [ABSTRACT FROM AUTHOR]

Background: Improved access to quality antenatal care (ANC) promotes healthy behaviors and early complication management, enhancing maternal and newborn outcomes. The Enhancing Nutrition and Antenatal Infection Treatment for Maternal and Child Health (ENAT) intervention in Ethiopia aimed to increase newborn birth weight by improving ANC utilization and quality. ENAT task shared and decentralized ANC services to facilitate early contact and point of care (POC) testing and management of maternal infections and anemia. This study assessed if task sharing and decentralization improved utilization and quality of ANC services at primary health care facilities. Methods: The study assessed changes in ANC coverage and quality before and after the ENAT intervention, in 65 health centers and 303 health posts across Amhara and Oromia regions of Ethiopia. The intervention task shared ANC services at health centers (Augst 2018-January 2021) and then decentralized services to health posts (February 2021-February 2022). Using descriptive analyses, this study assessed, between baseline and endline, changes in coverage in the proportion of women who: enrolled early into ANC; had at least one ANC contact; and had four or more ANC contacts. Similarly, the study separately assessed each quality indicator through changes in the proportion of iron and folic acid supplementation, and deworming tablets, and POC testing and treatment for anemia, syphilis, and asymptomatic bacteriuria at baseline, phase I and phase II. Results: ANC utilization and quality improved in the 368 sites. Between baseline and endline the proportion of women having an ANC contact before 16 weeks of gestational age increased from 6 to 37%, while those receiving at least one ANC contact and four or more ANC contacts increased from 74 to 91% and 45–57%, respectively. Iron and folic acid supplementation and deworming increased from 44 to 97% and from 44 to 79%, respectively. In the final 12 months of the intervention, 87%, 80%, and 87% of pregnant women attending ANC received POC testing for anemia, syphilis, and asymptomatic bacteriuria, respectively. Conclusions: Our findings suggest that bringing ANC services closer to communities can increase early ANC contact and enhance the coverage and quality of services, leading to better maternal and newborn health outcomes. [ABSTRACT FROM AUTHOR]

In this study, a self-synthesized rare-earth chelator 4，4′-Bis (1″，1″，1″，2″，2″，3″，3″-7-fluoro-4″，6″-hexanedione-6″-yl）chlorosulfonated terphenyl (BHHCT) was used to prepare hepatitis B surface antibody markers, and a time-resolved fluorescence immunoassay for the rapid detection of hepatitis B surface antigen (HBsAg) was developed by applying lateral-flow immunochromatographic test strips and an accompanying time-resolved fluorescence detection system. The linear range was 0. 2~500 ng/mL, the detection limit was 0. 16 ng/mL, and the linear regression coefficient of determination (R²) was 0. 9996. The intra-batch coefficient of variation was less than 5%, the inter-batch coefficient of variation was less than 8%, and the recoveries of the samples ranged from 94. 3% to 107. 8%. The method has the advantages of precision, rapidity, specificity and no need for specialized personnel to operate, which can meet the requirement of immediate detection of hepatitis B surface antigen. [ABSTRACT FROM AUTHOR]

Background: Head and neck reconstruction following ablative surgery results in alterations to maxillofacial anatomy and function. These postoperative changes complicate dental rehabilitation. Methods: An innovative modular, stackable guide system for immediate dental rehabilitation during mandibular reconstruction is presented. The virtual surgical planning was performed in Materialise Innovation Suite v26 and Blender 3.6 with the Blenderfordental add-on. The surgical guides and models were designed and manufactured at the point of care. Results: The duration of the surgery was 9 h and 35 min. Good implant stability (>35 Ncm) and a stable occlusion were achieved. After 9 months of follow-up, the occlusion remained stable, and a mouth opening of 25 mm was registered. The dental implants showed no signs of peri-implant bone loss. Superposition of the preoperative planning and postoperative position of the fibula parts resulted in an average difference of 0.70 mm (range: −1.9 mm; 5.4 mm). Conclusions: The in-house developed stackable guide system resulted in a predictive workflow and accurate results. The preoperative virtual surgical planning was time-consuming and required extensive CAD/CAM and surgical expertise. The addition of fully guided implant placement to this stackable guide system would be beneficial. More research with longer follow-ups is necessary to validate these results. [ABSTRACT FROM AUTHOR]

CXCL13 is a chemokine which is upregulated within the CNS in multiple sclerosis, Lyme neuroborreliosis, and other inflammatory diseases and is increasingly clinically useful as a biomarker. This review provides background for understanding its function in the immune system and its relationship to ectopic lymphoid follicles. Also reviewed are its utility in multiple sclerosis and Lyme neuroborreliosis and potential problems in its measurement. CXCL13 has the potential to be an exceptionally useful biomarker in a range of inflammatory diseases. [ABSTRACT FROM AUTHOR]

Efficient diagnosis of mycobacterial infections can effectively manage and prevent the transmission of infectious diseases. Unfortunately, existing diagnostic strategies are challenged by long assay times, high costs, and highly specialized expertise to distinguish between pulmonary tuberculosis (PTB) and nontuberculous mycobacterial pulmonary diseases (NTM‐PDs). Herein, in this study, an optimized 3D paper‐based analytical device (µPAD) is incorporated with a closed lateral flow (LF) strip into a loop‐mediated isothermal amplification (LAMP) device (3D‐µPAD‐LF‐LAMP) for rapid, low‐cost, and visual detection of pathogenic mycobacteria. The platform's microfluidic feature enhanced the nucleic acid amplification, thereby reducing the costs and time as compared to boiling, easyMAG, and QIAGEN techniques. Moreover, the LF unit is specifically designed to minimize aerosol contamination for a user‐friendly and visual readout. 3D‐µPAD‐LF‐LAMP is optimized and assessed using standard strains, demonstrating a limit of detection (LOD) down to 10 fg reaction−1. In a cohort of 815 patients, 3D‐µPAD‐LF‐LAMP displays significantly better sensitivity, specificity, negative predictive value (NPV), positive predictive value (PPV), and diagnostic accuracy than conventional bacterial culture and Xpert techniques. Collectively, 3D‐µPAD‐LF‐LAMP demonstrates enhanced accessibility, efficiency, and practicality for the diagnosis of multiple pathogenic mycobacteria, which can be applied across diverse clinical settings, thereby ultimately improving public health outcomes. [ABSTRACT FROM AUTHOR]

Background: Point-of-care hepatitis C virus (HCV) testing streamlines testing and treatment pathways. In this study, we established an HCV model of care in a homelessness service by offering antibody and RNA point-of-care testing. Methods: A nurse and peer-led HCV model of care with peer support were implemented between November 2021 and April 2022 at a homelessness service in Adelaide, Australia. All clients of the service were eligible to participate. Clients were offered an initial antibody point-of-care test, and antibody positive clients were immediately offered RNA point-of-care testing. Clients who tested RNA positive were linked to a viral hepatitis nurse for treatment. Results: A total of 230 clients received an HCV antibody point-of-care test, of which 68 (30%) were antibody positive and 11 (5%) were RNA positive. Of these, seven (64%) clients successfully completed treatment and five (45%) received a sustained virological response (SVR) test to confirm cure. Conclusions: We successfully established HCV testing and a treatment pathway at a homelessness service using HCV antibody and RNA point-of-care testing. The high testing uptake underscores the utility of HCV point-of-care testing when establishing HCV testing and treatment pathways. The low RNA positivity suggests that an initial HCV antibody test was cost-effective, and the four clients diagnosed with chronic HCV who were lost to follow-up indicate a need for enhanced treatment support. [ABSTRACT FROM AUTHOR]

A point-of-care testing (POCT) platform, i.e., a portable colorimetric immunosensor based on iron oxide magnetic beads and AuNPs, has been developed for detecting leather residues. The immunosensor demonstrates a linear detection range from 1 ng/mL to 10 µg/mL, with a limit of detection (LOD) of 0.985 ng/mL. The sensor exhibits high specificity and repeatability and performs effectively in detecting leather artifacts excavated from Inner Mongolia. Thus, the proposed colorimetric immunosensor not only enables the micro-detection of leather artifacts but also shows significant potential for on-site leather detection at archaeological sites. [ABSTRACT FROM AUTHOR]

Aim: To develop a multiclass non‐clinical screening tool for periodontal disease and assess its accuracy for differentiating periodontal health, gingivitis and different stages of periodontitis. Materials and Methods: A cross‐sectional diagnostic study on a convenience sample of 408 consecutive subjects was conducted by applying three non‐clinical index tests estimating different features of the periodontal health–disease spectrum: a self‐administered questionnaire, an oral rinse activated matrix metalloproteinase‐8 (aMMP‐8) point‐of‐care test (POCT) and determination of gingival bleeding on brushing (GBoB). Full‐mouth periodontal examination was the reference standard. The periodontal diagnosis was made on the basis of the 2017 classification of periodontal diseases and conditions. Logistic regression and random forest (RF) analyses were performed to predict various periodontal diagnoses, and the accuracy measures were assessed. Results: Four‐hundred and eight subjects were enrolled in this study, including those with periodontal health (16.2%), gingivitis (15.2%) and stage I (15.9%), stage II (15.9%), stage III (29.7%) and stage IV (7.1%) periodontitis. Nine predictors, namely 'gum disease' (Q1), 'a rating of gum/teeth health' (Q2), 'tooth cleaning' (Q3a), the symptom of 'loose teeth' (Q4), 'use of floss' (Q7), aMMP‐8 POCT, self‐reported GBoB, haemoglobin and age, resulted in high levels of accuracy in the RF classifier. High accuracy (area under the ROC curve > 0.94) was observed for the discrimination of three (health, gingivitis and periodontitis) and six classes (health, gingivitis, stages I, II, III and IV periodontitis). Confusion matrices showed that the misclassification of a periodontitis case as health or gingivitis was less than 1%–2%. Conclusions: Machine learning‐based classifiers, such as RF analyses, are promising tools for multiclass assessment of periodontal health and disease in a non‐clinical setting. Results need to be externally validated in appropriately sized independent samples (ClinicalTrials.gov NCT03928080). [ABSTRACT FROM AUTHOR]

Objective: Successful endotracheal intubation is a key step in advanced airway management. The gold standard confirmation for successful endotracheal intubation is end-tidal carbon dioxide (etCO2) monitoring, although recent studies suggest that ultrasound can also be used. In this study, we explored the time-sensitive early recognition of successful endotracheal intubation by comparing ultrasound and etCO2 monitoring. Methods: The study included 104 patients who were posted for elective surgery under general anaesthesia requiring endotracheal intubation. The time from removal of the face mask to ultrasound visualization of flutter in the trachea was compared with that of the appearance of six consecutive capnography waveforms following endotracheal intubation. Results: Ultrasound was a faster tool for recognizing successful endotracheal intubation [(21.63±7.38) seconds] compared with capnography [(40.62±7.93) seconds]. Conclusion: eCO2 requires more time for 6 continuous waveforms to confirm successful intubation and has a false positive rate. Supplementing the gold standard etCO2 with ultrasound is faster and reliable in patients with low pulmonary blood flow without needing positive pressure ventilation, such as during cardiopulmonary resuscitation, in high-risk emergency intubations, such as in trauma, or in difficult airways where intubation can be confirmed in real time. Ultrasound is a reliable and faster tool for the early identification of successful endotracheal intubation than end-tidal carbon dioxide. [ABSTRACT FROM AUTHOR]

Objectives: To assess success rates and cost-effectiveness of adrenal venous sampling (AVS) after implementing point-of-care rapid cortisol (RC) testing conducted using a europium nanoparticle-based fluoro-immunoassay in patients with primary hyperaldosteronism. Methods: A retrospective review of AVS procedures was conducted at our medical center between January 2016 and June 2024. The primary objective was to compare the success rates of AVS before and after the implementation of the RC testing. Secondary outcomes included a cost–benefit analysis. Results: Of 55 AVS procedures, 19 were conducted using RC testing and 36 were in the historical control cohort. The success rates for right vein sampling were 79% and 67%, respectively. Overall, in six (31.5%) patients in the RC cohort, a low RC selectivity index (SI) value, calculated within 10 min, enabled determination of unsuccessful cannulation and need for resampling during the same AVS session. Repeated sampling resulted in successful procedures in two cases (10.5%) and unsuccessful AVS in four cases, nonetheless sparing the need for repeated AVS sessions in 31.5% of cases. Utilizing RC potentially spared 6 patients from repeated AVS sessions, and considering the additional expenses on the RC test, its use afforded cost savings of an average of $1288 per patient. Conclusions: We demonstrated the cost-effectiveness of utilizing RC measurement in sparing the need for repeated AVS sessions. RC measurement during AVS enabled identification of correct catheter placement in real time, allowing for prompt decisions regarding the need for additional sampling attempts, thereby reducing subsequent costs of repeated AVS sessions. [ABSTRACT FROM AUTHOR]

Background: The International Normalized Ratio (INR) monitors anticoagulant treatment but relies on laboratory-based services. This could limit access to rapid monitoring and increase the diagnostic delay, both of which may be addressed by point-of-care testing (POCT). This study investigated the LumiraDx POC platform for INR monitoring. Methods: INR was measured on recalcified residual venous (n = 94) specimens from Chris Hani Baragwanath Hospital and capillary blood specimens (n = 254) from consenting enrolled participants at Charlotte Maxeke Johannesburg Academic Hospital Anticoagulation clinic, Johannesburg, South Africa. Standard-of-care (SOC) INR was measured on sodium-citrated venous blood using the Sysmex-CS2500 platform (Siemens Healthcare) and Neoplastin-R (Roche Diagnostics and Diagnostica Stago, Paris, France) within 2 h post-venipuncture. Within run, precision was measured using 2 LumiraDx control levels. The statistical agreement of paired INR measurements was also stratified by dosing decision. Results: The precision was within the manufacturer's claim for controls (level 1%CV: 3.63, level 2%CV: 2.24). Accuracy analysis showed a moderate overall agreement compared to the SOC INR results with a correlation coefficient of 0.94 (95% Cl, (0.9267 to 0.9497)). The overall precision (ρ > 0.9) and accuracy (Cb = 0.9842) were good with an absolute bias of 0.07. The 95% confidence intervals for the slope and intercept did not include 1.00 and 0.00, respectively; however, the total calculated error was within the minimal acceptable limits. Conclusion: The LumiraDx INR Test showed a good performance compared to laboratory-based testing and provided opportunity for rapid and patient-centric care. Owing to an increasing positive bias for INR > 3.5, confirmation with laboratory INR measurements may be required. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of streptococcal throat infection is an area where current practice results in significant over-diagnosis of bacterial infection, with the resulting implications for antimicrobial use and resistance. The use of molecular point of care testing (POCT) has previously been shown to alter antibiotic prescribing decisions when compared to Centor scoring. This paper explores the impact of the addition of POCT to clinical assessment using the McIsaac and FeverPAIN scoring systems. Methods: Retrospective analysis of the clinical records of 144 patients who had previously received point of care testing as part of a trial of POCT as an adjunct to usual care was undertaken. The McIsaac and FeverPAIN scores were calculated and then compared with the POCT result originally obtained. The records were also reviewed to identify further consultations within 10 days of being tested. Results: Sufficient clinical data were available to calculate the FeverPAIN and McIsaac scores in 81% of patients and outcome data were available for 96.5% of patients. For patients with a FeverPAIN score of 4 or 5, 50–67% of patients had a positive POCT result, while for patients with a McIsaac score of 4 or 5, 50–68% had a positive POCT result. Moreover, 16.7% of patients who tested negative, and 16.3% of patients who tested positive, had a further consultation within 10 days of being assessed. Conclusions: Although relatively few patients in this study had maximum scores on the FeverPAIN and McIsaac scoring, the addition of POCT was shown to alter antibiotic prescribing decisions in a significant number of patients, supporting the use of Abbott ID NOW point of care testing to reduce antibiotic prescribing. Larger studies are required to confirm these results and explore the health economic aspects and potential impacts on health inequalities. [ABSTRACT FROM AUTHOR]

Background/Objectives: Blood lactate concentration is often used to assess systemic hypoperfusion, tissue hypoxia, and sepsis in trauma patients and serves as a prognostic indicator and marker of response to therapy. Point-of-care (POC) devices provide rapid lactate measurements with a single drop of blood. In this study, lactate values from whole blood, measured with two POC devices, Abbott i-STAT® and the Nova Biomedical Lactate (LA) Plus™ meter, are compared. Methods: An observational analysis of 760 blood samples from four preclinical trauma animal models was performed. Lactate was measured simultaneously with two POC devices (i-STAT® and the Lactate Plus™ meter). The evaluation in the form of a Bland–Altman diagram showed the agreement of the tests. Results: The Spearman correlation was 0.9180 (95% CI 0.9056 to 0.9288) for i-STAT® vs. the LA Plus™ meter. Both tests showed a significant increase in lactate after injury (p < 0.05). The i-STAT® showed a small bias compared to the LA Plus™ meter (−0.0227 ± 0.4542 with 95% limits of agreement from −0.09129 to 0.8675). The LA Plus™ meter showed slightly higher values overall (0.0227 mmol/L), but the i-STAT® showed higher results at lactate levels above 2.5 mmol/L. Conclusions: The observed similarity in performance between the two devices suggests that both are capable of reliably measuring lactate levels in a trauma situation. The LA Plus™ meter provides fast results with only one drop of blood. This study supports the prehospital use of POC devices. [ABSTRACT FROM AUTHOR]

Background: Respiratory tract infections (RTIs) are a leading cause of pediatric emergency department (PED) visits, especially in children under five. These infections are primarily viral, complicating diagnosis and management. This study assesses the impact of point-of-care (POC) rapid diagnostic tests for respiratory viruses on clinical and economic outcomes in a PED setting. Materials and Methods: A retrospective analysis of 1396 POC tests for RSV, adenovirus, and influenza A/B was conducted in the PED of the Giannina Gaslini Institute, Genoa, Italy, from December 2022 to April 2024. Demographics, blood tests, admissions, and readmission rates were evaluated. Statistical analyses were performed using appropriate tests for categorical and continuous variables. Results: Of the tests, 31.5% were positive for at least one virus. Positive patients were younger and had higher hospitalization rates (50.7% vs. 39.9%) but fewer blood tests (38.2% vs. 51.7%). Economic analysis indicated lower costs for virus-positive patients. RSV-positive patients showed a significant association with higher hospitalization rates (67.8%) and readmission within 72 h. Conclusions: POC testing significantly improves patient management in PEDs by enabling rapid diagnoses, reducing unnecessary tests and hospitalizations, and guiding appropriate treatment. This approach supports better resource allocation, crucial during peak seasons, and has implications for reducing antibiotic use and resistance. Further research is warranted to explore long-term impacts on patient outcomes and healthcare efficiency. [ABSTRACT FROM AUTHOR]

Fungi are among the predominant pathogens seen in a greater proportion of infections acquired in healthcare settings. A common fungus that causes infections in medical settings is Candida species. Hospitalized patients who suffer from fungal diseases such as candidiasis and candidemia often have elevated rates of mortality and morbidity. It is evident that longer hospital stays have the possibility of bacterial and fungal recurrence and also have a negative economic impact. If left untreated, a Candida infection can spread to other organs and cause a systemic infection that can result in sepsis. Clinicians can treat patients quickly when fungal infections are timely detected, this enhances the results of clinical trials. Developing novel, sensitive, and quick methods for detecting Candida species is imperative. Conventional detection techniques are unsuitable for clinical settings and point-of-care systems as they require expensive equipment and take a longer detection time. This review examines a few of the most widely used biosensor systems for the detection of Candida species, their sensitivity, and the limit of detection. It focuses on various biorecognition elements used and follows utilization and advances in nanotechnology in the context of sensing. In addition to enabling general analysis and quick real-time analysis, crucial for detecting Candida species, biosensors provide an intriguing alternative to more conventional techniques. [ABSTRACT FROM AUTHOR]

The growing demand of diagnostic tools with enhanced analytical characteristics in term of sensitivity, selectivity, and low response time has encouraged researches to conduct their research towards development of point-of-care (POC) biosensors. POC diagnostic devices are powerful tools for detection, diagnosis, and monitoring of diseases at its initial stage. The above characteristics encouraged us to conduct active multidisciplinary and collaborative research oriented towards the design and development of POC sensing systems. Here, we present a brief overview of our recent achievement in the field of biomedical POC devices implemented in paper based microfluidic and screen printing electrodes and discuss the critical limitations that need to be surmounted to facilitate their translation into clinical practice in the future. [ABSTRACT FROM AUTHOR]

The value of C-reactive protein point-of-care testing (CRP POCT) to guide antibiotic prescriptions in adults has previously been emphasized. The aim of this study was to assess the impact of CRP POCT on antibiotic prescriptions by general practitioners (GPs) for suspected lower respiratory tract infections in children ≥3 years old and in adults. This was an open-label randomized trial (NCT03540706) conducted in 26 GPs in France between October 2019 and March 2023. Of the 404 participating patients, 207 (51.2%) were randomized to the CRP POCT group and 197 (48.8%) to the control group (i.e. no CRP POCT). During consultations, GPs measured CRP levels in patients randomized to the CRP POCT group. The primary endpoint was the proportion of patients in each group who were prescribed antibiotics by their GP during the consultation. Z-tests were used for comparisons. The overall proportion of patients treated with antibiotics was similar in the CRP POCT (n = 89/207, 43% CI: 36.2, 50.0) and in the control group (n = 94/197, 47.7% CI: 40.6, 54.9), difference: −4.7 CI: −14.4, 5.0; p 0.3. Overall, 75% of the GPs followed CRP-based antibiotic prescription recommendations in the CRP POCT group. CRP POCT did not reduce antibiotic prescriptions in this trial. [ABSTRACT FROM AUTHOR]

Objectives: Point‐of‐care ultrasound (POCUS) use is widespread in EDs and throughout those practising medicine. Between institutions and specialities, there is widespread variety and training. With this comes risk of patient harm and backlash to a clinically useful modality. Our objective is to form a statement that encompasses current published and unpublished guidance for creating and maintaining robust POCUS programs in EDs. Methods: Emergency Medicine Ultrasound Group (EMUG) identified this gap and volunteers from the group undertook a literature search of current best practice and institution guidelines relating to POCUS programs. They contacted colleagues from other specialities to find and get access to other countries and colleges' POCUS guidelines. EMUGs regularly run discussion forums (Collab‐labs) and points from these were considered. Recommendations were then formed from these and recurrent unpublished obstacles the group had encountered. The result was reviewed by Clinical Leads in Ultrasound and POCUS users in Australasia. Results: The recommendations were organised under five pillars: Infrastructure, Governance, Administration, Education and Quality. Conclusion: These recommendations complement existing guidelines and are not intended to replace them; however, we hope to promote discussion and provide reference support for those developing POCUS programs. Implementing a comprehensive and robust ED POCUS program will ensure safe, effective, and standardised high‐quality POCUS use, with the aim of improving patient care across Australia and New Zealand. Patient safety will be enhanced through effective risk management and quality assurance and there will be consistency in POCUS education, training and credentialing across institutions. [ABSTRACT FROM AUTHOR]

Objectives: Point‐of‐care ultrasound (POCUS) use is widespread in EDs and throughout those practising medicine. Between institutions and specialities, there is widespread variety and training. With this comes the risk of patient harm and backlash to a clinically useful modality. Our objective is to form a statement that encompasses current published and unpublished guidance for creating and maintaining robust POCUS programs in EDs. Methods: Emergency Medicine Ultrasound Group (EMUG) identified this gap and volunteers from the group undertook a literature search of current best practice and institution guidelines relating to POCUS programs. They contacted colleagues from other specialities to find and get access to other countries and colleges' POCUS guidelines. EMUGs regularly run discussion forums (Collab‐labs) and points from these were considered. Recommendations were then formed from these and recurrent unpublished obstacles the group had encountered. The result was reviewed by clinical leaders in ultrasound and POCUS users in Australasia. Results: The recommendations were organised under five pillars: Infrastructure, Governance, Administration, Education and Quality. Conclusion: These recommendations complement existing guidelines and are not intended to replace them; however, we hope to promote discussion and provide reference support for those developing POCUS programs. Implementing a comprehensive and robust ED POCUS program will ensure safe, effective and standardised high‐quality POCUS use, with the aim of improving patient care across Australia and New Zealand. Patient safety will be enhanced through effective risk management and quality assurance and there will be consistency in POCUS education, training and credentialing across institutions. [ABSTRACT FROM AUTHOR]

Objectives: Although it is the most performed invasive procedure, peripheral intravenous catheter (PIVC) insertion in children can be difficult. The primary objective of the study was to identify the factors associated with difficult intravenous access (DIVA) in the paediatric ED, including patient, proceduralist and situational factors. Methods: This was a single‐centre prospective observational cohort study conducted over 28 consecutive days. Research assistants observed PIVC insertion attempts for children under 16 years of age and recorded data for variables relating to the patient, proceduralist and event. Univariate logistic regression modelling was performed to identify factors associated with DIVA, defined as unsuccessful PIVC insertion on the first attempt. Results: A total of 134 participants were recruited; 66 were male (49%) with a median age of 5.7 years. Fifty‐two (39%) were classified as having DIVA. There was a total of 207 PIVC insertion attempts with two or more attempts needed for 48 children (36%). Patient factors associated with DIVA included age of 3 years or less and limited vein options. Proceduralist factors included gestalt of 50% or less chance of success, use of a larger gauge (smaller bore) PIVC and less PIVC insertion experience. Situational factors included a combative child, higher pain score and loud ambient noise. Conclusions: The present study identified multiple patient, proceduralist and situational factors that were associated with DIVA in the paediatric ED. Future studies should explore the development and implementation of a package to address DIVA in children, with the patient‐centred goals of reducing pain and improving success. [ABSTRACT FROM AUTHOR]

The article discusses the increasing importance of point-of-care ultrasound (POCUS) in pediatric intensive care units (PICUs) for evaluating kidney conditions. Topics discussed include the recent study on renal resistive index (RRI) as a predictor of acute kidney injury (AKI) in critically ill children, the limitations of traditional biomarkers like urine neutrophil gelatinase-associated lipocalin (NGAL), and the need for further research into kidney POCUS applications.

Background: Sepsis associated acute kidney injury (AKI) is linked with adverse outcomes in the PICU. Doppler-based renal resistive index (RRI) has shown promising results in adults for prediction of AKI. We aimed to explore the performance of RRI in children with sepsis. Methods: This prospective observational study (March – November 2022) included children aged 1–12 years with sepsis admitted to the PICU. RRI and urine neutrophil gelatinase associated lipocalin (NGAL) were measured within 12 h of admission. Children were followed up for 3 days. AKI (new and persistent) was defined as any child with KDIGO stage 2 or 3 AKI on day 3. Results: We enrolled 90 children but included 79 in final analysis. Two thirds (n = 53, 67%) had septic shock. Median (IQR) age was 6.2 years (4.1–9.2). RRI decreased with increasing age. Twenty-six (33%) children had AKI on day 3. Mean (SD) RRI was higher in the AKI group [0.72 (0.08) vs. 0.65 (0.07), p < 0.001].The area under ROC curve for RRI to detect AKI among the 1–4 year old group was 0.75 (95% CI:0.51, 0.98; p = 0.05) and among the 5–12 year old group was 0.76 (0.62, 0.89; p = 0.001). An RRI 0.71 predicted AKI with 100% sensitivity and 46.2% specificity among the 1–4-year-old group and RRI 0.69 predicted it with 70% sensitivity and 77.5% specificity in the 5–12-year-old group. RRI and eGFR at admission were independent predictors of AKI on multivariable analysis. Urine NGAL 94.8 ng/ml predicted AKI with 76.9% sensitivity and 77.4% specificity and AUROC was 0.74 (0.62, 0.86) among the 1–12-year-old group. Conclusions: RRI values varied with age. RRI showed good diagnostic accuracy to detect new/persistent AKI on day 3 in children with sepsis; however, it was less precise as an independent predictor. [ABSTRACT FROM AUTHOR]

Exosomes as new biomarkers for cancer diagnosis have attracted attention because they are highly released by tumor cells in various biological fluids. In this study, an electrochemical paper-based immunosensor device (Exo-sensing paper) is introduced for the detection of exosome in the serum. The Exo-sensing paper is a three-electrode system that is prepared using pattern paper and carbon and silver inks. The sensor part of this immunosensor contains a three-dimensional porous nanocomposite of nickel nanofoam coupled with graphene oxide and gold nanoparticles. The high specific surface area of this nanocomposite increases the antibody loading on the sensor surface significantly and consequently leads to obtaining a wide linear range of 500–1 × 107 Exospore µL−1 with a detection limit of 110 Exosome µL−1. Due to some advantages of this constructed Exo-sensing paper such as easy storage, simple application, low cost and good selectivity in the real samples, this system has a good potential to be used as a point of care testing for in situ detection of the exosomes and is a promising strategy for minimally invasive liquid biopsy. [ABSTRACT FROM AUTHOR]

Wireless biosensing has emerged as a critical technology due to its ability to provide real-time, continuous monitoring of physiological parameters without the constraints of wired connections. This review starts from the fundamental mechanisms of physical and chemical sensing in wireless biosensors, to the integration of advanced wireless technologies for energy harvesting and data communication, including Radio Frequency, Bluetooth, and other forms. Additionally, it covers diverse applications in wearable and implantable biosensors, such as cardiac monitoring, prosthetic enhancements, electronic skin and contact lenses. Attention is given to the emerging fields of osseosurface electronics and gastrointestinal capsule sensors, which represent significant advancements in non-invasive and minimally invasive health monitoring. The synergistic integration of these technologies paves the way for innovative diagnostic and therapeutic tools, promising improved patient outcomes and convenient healthcare solutions. This comprehensive overview aims to provide insights into the current state and future prospects of wireless biosensing technologies, underscoring their potential to be realized in various kinds of biosensors. Highlights: • Explores emerging capabilities of wireless biosensing technologies in providing continuous health monitoring • Showcases advancements in energy harvesting and seamless data transmission techniques in wireless sensing platforms • Dissects the diversified applications of wireless biosensors in the fields of precision medicine and point-of-care diagnostics [ABSTRACT FROM AUTHOR]

Disposable electrochemical biosensors with high sensitivity are very fit for point-of-care testing in clinical diagnosis. Herein, amino-functionalized, vertically ordered mesoporous silica films (NH2-VMSF) attached to an electrochemically polarized screen-printed carbon electrode (p-SPCE) are prepared using a simple electrochemical method and then utilized to construct a gated electrochemical aptasensor for rapid and sensitive determination of carcinoembryonic antigen (CEA). After being treated with the electrochemical polarization procedure, p-SPCE has plentiful oxygen-containing groups and improved catalytic ability, which help promote the stability of NH2-VMSF on SPCE without the use of an adhesive layer and simultaneously generate a highly electroactive sensing interface. Owing to the numerous uniform and ultrasmall nanopores of NH2-VMSF, CEA-specific aptamer anchored on the external surface of NH2-VMSF/p-SPCE serves as the gatekeeper, allowing the specific recognition and binding of CEA and eventually impeding the ingress of electrochemical probes [Fe(CN)63−/4−] through the silica nanochannels. The declined electrochemical responses of Fe(CN)63−/4− can be used to quantitatively detect CEA, yielding a wide detection range (100 fg/mL to 100 ng/mL) and a low limit of detection (24 fg/mL). Moreover, the proposed NH2-VMSF/p-SPCE-based electrochemical aptasensor can be applied to detect the amount of CEA in spiked human serum samples, which extends the biological application of a disposable NH2-VMSF/p-SPCE sensor by modulating the biological recognition species. [ABSTRACT FROM AUTHOR]