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Background: Invasive fungal infections are responsible for a large number of infections in hospitalized patients annually and are responsible for high morbidity and mortality. Familiarity with novel agents or strategies in this area can be challenging., Objectives: To identify the top 10 manuscripts on the treatment of invasive fungal infections from 2018 to 2023., Design: Modified Delphi consensus-building technique., Methods: A three-stage consensus-building approach was used comprised of (1) identifying relevant articles; (2) voting by a panel of experts to establish consensus on the importance of these articles; and (3) finalizing the list of top articles by a small group. Members of the Southeastern Research Group Endeavor network served as content experts. Publications from 2018 to 2023 were evaluated if articles met the following inclusion criteria: (1) published between 2018 and 2023, (2) contained content related to fungal infections, and (3) included an actionable intervention., Results: A total of 6518 potential publications were assessed. After applying inclusion and exclusion criteria, 82 articles were reviewed. The top 10 publications related to invasive fungal infections, selected by a panel of experts, are summarized in this manuscript and include publications related to the treatment of invasive aspergillosis, candidiasis, and cryptococcosis., Conclusion: This article highlights the selected publications and may serve as a key resource for teaching and training. Clinicians may also employ these reported interventions to identify new opportunities to optimize antifungal therapeutic strategies within one's institution., (© The Author(s), 2024.)

A novel electrochemical glucose sensor was created for a simple but semiquantitative visual screening of specific glucose concentrations in urine. This noninvasive glucose biosensor integrated a disposable, paper-based sensing strip and a simple amplifier circuit with a visual readout. The paper strip consisted of five enzyme-activated electrodes. Each electrode was connected to a specific indicator circuit that triggered a light-emitting diode (LED) when a predefined glucose concentration was reached. The device features (1) low-cost, disposable, paper-based glucose oxidase (GOx)/poly(3,4-ethylenedioxythiophene) polystyrene sulfonate (PEDOT:PSS) sensing electrodes, (2) simple signal amplification, and (3) on-site, rapid, and visual detection. The sensor generated reliable, discrete visual responses to determine five glucose levels (1, 2, 3, 4, and higher than 4 mM) in urine in less than 2 min. This innovative approach will provide a simple but powerful glucose sensing paradigm for use in POC diagnostics.

Introduction:: Paper is the most important material of the printing industry and is being improved due to the increasing needs of industry. The most important process to improve the optical and physical properties of paper is the surface coating. Paper has a smoother and opaquer surface with surface coating. In addition, brightness, whiteness, and yellowness values   are improved with surface coating. Ultraviolet (UV) light in sunlight causes changes in the structure of the paper and coating chemicals and accordingly causes yellowing. Para-amino benzoic acid (PABA), due to its chemical structure, is a UV-blocking agent used in sunscreen creams., Methods:: The effect of PABA on paper gloss, yellowness, and lightfastness values   was investigated by adding it into the surface coating formulation. For this purpose, coating formulations were prepared with cationic starch and 3%, 5%, and 7% PABA; coatings were applied to the paper according to laboratory condition standards. Coated papers were printed with an IGT-C1 lab-type offset printability device with magenta ink. The printed papers were then exposed to a light fastness test with Solarbox. The color, brightness, and yellowness values   of all samples before and after lightfastness were measured with an X-Rite spectrophotometer. The gloss of coated and printed paper sample values was measured with a BYK-Gardner glossmeter., Results:: The gloss values   of paper to which PABA was added, increased; however, it was determined that these gloss values   decreased after the lightfastness test., Conclusions:: PABA-added cationic starch coatings are more affected by UV light than cationic starch coatings.

Tablet computers have emerged as increasingly useful tools in medical education, particularly for assessment. However, it is not fully established whether tablet computers influence the quality and/or quantity of feedback provided in high stakes assessments. It is also unclear how electronically-recorded feedback relates to student performance. Our primary aim was to determine whether differences existed in feedback depending on the tool used to record it., Methods: We compared quantitative and qualitative feedback between paper-scoring sheets versus iPads™ across two consecutive years of a final year MBChB (UK medical degree) Objective Structured Clinical Examination. Quality of comments (using a validated five-point rating scale), number of examiner comments and number of words were compared across both methods of recording assessment performance using chi-squared analysis and independent t-test. We also explored relationships between student performance (checklist and global scoring) and feedback., Results: Data from 190 students (2850 paper scored interactions) in 2015 and 193 (2895 iPad™ scored interactions) in 2016 were analysed. Overall, a greater number of comments were given with iPad™ compared to written (42% versus 20%; p < 0.001) but the quality of feedback did not differ significantly. For both written and electronic feedback, students with low global scores were more likely to receive comments (p < 0.001)., Conclusion: The use of iPads™ in high stakes assessment increases the quantity of feedback compared to traditional paper scoring sheets. The quantity and quality of feedback for poorer performing candidates (by global score) were also better with iPad™ feedback., Competing Interests: No conflict of interests declared

Objectives: Guidewire occasionally creates a loop-like appearance between the right subclavian artery and brachiocephalic artery when performing coronary angiography (CAG) with right radial artery (RtRA) access. We called this occurrence a looped guidewire at the brachiocephalic artery (looped GW at BA). It is associated with difficulties in catheter manipulation. This study aimed to assess the predictors of forming a looped GW at the BA., Methods: We examined 175 (mean age, 71.3 ± 9.5 years; 74.9% men) consecutive patients who underwent elective CAG with the RtRA access. Looped GW at the BA was defined as a loop-like appearance of the 0.035-inch GW between the right subclavian and brachiocephalic artery on a frontal view or left anterior oblique. To identify the predictors of looped GW at BA, patient characteristics and examination data obtained before CAG were compared between patients with and without looped GW at the BA., Results: The prevalence of looped GW at BA was 10.9%. The cardio-ankle vascular index (CAVI), which reflects arterial stiffness, was significantly different in patients with or without looped GW at BA (9.8 ± 1.0 vs. 8.9 ± 1.5, p   = 0.0092). The area under the receiver-operating characteristic curve of CAVI to predict looped GW at BA was 0.745, with 0.94 sensitivity and 0.57 specificity in a cutoff point of CAVI ≥9.0., Conclusions: Looped GW at BA can be ruled out by CAVI and is associated with high arterial stiffness., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

A merged system incorporating paperfluidics and papertronics has recently emerged as a simple, single-use, low-cost paradigm for disposable point-of-care (POC) diagnostic applications. Stand-alone and self-sustained paper-based systems are essential to providing effective and lifesaving treatments in resource-constrained environments. Therefore, a realistic and accessible power source is required for actual paper-based POC systems as their diagnostic performance and portability rely significantly on power availability. Among many paper-based batteries and energy storage devices, paper-based microbial fuel cells have attracted much attention because bacteria can harvest electricity from any type of organic matter that is readily available in those challenging regions. However, the promise of this technology has not been translated into practical power applications because of its short power duration, which is not enough to fully operate those systems for a relatively long period. In this work, we for the first time demonstrate a simple and long-lasting paper-based biological solar cell that uses photosynthetic bacteria as biocatalysts. The bacterial photosynthesis and respiration continuously and self-sustainably generate power by converting light energy into electricity. With a highly porous and conductive anode and an innovative solid-state cathode, the biological solar cell built upon the paper substrates generated the maximum current and power density of 65 µA/cm 2 and 10.7 µW/cm 2 , respectively, which are considerably greater than those of conventional micro-sized biological solar cells. Furthermore, photosynthetic bacteria in a 3-D volumetric chamber made of a stack of papers provided stable and long-lasting electricity for more than 5 h, while electrical current from the heterotrophic culture on 2-D paper dramatically decreased within several minutes.

Abstract Healthcare services in many countries have been partially or completely disrupted by the Coronavirus (COVID-19) pandemic since its onset in the end of 2019. Amongst the most impacted are the elective medical and surgical services in order to conserve resources to care for COVID-19 patients. As the number of infected patients decrease across Canada, elective surgeries are being restarted in a staged manner. Since Otolaryngologists – Head & Neck Surgeons manage surgical diseases of the upper aerodigestive tract where the highest viral load reside, it is imperative that these surgeries resume in a safe manner. The aim of this document is to compile the current best evidence available and provide expert consensus on the safe restart of rhinologic and skull base surgeries while discussing the pre-operative, intra-operative, and post-operative care and tips. Risk assessment, patient selection, case triage, and pre-operative COVID-19 testing will be analyzed and discussed. These guidelines will also consider the optimal use of personal protective equipment for specific cases, general and specific operative room precautions, and practical tips of intra-operative maneuvers to optimize patient and provider safety. Given that the literature surrounding COVID-19 is rapidly evolving, these recommendations will serve to start our specialty back into elective rhinologic surgeries over the next months and they may change as we learn more about this disease.

Use of a smartphone as an optical detector for paper microfluidic devices has recently gained substantial attention due to its simplicity, ease of use, and handheld capability. Utilization of a UV light source enhances the optical signal intensities, especially for the particle immunoagglutination assay that has typically used visible or ambient light. Such enhancement is essential for true assimilation of assays to field deployable and point-of-care applications by greatly reducing the effects by independent environmental factors. This work is the first demonstration of using a UV LED (UVA) to enhance the Mie scatter signals from the particle immunoagglutination assay on the paper microfluidic devices and subsequent smartphone detection. Smartphone's CMOS camera can recognize the UVA scatter from the paper microfluidic channels efficiently in its green channel. For an Escherichia coli assay, the normalized signal intensities increased up to 50% from the negative signal with UV LED, compared with the 4% to 7% with ambient light. Detection limit was 10 colony-forming units/mL. Similar results were obtained in the presence of 10% human whole blood.

Abstract The novel Coronavirus (COVID-19) has created a worldwide deadly pandemic that has become a major public health challenge. All semi-urgent and elective medical care has come to a halt to conserve capacity to care for patients during this pandemic. As the numbers of COVID-19 cases decrease across Canada, our healthcare system also began to reopen various facilities and medical offices. The aim for this document is to compile the current evidence and provide expert consensus on the safe return to clinic practice in Otolaryngology – Head & Neck Surgery. These recommendations will also summarize general precaution principles and practical tips for office across Canada to optimize patient and provider safety. Risk assessment and patient selection are crucial to minimizing exposure to COVID-19. Controversial topics such as COVID-19 mode of transmission, duration of exposure, personal protective equipment, and aerosol-generating procedures will be analyzed and discussed. Practical solutions of pre-visit office preparation, front office and examination room set-up, and check out procedures are explored. Specific considerations for audiology, pediatric population, and high risk AGMPs are also addressed. Given that the literature surrounding COVID-19 is rapidly evolving, these guidelines will serve to start our specialty back into practice over the next weeks to months and they may change as we learn more about this disease.

In paper-based microfluidics, the simplest devices are colorimetric, giving qualitative results. However, getting quantitative data can be quite a bit more difficult. Distance-based devices provide a user-friendly means of obtaining quantitative data without the need for any additional equipment, simply by using an included ruler or calibrated markings. This article details the development of a quantitative DNA detection device that utilizes the aggregation of polystyrene microspheres to affect the distance that microspheres wick through filter paper. The microspheres are conjugated to single-stranded DNA (ssDNA) oligomers that are partially complementary to a target strand and, in the presence of the target strand, form a three-strand complex, resulting in the formation of aggregates. The higher the concentration of the target strand, the larger the aggregate, and the shorter the distance wicked by the microspheres. This behavior was investigated across a wide range of target concentrations and under different incubation times to understand aggregate formation. The device was then used to successfully detect a target strand spiked in extracted plant DNA.

Lactoferrin is an abundant glycoprotein in human body fluids and is known as a biomarker for various diseases. Therefore, point-of-care testing (POCT) for lactoferrin is of interest. Microfluidic paper-based analytical devices (µPADs) have gained a lot of attention as next-generation POCT device candidates, due to their inexpensiveness, operational simplicity, and being safely disposable. This work presents a colorimetric sensing approach for quantitative lactoferrin analysis. The detection mechanism takes advantage of the high affinity of lactoferrin to ferric ions (Fe 3+ ). Lactoferrin is able to displace an indicator from a colorimetric 2-(5-bromo-2-pyridylazo)-5-diethylaminophenol (5-Br-PADAP)-Fe 3+ complex, resulting in a color change. A 5-Br-PADAP-Fe 3+ complex was encapsulated into water-dispersible poly(styrene- block -vinylpyrrolidone) particles, whose physical entrapment in the cellulosic fiber network results in the immobilization of the complex to the paper matrix. The complex-encapsulating particles showed a color change response in accordance with lactoferrin concentration. Both color intensity-based paper well plates and distance readout-based µPADs are demonstrated. Color intensity-based devices allowed quantitative analysis of lactoferrin concentrations with a limit of detection of 110 µg/mL, using a smartphone and a color readout app. On the other hand, distance readout-based µPADs showed changes of the length of colored sections in accordance with lactoferrin concentration. In summary, we successfully developed both colorimetric intensity-based paper wells and distance-based µPADs for lactoferrin detection. This work demonstrates a user-friendly colorimetric analysis platform for lactoferrin without requiring lab equipment and expensive antibodies.

Background: The prevalence of obesity is rising, and obese persons are more likely to use healthcare services and require moving and handling care., Aims: This study explored the frequency, logistics and barriers to the provision of bariatric patient-handling care including equipment availability in acute hospitals., Methods: A cross-sectional study design using an anonymous 24-item questionnaire was used to survey 322 clinical nurse managers. Completed hard-copy questionnaires ( n  = 132) were returned by post., Results: Most clinical nurse managers (93.1%) provided care for bariatric patients and 85.6% reported barriers to the provision of bariatric care within their clinical area. The principal barriers were lack of equipment (75%), staff (65.2%) and training (57.6%). Only 11.4% owned all the required equipment. Owning equipment provided significantly greater access to a hoist ( P  = 0.001) and chair ( P  = 0.032) than renting. Only 9.5% reported that rented equipment always arrives on time. The majority (74.4%) did not have guidelines for caring for bariatric patients, and 46.2% considered this to be a barrier., Conclusions: Barriers to caring for bariatric patients were identified. Most of the equipment was rented, and significant delays in its delivery were reported. The need for education and training and the dissemination of policies and guidelines were identified., (© The Author(s) 2023.)

Background: Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution., Aims: To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature., Methods: Use of Neale's (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study., Results: DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread., Conclusions: DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people's perceptions of adult services as supportive, empowering and available. DC can be used for frequent 'check-ins' and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting., (© The Author(s) 2023.)