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BackgroundNational guidelines recommend germline genetic testing (GT) for all patients with early-onset colorectal cancer. With recent advances in targeted therapies and GT, these guidelines are expected to expand to include broader groups of patients with colorectal cancer. However, there is a shortage of genetic professionals to provide the necessary education and support for informed consent. As such, there is a pressing need to identify alternative approaches to facilitate and expedite access to GT. ObjectiveThis study describes the development of a pretest education intervention, Nest-CRC, to facilitate the uptake of germline GT among patients with early-onset colorectal cancer. Patients with early-onset colorectal cancer and health care providers reviewed Nest-CRC, and their reactions and recommendations were captured using a nested mixed methods approach. MethodsUsing the learner verification approach, we conducted 2 sequential phases of surveys and interviews with English- and Spanish-speaking patients with early-onset colorectal cancer and health care providers. The surveys assessed participants’ experiences with genetic services and provided immediate feedback on the Nest-CRC genetic education modules. Semistructured interviews evaluated participants’ perceptions of self-efficacy, attraction, comprehension, cultural acceptability, and usability of Nest-CRC. Survey data were analyzed using descriptive statistics (mean, median, and proportions), while interview data were analyzed through line-by-line coding of the transcribed interviews. After each phase, Nest-CRC was refined based on participants’ recommendations. ResultsA total of 52 participants, including 39 patients with early-onset colorectal cancer and 13 providers, participated in the study. Of these, 19 patients and 6 providers participated in phase 1 (N=25), and 20 patients and 7 providers participated in phase 2 (N=27). Most participants (phase 1: 23/25, 92%, to 25/25, 100%; phase 2: 24/27, 89%, to 27/27, 100%) agreed that each of the 5 education modules was easy to understand and helpful; 13 patients reported no history of GT, with 11 (85%) expressing interest in GT and 2 (15%) remaining unsure after completing Nest-CRC. Participants reported that Nest-CRC provided sufficient information to help them decide about GT. The tool was deemed acceptable by individuals from diverse backgrounds, and participants found it visually attractive, easy to comprehend, and user-friendly. ConclusionsThe findings revealed that Nest-CRC is a promising strategy for facilitating pretest education and promoting GT. Nest-CRC has been refined based on participant recommendations and will be re-evaluated.

Objective: Given the critical role of general practitioners (GPs) in the early diagnosis and management of asbestos-related diseases (ARDs), and the significant history of asbestos fibres pollution in Alessandria Local Health Authority (ASL AL), this project aimed to assess the knowledge and awareness of asbestos risks, as well as the experience in diagnosing ARDs among GPs working in Alessandria province, Northern Italy. Methods: A questionnaire was administered to 216 GPs from all ASL AL territorial districts during 26 Territorial Assistance Equipes (EATs) meetings, held from September 2022 to January 2023. It contained 29 questions covering three main areas: ‘knowledge and awareness’, ‘competence and experience’, ‘sociodemographic characteristics and workload’. Results: Although GPs were aware of the health hazards of asbestos (94 %) and the increased risk of mesothelioma from asbestos exposure (92.6 %), significant disparities and heterogeneity of knowledge were observed among territorial districts and by comparing Casale Monferrato district with all the others, particularly regarding asbestos exposure routes, reporting of occupational diseases, and mesothelioma latency. Conclusions: This project provides a comprehensive overview of GPs' knowledge, awareness and experience in managing ARDs, providing indications of customised training requirements. This evaluation could be extended to all areas with a history of previous asbestos exposure and provide a useful tool for policy makers to define and plan strategic actions on asbestos. This work could also be adapted to different realities with a history of environmental pollutant exposure other than asbestos, which pose a risk for the development of several diseases.

The field of radionuclide therapy (RNT) for prostate cancer (PC) is growing rapidly, with recent Food and Drug Administration approval of the first 177Lu-PSMA ligand. We aimed to develop the first patient-reported outcome (PRO) measure for PC patients receiving RNT. Methods: We identified relevant symptoms and toxicities by reviewing published trials and interviews with PC patients receiving RNT (n = 29), caregivers (n = 14), and clinicians (n = 11). Second, we selected items for measure inclusion. Third, we refined the item list with input from experts in RNTs and PROs. Fourth, we finalized the Functional Assessment of Cancer Therapy-Radionuclide Therapy (FACT-RNT) with patient input. Results: This multistep process yielded a brief 15-item measure deemed by key stakeholders to be relevant and useful in the context of RNT for PC. Conclusion: The FACT-RNT is a new standardized tool to monitor relevant symptoms and toxicities among PC patients in RNT trials and real-world settings.

Natalia A Warren,1,2,* Steven L Maskin,3,* Varadraj Gurupur,4,* Deidre A Rector,1,* Diana Adelman,1,* Susan Howell,1,* John McAree,1,* Ruthie Dibble,1,* Celia Carlisano,1,* David P Maconi,1,* Dirk Schrotenboer,5,* Maria Jaimes,3,* Nancy Marte,3,* Theresa Carlisano,1,* Claire Toland,3,* Jongik Chung,6,* Sandra L Cremers,7 Glenn S Corbin8 1Not A Dry Eye Foundation, Daytona Beach, FL, USA; 2School of Modeling, Simulation, and Training, University of Central Florida, Orlando, FL, USA; 3Dry Eye and Cornea Treatment Center, Tampa, FL, USA; 4Department of Health Management and Informatics, University of Central Florida, Orlando, FL, USA; 5Dry Eye Spa of West Michigan, Holland, MI, USA; 6Department of Statistics and Data Science, University of Central Florida, Orlando, FL, USA; 7Johns Hopkins Medical Institution, Baltimore, MD, USA; 8Wyomissing Optometric Center, Inc, Wyomissing, PA, USA*These authors contributed equally to this workCorrespondence: Natalia A Warren, Not A Dry Eye Foundation, 1019 Sea Shell Court, Daytona Beach, FL, 32124, Tel +1 855-544-6553, Email Natalia.warren@notadryeye.orgIntroduction: Although affecting an estimated 35% of the population, Dry Eye is not well understood by patients and the medical community. As a result, both in research and clinical settings, diagnostic and treatment protocols tend to be non-specific, ad hoc, and inadequate, with a narrow industry-driven focus. The purpose of this convening was to propose a research roadmap that orients Dry Eye researchers toward a comprehensive patient-centered approach to diagnosing and treating Dry Eye, Meibomian gland dysfunction (MGD), and related comorbidities with a goal of improving clinical outcomes for Dry Eye/MGD patients.Methods: Sixteen participants, including Dry Eye/MGD patients, caregivers, and patient advocates together with a group of experts in Dry Eye, MGD and other fields identified gaps in research on Dry Eye and MGD diagnostic and treatment approaches (age range 20– 80; male to female ratio of 7:11; patients: 7). During a 2-day virtual convening, participants were assigned to topic-specific focus-group sessions to discuss and develop research questions pertaining to Dry Eye and MGD. The research questions were compiled into a proposed patient-centered roadmap for Dry Eye and MGD research. Two additional participants contributed to the proposed roadmap following the convening.Results: The focus groups identified over 80 patient-centered research questions important to patients and other stakeholders and compiled these into a proposed research roadmap.Conclusion: The convened stakeholders aim to establish a cohesive and comprehensive patient-centered approach to treating Dry Eye, Meibomian Gland Dysfunction, and comorbidities. The research roadmap will serve as a reference for researchers, educational institutions, clinicians, and others evaluating diagnostic and treatment protocols in Dry Eye and MGD.Keywords: dry eye disease, Meibomian gland dysfunction, patient-centered research, patient advocacy, ocular surface disease, patient care

Although optical microscopy is a widely used technique across various multidisciplinary fields for inspecting small-scale objects, surfaces or organisms, it faces a significant limitation: the lateral resolution of optical microscopes is fundamentally constrained by light diffraction. Dielectric micro-spheres, however, offer a promising solution to this issue as they are capable of significantly enhancing lateral resolution through extraordinary phenomena, such as a photonic nanojet.Building upon the potential of dielectric micro-spheres, this paper introduces a novel approach for fabricating 3D micro-devices designed to enhance lateral resolution in optical microscopy. The proposed 3D micro-device comprises a modified coverslip and a micro-sphere, facilitating easy handling and integration into any existing optical microscope. To manufacture the device, two advanced femtosecond laser techniques are employed: femtosecond laser ablation and multi-photon lithography. Femtosecond laser ablation was employed to create a micro-hole in the coverslip, which allows light to be focused through this aperture. Multi-photon lithography was used to fabricate a micro-sphere with a diameter of 20 µm, along with a cantilever that positions the above the processed micro-hole and connect it with the coverslip. In this context, advanced processing strategies for multi-photon lithography to produce a micro-sphere with superior surface roughness and almost perfect geometry (λ/8) from a Zr-based hybrid photoresist are demonstrated. The performance of the micro-device was evaluated using Mirau-type coherence scanning interferometry in conjunction with white light illumination at a central wavelength of 600 nm and a calibration grid (Λ = 0.28 µm, h > 50 nm). Here, the 3D micro-device proved to be capable of enhancing lateral resolution beyond the limits achievable with conventional lenses or microscope objectives when used in air. Simultaneously, it maintained the high axial resolution characteristic of Mirau-type coherence scanning interferometry. The results and optical properties of the micro-sphere were analyzed and further discussed through simulations.

The prevalence of malnutrition in patients is very high in Europe (>70%). An Italian FADOI-SINPE survey revealed that malnutrition is an underestimated problem by internists. The AMIDO study examines malnutrition in Acqui Terme Hospital (Alessandria, Italy) Internal Medicine Department patients. Patients were screened for malnutrition using the Malnutrition Universal Screening Tool (MUST) upon admission. 268 patients (49.63% male) were enrolled, with a median age of 83 years. At admission, the prevalence of malnutrition risk was 48.88%. The proportion of patients who came from home resulted to have a slight decreasing trend among the three subgroups according to MUST (84.67%, 82.76%, and 73.53% in increasing order of MUST score respectively), but was not statistically significant (P=0.10). Dementia [odds ratio (OR): 6.36; 95% confidence interval (CI): 2.52-18.63], heart failure (OR: 2.45; 95% CI: 1.33-4.57), neoplasm (OR: 2.24; 95% CI: 1.08-4.77) and infectious diseases (OR: 2.27; 95% CI: 1.226-4.274) increase malnutrition odds. Increasing attention to malnutrition risk is crucial for patients with dementia, neoplasm, heart failure, and infectious diseases, which raise malnutrition risk probability.

Abstract There is a large pool of ideas in both mainstream and non‐mainstream medicine on how diet can be manipulated in order to treat or prevent illnesses. Despite this, our understanding of how specific changes in diet influence the structure and function of the gastrointestinal tract is limited. This review aims to describe two areas that might provide key information on the integrity and function of the gastrointestinal tract. First, demystifying the “leaky gut syndrome” requires rational application and interpretation of tests of intestinal barrier function. Multiple ways of measuring barrier function have been described, but the inherent difficulties in translation from animal studies to humans have created misinterpretations and misconceptions. The intrinsic nature of intestinal barrier function is dynamic. This is seldom considered in studies of intestinal barrier assessment. To adequately understand the effects of dietary interventions on intestinal barrier function, background barrier function in different regions of the gut and the dynamic responses to stressors (such as psychological stress) should be assessed as a minimum. Second, intestinal ultrasound, which is now established in the assessment and monitoring of inflammatory bowel disease, has hitherto been poorly evaluated in assessing real‐time intestinal function and novel aspects of structure in patients with disorders of gut‐brain interaction. In conclusion, a more complete functional and structural profile that these investigations enable should permit a greater understanding of the effects of dietary manipulation on the gastrointestinal tract and provide clinically relevant information that, amongst other advantages, might permit opportunities for personalized health care delivery.

Breast milk is the natural source of nutrition for infants, but while it supports their health, it can also be a potential source of toxic inorganic particulate matter, and this applies to both breast milk and industrially produced milk. The aim of the present study was to evaluate the presence of nanoparticles in both breast milk and formula milk samples. We collected and analyzed, via a new electron scanning microscopic procedure, 19 samples of breast milk from Italian women and 19 formula milk samples produced by different companies. Organic–inorganic agglomerates were detected in 58% of formula and in 63% of breast milk samples, respectively. In addition, a significantly (p < 0.05) greater size of nanoparticles was observed in formula milk samples. The results, showing the presence of inorganic nanosized particles in breast and artificial milk, may lead to future studies aimed at investigating possible nanosized contamination of milk and identifying early prevention strategies for women and animals involved in the food chain.

Asbestos research, identification, and quantification have been performed over the years, and the relationship between fiber inhalation and lung disease development is well defined. The same cannot be said for the gastroenteric system: the International Agency for Research on Cancer (IARC) believes that colorectal cancer (CRC) could be associated with asbestos exposure, but research has not demonstrated a casual nexus between exposure and CRC, despite highlighting an association tendency. The combination of scanning electron microscopy (SEM) and energy-dispersive spectroscopy (EDS) is the most applied technique in asbestos fiber identification in tissues and intestinal mucosa. In this study, SEM/EDS was applied to evaluate the presence of asbestos fibers and bodies (ABs) inside the tissue of eleven patients affected by CRC who had undergone environmental exposure due to living in an asbestos-polluted area where an Eternit plant had been active in the past. This technique was coupled with optical microscopy (OM) to verify whether the latter could be applied to evaluate the presence of these mineral phases, with the goal of understanding its suitability for identifying fibers and ABs in colon tissues. In addition to verifying the presence of fibers, this study allowed us to identify the deposition site of said fibers within the sample and possibly detect associated tissue reactions using OM, over a shorter time and at lower costs. Despite being a preliminary and descriptive work, the obtained results allowed us to propose a method involving first-sample OM observation to identify regulated (fibers with a length ≥ 5 μm, a thickness ≤ 3 μm, and a length/thickness ratio > 3) asbestos phases and ABs in the extra-respiratory system. In fact, OM and SEM/EDS provided similar information: no asbestiform morphology or ABs were found, but phyllosilicates and other inorganic materials were identified. This research needs to be continued using higher-resolution techniques to definitively rule out the presence of these fibers inside tissues whilst also increasing the number of patients involved.

Given the ongoing COVID-19 pandemic, there is a need to identify SARS-CoV-2 and to differentiate it from other respiratory viral infections, especially influenza A and B, in various critical settings. Since their introduction, the use of rapid antigen tests has spread worldwide, but there is variability in their diagnostic accuracy. In the present study, we evaluated the clinical performance of the ID NOW™ COVID-19 2.0, a molecular point-of-care test (POCT) based on enzymatic isothermal amplification for the differential diagnosis of SARS-CoV-2 and influenza A/B in a pediatric emergency setting. A cohort of pediatric patients admitted between December 2022 and February 2023 were simultaneously tested with the POCT and standard laboratory molecular assay. Our findings showed high negative agreement of the POCT assay across the different age groups for SARS-CoV-2, influenza A, and influenza B (more than 98.0%), while its positive agreement varied significantly for the abovementioned viral species from 50.0% to 100%. These results highlight the potential of the ID NOW™ COVID-19 2.0 POCT assay as a reliable and rapid tool for excluding SARS-CoV-2 and influenza A/B infections in symptomatic pediatric patients, although its variable positive agreement suggests a need for confirmatory RT-qPCR testing in certain clinical and epidemiological settings in order to ensure accurate diagnosis and appropriate patient management.

Cystoisospora belli causes intestinal infection in immunocompromised hosts, including human immunodeficiency viruses (HIV)-positive patients, especially from tropical and sub-tropical areas, with watery and recurrent diarrhea, leading in advanced cases to malabsorption and death. Microbiological diagnosis is limited by intermittent or low shedding of oocysts in stool; therefore, endoscopy may be necessary to identify the pathogen in histological samples. Trimethoprim-sulfamethoxazole (TMP-SMX) represents the treatment of choice, and alternative agents are used in recurrences, but limited efficacy is described. Here, we present recently observed case of severe and fatal infection due to C. belli in a HIV-positive 40-year-old man from Brazil, revealing several limitations in diagnosis and therapy, which need to be investigated further. In particular, it is still not clear how the infection persisted over time leading to malabsorption, kidney injury, and subsequent death, even if a reasonable immune reconstitution was demonstrated. Additionally, we investigated what mechanisms might cause, whether failure of recovery of the immune response specifically to C. belli, drug malabsorption, resistance to TMP-SMX, sequestration into lymphoid tissue, or co-presence of visceral untreated Kaposi sarcoma. Also, the appropriate dosage and way of administration of the best therapeutic regimen were examined, since there is a lack of literature on these issues. Globalization and wider use of immunosuppressive therapies underline the importance of maintaining adequate awareness, also in HIV-negative and non-immigrant populations.

Fecal Microbiota Transplantation (FMT) represents a promising therapeutic tool under study for several purposes and is currently applied to the treatment of recurrent Clostridioides difficile infection. However, since the use of fresh stool was affected by several issues linked to donor screening, the development of a frozen stool bank is a reliable option to standardize FMT procedures. Nevertheless, different environmental factors impact microbial viability. Herein, we report the effect of different thawing temperatures and storage conditions on bacterial suspensions in the FMT procedure. In total, 20 stool samples were divided into aliquots and tested across a combination of different storing periods (15, 30; 90 days) and thawing procedures (4 °C overnight, room temperature for 1 h; 37 °C for 5 min). Focusing on storage time, our data showed a significant reduction in viability for aerobic and anaerobic bacteria after thawing for 15 days, while no further reductions were observed until after 90 days. Instead, among the different thawing procedures, no significant differences were observed for aerobic bacteria, while for anaerobes, thawing at 37 °C for 5 min was more effective in preserving the bacterial viability. In conclusion, the frozen fecal microbiota remained viable for at least three months, with an excellent recovery rate in all three thawing conditions.

Nowadays, data concerning the risk of autoimmune disease after SARS-CoV-2 (COVID-19) vaccination is controversial. The aim of this single centre prospective follow-up study was to evaluate whether healthcare workers (HCWs) vaccinated with BNT162b2 mRNA and mRNA-1273 will show a development and/or a persistence of autoantibodies, focussing on the detection of antibodies against nuclear antigens (antinuclear antibodies, ANA). We enrolled 155 HCWs, however only 108 of them received the third dose and were considered for further analysis. Blood samples were collected before vaccine inoculation (T0), at 3 (T1) and 12 months (T2) after the first dose. All samples were analysed for the presence of a) ANA using indirect Immunofluorescence [IIF] (dilutions of 1:80, 1:160. 1:320 and 1:640), and anti-smooth muscle antibodies (ASMA); b) anti-myeloperoxidase (anti-MPO), anti-proteinase 3 (anti-PR3) and anti-citrullinated peptide antibodies (aCCP) [FEIA]; c) anti-phospholipid antibodies (anticardiolipin [aCL], anti-beta-2- glycoprotein I [anti-ß-2GPI] (Chemiluminescence). Line-blot technology was performed using the following kit: EUROLINE ANA profile 3 plus DFS70 (IgG). Our research suggests that mRNA based anti-SARSCoV-2 vaccines can induce the production of de novo ANA in 22/77(28,57%) of subjects and that the percentage of positivity seems to be directly correlated to the number of vaccine expositions: 6/77 (7,79%) after 2 doses; 16/77 (20,78%) after 3 doses. Since it is known that hyperstimulation of the immune system could lead to autoimmunity, these preliminary results seem to further sustain the idea that the hyperstimulation of the immune system might lead to an autoinflammatory mechanism and eventually to autoimmune disorders. However, the link between SARS-CoV-2 vaccination and the development of autoimmune diseases needs to be further investigated.

Abstract Background This study aimed to explore whether explainable Artificial Intelligence methods can be fruitfully used to improve the medical management of patients suffering from complex diseases, and in particular to predict the death risk in hospitalized patients with SARS-Cov-2 based on admission data. Methods This work is based on an observational ambispective study that comprised patients older than 18 years with a positive SARS-Cov-2 diagnosis that were admitted to the hospital Azienda Ospedaliera “SS Antonio e Biagio e Cesare Arrigo”, Alessandria, Italy from February, 24 2020 to May, 31 2021, and that completed the disease treatment inside this structure. The patients’medical history, demographic, epidemiologic and clinical data were collected from the electronic medical records system and paper based medical records, entered and managed by the Clinical Study Coordinators using the REDCap electronic data capture tool patient chart. The dataset was used to train and to evaluate predictive ML models. Results We overall trained, analysed and evaluated 19 predictive models (both supervised and unsupervised) on data from 824 patients described by 43 features. We focused our attention on models that provide an explanation that is understandable and directly usable by domain experts, and compared the results against other classical machine learning approaches. Among the former, JRIP showed the best performance in 10-fold cross validation, and the best average performance in a further validation test using a different patient dataset from the beginning of the third COVID-19 wave. Moreover, JRIP showed comparable performances with other approaches that do not provide a clear and/or understandable explanation. Conclusions The ML supervised models showed to correctly discern between low-risk and high-risk patients, even when the medical disease context is complex and the list of features is limited to information available at admission time. Furthermore, the models demonstrated to reasonably perform on a dataset from the third COVID-19 wave that was not used in the training phase. Overall, these results are remarkable: (i) from a medical point of view, these models evaluate good predictions despite the possible differences entitled with different care protocols and the possible influence of other viral variants (i.e. delta variant); (ii) from the organizational point of view, they could be used to optimize the management of health-care path at the admission time.

Objective: to analyze the evidence of content validity of the comic strip "I have diabetes, what now?" Methods: methodological research into the production of health technology in the form of a comic book to support family members and hospitalized children diagnosed with type 1 diabetes mellitus. After developing the educational technology, the content was validated with six children and seven family members using a Likert scale, with indicators analyzed using the Content Validity Index. Results: the educational technology showed good validation indices according to the evaluation of the children (0.833) and family members (1,000). Conclusion: the children identified with the character in the story and agreed that it was a tool for understanding the disease, and family members said that it would be useful to disseminate the technology in other health services. Contributions to practice: there are situations that permeate aspects related to the care of children with diabetes, so the comic book could contribute to the quality of multi-professional care for this population affected by Diabetes Mellitus.

The measurement of blood pH and gas analytes (BPGA), soon after birth, constitutes the first-line standard of care procedure in high-risk newborns. However, no data is available in capillary blood on perinatal bias such as gestational age (GA), weight at birth (BW), delivery mode, and gender. The aims of the present study were to investigate whether in a cohort of healthy preterm (PT) and term (T) infants BPGA were GA, BW, delivery mode and gender dependent, thus affecting BPGA reliability as diagnostic test. We performed a prospective case-control study in 560 healthy infants (PT: n=115, T: n=445). BPGA was measured within 24-h from birth. Perinatal characteristics, outcomes, and clinical examination were also recorded. PT infants showed higher (p<0.001) carbon dioxide partial pressure (pCO2), fraction of fetal hemoglobin (HbF), base excess (BE), bicarbonate (HCO3), and lower lactate (Lac) levels. When corrected for delivery mode, higher (p<0.001) HbF, BE, HCO3, and lower Lac levels were found. Similarly, higher (p<0.05, for all) pCO2, HbF, BE, HCO3 and lower Lac levels were found between female and male PT and T infants. Repeated multiple logistic regression analysis showed that BPGA was GA, BW, delivery mode and gender dependent. The present results showing that BPGA can be affected by a series of perinatal outcomes open the way to further investigations providing longitudinal BPGA reference curves in the transitional phase, thus empowering BPGA role as a reliable diagnostic and therapeutic strategies efficacy marker. [ABSTRACT FROM AUTHOR]

Asbestos is a term that includes six fibrous mineral phases related to different lung diseases, including asbestosis, lung cancer, and Malignant Pleural Mesothelioma (MPM). Since the last century, these minerals have been widely studied under their mineralogical/chemical and physical aspects with in vivo and in vitro studies to understand the mechanisms of their carcinogenicity. There are several techniques described in the literature, as optical and electron microscopies, for the identification of coated (asbestos bodies, ABs) and uncoated fibers, but only micro-Raman spectroscopy permits a sure characterization of these minerals—and of the related phases—directly in the histological sections of pulmonary parenchyma without any manipulation. In this case, the risk of the loss of associated inorganic phases from asbestos bodies (ABs) and fibers (e.g.: iron or carbonaceous micro-particles) is avoided. Asbestos bodies are produced by the activity of alveolar macrophages with degradation/inactivation of asbestos fibers. Inside the alveolar macrophages, organic and inorganic material settles on the foreign fibers forming an iron-rich proteic and carbonaceous coating. In this study, Variable Pressure Scanning Electron Microscopy with annexed Electron Dispersive Spectroscopy (VP-SEM/EDS) and micro-Raman spectroscopy were applied to the characterization of the phases in the ABs. Characterization of carbonaceous materials (CMs), observed in pristine asbestos phases in previous works, was therefore performed, addressing the micro-Raman laser beam on different points of the asbestos bodies, and Raman mappings on ABs were carried out for the first time. Coupling the data obtained by VP-SEM/EDS and micro-Raman spectroscopy, it was possible to collect information about the iron and carbonaceous phases adhered to the fibers, probably lost during the classical tissue digestion procedures. Information about both mineral and carbonaceous components might be useful to understand the whole structure of “asbestos bodies” and the inflammogenic and carcinogenic effects of the asbestos phases coupled to CMs, that might derive from cigarette smoke or from environmental pollution; this study might be useful to deepen also the possible detrimental role of ABs in the tissues.

To carry out effective and quick identification of SARS-CoV-2 from nasopharyngeal swabs and contain outbreaks, reliable and rapid tools are needed. Herein, we compared a rapid antigen test based on active microfluidic technology to an RT-qPCR assay in pediatric and young adult patients admitted to the Pediatric Emergency Unit of a Children’s Hospital. Nasopharyngeal swabs collected from patients with suspected COVID-19 disease and from those without COVID-19 related symptoms, but requiring hospitalization, were performed with both antigen test and RT-qPCR assays. We included 375 patients with a median age of 5 years in the study, with an estimated overall prevalence of 7.2%. Overall, we observed a specificity of 97.4% (95% CI: 94.9–98.7) and a sensitivity of 66.6% (95% CI: 46.0–82.7) with a positive likelihood ratio (LR+) of 25.8 (95% CI: 12.8–51.8). In the subgroup of symptomatic patients, the specificity and the sensitivity were 95.2% (95% CI: 89.4–98.0) and 80.0% (95% CI: 44.2–96.5) respectively; LR+ was 16.6 (95% CI: 7.19–38.6). In the asymptomatic subset, the performance showed a specificity of 98.7% (95% CI: 95.8–99.7), a sensitivity of 58.8% (95% CI: 33.5–80.6), and an LR+ of 43.7 (95% CI: 13.3–144.0). Compared to RT-qPCR, the new microfluidic-based antigen test showed higher specificity (>95%) in the pediatric population, thus representing a suitable point-of-care testing (POCT) in a clinical setting with low prevalence of COVID-19.