Rapid Procedure Research Articles

Rapid Gas-Chromatographic Determination of Phenol and Cresols in Water by Extractive Freezing-Out

A rapid procedure for the determination of phenol and cresol isomers in drinking, sea, and polluted domestic wastewater is developed based on a single-stage extraction of analytes by extractive freezing-out under sample centrifugation conditions. In combination with gas chromatography, the procedure provides the minimum detection limits for each of phenols in 10 mL of water at a level of 0.0005 µg/mL. The duration of sample preparation does not exceed 30 min; the consumption of the ethoxyethane extractant is 1.4 mL. In comparison with liquid–liquid and solid-phase extraction traditionally used at the stage of sample preparation, the proposed procedure is simpler and more environmentally friendly. The stages of filtering samples and dehydrating extracts are excluded; the amount of chemical glassware is minimized.

Preventive Proximal Splenic Artery Embolization for High-Grade AAST-OIS Adult Spleen Trauma without Vascular Anomaly on the Initial CT Scan: Technical Aspect, Safety, and Efficacy-An Ancillary Study.

The spleen is the most commonly injured organ in blunt abdominal trauma. Its management depends on hemodynamic stability. According to the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS ≥ 3), stable patients with high-grade splenic injuries may benefit from preventive proximal splenic artery embolization (PPSAE). This ancillary study, using the SPLASH multicenter randomized prospective cohort, evaluated the feasibility, safety, and efficacy of PPSAE in patients with high-grade blunt splenic trauma without vascular anomaly on the initial CT scan. All patients included were over 18 years old, had high-grade splenic trauma (≥AAST-OIS 3 + hemoperitoneum) without vascular anomaly on the initial CT scan, received PPSAE, and had a CT scan at one month. Technical aspects, efficacy, and one-month splenic salvage were studied. Fifty-seven patients were reviewed. Technical efficacy was 94% with only four proximal embolization failures due to distal coil migration. Six patients (10.5%) underwent combined embolization (distal + proximal) due to active bleeding or focal arterial anomaly discovered during embolization. The mean procedure time was 56.5 min (SD = 38.1 min). Embolization was performed with an Amplatzer™ vascular plug in 28 patients (49.1%), a Penumbra occlusion device in 18 patients (31.6%), and microcoils in 11 patients (19.3%). There were two hematomas (3.5%) at the puncture site without clinical consequences. There were no rescue splenectomies. Two patients were re-embolized, one on Day 6 for an active leak and one on Day 30 for a secondary aneurysm. Primary clinical efficacy was, therefore, 96%. There were no splenic abscesses or pancreatic necroses. The splenic salvage rate on Day 30 was 94%, while only three patients (5.2%) had less than 50% vascularized splenic parenchyma. PPSAE is a rapid, efficient, and safe procedure that can prevent splenectomy in high-grade spleen trauma (AAST-OIS) ≥ 3 with high splenic salvage rates.

Performance of the procedure for ultra-rapid extraction and loop-mediated isothermal amplification (PURE-LAMP) method to detect malaria in Haiti

BackgroundMalaria continues to cause burden in various parts of the world. Haiti, a Caribbean country, is among those aiming to eliminate malaria within a few years. Two surveys were conducted in Haiti during which we aimed to evaluate the performance of the simple and rapid procedure for ultra-rapid extraction–loop-mediated isothermal amplification (PURE-LAMP) method with dried blood spots as an alternative diagnostic method for malaria in the context of low to very low rates of transmission.MethodsFebrile and afebrile people were recruited from three administrative divisions within Haiti: Nippes, Sud and Grand’Anse, during the summers of 2017 (early August to early September) and 2018 (late July to late August). Their blood samples were tested by microscopy, rapid diagnostic tests (RDT), PURE-LAMP and nested PCR to detect Plasmodium infection. Sensitivity, specificity, positive and negative predictive values and kappa statistics were estimated with the nested PCR results as the gold standard.ResultsAmong 1074 samples analyzed, a positive rate of 8.3% was calculated based on the nested PCR results. Among febrile participants, the rates in 2017 and 2018 were 14.6% and 1.4%, respectively. Three positives were detected among 172 afebrile participants in 2018 by PURE-LAMP and nested PCR, and all three were from the same locality. There was no afebrile participants recruited in 2017. The PURE-LAMP, RDT and microscopy had respective sensitivities of 100%, 85.4% and 49.4%. All of the testing methods had specificities over 99%.ConclusionsThis study confirmed the high performance of the PURE-LAMP method to detect Plasmodium infection with dried blood spots and recommends its use in targeted mass screening and treatment activities in low endemic areas of malaria.

Rapid Detection of Predominant SARS-CoV-2 Variants Using Multiplex High-Resolution Melting Analysis.

Coronavirus disease 2019, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a considerable threat to global public health. This study developed and evaluated a rapid, low-cost, expandable, and sequencing-free high-resolution melting (HRM) assay for the direct detection of SARS-CoV-2 variants. A panel of 64 common bacterial and viral pathogens that can cause respiratory tract infections was employed to evaluate our method's specificity. Serial dilutions of viral isolates determined the sensitivity of the method. Finally, the assay's clinical performance was assessed using 324 clinical samples with potential SARS-CoV-2 infection. Multiplex HRM analysis accurately identified SARS-CoV-2 (as confirmed with parallel reverse transcription-quantitative PCR [qRT-PCR] tests), differentiating between mutations at each marker site within approximately 2 h. For each target, the limit of detection (LOD) was lower than 10 copies/reaction (the LOD of N, G142D, R158G, Y505H, V213G, G446S, S413R, F486V, and S704L was 7.38, 9.72, 9.96, 9.96, 9.50, 7.80, 9.33, 8.25, and 8.25 copies/reaction, respectively). No cross-reactivity occurred with organisms of the specificity testing panel. In terms of variant detection, our results had a 97.9% (47/48) rate of agreement with standard Sanger sequencing. The multiplex HRM assay therefore offers a rapid and simple procedure for detecting SARS-CoV-2 variants. IMPORTANCE In the face of the current severe situation of increasing SARS-CoV-2 variants, we developed an upgraded multiplex HRM method for the predominant SARS-CoV-2 variants based on our original research. This method not only could identify the variants but also could be utilized in subsequent detection of novel variants since the assay has great performance in terms of flexibility. In summary, the upgraded multiplex HRM assay is a rapid, reliable, and economical detection method, which could better screen prevalent virus strains, monitor the epidemic situation, and help to develop measures for the prevention and control of SARS-CoV-2.

A rapid procedure to generate stably transfected HEK293 suspension cells for recombinant protein manufacturing: Yield improvements, bioreactor production and downstream processing

The human cell line HEK293 is one of the preferred choices for manufacturing therapeutic proteins and viral vectors for human applications. Despite its increased use, it is still considered in disadvantage in production aspects compared to cell lines such as the CHO cell line. We provide here a simple workflow for the rapid generation of stably transfected HEK293 cells expressing an engineered variant of the SARS-CoV-2 Receptor Binding Domain (RBD) carrying a coupling domain for linkage to VLPs through a bacterial transpeptidase-sortase (SrtA). To generate stable suspension cells expressing the RBD-SrtA, a single two plasmids transfection was performed, with hygromycin selection. The suspension HEK293 were grown in adherent conditions, with 20% FBS supplementation. These transfection conditions increased cell survival, allowing the selection of stable cell pools, which was otherwise not possible with standard procedures in suspension. Six pools were isolated, expanded and successfully re-adapted to suspension with a gradual increase of serum-free media and agitation. The complete process lasted four weeks. Stable expression with viability over 98% was verified for over two months in culture, with cell passages every 4–5 days. With process intensification, RBD-SrtA yields reached 6.4 μg/mL and 13.4 μg/mL in fed-batch and perfusion-like cultures, respectively. RBD-SrtA was further produced in fed-batch stirred tank 1L-bioreactors, reaching 10-fold higher yields than perfusion flasks. The trimeric antigen displayed the conformational structure and functionality expected. This work provides a series of steps for stable cell pool development using suspension HEK293 cells aimed at the scalable production of recombinant proteins.

Determination of Rhodium in Soil by Dispersive Solid-Phase Extraction (DSPE) with Manganese Ferrite Nanoparticles and Flame Atomic Absorption Spectrometry (FAAS)

Manganese ferrite (MnFe2O4) nanoparticles-assisted dispersive solid-phase extraction (MF-DSPE) was developed for the determination of rhodium (Rh) in soil samples at low levels with good accuracy and precision by flame atomic absorption spectrometry (FAAS). The synthesis of MnFe2O4 nanoparticles was carried out in a microwave system by a rapid procedure. The pH, buffer volume, sorbent mass, sample volume, eluent volume/concentration, and mixing time were identified with univariate optimization. Under the optimal conditions, the limits of detection (LOD) and quantitation (LOQ) were 4.4 and 14.7 µg L−1, respectively. The sensitivity was improved by 121.9-fold based upon comparison of the limits of detection with and without preconcentration. The applicability was investigated by spiking rhodium into soil extracts, and good recovery results between 91.2% and 122.2% were achieved using matrix matching calibration. The results showed that MF-DSPE-FAAS determines low levels of rhodium in soil with good accuracy and precision.

A new and rapid process as an efficacy essential oils extraction system of Ammoides verticillata (Duby) Briq.

Ammoides verticillata (Duby) Briq. (A. verticillata) is an aromatic plant belonging to the family Apiaceae. The present study optimized a rapid procedure of essential oils (EOs) extraction from the species. Two extraction methods were compared: hydro-distillation (HD) and Pressure Cooker Pre-treatment Hydrodistilation (PCPHD). The results showed that the maximum essential oil yield was obtained from 50 g of the uncrushed plant material after 15 min of maceration under a heating temperature of 250°C for HD. The results revealed that the PCPHD produced quickly higher A. verticillata essential oils yield (4.22%) for 90 min compared with the HD (2.88%) for 180 min. The PCPHD provided a high amount of oxygenated compounds compared to the conventional HD method. The extraction cost, time, and energy were significantly lower in the PCPHD method compared with the HD method. Moreover, the energy necessary to extract A. verticillata EOs was 2.1 kWh for 180 min of HD and 1.05 kWh for 90 min of PCPHD. The amount of carbon dioxide released into the atmosphere during HD extraction (1.68 kg CO2/g EOs) was higher than that released during PCPHD extraction (0.84 kg CO2/g EOs). In addition, the wastewater from the PCPHD (0.177 L/g EOs) was far less than that from the HD (0.26 L/g EOs). The PCPHD was an efficient green alternative and economical method to extract a high yield of the A. verticillata essential oil.

Facile in-situ grown spinel MnCo2O4/MWCNT and MnCo2O4/Ti3C2 MXene composites for high-performance asymmetric supercapacitor with theoretical insight

The logical construction of electrode materials along with greater electrochemical features and solid architectural design is a strategic approach for boosting the electrochemical performance of supercapacitors. However, it is tough and complicated to develop diverse composite materials with better electronic conductivity and greater specific capacitance via rapid and cost-effective synthesis procedures. Herein, we propose a straightforward and simple approach by employing the hydrothermal technique for the synthesis of spinel MnCo2O4 composite nanostructures using 1D MWCNT and 2D MXene (Ti3C2Tx) materials with detailed analysis of the supercapacitor performance as compared to existing literature on similar studies. The MCO/TCX (MnCo2O4/Ti3C2Tx) composite shows an impressive capacitance of 860.22 F/g at a current density of 2 A/g after electrochemical optimization. Furthermore, an asymmetric supercapacitor device (ASCs) was constructed using MCO and its composites MCO/MWCNT and MCO/TCX as a positive, and AC was employed as a negative electrode to test its device capability. Comparatively, the MCO/TCX//AC SC device demonstrated exceptional energy storage properties with a better specific capacitance value of 126.58 F/g at 0.8 A/g of current density, an elevated energy density of 40 Wh/kg, with a power density of 4828 W/kg along a capacitance retention rate of 87 % over 5000 cycles, suggesting better cycle life. Whereas, the MCO/MWCNT//AC device shows a better cycling performance of 91 % after 5000 cycles with a superior energy and power density of 27.04 Wh/kg and 1448 W/kg respectively. Also the theoretical insight for further understanding of the charge-storage mechanism through DFT calculations provides an estimate of electronic properties and quantum capacitance calculated for the pristine MCO and its hybrids with CNT and Ti3C2Tx MXene and information on the interactions between orbitals, the bonding process, and the charge transfer capabilities of each electrode material. The theoretical studies also confirm that the electronic properties and therein charge storage performance have an increasing trend in the order of MCO < MCO/CNT < MCO/TCX consistent with the experimental findings. Additionally, these simulations conclude that the hybrid MCO/TCX has the largest quantum capacitance which is in accordance with the findings of the experiments. The improved performance of MCO/TCX is due to the enlarged surface area that allows higher charge transfer from TCX to MCO. The charge transferred from the C 2p orbital of TCX to the Mn 3d orbital of MCO is the leading cause for the capacitance improvement mechanism of hybrid MCO/TCX. This work offers a simple procedure for developing energy storage devices using spinel MnCo2O4-based composite electrode materials supported by 1D carbon nanotube and 2D MXene that offer superior electrochemical performance and the fabricated electrodes that could be employed further for energy storage-based applications.

Mountain wetland soil carbon stocks of Huascarán National Park, Peru.

Although wetlands contain a disproportionately high amount of earth's total soil carbon, many regions are still poorly mapped and with unquantified carbon stocks. The tropical Andes contain a high concentration of wetlands consisting mostly of wet meadows and peatlands, yet their total organic carbon stocks are poorly quantified, as well as the carbon fraction that wet meadows store compared to peatlands. Therefore, our goal was to quantify how soil carbon stocks vary between wet meadows and peatlands for a previously mapped Andean region, Huascarán National Park, Peru. Our secondary goal was to test a rapid peat sampling protocol to facilitate field sampling in remote areas. We sampled soil to calculate carbon stocks of four wetland types: cushion peat, graminoid peat, cushion wet meadow, and graminoid wet meadow. Soil sampling was conducted by using a stratified randomized sampling scheme. Wet meadows were sampled to the mineral boundary using a gouge auger, and we used a combination of full peat cores and a rapid peat sampling procedure to estimate peat carbon stocks. In the lab, soils were processed for bulk density and carbon content, and total carbon stock of each core was calculated. We sampled 63 wet meadows and 42 peatlands. On a per hectare basis, carbon stocks varied strongly between peatlands (avg. 1092 MgC ha-1) and wet meadows (avg. 30 MgC ha-1). Overall, wetlands in Huascarán National Park contain 24.4 Tg of carbon with peatlands storing 97% of the total wetland carbon and wet meadows accounting for 3% of the wetland carbon in the park. In addition, our results show that rapid peat sampling can be an effective method for sampling carbon stocks in peatlands. These data are important for countries developing land use and climate change policies as well as providing a rapid assessment method for wetland carbon stock monitoring programs.

Introducing a Rapid DNA Analysis Procedure for Crime Scene Samples Outside of the Laboratory-A Field Experiment.

Technological innovations enable rapid DNA analysis implementation possibilities. Concordantly, rapid DNA devices are being used in practice. However, the effects of implementing rapid DNA technologies in the crime scene investigation procedure have only been evaluated to a limited extent. In this study a field experiment was set up comparing 47 real crime scene cases following a rapid DNA analysis procedure outside of the laboratory (decentral), with 50 cases following the regular DNA analysis procedure at the forensic laboratory. The impact on duration of the investigative process, and on the quality of the analyzed trace results (97 blood and 38 saliva traces) was measured. The results of the study show that the duration of the investigation process has been significantly reduced in cases where the decentral rapid DNA procedure was deployed, compared to cases where the regular procedure was used. Most of the delay in the regular process lies in the procedural steps during the police investigation, not in the DNA analysis, which highlights the importance of an effective work process and having sufficient capacity available. This study also shows that rapid DNA techniques are less sensitive than regular DNA analysis equipment. The device used in this study was only to a limited extent suitable for the analysis of saliva traces secured at the crime scene and can mainly be used for the analysis of visible blood traces with an expected high DNA quantity of a single donor.

Integrating pragmatic and implementation science randomized clinical trial approaches: a PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) analysis

BackgroundOver the past two decades, pragmatic and implementation science clinical trial research methods have advanced substantially. Pragmatic and implementation studies have natural areas of overlap, particularly relating to the goal of using clinical trial data to leverage health care system policy changes. Few investigations have addressed pragmatic and implementation science randomized trial methods development while also considering policy impact.MethodsThe investigation used the PRagmatic Explanatory Continuum Indicator Summary-2 (PRECIS-2) and PRECIS-2-Provider Strategies (PRECIS-2-PS) tools to evaluate the design of two multisite randomized clinical trials that targeted patient-level effectiveness outcomes, provider-level practice changes and health care system policy. Seven raters received PRECIS-2 training and applied the tools in the coding of the two trials. Descriptive statistics were produced for both trials, and PRECIS-2 wheel diagrams were constructed. Interrater agreement was assessed with the Intraclass Correlation (ICC) and Kappa statistics. The Rapid Assessment Procedure Informed Clinical Ethnography (RAPICE) qualitative approach was applied to understanding integrative themes derived from the PRECIS-2 ratings and an end-of-study policy summit.ResultsThe ICCs for the composite ratings across the patient and provider-focused PRECIS-2 domains ranged from 0.77 to 0.87, and the Kappa values ranged from 0.25 to 0.37, reflecting overall fair-to-good interrater agreement for both trials. All four PRECIS-2 wheels were rated more pragmatic than explanatory, with composite mean and median scores ≥ 4. Across trials, the primary intent-to-treat analysis domain was consistently rated most pragmatic (mean = 5.0, SD = 0), while the follow-up/data collection domain was rated most explanatory (mean range = 3.14–3.43, SD range = 0.49–0.69). RAPICE field notes identified themes related to potential PRECIS-2 training improvements, as well as policy themes related to using trial data to inform US trauma care system practice change; the policy themes were not captured by the PRECIS-2 ratings.ConclusionsThe investigation documents that the PRECIS-2 and PRECIS-2-PS can be simultaneously used to feasibly and reliably characterize clinical trials with patient and provider-level targets. The integration of pragmatic and implementation science clinical trial research methods can be furthered by using common metrics such as the PRECIS-2 and PRECIS-2-PS. Future study could focus on clinical trial policy research methods development.Trial registrationDO-SBIS ClinicalTrials.gov NCT00607620. registered on January 29, 2008. TSOS ClinicalTrials.gov NCT02655354, registered on July 27, 2015.

Insights from establishing a high throughput viral diagnostic laboratory for SARS-CoV-2 RT-PCR testing facility: challenges and experiences.

Background: The World Health Organization declared the coronavirus disease 2019 (COVID-19) a global pandemic on 11 March 2020. Identifying the infected people and isolating them was the only measure that was available to control the viral spread, as there were no standardized treatment interventions available. Various public health measures, including vaccination, have been implemented to control the spread of the virus worldwide. India, being a densely populated country, required laboratories in different zones of the country with the capacity to test a large number of samples and report test results at the earliest. The Indian Council of Medical Research (ICMR) took the lead role in developing policies, generating advisories, formulating guidelines, and establishing and approving testing centers for COVID-19 testing. With advisories of ICMR, the National Institute of Cancer Prevention and Research (NICPR) established a high-throughput viral diagnostic laboratory (HTVDL) for RT-PCR-based diagnosis of SARS-CoV-2 in April 2020. HTVDL was established during the first lockdown to serve the nation in developing and adopting rapid testing procedures and to expand the testing capacity using "Real-Time PCR." The HTVDL provided its testing support to the national capital territory of Delhi and western Uttar Pradesh, with a testing capacity of 6000 tests per day. The experience of establishing a high-throughput laboratory with all standard operating procedures against varied challenges in a developing country such as India is explained in the current manuscript which will be useful globally to enhance the knowledge on establishing an HTVDL in pandemic or non-pandemic times.

Rapid identification of canine uropathogens by matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and the clinical factors that correlated bacterial species and antimicrobial resistance.

Using the matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry (MALDI-TOF MS) method for bacterial diagnosis, rapid urine sample preparation can reduce time relapsing of diagnosis and improve discriminatory power in coinfection cases. We aimed to evaluate rapid urine preparation procedures before MALDI-TOF MS application using dog clinical urine samples in comparison with standard microbiological diagnostic methods by agreement analysis. We determined the frequency and distribution of bacteria and bacterial resistance and their correlations to clinical history. Three experimental procedures comprising direct centrifugation, 10% sodium dodecyl sulfate digestion, and ultrasonic preparation were performed for method validation and sensitivity. Sterile urine containing Escherichia coli and/or Staphylococcus aureus were used as simulated samples. By ultrasonic preparation, the microorganisms could be detected 1.46-1.51 × 105 CFU, which was considered the most suitable technique. This preparation was significantly consistent with the routine method based on data from Hospital Information Systems for 50 urine samples from canine cystitis. By standard protocol, Enterobacteriaceae and Staphylococcus pseudintermedius were found in most of the 155 urine samples with cystitis. Extended-spectrum beta-lactamase-producing Enterobacteriaceae was found in 25-30% of the samples. Imipenem resistance was found in 70% of Acinetobacter baumannii cases; almost all were resistant to second-generation fluoroquinolones and tetracyclines. The most efficient antibiotic for treating bacterial urinary tract infection was amoxicillin plus clavulanic acid. A. baumannii and Pseudomonas aeruginosa were susceptible to pradofloxacin. Prolonged urine catheterization was linked to lower urinary tract infections by Enterobacter spp., which also correlated with chronic kidney disease.

ROLE OF ULTRASONOGRAPHY-GUIDED FINE NEEDLE ASPIRATION CYTOLOGY IN HEPATIC LESIONS: A PROSPECTIVE AND OBSERVATIONAL STUDY AT A TERTIARY HEALTH-CARE CENTRE IN CENTRAL INDIA

Objectives: The liver is a common site for primary as well as secondary malignancies. Ultrasonography (USG)-guided fine needle aspiration cytology (FNAC) is a rapid, accurate, economical, and safe diagnostic procedure for various hepatic lesions. The aims of the study were to categorize and study the cytomorphological features of the hepatic lesions, study the age and sex distribution and analyzing cytological features of the hepatic lesions, and to evaluate the sensitivity, specificity, and diagnostic accuracy of USG-guided FNAC in diagnosing hepatic lesions. Methods: A prospective and observational study of 64 patients with clinically and radiologically diagnosed hepatic lesions and referred for FNAC in department of pathology of a tertiary care hospital. USG-guided FNAC was performed in each patient and cytological features were analyzed. Results: In our study, out of total 64 USG-guided FNAC of liver, metastasis was most common – 33 cases (51.56%), followed by primary hepatocellular carcinoma – 18 cases (28.12%), liver abscess – 6 cases (9.37%), and 7 cases (10.93%) were unsatisfactory smears. Conclusion: USG-guided FNAC, in expert hands being simple, safe, quick, reliable, cost-effective, efficient, and easily available OPD-based procedure and with less number of complications, it has a very important role in accurate diagnosis of primary hepatocellular carcinoma, secondary malignant tumors of liver, and inflammatory lesions of liver.

ASSESMENT OF DIAGNOSTIC ACCURACY OF ULTRASONOGRAPGY-ASSISTED FINE-NEEDLE ASPIRATION CYTOLOGY IN OVARIAN MASS LESIONS

Objectives: Ultrasonography (USG)-guided fine-needle aspiration cytology (FNAC) of ovarian lumps is being increasingly used for the successful diagnosis of ovarian mass lesions and it is a rapid, accurate, economical, and safe procedure to diagnose various ovarian mass lesions. The aims of the study were to categorize and study the cytomorphological features of the ovarian mass lesions, study the age distribution and analyzing cytological features of the ovarian mass lesions, and to evaluate the sensitivity, specificity, and diagnostic accuracy of USG-guided FNAC in diagnosing ovarian mass lesions. Methods: A prospective observational study of 24 patients with clinically and radiologically diagnosed ovarian mass lesions and referred for FNAC in Department of Pathology of a tertiary care hospital. USG-guided FNAC was performed in each patient and cytological features were analyzed. Results: In our study, out of total 24 USG-guided FNAC of ovarian lesions, ovarian malignancies were most common – 11 cases (45.83%), followed by benign ovarian tumors – ten cases (41.66%), inflammatory lesion – one case (4.16%), and two cases (8.33%) were unsatisfactory smears. In our study, diagnostic accuracy of USG-guided FNAC was found to be 91.66%. Conclusion: USG-guided FNAC is a simple, safe, quick, reliable, efficient, and easily available diagnostic procedure and with less number of complications that it has a very important role in accurate diagnosis of ovarian mass lesions. It is a safer alternative to the more expensive and time consuming surgical procedure like diagnostic laparotomy.

Implementing point-of-care medical information systems into trauma and general surgeon practice in a middle-income country: a qualitative study utilizing the Consolidated Framework for Implementation Research

BackgroundPoint-of-care medical information systems (POCMIS) can provide an efficient and effective means of strengthening health systems globally through their encouragement of continued medical education. Using the Consolidated Framework for Implementation Research (CFIR) as a guide, this research provides suggestions for improved implementation of POCMIS in low- and middle-income countries informed by an intervention implemented across public and military hospitals in Lima, Peru.MethodsAnalysis is based on qualitative interviews conducted with 12 Peruvian surgeons across eight public hospitals and one military hospital who received an intervention that provided free access to UpToDate and introduced Google Translate. The post-intervention interviews were transcribed, translated, and analyzed for themes overlapping with CFIR constructs to expose barriers to implementation and suggestions for improved implementation of future interventions.ResultsBarriers included a lack of seniority buy-in and engaged leadership, an overabundance of personal preferences for multiple POCMIS, and a culture of assumption that inhibited open communication regarding access to and use of POCMIS. Suggestions for improved implementation focused on the adaptation of the intervention. Namely, surgeons discussed regionally-specific adaptations as well as adaptations specific to their surgical specialty including visual, rather than written, representation of the information available via POCMIS.ConclusionsResults indicate necessary adaptations for implementing interventions including POCMIS in LMICs, mimicking much of the implementation science literature on intervention adaptation. In addition to explicit suggestions provided by surgeons, we also suggest actionable steps to adapt to barriers identified in our data. Rapid assessment procedures (RAP) are one established methodological technique useful for assessing organization culture prior to implementation, allowing for necessary cultural adaptations. Dynamic adaption process (DAP) is another useful and established method that breaks implementation into four phases allowing for adaptations based on the initial assessment of the intervention site.

DIAGNOSTIC UTILITY OF BREAST FNAC IN THE EVALUATION OF PALPABLE MASSES - A TERTIARY CENTRE STUDY

Background: The purpose of the study was to evaluate the cytological features of palpable breast masses and to advocate the utility of breast FNAC . Material And Methods: Aretrospective study of one and a half years duration was conducted in the Department of Pathology of a tertiary care hospital which included 110 patients with palpable breast masses. Histopathological correlation in 110 cases was obtained and diagnostic efcacy calculated by sensitivity, specicity, poisitive predictive value (PPV) and negative predictive values (NPV). Results: Cytological diagnosis was rendered in 110 patients with age group ranging from 15 to 68 years. Breast lesions commonly presented in upper inner quadrant (48%) of both breasts. Aspirates were diagnosed as non-neoplastic in 15 lesions (13.6%) and neoplastic in 95 lesions (86.36%) [benign 65.45%, and malignant 20.9%]. There were two false positives and one false negative, with 96.83% specicity, 97.87% sensitivity, PPV 95.83%, NPV 98.39%, and diagnostic efcacy of 97.27% for the palpable breast lesions respectively. Conclusion: FNAC is a rapid and economical procedure with high accuracy for cytological diagnoses of breast masses and helps the surgeon to plan for further treatment.

The application of social cognitive theory (SCT) to the mHealth diabetes physical activity (PA) app to control blood sugar levels of type 2 diabetes mellitus (T2DM) patients in Takalar regency.

Background: People with Diabetes Mellitus (DM) experience an increased health risk due to reduced physical activities. Cellular health technology (mHealth) offers a way that people with DM can engage in more complex physical activities. Social Cognitive Theory (SCT) is the most commonly used theory in increasing physical activities. This study aims to find out the application of SCT in mHealth app to control blood sugar (GDP, HbA1C) of T2DM patients. Design and Method: This present study used a mixed method sequential explanatory design related to the application of mHealth Diabetes Physical Activity in Takalar Regency. The first step was to use qualitative methods with rapid assessment procedures in developing the application of SCT in mHealth. The second step was to validate and test the app through usability testing. The last step was intervening the development of mHealth app using quasi-experimental designs related to the influence of mHealth Diabetes Physical activity interventions in controlling blood sugar (GDP, HbA1c) in T2DM patients. The first group was the mHealth diabetes Physical activity (PA) intervention group; the second intervention group was a group monitored through Whatsapp group; and the third group was the group with physical activity module but without monitoring. Expected outcome: The findings of this study are expected to be the basis of evidence for nurses holding DM programs to make relevant policies and design an app-based physical activity promotion programs for T2DM patients. Conclusion: This protocol qualifies to be the basis of evidence for nurses holding Diabetes Mellitus programs in improving health services through IT-based health promotion programs.

Designing and fabrication of electrochemical nano-biosensor for the fast detection of SARS-CoV-2-RNA

SARS-CoV-2 caused a global panic among populations. Rapid diagnostic procedures for the virus are crucial for disease control. Thus, the designed signature probe from a highly conserved region of the virus was chemically immobilized onto the nanostructured-AuNPs/WO3-screen printed electrodes. Different concentrations of the matched oligonucleotides were spiked to test the specificity of the hybridization affinity whereas the electrochemical impedance spectroscopy was used for tracking the electrochemical performance. After a full assay optimization, limits of detection and quantification were calculated based on linear regression and were valued at 298 and 994 fM, respectively. Further, the high performance of the fabricated RNA-sensor chips was confirmed after testing the interference status in the presence of the mismatched oligos in one nucleotide and completely one. Worthy to mention that the single-stranded matched oligos can be hybridized to the immobilized probe in 5 min at room temperature. The designed disposable sensor chips are capable of detecting the virus genome directly. Therefore, the chips are a rapid tool for SARS-CoV-2 detection.

Assessment of Chemical Toxicity in Adult Drosophila Melanogaster.

Human industries generate hundreds of thousands of chemicals, many of which have not been adequately studied for environmental safety or effects on human health. This deficit of chemical safety information is exacerbated by current testing methods in mammals that are expensive, labor-intensive, and time-consuming. Recently, scientists and regulators have been working to develop new approach methodologies (NAMs) for chemical safety testing that are cheaper, more rapid, and reduce animal suffering. One of the key NAMs to emerge is the use of invertebrate organisms as replacements for mammalian models to elucidate conserved chemical modes of action across distantly related species, including humans. To advance these efforts, here, we describe a method that uses the fruit fly, Drosophila melanogaster,to assess chemical safety. The protocol describes a simple, rapid, and inexpensive procedure to measure the viability and feeding behavior of exposed adult flies. In addition, the protocol can be easily adapted to generate samples for genomic and metabolomic approaches. Overall, the protocol represents an important step forward in establishing Drosophila as a standard model for use in precision toxicology.