Rapid Test Research Articles

A New Test for Evaluating the Psychological Impact of COVID-19 in Nurses

Introduction During the COVID-19 pandemic, many health care workers were involved and suffered significant physical and psychological strain, and nursing was one of the main players. Clearly and objectively establishing the psychological impact on nurses during the pandemic is necessary for long-term recovery and to be prepared for new outbreaks in the future. Aim The aims of this study were to evaluate the perceived impact on nurses at risk of psychological stress at work during a major health care crisis and determine the psychological impact and its influencing factors. Methods An online questionnaire was designed and distributed between April 9 and April 19, 2020, in Spain. The comprehensive self-conducted questionnaire included demographic information and the Psychological Stress and Adaptation at work Score. For the analysis, descriptive statistics, logistic regressions, and receiver operating characteristic curves were determined. Results A total of 825 nurses (33% working in intensive care units and emergency departments) answered the questionnaire. A logistic regression analysis revealed that nurses with higher psychological stress scores experienced more physical overload (P = .02), higher psychological overload (P < .01), poor teamwork (P = .02), more distress due to new circumstances (P < .01), more personal impact of how society responded to COVID-19 (P < .01), anticipation of negative future consequences (P < .01), and worse balance between family and work (P < .01). The area under the curve for the cutoff point of Psychological Stress and Adaptation at work Score 40 was 0.82 (95% confidence interval, 0.79-0.91), with 70% sensitivity and 81% specificity. The positive predictive value was 72%, and the negative predictive value was 80%. Conclusion Psychological Stress and Adaptation at work Score is a rapid and accurate test for evaluating the psychological well-being of health care staff that can be used when crisis prevents the use of conventional stress diagnosis methods. Higher psychological impact was observed in nurses who worked in the intensive care unit and in the hospital ward.

SARS-CoV-2 antigen rapid detection tests: test performance during the COVID-19 pandemic and the impact of COVID-19 vaccination

SARS-CoV-2 antigen rapid detection tests (RDTs) emerged as point-of-care diagnostics alongside reverse transcription polymerase chain reaction (RT-qPCR) as reference. In a prospective performance assessment from 12 November 2020 to 30 June 2023at a single centre tertiary care hospital, the sensitivity and specificity (primary endpoints) of RDTs from three manufacturers (NADAL®, Panbio™, MEDsan®) were compared to RT-qPCR as reference standard among patients, accompanying persons and staff aged≥six month in large-scale, clinical screening use. Regression models were used to assess influencing factors on RDT performance (secondary endpoints). Among 78,798 paired RDT/RT-qPCR results analysed, overall RDT sensitivity was 34.5% (695/2016; 95% CI 32.4-36.6%), specificity 99.6% (76,503/76,782; 95% CI 99.6-99.7%). Over the pandemic course, sensitivity decreased in line with a lower rate of individuals showing typical COVID-19 symptoms. The lasso regression model showed that a higher viral load and typical COVID-19 symptoms were directly significantly correlated with the likelihood of a positive RDT result in SARS-CoV-2 infection, whereas age, sex, vaccination status, and the Omicron VOC were not. The decline in RDT sensitivity throughout the pandemic can primarily be attributed to the reduced prevalence of symptomatic infections among vaccinated individuals and individuals infected with Omicron VOC. RDTs remain valuable for detecting SARS-CoV-2 in symptomatic individuals and offer potential for detecting other respiratory pathogens in the post-pandemic era, underscoring their importance in infection control efforts. German Federal Ministry of Education and Research (BMBF), Free State of Bavaria, Bavarian State Ministry of Health and Care.

Rabies post-exposure prophylaxis: a retrospective analysis of timing of initiation and antibody responses in a Belgian cohort.

BackgroundWe aimed to determine the timeliness of rabies post-exposure prophylaxis (PEP) and the proportion of individuals with an adequate antibody response post-PEP among those attending the Belgian national reference center. MethodsRetrospective analysis of patient records who attended our center from 2018-2023. Delay was defined as rabies immunoglobulin (RIG) and vaccine initiation beyond 2 calendar days after exposure. Antibodies were measured by rapid fluorescent focus inhibition test (RFFIT) after PEP in high-risk exposures. A titer ≥0.5 IU/ml was considered adequate. ResultsWe reviewed 317 patient records. Among individuals with inland exposure (n=103), 85% timely received PEP. Among travelers exposed abroad (n=214), administration of RIG and vaccine initiation were timely in 30% and 50% of cases, respectively. An adequate antibody response was detected in 99.5% (195/196) individuals. ConclusionSubstantial PEP delays among travelers were observed. The robust antibody responses suggest that routine serological follow-up is not necessary for all patients.

A case study of the 2023 highly pathogenic avian influenza (HPAI) outbreak in tern (Sternidae) colonies on the east coast of the Republic of Ireland

ABSTRACT Capsule:HPAI H5N1 had a significant impact on breeding Common Terns Sterna hirundo, Arctic Terns Sterna paradisaea and Roseate Terns Sterna dougallii on the east coast of the Republic of Ireland (ROI) in 2023, with a lesser impact on Sandwich Terns Thalasseus sandvicensis and only two cases among Little Terns Sternula albifrons. Aims: To document the outbreak of HPAI H5N1 in the tern colonies on the east coast of ROI during the 2023 breeding season. Methods:Precautions were taken from the start of the breeding season, including personal protective equipment (PPE) and safe operating procedures. Regular meetings were held between BirdWatch Ireland and the National Parks and Wildlife Service (NPWS) to respond to the emerging situation. Once HPAI was confirmed in a colony, all ringing and nest visits were stopped. Carcass removal was carried out at all affected colonies and most carcasses were incinerated. Results: Common Terns suffered the highest mortality across all colonies in 2023, with smaller but notable numbers of dead Roseate Terns and Arctic Terns, but very few Sandwich Terns and only two Little Tern deaths were attributed to HPAI. Conclusion: Regular meetings between relevant organizations were invaluable in preparing for outbreaks and ensuring an adaptive approach as the situation changed over time and between colonies. There was no way of knowing if the actions taken were effective, as the pattern of virus spread between species and sites remains poorly understood. Future clarity over the role of various state agencies and other relevant bodies in responding to HPAI in wild birds, greater sharing of real-time information, and pre-arranged agreements to ensure rapid testing and disposal of carcasses, would be useful to ensure an effective response to future outbreaks.

Investigation of strength, durability, and microstructure properties of concrete with waste marble powder as a partial replacement of cement

Purpose Cement plays a significant part in concrete, and with the increasing demand for concrete, cement output varies day by day, allowing production to carbon dioxide emissions. As well as marble processing creates stone slurry and solid discards. These are often dumped irresponsibly on open land, polluting the soil. This improper disposal of marble waste is a major environmental concern. This study aims to propose a sustainable solution for reusing this waste material as a concrete additive. Design/methodology/approach A total of 135 concrete cubes of size 150 × 150 × 150 mm, 54 concrete cylinders of size 150 mm dia. and 300 mm height and 54 concrete beams of size 150 × 150 × 700 mm were cast. The replacement was 0%, 2.5%, 5%, 7.5%, 10%, 12.5%, 15%, 17.5% and 20% by weight of cement with marble dust to create M30 concrete with a water-cement ratio of 0.45. The test was performed to find the compressive strength (CS), flexural strength (FS) and split tensile strength. Also, durability tests like rapid chloride penetration test (RCPT), acid attack, ultrasonic pulse velocity (UPV) and water permeability test were performed. Findings After 7 and 28 days of curing, it was found that replacing 5% of cement with marble powder led to an initial strength improvement of up to 25% for both curing periods. However, further increases in marble dust resulted in an inconsistent decrease in strength for all the mixtures. Also, durability properties like acid attack test, water permeability test and RCPT, showed good performance at the optimum percentage of waste marble powder (WMP) as cement replacement. The microscopic analysis revealed a denser pore structure at lower WMP replacement levels, likely due to the powder filling in gaps. Originality/value This study reveals that by substituting 5% (optimum) of cement with WMP, there was CS improvement up to 8.4% and 17% for both 7 and 28 days of curing. WMP is typically finer than cement particles and fills the voids in the concrete more effectively, resulting best performance at optimum percentage against RCPT, UPV, acid attack and water permeability.

Pediatric tonsilitis: modern tactics against an old foe

Abstract Background Pediatric tonsillitis (PT) impacts public health due to its widespread incidence and the prevalent overprescription of antibiotics driven by concerns over Group A β-hemolytic streptococcus (SGA) complications. Rapid antigen diagnostic tests (RADT) serve as vital tools for promptly identifying SGA infections in PT cases. However, despite their widespread availability, healthcare professionals often underutilize RADT, leading to inappropriate antibiotic prescriptions. Clinical audits and feedback to professionals emerge as solutions to this issue. Methods An audit was conducted on clinical cases of PT during 2023 to evaluate the correct usage of RADT and subsequent antibiotic prescription across various primary care practices in Lisbon, Portugal. Afterwards, a pilot practice was selected to assess the feasibility and utility of an online tool designed specifically to report RADT results and create a real-time surveillance system of incidence of SGA with feedback to prescribing clinicians. Following the revision of the reporting tool after the pilot, its implementation was extended to multiple practices across the Lisbon region. Results From the 1050 clinical cases analyzed, 992 had an indication to do a RADT according to the Portuguese guidelines, however only 282 (28.4%) tests were done. Overall, only 19.6% of PT cases were considered fully compliant. During the pilot, the introduction of the online tool led to a 3.259 increase in reporting (from 0.574 RADT/day to 1.872 RADT/day) for the same time period between February and March. Conclusions The implementation of an online reporting tool represents a significant advancement in SGA surveillance efforts, detecting cases promptly for public health interventions. This initiative underscores the importance of continuous quality improvement in diagnostics and shows digital tools’ potential for better disease surveillance in clinical settings. Key messages • Underutilization of RADT in PT cases contributes to inappropriate antibiotic prescriptions, compromising patient care. • Introduction of an online reporting tool significantly enhances RADT usage, aiding prompt SGA detection for improved public health interventions.

Epidemiological, clinical, paraclinical, evolutionary, and therapeutic aspects of hypertensive patients infected by COVID-19: about 702 patients in our city

Abstract Introduction Hypertension (HT) is a major cardiovascular risk factor frequently observed in COVID-19 patients. This study aimed to determine the frequency of hypertensive patients infected with COVID-19 at a national hospital, describe their epidemiological, clinical, paraclinical, and therapeutic profile, their disease progression, and identify factors associated with death. Methodology A retrospective, descriptive, and analytical study was conducted over 24 months and 4 days, from 27 March 2020 to 30 March 2022, at national hospital. Included were hospitalized patients at a hospital with a confirmed COVID-19 diagnosis, known hypertensives, regardless of gender, and with a hospitalization record. COVID-19 diagnosis was based on a positive SARS-CoV-2 RT-PCR or a positive COVID Rapid Diagnostic Test. Data were collected using a survey form, with a p-value less than 0.05 considered statistically significant for bivariate analysis. Results The study enrolled 702 patients, a hospital frequency of 23.95%. The average age was 65.14 ± 12.24 years with a sex ratio of 0.81. Comorbidities were predominantly diabetes (40.5%) and dyslipidemia (4.8%). Common symptoms included cough (65%), dyspnea (42.3%), fever (47.4%), and asthenia (35.9%). Blood pressure was normal in 15.2%, high-normal in 16.8% of patients. HT was Grade I in 12.1%, Grade II in 10%, and Grade III in 6.8% of the population, with blood pressure unmeasurable in 0.3% of known hypertensive patients. SARSCOV2 infection was mild in 34.2% and moderate in 42.8% of cases. CT scans showed extensive (31.8%), severe (25.9%), moderate (25.6%), critical (8.5%), and minimal (7.9%) lung damage. Treatment mainly consisted of ACE inhibitors (29%), ACE inhibitors in combination with another antihypertensive (8.4%), and ARBs in combination with an antihypertensive (). The average hospital stay was 12.85 days with a favorable outcome in 81% and a mortality rate of 15.5%. Factors associated with death included not being vaccinated against COVID-19 (HR: 11.70; 95% CI: 1.324-103.519), critical clinical form (HR: 11.70; 95% CI: 1.324-103.519), pulmonary consolidation (HR: 8.87; 95% CI: 7.539-24.207), high creatinine (HR: 4.69; 95% CI: 1.360-16.181), critical CT thoracic level (HR: 2.42; 95% CI: 1.020-5.745), and not taking ARBs (HR: 6.02; 95% CI: 2.812-12.889). Conclusion HT can be associated with COVID-19, impacting the disease's prognosis with significant mortality. Preventing its incidence and morbidity/mortality is crucial.

Respiratory Syncytial Virus Infection in Children with Bronchiolitis

Background: Respiratory Syncytial Virus (RSV) is the most common organism causing bronchiolitis. Bronchiolitis is almost always diagnosed clinically. As a result, the availability of bedside sensitive rapid RSV antigen tests is critical for timely RSV acute respiratory infection diagnosis. Methods and materials: This study was conducted to detect RSV antigen positivity and the sociodemographic profile of children with RSV antigen positive bronchiolitis. From October 2022 to March 2023, this observational study was conducted in the pediatrics department of Chattogram Medical College Hospital. Ninety-two nasopharyngeal swabs from children younger than two years, were tested for RSV antigen. The mean and standard deviation were used to express the demographic data. Chi-square analysis was used to examine differences in group proportions. Results: RSV antigen positivity was detected in 45.7% of the 92 cases, with a mean age of 4.18±3.08 months. Severe bronchiolitis cases were more common (22.8%) among antigen positive cases and had the longest hospital stay. During the months of November (42.4%) and December (29.3%), RSV infection levels peaked. This study describes that during the seasonal epidemics, RSV was the main concern, as the number of positive cases decreased in the months that followed. The signs and symptoms of RSV positive and negative cases were not significantly different. Conclusion: A simple, low-cost and bedside RSV test can be considered as a valuable diagnostic tool in a low resource setting. J Bangladesh Coll Phys Surg 2024; 42: 368-378

An Irish public health policy research team: impact and lessons learned, one year on

Abstract Issue In 2023, in Ireland, a public health policy research team was established in the Health Information and Quality Authority to conduct evidence syntheses and provide evidence-based advice to inform national decision-making, at the request of the Department of Health. One year on, we reflect on the impact of this team and outline lessons learned. These findings may support other countries in creating and developing public health policy research teams. Description of the problem We aim to answer the following questions: What impact can a public health policy research team have and what are the lessons learned, one year on? Projects completed by the team in 2023 were reviewed for stakeholder engagement (such as expert and public and patient involvement) and impact (feedback from policymakers, resulting public health actions or policies and online report downloads). Results Seven public health projects were completed in 2023, in areas including: Long COVID, public health reform, rapid multiplex testing, and medical countermeasure stockpiling. National and international stakeholders were engaged with via expert advisory group membership, document review and project presentations. Patient representatives were included from Long COVID Advocacy Ireland and Rare Diseases Ireland. Project reports were downloaded a total of 281 times. Positive feedback was received from all stakeholders. Project findings were presented to policymakers to inform national public health and rare disease strategy development, and the Long COVID model of care in Ireland. Lessons Early and ongoing stakeholder engagement is key when translating research to practice, via policy. Innovative methods of engagement, including public and patient involvement, can ensure meaningful collaboration. Adapting methodologies to meet stakeholder needs, such as rapid evidence synthesis, enhances impact. Lastly, research impact on policy takes time, and an understanding of national policy development is required. Key messages • A public health policy research team provides impactful evidence synthesis to advise national policymakers. • Stakeholder engagement is key to developing impactful policy advice.

Blood biomarkers to detect functional impairment in adult patients with repaired Tetralogy of Fallot

Abstract Background The relationship between plasma brain natriuretic peptide (NT-proBNP) and soluble suppression of tumorigenicity-2 (sST2) with structural adaptions and exercise capacity remains incompletely described in patients with repaired Tetralogy of Fallot (rTOF). Methods Peripheral venous blood samples were drawn for 99 patients with repaired TOF, 59 patients with severe pulmonary regurgitation (PR) and 40 patients with no or mild PR. NT-proBNP was measured using enzyme-linked immunosorbent assays (Roche Diagnostics, Indianapolis, IN). Soluble ST2 levels were assessed on Aspect-plus ST2 quantitative rapid test. Results The mean value of NT-proBNP was 160±137 pg/ml, and sST2 was 29±13, ng/ml in the entire population. Mean NT-proBNP was significantly higher in patients with severe PR (169±150 vs145±118, pg/ml, p<0.001), while similar sST2 levels were observed in both groups (29±14 vs30±12, ng/ml, p>0.05). NT-proBNP and sST2 levels were higher in patients with transannular patch when compared to other RVOT intervention. Both biomarkers were significantly associated with exercise capacity, but NT-proBNP (r=-.60, p<0.001) was stronger. The optimal cut-off of 90pg/ml for NT-proBNP had a sensitivity of 74% and specificity of 63% for detection of impaired exercise capacity. Conclusions Serum levels of sST2 and NT-proBNP are elevated in patients with repaired TOF, with higher values observed in those with severe PR, but also in patients undergoing transannular patch. Incorporating both markers in these patients increased the ability to detect impairment in exercise capacity.

Comparison of rapid test for high-sensitivity troponin I with laboratory high-sensitivity troponin T in patients with acute chest pain - a prospective monocentric study

Abstract Background and purpose High-sensitivity troponin (hs-Tn) assays are recommended for routine clinical use for diagnosis of acute coronary syndrome (ACS). However, laboratory hs-TnT can be elevated due to non-cardiac conditions, such as pulmonary embolism, skeletal muscle injury or chronic kidney disease. The aim of our study was to compare the diagnostic accuracy of the bed-side rapid hs-troponin I (hs-TnI) assay with hs-TnT measured by routine laboratory. Methods This prospective monocentric study was conducted at a tertiary hospital outpatient cardiac unit with an emergency clinic for patients with acute symptoms. A total of 129 patients were included between May 2021 and August 2022. Hs-TnI was measured via a bed-side test from whole blood directly in the emergency room, while hs-TnT was measured from plasma through the routine laboratory. Definite ACS was confirmed by coronary angiography. Patients were compared by grouping them into definitive diagnosis of ACS or no ACS. Hs-TnI as well as hs-TnT values were compared for accuracy and predictive values. Routine clinical parameters and comorbidities were documented and compared as well. Agreement between hs-TnI and hs-TnT was assessed by likelihood ratios and Bland Altman plot. Results Overall, 129 patients (65.1% male, 61.8 ± 15.6 years) with acute chest pain were analysed. Median hs-TnI was 7.0 ng/L (IQR: 2.7-15.8), while median hs-TnT was 14 ng/L (IQR: 7.0-31.0). Results for TnI were available faster (average: 1:14 h ± 0:54) compared to TnT. Coronary angiography confirmed ACS in 17 patients (13.2%) displaying significant coronary stenoses requiring intervention. The relative risk of ACS patients to have an elevated hs-TnI result was 6.59 compared to that of 2.29 for the hs-TnT test, meaning that a positive hs-TnI test was a better classifier for validated ACS than that of hs-TnT. Hs-TnI exhibited equivalent negative predictive value to hs-TnT (99%) for definite ACS diagnosis, but had comparatively higher positive predictive value (50.0 vs. 25.8%). Bland Altman plot of hs-TnI versus hs-TnT showed an average difference of -4.6 ng/L (95% CI: -12.4 to 3.2) between the tests. In 39 patients with chronic kidney disease (minimum stage 3a CKD) median hs-TnT (27.0 ng/L, IQR: 16.0-55.0) values were higher than hs-TnI (11.2 ng/L, IQR: 7.5-30.7). Conclusion Bed-side hs-TnI is comparable to hs-TnT with a high degree of agreement. Measurement of troponin I using the rapid bed-side hs-TnI assay possesses a shorter blood-draw-to-result-time than routine troponin T measurement.

Performance of the Flash10 COVID-19 point-of-care molecular test

After the COVID-19 pandemic, fever clinics urgently require rapid nucleic acid tests to enhance their capacity for timely pathogen detection. This study evaluated the analytical performance and clinical utility of the Flash10 SARS-CoV-2 point-of-care test (Flash10 POCT) for detecting SARS-CoV-2 in patients with fever in the adult fever clinic in Beijing Tsinghua Changgung Hospital from August 1 to August 30, 2023. The analytical performance and clinical utility of the Flash10 POCT for detecting SARS-CoV-2 were assessed in 125 patients with fever syndrome in the adult fever clinic. The Flash10 POCT demonstrated an analytical precision of 3.1% for the Ct values of the ORF1ab gene and 2.9% for the Ct values of the N gene in SARS-CoV-2 nucleic acid testing. Furthermore, the Flash10 POCT demonstrated a lower limit of detection (LoD) of 100 copies/mL, with no detected aerosol contamination leakage. Of the 125 patients (median age 61.9 years, 52% male and 48% female), both the Flash10 POCT and RT-PCR tests yielded positive results for 100 patients and negative results for 25 patients (Fisher’s exact test, p < 0.0001). The median turn-around-time for the Flash10 POCT was significantly shorter, at 1.05 h, compared to 16.15 h required for RT-PCR tests (Wilcoxon signed rank test, p < 0.0001). The Flash10 POCT showed high analytical performance, achieving a 100% detection rate for SARS-CoV-2 compared to RT-PCR tests, while also exhibiting a significantly shorter turn-around-time. Implementing the Flash10 POCT had the potential to expedite the care of adults presenting with fever.

Association Between Rapid Urease Test For H. Pylori Incidence And Non-Ulcer Dyspepsia In Bangladeshi Patients

Introduction: Dyspepsia is a fairly common group of symptoms including epigastric pain, epigastric burning, postprandial fullness, early satiation, bloating in the upper abdomen, nausea, vomiting and belching. Interestingly the majority of them are found to have no ulcer, and they are termed as non-ulcer dyspepsia (NUD). However. Different studies worldwide have found there is an association between H. Pylori infection and NUD. Objective: To evaluate the infection rates of H. pylori in patients, presenting with dyspepsia without any evidence of ulcer on endoscopy. Materials and methods: This cross-sectional study was conducted from June, 2022 to December, 2022. The study included 100 patients (46 males and 54 females) with NUD and recruited by convenient sampling method. Result: In the study, the prevalence of H. pylori infection in patients with NUD is 53% on the basis of (Rapid urease test) RUT. Gender-based prevalence was found to be 53.7% and 52.17% for women and men, respectively. The highest prevalence rate was found in the age group of 25-34 years. The prevalence of H. pylori infection was slightly higher for urban people. Conclusion: H.Pylori infection can be easily identified by RUT. The study has found significant correlation of H. pylori infection with NUD by using RUT. J Dhaka Med Coll. 2023; 32(1) : 4-8

Validation of EUCAST rapid antimicrobial susceptibility testing directly from positive blood cultures in a non-automated lab setting

ABSTRACT Introduction To speed up antimicrobial susceptibility testing (AST), the European Committee on Antimicrobial Susceptibility Testing (EUCAST) proposed rapid AST (RAST), a disk diffusion method to be read after 4, 6 and 8 hours of incubation. We investigated the feasibility of implementation of RAST in a non-automated lab setting. Materials & methods To this end, reference strains as well as a variety of clinical and resistant strains were used to spike sterile hemocultures (BioMérieux BACT/ALERT 3D® and Becton Dickinson BACTEC FX® systems), followed by RAST in comparison to classical long-incubation AST. Results & conclusion Our results with reference strains show that reading RAST after 4 hours is frequently too soon to obtain clinical results, and that Streptococcus pneumoniae reference strain did yield readable inhibition zones in RAST when harvested from BioMérieux BACT/ALERT 3D® bottle cultures. In a wider panel of strains, Gram positives RAST results were very similar to standard AST, while with Gram negative species errors were more frequently observed, limiting clinical implementation.

Investigating the influence of various metakaolin combinations with different proportions of pond ash and Alccofine 1203 on ternary blended geopolymer concrete at ambient curing.

This paper explores the use of a ternary blended geopolymer concrete (TBGPC) incorporating metakaolin (MK), pond ash (PA), and Alccofine 1203 (AF). Three combinations of MK (25%, 50%, and 75%) with varying proportions of PA and AF were prepared, validating against M30 grade cement concrete (CC). TBGPC was prepared with an 8 molarity sodium hydroxide, sodium silicate to sodium hydroxide ratio of 2.0, liquid to binder ratio of 0.5, and an ambient curing mode. For CC, a water to cement ratio of 0.42 and water curing mode were adopted. The mechanical properties and durability behavior of TBGPC and CC specimens were evaluated through compressive strength, rapid chloride penetration test, permeability test, sorptivity test, and water absorption test. The M50P35A15 mix demonstrated remarkable compressive strength improvements, showing a 203% increase over the CC mix at 1day and 250% by 3days. This trend continued with a 155% increase at 7days, 68% at 28days, and 52% at 90days, consistently outperforming the CC mix. Additionally, microstructure characteristics of the M50P35A15 mix were analyzed through SEM studies, providing validation for the observed strength development. Notably, M50P35A15 mix demonstrated substantially higher early and later strength gain. This enhancement in strength was attributed to the gradual densification of the microstructure over time and the formation of additional NASH and CASH gel in M50P35A15 mix. At 28days, the M50P35A15 mix exhibited excellent durability characteristics, with a Coulomb value of 1008, permeability of 10mm, sorptivity of 0.45mm/√min × 10-4, and water absorption of 1.07%. This study demonstrates the potential of MK, PA, and AF as viable materials for sustainable geopolymer concrete, offering a low-carbon alternative to traditional cement concrete with superior strength and durability aspects.

Noninvasive in vivo photoacoustic detection of malaria with Cytophone in Cameroon

Current malaria diagnostics are invasive, lack sensitivity, and rapid tests are plagued by deletions in target antigens. Here we introduce the Cytophone, an innovative photoacoustic flow cytometer platform with high-pulse-rate lasers and a focused ultrasound transducer array to noninvasively detect and identify malaria-infected red blood cells (iRBCs) using specific wave shapes, widths, and time delays generated from the absorbance of laser energy by hemozoin, a universal biomarker of malaria infection. In a population of Cameroonian adults with uncomplicated malaria, we assess our device for safety in a cross-sectional cohort (n = 10) and conduct a performance assessment in a longitudinal cohort (n = 20) followed for 30 ± 7 days after clearance of parasitemia. Longitudinal cytophone measurements are compared to point-of-care and molecular assays (n = 94). Cytophone is safe with 90% sensitivity, 69% specificity, and a receiver-operator-curve-area-under-the-curve (ROC-AUC) of 0.84, as compared to microscopy. ROC-AUCs of Cytophone, microscopy, and RDT compared to quantitative PCR are not statistically different from one another. The ability to noninvasively detect iRBCs in the bloodstream is a major advancement which offers the potential to rapidly identify both the large asymptomatic reservoir of infection, as well as diagnose symptomatic cases without the need for a blood sample.

A Novel Immunochromatographic Test Strip Using Lanthanide-Labeled Fluorescent Nanoparticles for the Serological Detection of Toxoplasma gondii in Dogs and Cats

Toxoplasma gondii (T. gondii) is an important zoonotic pathogen which induces both acute and chronic toxoplasmosis. Timely diagnosis of T. gondii is crucial for effective disease management. Here, we present a pioneering approach using europium (III)-chelated nanoparticles (EuNPs) in a rapid lateral flow immunochromatographic test strip (ICTS) for detecting T. gondii antibodies in serum samples. By conjugating EuNPs with Staphylococcus aureus protein A, we efficiently captured T. gondii-specific antibodies, which bound to T. gondii antigens on the test line (T-line), generating a distinct fluorescent signal. Employing this novel method, we conducted an extensive epidemiological investigation of T. gondii infections among dogs and cats in Shanghai, China. This innovative ICTS allows for rapid results within 25 min, which include a qualitative result through naked-eye observation under an ultraviolet lamp and a quantitative one derived using a strip reader. With a detection limit of 1:6400 for dog positive serum and no cross-reactivity with other canine and feline pathogens, the EuNPs-ICTS demonstrated excellent consistency with standard enzyme-linked immunosorbent assay results for dogs (κ = 0.91) and cats (κ = 0.92). In addition, 20.38% of 996 dog serum samples and 14.18% of 416 cat serum samples revealed T. gondii antibodies, highlighting the efficacy of this approach. Our study presents a rapid, sensitive, specific, and reproducible EuNPs-ICTS, serving as a promising tool for on-the-spot diagnosis of T. gondii infections in dogs and cats.

Use of point-of-care tests in pharyngotonsillitis – a registry-based study in primary health care

Background Point-of-care (POC) tests, including C-reactive protein (CRP) tests and rapid antigen detection tests (RADT) for group A streptococci (GAS), are widely used in Swedish primary health care (PHC). This study quantifies their use in pharyngotonsillitis and explore their association with antibiotic prescribing. Material and methods Retrospective data from 2012–2016 in Region Kronoberg, Sweden, included all PHC visits with a pharyngotonsillitis diagnosis. Patient characteristics, test usage and antibiotic prescriptions were linked by visit date and personal identification number. Descriptive statistics were used for POC test analysis. Logistic regression assessed the association between CRP levels and antibiotic prescribing. Results Of 24,237 visits, 68% included RADT and 36% included a CRP test, with 89% of CRP tests performed alongside RADT. CRP testing was more frequent in patients with negative (56%) than positive RADTs (42%) (p < .001). Overall, 66% of RADTs were positive. Median CRP levels were 23 mg/l for positive RADT and 31 mg/l for negative RADT (p < .001). Antibiotics were prescribed for 95% of positive RADTs and 43% of negative RADTs (p < .001). In patients with negative RADTs, CRP testing was associated with higher antibiotic prescribing (57%) compared to no CRP testing (26%) (p < .001). Among these patients, CRP levels were associated with prescribing (aOR 1.032; 95% CI 1.029–1.035; p < .001), with 50% of prescriptions occuring at CRP levels ≤ 20 mg/l. Conclusion The use of RADTs and the proportion of positive test were higher than expected, indicating inappropriate use and diagnostic bias. CRP testing, contrary to guidelines, was common and associated with increased antibiotic prescribing.

Histopathological Features of Chronic Gastritis and its Association with Helicobacter pylori Infection.

A Helicobacter pylori (H. pylori) infection is the most common cause of chronic gastritis (CG), with approximately 50% of the world's population infected. Long-term infection increases the risk of progression to gastric cancer. This study evaluated the histopathological changes in CG using the Updated Sydney System (USS) to estimate the prevalence and correlation of H. pylori gastritis with other histological variables. This research was a prospective observational study conducted in the Department of Pathology of a tertiary care teaching hospital in Central India. The study was conducted between Feb 2017 to April 2018. Two antral biopsies were taken per patient, one for a Rapid Urease Test and the second for routine histopathology. All samples were analyzed according to the USS. CG was found in 83.84% of total dyspeptic patients. The most common age group was 31-40 years, with a male preponderance. Of 109 gastric antral biopsies with histopathological evidence of chronic gastritis, neutrophilic activity, intestinal metaplasia, atrophy, and lymphoid aggregates were present in 50 (45.87%), 10 (9.2%), 23 (21.10%), and 11(10.09%) cases, respectively. The prevalence of H. pylori was 46.78%, and its association with the degree of chronic inflammation and intestinal metaplasia was statistically significant. H. pylori was significantly associated with the degree of chronic inflammation and intestinal metaplasia. Hence, this study suggests a vigorous search for H. pylori should be initiated if chronic inflammation and intestinal metaplasia are seen in antral gastric biopsies.

A fluorescent sensor for rapid and quantitative aquatic bacteria detection based on bacterial reactive oxygen species using Ag@carbon dots composites.

A novel fluorescent sensor based on silver nanoparticle-carbon dot composites (Ag@CDs) has been developed for the rapid and quantitative detection of aquatic bacteria. The sensor operates on the principle of plasmon-enhanced resonance energy transfer, where the fluorescence of CDs is quenched by Ag nanoparticles and restored upon bacterial interaction due to the generation of reactive oxygen species. The Ag@CDs exhibit a linear response to bacterial concentration over the range 7 × 104 ~ 4 × 107 CFU·mL-1, with a low detection limit of 4 × 104 CFU·mL-1. The fluorescence recovery is rapid, reaching maximum intensity within 5 min. The method demonstrates high selectivity, with minimal interference from common ions and compounds found in municipal and industrial wastewater. The Ag@CDs-based 96-well plate assay for quantitative measurement of bacteria was developed. The assay's performance was further validated through the analysis of real water samples, showing a recovery of 94.0 ~ 102% for domestic wastewater and 97.6 ~ 106% for industrial wastewater. Also, Ag@CDs-based test strips assay for semi-quantitation were developed for rapid in-field aquatic bacteria detection. Ag@CDs can be conveniently integrated into 96-well plates and test strips, providing rapid on-site aquatic bacteria testing.