Analyzing factors affecting positivity in drive-through COVID-19 testing: a cross-sectional study.

BACKGROUND: Demand for COVID-19 testing prompted the implementation of drive-through testing systems. However, limited research has examined factors influencing testing positivity in this setting. METHODS: From October 2020 to March 2023, a total of 1,341 patients, along with their clinical information, were referred from local clinics to the Sasebo City COVID-19 drive-through PCR center for testing. Association between clinical information or factors related to the drive-through center and testing results was analyzed by Fisher's exact test and logistic regression models. RESULTS: Individuals testing positive exhibited higher frequencies of upper respiratory symptoms; cough (OR 1.5 (95% CI 1.2-1.8), p < 0.001, q = 0.005), sore throat (OR 2.4 (95% CI 1.9-3.0), p < 0.001, q < 0.001), runny nose (OR 1.4 (95% CI 1.1-1.8), p = 0.002, q = 0.009), and systemic symptoms; fever (OR 1.5 (95% CI 1.1-2.0), p = 0.006, q = 0.02), headache (OR 1.9 (95% CI 1.4-2.5), p < 0.001, q < 0.001), and joint pain (OR 2.7 (95% CI 1.8-4.1), p < 0.001, q < 0.001). Conversely, gastrointestinal symptoms; diarrhea (OR 0.2 (95% CI 0.1-0.4), p < 0.001, q < 0.001) and nausea (OR 0.3 (95% CI 0.1-0.6), p < 0.001, q < 0.001) were less prevalent among positives. During omicron strain predominant period, higher testing positivity rate (OR 20 (95% CI 13-31), p < 0.001) and shorter period from symptom onset to testing (3.2 vs. 6.0 days, p < 0.001) were observed compared to pre-omicron period. Besides symptoms, contact history with infected persons at home (OR 4.5 (95% CI 3.1-6.5), p < 0.001, q < 0.001) and in office or school (OR 2.9 (95% CI 2.1-4.1), p < 0.001, q < 0.001), as well as the number of sample collection experiences by collectors (B 7.2 (95% CI 2.8-12), p = 0.002) were also associated with testing results. CONCLUSIONS: These findings underscore the importance of factors related to drive-through centers, especially contact history interviews and sample collection skills, for achieving higher rates of COVID-19 testing positivity. They also contribute to enhanced preparedness for next infectious disease pandemics.

Current Trends and Challenges of Microbiome Research in Prostate Cancer.

PURPOSE OF REVIEW: The role of the gut microbiome in prostate cancer is an emerging area of research interest. However, no single causative organism has yet been identified. The goal of this paper is to examine the role of the microbiome in prostate cancer and summarize the challenges relating to methodology in specimen collection, sequencing technology, and interpretation of results. RECENT FINDINGS: Significant heterogeneity still exists in methodology for stool sampling/storage, preservative options, DNA extraction, and sequencing database selection/in silico processing. Debate persists over primer choice in amplicon sequencing as well as optimal methods for data normalization. Statistical methods for longitudinal microbiome analysis continue to undergo refinement. While standardization of methodology may help yield more consistent results for organism identification in prostate cancer, this is a difficult task due to considerable procedural variation at each step in the process. Further reproducibility and methodology research is required.

Ex vivo instability of lipids in whole blood: preanalytical recommendations for clinical lipidomics studies.

Reliability, robustness, and interlaboratory comparability of quantitative measurements is critical for clinical lipidomics studies. Lipids' different ex vivo stability in blood bears the risk of misinterpretation of data. Clear recommendations for the process of blood sample collection are required. We studied by UHPLC-high resolution mass spectrometry, as part of the "Preanalytics interest group" of the International Lipidomics Society, the stability of 417 lipid species in EDTA whole blood after exposure to either 4°C, 21°C, or 30°C at six different time points (0.5 h-24 h) to cover common daily routine conditions in clinical settings. In total, >800 samples were analyzed. 325 and 288 robust lipid species resisted 24 h exposure of EDTA whole blood to 21°C or 30°C, respectively. Most significant instabilities were detected for FA, LPE, and LPC. Based on our data, we recommend cooling whole blood at once and permanent. Plasma should be separated within 4 h, unless the focus is solely on robust lipids. Lists are provided to check the ex vivo (in)stability of distinct lipids and potential biomarkers of interest in whole blood. To conclude, our results contribute to the international efforts towards reliable and comparable clinical lipidomics data paving the way to the proper diagnostic application of distinct lipid patterns or lipid profiles in the future.

Evaluation of 92 cardiovascular proteins in dried blood spots collected under field-conditions: Off-the-shelf affinity-based multiplexed assays work well, allowing for simplified sample collection.

Workplace-collected blood spots deposited on filter paper were analysed with multiplexed affinity-based protein assays and found to be suitable for proteomics analysis. The protein extension assay (PEA) was used to characterize 92 proteins using 1.2 mm punches in repeated samples collected from 20 workers. Overall, 97.8% of the samples and 91.3% of the analysed proteins passed quality control. Both within and between spot correlations using six replicates from the same individual were above 0.99, suggesting that comparable levels are obtained from multiple punches from the same spot and from consecutive spots. Protein levels from dried blood and wet serum from the same individuals were compared and the majority of the analysed proteins were found to be significantly correlated. These results open up for simplified sample collection of blood in field conditions for proteomic analysis, but also highlight that not all proteins can be robustly measured from dried whole blood.

Reference standard analysis of multiple new and old plasma clearance models and renal clearance with special attention to measurement of reduced glomerular filtration rate.

Nine models were evaluated as candidate glomerular filtration rate (GFR) reference standards in three datasets using [51Cr(EDTA)]- or [169Yb(DTPA)]2- anions in 98 studies. Noncompartmental methods formed an upper limit for estimating mass excreted and voluntary urine collection formed a lower limit. For current models and methods, reduced GFR in adults resulted in inflated clearance estimates. Two different logarithmic models with exponential tails were created and may have underestimated reduced clearance. The logarithmic formulae can be used with only two plasma samples, and fit 13 multiple time-samples from 5 min to 24 h with an 8% standard deviation of residuals compared to 20% error for monoexponentials. For shorter times (4 or 5 h) the fit errors decreased but the ratio of errors remained at circa 2.5 times lesser for the logarithmic versus monoexponential models. Adaptively regularised gamma variate, Tk-GV, models that are well documented, but not in common use, were largely contained within the reference extreme values, were unbiased for different levels of clearance and were the only models to be uncorrelated to volume of distribution from mean residence time divided by weight. Using Tk-GV as a candidate reference standard, potentially better methods for routine clinical usage were discussed. Prospective clinical testing, and metabolic scaling of decreased renal function is advised for potential changes to patient triage.

Aggregation Kinetics of TiO2 Nanoparticles in Human and Artificial Sweat Solutions: Effects of Particle Properties and Sweat Constituents.

Dermal penetration potentials of titanium dioxide nanoparticles (TiO2 NPs) may be affected by aggregation upon contact with sweat. This study investigated the aggregation kinetics of three TiO2 NPs in thirty human sweat samples and four artificial sweat standards. Effects of particle concentration, sweat type, and inorganic (sodium chloride, disodium hydrogen phosphate, and sodium dihydrogen phosphate) and organic (l-histidine, lactic acid, and urea) constituents were examined. Three TiO2 NPs remained colloidally stable in >20/30 human sweat samples and showed significant negative correlations (P < 0.01) between aggregation rates and |zeta potentials|. They aggregated rapidly over 20 min to >750 nm in three artificial sweat standards, while remained more stable in the International-Standard-Organization-pH-5.5 standard. Aggregation behaviors of three TiO2 NPs mostly followed the Derjaguin-Landau-Verwey-Overbeek (DLVO) theory, allowing for determining their critical coagulation concentrations in inorganic constituents (15-491 mM) and Hamaker constants (3.3-7.9 × 10-21 J). Higher concentrations of particles, inorganic constituents, and l-histidine destabilized three TiO2 NPs, whereas urea inhibited aggregation. Three TiO2 NPs adsorbed organic sweat constituents via complexation with amino or carboxyl groups, with isotherms following the Langmuir model. Correlation analyses further suggested that the adsorbed organic constituents may stabilize three TiO2 NPs against aggregation in sweat by steric hindrance.

Design and Evaluation of In-Plane Silicon Microneedles Fabricated with Post-CMOS Compatible Processes.

In this paper, a comprehensive study was carried out on in-plane silicon (Si) microneedles, a useful tool for transdermal drug delivery and sample collection. Microneedles with eleven designs were investigated by post-complementary metal-oxide-semiconductor (CMOS) compatible microfabrication processes and characterized via pricking tests by insertion in chicken breast flesh. Mechanical strength of all designs were also evaluated by theoretical calculation and finite element modeling (FEM) for bending and buckling analysis. To efficiently improve the sharpness and insertion, the wedge-shaped needle tips with thickness determined by Si wafer thickness were sharpened by a wet chemical etching process. Insertion forces recorded from pricking tests and bending and buckling from theoretical calculation and FEM analysis before and after etching were compared. The results showed that the insertion force, free bending force and the maximum buckling force were all reduced and the maximum bending stress were improved after tip sharpening. Furthermore, the buckling safety factor of all eleven designs was great than 1 and the maximum bending stress was less than the fracture strength of Si, indicating that our in-plane Si microneedles are robust enough for insertion into human skin.

Clinical Evaluation of Plasma Separation Cards as a Tool to Collect, Store, and Test Blood Samples for Hepatitis B and C Serological Markers.

BACKGROUND: The plasma separation card (PSC) is a new device for collecting finger-pricking-derived small amount of blood in a solid support that is stable at room temperature and can be archived, mailed, and processed at a later time. This tool can facilitate screening at risk populations located in rural areas without local health care infrastructures. We evaluated the performance of PSC in the collection and preparation of blood samples for the determination of hepatitis B and C serological markers. METHODS: Blood obtained from 334 consecutive patients referred for the detection of hepatitis B surface antigens (HBsAg), hepatitis B surface antibodies (anti-HBs) and hepatitis C antibodies (anti-HCV) was analyzed in parallel using standard (STD) and PSC-based sample collection and preparation procedures. Results obtained from STD or PSC processed samples were compared for their detection rate and correlation. RESULTS: Using STD, we detected 5 samples positive for HBsAg, 150 for anti-HBs, and 23 for anti-HCV with a rate of concordance with PSC of 100%, 100%, and 91% respectively. The 100% concordance observed for anti-HBs was based on a cutoff of 2.6 IU/L for PSC-derived sample corresponding to the 10 IU/L threshold associated with immunity to hepatitis B. STD and PSC showed a good correlation (R2 = 0.85) in the detection of anti-HBs titers. The 2 anti-HCV PSC negative samples had no detectable viremia. CONCLUSIONS: These data confirm the utility of PSC as a tool to support viral hepatitis screening programs in rural areas lacking local clinical infrastructures and testing facilities.

Impact of expression mode and timing of sample collection, relative to milk ejection, on human milk bacterial DNA profiles.

AIM: To investigate the impact of expression mode: electric breast pump or hand expression, and timing of sample collection: pre- and post-milk ejection on human milk (HM) bacterial DNA profiles. METHODS AND RESULTS: Three HM samples from the same breast were collected from 30 breastfeeding mothers: a pre-milk ejection pump-expressed sample (pre-pump), a post-milk ejection pump-expressed sample (post-pump) and a post-milk ejection hand-expressed sample (post-hand). Full-length 16S rRNA gene sequencing was used to assess milk bacterial DNA profiles. Bacterial profiles did not differ significantly based on mode of expression nor timing of sample collection. No significant differences were detected in the relative abundance of any OTUs based on expression condition (pre-pump/ post-pump and post-pump/post-hand) with univariate linear mixed-effects regression analyses (all P-values > 0·01; α = 0·01). Similarly, no difference in richness was observed between sample types (number of observed OTUs: post-pump/post-hand P = 0·13; pre-pump/post-pump P = 0. 45). CONCLUSION: Bacterial DNA profiles of HM did not differ according to either expression method or timing of sample collection. SIGNIFICANCE AND IMPACT OF THE STUDY: Hand or pump expression can be utilized to collect samples for microbiome studies. This has implications for the design of future HM microbiome studies.

Central Line Care and Management: Adopting Evidence-Based Nursing Interventions.

Central line-associated bloodstream infections occur not only in the intensive care unit but also the non-intensive care units of the hospital. The purpose of this article is to review current evidence to guide perianesthesia nurses in the care of a patient with a central vascular access device (CVAD). The CVAD bundle focuses on five key elements: hand hygiene, maximal sterile barrier, chlorhexidine antiseptic, catheter site selection, and daily evaluation of the need for the device. Once the CVAD is placed, evidence-based care and maintenance are the responsibility of the nurse. Ensuring proper maintenance and care of a CVAD falls within nursing practice and interventions can significantly reduce the patient's risk of central line-associated bloodstream infection. The single most crucial step a nurse can take to help prevent central line-associated bloodstream infections is performing proper hand hygiene. Other interventions focus on dressing management, bathing practices, access of intravenous infusion sets, blood draws, and management of port line occlusions. Familiarity and adoption of best practice interventions in the maintenance and care of patients with CVADs will help the perianesthesia nurse protect patients and prevent harm.