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With the advent of digital cameras, there has been an explosion in the number of medical specialties using images to diagnose or document disease and guide interventions. In many specialties, these images are not added to the patient's electronic medical record and are not distributed so that other providers caring for the patient can view them. As hospitals begin to develop enterprise imaging strategies, they have found that there are multiple challenges preventing the implementation of systems to manage image capture, image upload, and image management. This HIMSS-SIIM white paper will describe the key workflow challenges related to enterprise imaging and offer suggestions for potential solutions to these challenges., Competing Interests: Compliance with ethical standards Disclosures Towbin: Grant Funding: Cystic Fibrosis Foundation; Siemens; Guerbet Author/Royalties: Elsevier. Mark Bronkalla: Employee of Merge Healthcare and IBM company which is in the business of providing Medical Imaging products including VNAs, PACS, and Enterprise viewers.

Introduction One in six people live with disability in Australia with higher levels of disability of people from diverse communities, such as those with culturally and linguistically diverse (CALD) backgrounds. In Australia, CALD refers to people from diverse ethnicity and cultures, nationalities, societal structures and religions that may or may not speak a language other than English. This study employs researchers with lived experience of disability and peer support to study the impact of peer support for people with disability, including people from CALD backgrounds, in two peer-led organisations in New South Wales (NSW) Australia.Methods and analysis This study uses participatory action research and inclusive research design with researchers with lived experience, having lived experience of disability and a peer in the disability community, leading the research.Over three years, three different groups will be recruited through Community Disability Alliance Hunter (CDAH) and Diversity and Disability Alliance (DDAlliance): (1) peers with disability, (2) peer leaders with disability and (3) researchers with lived experience of disability and peer support. Data collection and creation methods include semistructured interviews, surveys and focus groups. Qualitative data will be analysed using thematic analysis through the lens of the researchers with lived experience.Ethics and dissemination Ethical approval was granted by the University of Newcastle Human Research Ethics Committee (Approval No: H-2021-0088). Dissemination includes peer-reviewed publications, presentations at local, national and international conferences and written reports for user-led organisations, disability service providers, disability agencies and people with disability.

Introduction Nutrition education is the cornerstone to maintain optimal pregnancy outcomes including gestational weight gain (GWG). Nevertheless, default for appointments is common and often lead to suboptimal achievement of GWG, accompanied with unfavourable maternal and child health outcomes. While mobile health (mHealth) usage is increasing and helps minimising barriers to clinic appointments among pregnant mothers, its effectiveness on health outcomes has been inconclusive. Therefore, this study aimed to address the gap between current knowledge and clinical care, by exploring the effectiveness of mHealth on GWG as the primary outcome, hoping to serve as a fundamental work to achieve optimal health outcomes with the improvement of secondary outcomes such as physical activity, psychosocial well-being, dietary intake, quality of life and sleep quality among pregnant mothers.Methods and analysis A total of 294 eligible participants will be recruited and allocated into 3 groups comprising of mHealth intervention alone, mHealth intervention integrated with personal medical nutrition therapy and a control group. Pretested structured questionnaires are used to obtain the respondents’ personal information, anthropometry data, prenatal knowledge, physical activity, psychosocial well-being, dietary intake, quality of life, sleep quality and GWG. There will be at least three time points of data collection, with all participants recruited during their first or second trimester will be followed up prospectively (after 3 months or/and after 6 months) until delivery. Generalised linear mixed models will be used to compare the mean changes of outcome measures over the entire study period between the three groups.Ethics and dissemination Ethical approvals were obtained from the ethics committee of human subjects research of Universiti Putra Malaysia (JKEUPM-2022-072) and medical research & ethics committee, Ministry of Health Malaysia: NMRR ID-22-00622-EPU(IIR). The results will be disseminated through journals and conferences targeting stakeholders involved in nutrition research.Trial registration number Clinicaltrial.gov ID: NCT05377151.

Abstract This study performs a chemical investigation of blood plasma samples from patients with and without fibromyalgia, combined with some of the symptoms and their levels of intensity used in the diagnosis of this disease. The symptoms evaluated were: visual analogue pain scale (VAS); fibromyalgia impact questionnaire (FIQ); Hamilton anxiety rating scale (HAM); Tampa Scale for Kinesiophobia (TAMPA); quality of life Questionnaire—physical and mental health (QL); and Pain Catastrophizing Scale (CAT). Plasma samples were analyzed by paper spray ionization mass spectrometry (PSI-MS). Spectral data were organized into datasets and related to each of the symptoms measured. The datasets were submitted to multivariate classification using supervised models such as principal component analysis with linear discriminant analysis (PCA-LDA), successive projections algorithm with linear discriminant analysis (SPA-LDA), genetic algorithm with linear discriminant analysis (GA-LDA) and their versions with quadratic discriminant analysis (PCA/SPA/GA-QDA) and support vector machines (PCA/SPA/GA-SVM). These algorithm combinations were performed aiming the best class separation. Good discrimination between the controls and fibromyalgia samples were observed using PCA-LDA, where the spectral data associated with the CAT symptom achieved 100% classification sensitivity, and associated with the VAS symptom achieved 100% classification specificity, with both symptoms at the moderate level of intensity. The spectral variable at 579 m/z was found to be substantially significant for classification according to the PCA loadings. According to the human metabolites database, this variable can be associated with a LysoPC compound, which comprises a class of metabolites already evidenced in other studies for fibromyalgia diagnosis. This study proposed an investigation of spectral data combined with clinical data to compare the classification ability of different datasets. The good classification results obtained confirm this technique is as a good analytical tool for the detection of fibromyalgia, and provides theoretical support for other studies about fibromyalgia diagnosis.

ABSTRACT Coronary artery calcification is probably the main determinant of the poor outcome of percutaneous coronary interventions and is associated with higher rates of adverse events. There are currently different balloon or specific device-based plaque modification techniques available. Knowing their characteristics and proper use is key for the optimal treatment of calcified lesions. This position paper—promoted by the Interventional Cardiology Association of the Spanish Society of Cardiology (ACI-SEC)—describes existing plaque modification techniques currently available and proposes an algorithm for the management of calcified lesions.

Introduction Patient-reported outcomes (PRO) are currently collected from trial participants using paper questionnaires by the Clinical Trials and Statistics Unit at The Institute of Cancer Research (ICR-CTSU). Streamlining PRO collection using electronic questionnaires (ePRO) may improve data collection and patient experience. Here, we outline our protocol for a Study within a trial of electronic versus paper-based Patient-Reported oUtcomes CollEction (SPRUCE), which investigates the acceptability of ePRO in oncology clinical trials.Methods and analysis SPRUCE was developed alongside patient and public contributors. SPRUCE runs in multiple host trials with a partially randomised patient preference design, allowing participants to be randomised or choose their preference of electronic or paper questionnaires. Questionnaires are scheduled in accordance with host trial follow-up. The primary objective will assess differences in return rates (compliance) between ePRO and paper PROs at the first timepoint post-host trial intervention in the randomised group. Paper PRO compliance is expected to be 90%. 244 randomised participants are required to exclude ≤80% compliance rates with ePRO (10% non-inferiority margin, with 80% power and one-sided alpha=0.05). SPRUCE aims to assess acceptability of ePRO in oncology clinical trials, establish whether ePRO is acceptable to ICR-CTSU trial participants and can capture complete PRO data, consistent with paper PROs.Ethics and dissemination The SPRUCE protocol (ICR-CTSU/2021/10074) was approved by the Coventry and Warwick Central Research Ethics Committee (21/WM/0223) on 21 October 2021. Results will be disseminated via presentations, publications and lay summaries. No participant identifiable data will be included.Trial registration SWAT169.

Introduction Cabozantinib monotherapy is an option for treatment of advanced renal cell carcinoma (RCC). However, cabozantinib dose modification and discontinuation due to symptomatic adverse events (AEs) remains a challenge. The use of patient-reported outcomes (PROs) may help manage symptomatic AEs, which is reported to lead to improved quality of life (QOL), avoidance of drug discontinuation and better survival. This study aims to investigate the clinical benefits of PROs in patients with RCC receiving cabozantinib and the most appropriate medium for PRO monitoring (electronic [e]-PRO or paper-PRO).Methods and analysis This study is being conducted at about 35 sites in Japan. Patients aged ≥18 years with unresectable or metastatic RCC initiating treatment with cabozantinib monotherapy are eligible and will be randomised to: (1) e-PRO monitoring, (2) paper-PRO monitoring or (3) usual care without PRO monitoring. Recruitment began in December 2021 (target sample size, 105). Patients start treatment with cabozantinib 60 mg once daily, and in the PRO groups, will record daily medication intake, weight, temperature, blood pressure and AEs. Endpoints include the proportion of patients with a ≥5-point deterioration on the Functional Assessment of Cancer Therapy-Kidney Cancer Symptom Index (FKSI-19; primary endpoint), progression-free survival, QOL, dose adjustments, relative dose intensity, treatment-emergent AEs and frequency of interventions for AEs outside of the scheduled visits. Patient and physician opinions of the PRO monitoring systems and patient compliance with e-PRO/paper-PRO input are also being measured.Ethics and dissemination The study is being conducted in compliance with the Declaration of Helsinki, the International Council for Harmonisation guidelines for Good Clinical Practice and the Clinical Trials Act. Written informed consent is being obtained from all patients, and the protocol has been approved by the Hokkaido University Hospital Certified Review Board (approval number, CRB021-005). The results will be presented at conferences and submitted to a peer-reviewed journal.Trial registration number jRCTs011210055.

This position paper has been drafted by experts from the Czech national board of diseases with bronchial obstruction, of the Czech Pneumological and Phthisiological Society. The statements and recommendations are based on both the results of randomized controlled trials and data from cross-sectional and prospective real-life studies to ensure they are as close as possible to the context of daily clinical practice and the current health care system of the Czech Republic. Chronic Obstructive Pulmonary Disease (COPD) is a preventable and treatable heterogeneous syndrome with a number of pulmonary and extrapulmonary clinical features and concomitant chronic diseases. The disease is associated with significant mortality, morbidity and reduced quality of life. The main characteristics include persistent respiratory symptoms and only partially reversible airflow obstruction developing due to an abnormal inflammatory response of the lungs to noxious particles and gases. Oxidative stress, protease-antiprotease imbalance and increased numbers of pro-inflammatory cells (mainly neutrophils) are the main drivers of primarily non-infectious inflammation in COPD. Besides smoking, household air pollution, occupational exposure, low birth weight, frequent respiratory infections during childhood and also genetic factors are important risk factors of COPD development. Progressive airflow limitation and airway remodelling leads to air trapping, static and dynamic hyperinflation, gas exchange abnormalities and decreased exercise capacity. Various features of the disease are expressed unequally in individual patients, resulting in various types of disease presentation, emerging as the "clinical phenotypes" (for specific clinical characteristics) and "treatable traits" (for treatable characteristics) concept. The estimated prevalence of COPD in Czechia is around 6.7% with 3,200-3,500 deaths reported annually. The elementary requirements for diagnosis of COPD are spirometric confirmation of post-bronchodilator airflow obstruction (post-BD FEV1/VCmax

The purpose of the present study was to explore whether Computer-Based Cognitive Training (C-BCT) versus Paper-Pencil Cognitive Training (P-PCT) is more beneficial in improving cognitive and language deficits in Greek patients living with Alzheimer’s disease (pwAD). Twenty pwAD were assigned to two groups: (a) the C-BCT group, receiving a computer-based cognitive training program using the RehaCom software, and (b) the P-PCT group, which received cognitive training using paper and pencil. The cognitive training programs lasted 15 weeks and were administered twice a week for approximately one hour per session. The analyses of each group’s baseline versus endpoint performance demonstrated that the P-PCT group improved on delayed memory, verbal fluency, attention, processing speed, executive function, general cognitive ability, and activities of daily living. In contrast, the C-BCT group improved on memory (delayed and working), naming, and processing speed. Comparisons between the two groups (C-BCT vs. P-PCT) revealed that both methods had significant effects on patients’ cognition, with the P-PCT method transferring the primary cognitive benefits to real-life activities. Our findings indicate that both methods are beneficial in attenuating cognitive and language deficits in pwAD. The need for large-scale neurobehavioral interventions to further clarify this issue, however, remains a priority.

Abstract In medical institutions, radiation shielding is an effective strategy to protect medical personnel and patients from exposure. Reducing the weight of the shield worn by medical personnel in the radiation generating area plays a key role in improving their productivity and mobility. In this study, a new lightweight radiation shield was developed by electrospinning a polymer-tungsten composite material to produce nanofibers with a multi-layered thin-film structure similar to that of a morpho butterfly wing. The fabricated shield was in the form of 0.1 mm thick flexible shielding paper. The multi-layer structure of the thin shielding paper was obtained through nanofiber pattern formation via electrospinning a dispersion of tungsten particles. At 0.1 mm thickness, the paper’s shielding rate was 64.88% at 60 keV. Furthermore, at 0.3 mm thick and arranged in a laminated structure, the shielding rate was 90.10% and the lead equivalent was 0.296 mmPb. When used as an apron material, the weight can be reduced by 45% compared to existing lead products. In addition, the material is highly processable and can be used to manufacture various flexible products, such as hats, gloves, underwear, and scarves used in medical institutions.

Abstract Numerous scientific, health care, and industrial applications are showing increasing interest in developing optical pH sensors with low-cost, high precision that cover a wide pH range. Although serious efforts, the development of high accuracy and cost-effectiveness, remains challenging. In this perspective, we present the implementation of the machine learning technique on the common pH paper for precise pH-value estimation. Further, we develop a simple, flexible, and free precise mobile application based on a machine learning algorithm to predict the accurate pH value of a solution using an available commercial pH paper. The common light conditions were studied under different light intensities of 350, 200, and 20 Lux. The models were trained using 2689 experimental values without a special instrument control. The pH range of 1: 14 is covered by an interval of ~ 0.1 pH value. The results show a significant relationship between pH values and both the red color and green color, in contrast to the poor correlation by the blue color. The K Neighbors Regressor model improves linearity and shows a significant coefficient of determination of 0.995 combined with the lowest errors. The free, publicly accessible online and mobile application was developed and enables the highly precise estimation of the pH value as a function of the RGB color code of typical pH paper. Our findings could replace higher expensive pH instruments using handheld pH detection, and an intelligent smartphone system for everyone, even the chef in the kitchen, without the need for additional costly and time-consuming experimental work.

Abstract The study's goal was to develop a spore-based paper strip biosensor for detecting ß-lactam antibiotics in milk using the enzyme induction principle. A new spore-based paper strip biosensor has been developed after important operating parameters such as spore volume, substrate volume, exposure time and temperature, and incubation time and temperature were optimised. The limit of detection for various ß-lactam antibiotics, including amoxicillin, penicillin, ampicillin, carbenicillin, cloxacillin, nafcillin, oxacillin, cephalothin, cefalexin, cefoxitin, cefazolin, and cefuroxime, was determined in milk with detection sensitivity of 1 ppb, 2 ppb, 2 ppb, 10 ppb, 10 ppb, 10 ppb, 20 ppb, 10 ppb 1000 ppb, 10 ppb 300 ppb and 100 ppb, respectively. It was also tested with other contaminants such non-ß-lactam antibiotics, pesticides, aflatoxin, heavy metals, and other chemical contaminants, and no interference was found, indicating that the created biosensor had a low rate of false positive and negative results. In comparison to the AOAC-approved CHARM-ROSA ß-lactam strip test, which identified 7 raw milk and zero pasteurised milk samples positive for ß-lactam antibiotics, the sensor was further analysed and verified using 200 raw milk and 105 pasteurised milk samples. This indicates a perfect match between our biosensor and the AOAC-approved CHARM-ROSA ß-lactam strip test. The developed spore-based paper strip biosensors are expected to be useful in the rapid and cost-effective detection of ß-lactam antibiotic residues in milk samples at the dairy farm, reception dock, and production units, respectively.

Abstract There is increasing focus on applying deep learning methods to electrocardiograms (ECGs), with recent studies showing that neural networks (NNs) can predict future heart failure or atrial fibrillation from the ECG alone. However, large numbers of ECGs are needed to train NNs, and many ECGs are currently only in paper format, which are not suitable for NN training. We developed a fully-automated online ECG digitisation tool to convert scanned paper ECGs into digital signals. Using automated horizontal and vertical anchor point detection, the algorithm automatically segments the ECG image into separate images for the 12 leads and a dynamical morphological algorithm is then applied to extract the signal of interest. We then validated the performance of the algorithm on 515 digital ECGs, of which 45 were printed, scanned and redigitised. The automated digitisation tool achieved 99.0% correlation between the digitised signals and the ground truth ECG (n = 515 standard 3-by-4 ECGs) after excluding ECGs with overlap of lead signals. Without exclusion, the performance of average correlation was from 90 to 97% across the leads on all 3-by-4 ECGs. There was a 97% correlation for 12-by-1 and 3-by-1 ECG formats after excluding ECGs with overlap of lead signals. Without exclusion, the average correlation of some leads in 12-by-1 ECGs was 60–70% and the average correlation of 3-by-1 ECGs achieved 80–90%. ECGs that were printed, scanned, and redigitised, our tool achieved 96% correlation with the original signals. We have developed and validated a fully-automated, user-friendly, online ECG digitisation tool. Unlike other available tools, this does not require any manual segmentation of ECG signals. Our tool can facilitate the rapid and automated digitisation of large repositories of paper ECGs to allow them to be used for deep learning projects.

Abstract In the present work, the composite cross-linked were used to consolidate the dyed paper manuscripts. Nanocomposites of mesoporous silica nanoparticle (MPSNP)/polyvinyl alcohol (PVA) and cellulose nanofiber (CNF)/PVA, which have never been used before, have been evaluated for the consolidation process of the dyed paper manuscripts with madder extract. Three concentrations 1%, 3%, and 5% have been prepared. Analysis and investigation methods like scanning electron microscope (SEM), transmission electron microscope (TEM), dynamic light scattering analysis (DLS), X-Ray diffraction Analysis (XRD), atomic force microscope (AFM), Fourier transform infrared spectroscopy (FTIR) and total color difference (ΔE) by spectrophotometer have been used in order to characterize the prepared nano-sized composites and evaluate the treated dyed paper samples before and after the aging process. The results of surface morphology by SEM revealed the effectiveness of MPSNP/PVA core–shell nanocomposite at 5% in the consolidation process, where the improvement of properties of the aged dyed paper samples. The fibers of the treated paper became strong and appeared clearly. The result of ΔE measurements showed that the treated sample with MPSNP/PVA nanocomposite at 5% gave the lowest ΔE (5.22), while, the treated sample with CNF/PVA nanocomposite at 5% gave the highest ΔE value (11.66). Mechanical measurements (tensile strength and elongation) revealed the efficiency of MPSNP/PVA nanocomposite at 5% in the treatment of the aged dyed paper samples. The treated sample with the mentioned material gave tensile strength and elongation values of 84.8 N/nm2 and 1.736%, respectively. In contrast, the treated sample with CNF/PVA nanocomposite at 1% gave the lowest tensile strength and elongation values 38.2 N/nm2, and 1.166%, respectively. FTIR analysis revealed an increase was noticed in the CH2 stretching band (refers to the crystallinity of cellulose), where the intensity of the treated sample with MPSNP/PVA nanocomposite was at a 5% increase compared to the control sample. The FTIR results supported the results of mechanical measurements. The intensity of the CH2 stretching band, which refers to the crystallinity index of cellulose, was increased with the use of MPSNP/PVA nanocomposite at 3% and 5%, which explains the improvement in mechanical properties. This may be due to the nano-mineral particles, which improve the mechanical properties. Additionally, they reduce the effect of accelerated thermal aging on the cellulosic fibers and give them stability. The detailed analysis of analytical methods used for evaluation revealed the novelty of MPSNP/PVA nanocomposite, especially at 5%. It has a potential role in strengthening and improving different properties of the dyed paper manuscripts with madder extract.

Abstract Paper-based analytical devices are promising choices for rapid tests and lab-on-chip detection techniques. Carbon quantum dots (CQDs), on the other hand, are biocompatible nanomaterials, which are industrially promising, due to their fast and cost-effective gram-scale synthesis techniques, as well as their significantly high and stable photoluminescence (PL) properties, which are durable and reliable over a year. However, there have been limitations in the entrapment of CQDs on cellulose papers in a way that their PL is not influenced by the flowing of the CQDs with the stream of analyte fluid, making the sensors less accurate at very low concentrations of liquid analytes. Therefore, in this investigation, a polyvinyl alcohol/alkaline-based method was systematically generated and developed to entrap CQDs inside a 3D crystalline matrix on paper, in a way that they can be used directly as probes for a simple drop-and-detect method. As a proof of concept, N/P-doped CQD on cellulose paper was used to make fluorescent paper-based analytical devices for identifying traces of Hg2+ of around 100 ppb. The designed sensor was tested over several months, to study its durability and functionality over long periods, for potential industrial applications.

The entire world seems to have responded to COVID-19 pandemic in a knee-jerk manner with a short mindset without building on the existing strengths of public health infrastructure. National governments cannot be blamed for this as we are dealing with a crisis that comes once in a lifetime. Realising this, the Organized Medicine Academic Guild (OMAG) an association of major health associations in this country has suggested measures for long-term solutions to COVID-19-like pandemics in the form of a policy paper by OMAG.

Abstract Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder associated with increased immune activity and severe, progressive heterotopic ossification. We previously described a cohort of 32 patients with FOP who were either exposed to SARS-CoV-2 or received a COVID-19 vaccine1 and showed that these patients did not develop heterotopic ossification after COVID-19 vaccination. Here, we present additional clinical data from new subjects and additional long-term follow-up from the first cohort. We enrolled 15 new subjects between August 24th, 2021 and May 17th, 2022 and collected additional self-reported outcomes. The larger cohort with 47 individuals encompassing 49 events showed that patients with FOP exhibited no additional change in FOP disease activity or flare activity resulting from COVID-19 infection or after receipt of a SARS-CoV-2 vaccine. Thus, although any vaccination carries a risk of inducing heterotopic ossification in patients with FOP, our results show that patients with FOP who choose to receive a COVID-19 vaccination may be able to tolerate the procedure without a high risk of heterotopic ossification when following the published guidelines.

Abstract Background In recent years, significant advances have been made in the field of rare diseases (RDs). However, there is a large number of RDs without specific treatment and half of these treatments have public funding in Spain. The aim of the FINEERR project was to carry out a multidisciplinary strategic discussion on the challenge of funding and access to RD-targeted drugs in Spain, in order to agree on specific proposals for medium-term improvement and hence support decision-making in the Spanish National Healthcare System (SNHS). Results The FINEERR Project was organized around a CORE Advisory Committee, which provided an overview, agreed on the design and scope of the project, and selected the members within each of four working groups (WG). Overall, 40 experts discussed and reached a consensus on different relevant aspects, such as conditioning factors for initial funding and access, evaluation and access to RD-targeted therapies, funding of these therapies, and implementation of a new funding and access model. From these meetings, 50 proposals were defined and classified by their level of relevance according to the experts. A descriptive analysis of responses was performed for each proposal. Thereafter, experts completed another questionnaire where they ranked the 25 most relevant proposals according to their level of feasibility of being implemented in the SNHS. The most relevant and feasible proposals were to improve: process of referral of patients with RDs, control over monitoring mechanisms, and communication between healthcare professionals and patients. Conclusions The FINEERR project may provide a starting point for stakeholders involved in the process of funding and access to RD-targeted therapies in Spain to provide the necessary resources and implement measures to improve both the quality of life and life expectancy of patients with RDs.

Abstract Background In drug development, few molecules from a large pool of early candidates become successful medicines after demonstrating a favourable benefit-risk ratio. Many decisions are made along the way to continue or stop the development of a molecule. The probability of pharmacological success, or PoPS, is a tool for informing early-stage decisions based on benefit and risk data available at the time. Results The PoPS is the probability that most patients can achieve adequate pharmacology for the intended indication while minimising the number of subjects exposed to safety risk. This probability is usually a function of dose; hence its computation typically requires exposure–response models for pharmacology and safety. The levels of adequate pharmacology and acceptable risk must be specified. The uncertainties in these levels, in the exposure–response relationships, and in relevant translation all need to be identified. Several examples of different indications are used to illustrate how this approach can facilitate molecule progression decisions for preclinical and early clinical development. The examples show that PoPS assessment is an effective mechanism for integrating multi-source data, identifying knowledge gaps, and forcing transparency of assumptions. With its application, translational modelling becomes more meaningful and dose prediction more rigorous. Its successful implementation calls for early planning, sound understanding of the disease-drug system, and cross-discipline collaboration. Furthermore, the PoPS evolves as relevant knowledge grows. Conclusion The PoPS is a powerful evidence-based framework to formally capture multiple uncertainties into a single probability term for assessing benefit-risk ratio. In GSK, it is now expected for governance review at all early-phase decision gates.

Medical specialty societies often serve their membership by publishing paper forms that may simultaneously include practice guidelines, dataset specifications, and suggested layouts. Many times these forms become de facto standards for the specialty but transform poorly to the logic, structure, preciseness, and flexibility needed in modern electronic medical records. This paper analyzes one such form - a prenatal record published by the American College of Obstetricians and Gynecologists - with the intent to elucidate lessons for other specialty societies who might craft their recommendations to be effectively incorporated within modern electronic medical records. Lessons learned include separating datasets from guidelines/recommendations, specifying, codifying, and qualifying atomic data elements, and leaving graphic design to professionals.

Abstract Purpose Japan, with an increasing number of elderly people needing long-term care in a super-aged society, urgent needs to develop the clinical guidelines on implant maintenance for elderly people with declining independence. The purpose is to categorize the troubles encountered in the care of patients with dental implants and to indicate actual practices and points of note. Methods From the members of the Japanese Society of Oral Implantology, 12 expert panelists who were experienced with many problems of implant maintenance during dental visits and were familiar with their solutions were selected. Through repeated discussions in the many panel meetings, the problems of implant maintenance during dental visits were distilled. Results During a dental visit, the oral cavity, general conditions, and background of elderly patients who cannot orally care for themselves must be grasped, and medical staff, care managers, and patients should understand the changes in these factors as time goes by. The solutions and responses that can be made differ greatly depending on the medical care facilities, the environment, differences in the experience of medical staff, and the patient’s background. Thus, it is necessary to select safe treatments appropriate to each situation. Conclusions This paper features many opinions based on clinical experiences. However, clinical guidelines on implant management during dental visits should be formulated in the future based on the accumulation of evidence through the implementation of clinical research.

Although the shock has long and routinely been treated, right heart and pulmonary circulation used to be the forgotten corners in clinical management. Twenty years ago, my colleagues and I published the paper Right Ventricular Function of Patients with Septic Shock: Clinical Significance and proposed the strategy of 'right heart priority', in which we took right heart as a starting point, completed whole circulation pathway of blood flow clinically with hemodynamic indicators, and performed treatment based on the hemodynamic changes at real locations, degrees and responses to therapeutic interventions. Over the past 20 years, this strategy has been confirmed by many others and practiced in many hospitals worldwide. The current treatment of shock is a continuous, dynamic, target directed quantitative hemodynamic therapy and is moving from individualized treatment towards organ targeted treatment.

Abstract Hydrogen peroxide (H2O2) has attracted considerable attention for use as a disinfectant ingredient for various applications over the decades. The use of H2O2 within the safety regulations can avoid its toxicity to human health and the environment. In this study, a paper-based sensor containing green-synthesized silver nanoparticles (P-AgNPs) was developed for use in a smartphone in the determination of the H2O2 concentration. In the synthesis process, an extract of spent coffee grounds was used as a bioreducing agent. The effects of reaction time and silver nitrate (AgNO3) concentration on the green synthesis of silver nanoparticles (AgNPs) were investigated. The optimum conditions for the preparation of P-AgNPs were determined to be 100 mM AgNO3 (P-AgNPs-100) and 15 h synthesis time. The P-AgNPs-100 sensor exhibited high sensitivity with a detection limit of 1.26 mM H2O2, which might be suitable for the detection of H2O2-based household and beverage sanitizers. The H2O2 detection capability of P-AgNPs-100 was comparable to that of a commercial strip sensor. Furthermore, P-AgNPs-100 had a detection efficiency of more than 95% after long-term storage for 100 days.

Abstract The present study aimed to investigate indigenous bacteria possibility in recycled paper and cardboard mill (RPCM) wastewater treatment through the isolation and identification of full-scale RPCM indigenous bacteria. The molecular characterization of the isolated bacteria was performed by 16S rRNA gene sequencing. Klebsiella pneumoniae AT-1 (MZ599583), Citrobacter freundii AT-4 (OK178569), and Bacillus subtilis AT-5 (MZ323975) were dominant strains used for RPCM wastewater bioremediation experiments. Under optimal conditions, the maximum values of chemical oxygen demand (COD) and color biodegradation by C. freundii AT-4 were 79.54% and 43.81% after 10 days of incubation, respectively. In the case of B. subtilis strain AT-5 and K. pneumoniae AT-1, the maximum values of COD and color biodegradation were 70.08%, 45.96%, 71.26%, and 32.06%, respectively. The results from optimal conditions regarding efficiency were higher in comparison with the efficiency obtained from the oxidation ditch treatment unit in full-scale RPCM-WWTP. Therefore, the present study introduces the isolated indigenous bacteria strains as a promising candidate for improving the RPCM-WWTP efficiency using bioremediation.

Abstract The effect of cellulose nanofibers (CNFs)/polyvinyl alcohol (PVA) coating on the hydrophobic, oleophobic, and strength properties of paper were investigated. The results showed that the size of bamboo fibers (BFs) decreased significantly and the crystallinity increased significantly after biological enzyme treatment. The average length of CNFs obtained by high pressure homogenization was 2.4 µm, the diameter was 28.7 nm, and the crystallinity was 63.63%. When the coating weight of PVA/CNF was 2.0 g/m2 and the CNF dosage was increased from 0.0% to 3.0%, the paper grease resistance grade was increased from 7 to 9, the Cobb value was decreased from 22.68 ± 0.29 g/m2 to 18.37 ± 0.63 g/m2, the contact angle was increased from 67.82° to 93.56°, and the longitudinal and transverse tensile index were increased from 67.72 ± 0.21 N m/g and 37.63 ± 0.25 N m/g to 68.61 ± 0.55 N m/g and 40.71 ± 0.78 N m/g, respectively. When the CNF dosage was 3.0% and the coating weight of PVA/CNF was 4.0 g/m2, the grease resistance grade of the paper was 12, the Cobb value was 21.80 ± 0.39 g/m2, and the longitudinal and transverse tensile indices were 72.11 ± 0.43 N m/g and 42.58 ± 0.48 N m/g, respectively. In summary, the increase of CNFs can effectively improve the lipophobicity, hydrophobicity and tensile strength of the PVA coated paper.

Abstract Accurate quantification of blood creatinine is important to estimate the glomerular filtration rate. Existing techniques using liquid chromatography tandem mass spectrometry (LC–MS/MS) have a high accuracy and eliminate most interferences encountered in routine enzymatic and Jaffé methods. However, they require laborious and time-consuming sample treatment and data acquisition. The aim of this study is to develop a fast and simple method to enable a direct analysis of whole blood creatinine with performance measures that are comparable to conventional LC–MS/MS. 5μL whole blood is formed as a three-dimensional spheroid on hydrophobic silanized paper substrates which then undergoes paper-spray ionization—tandem mass spectrometry (PSI–MS/MS). The method is validated using real human samples and compared with LC–MS/MS. PSI–MS/MS whole blood analysis exhibited a lower limit of quantification of 2.5 μg/mL, precision ≤ 6.3%, recovery in the range of 88–94% and excellent linearity (R2 > 0.99; 2.5—20 μg/mL) covering the normal range for creatinine levels. Creatinine levels were comparable to those measured by LC–MS/MS with small deviations of less than 0.3 μg/mL. This simple, fast and accurate microsampling technique for direct analysis of creatinine from whole blood shows promise for routine clinical screening and monitoring. This approach can be readily extended for other analytes of interest and, due to inherent advantages relating to cost, storability, speed, and simplicity, it can be especially advantageous for use in resource-limited settings.

Abstract The simplest point-of-care assays are usually paper and plastic devices that detect proteins or nucleic acids at low cost and minimal user steps, albeit with poor limits of detection. Digital assays improve limits of detection and analyte quantification by splitting a sample across many wells (or droplets), preventing diffusion, and performing analyte amplification and detection in multiple small wells. However, truly digital nucleic acid amplification tests (NAATs) require costly consumable cartridges that are precisely manufactured, aligned, and operated to enable low detection limits. In this study, we demonstrate how to implement near-digital NAATs in low-cost porous media while approaching the low limits of detection of digital assays. The near-digital NAAT was enabled by a paper membrane containing lyophilized amplification reagents that automatically, passively meters and distributes a sample over a wide area. Performing a NAAT in the paper membrane while allowing diffusion captures many of the benefits of digital NAATs if the pad is imaged at a high spatial resolution during amplification. We show that the near-digital NAAT is compatible with a low-cost paper and plastic disposable cartridge coupled to a 2-layer rigid printed circuit board heater (the MD NAAT platform). We also demonstrate compatibility with biplexing and imaging with mobile phones with different camera sensors. We show that the near-digital NAAT increased signal-to-noise ratios by ~ 10×, improved limits of detection from above 103 copies of methicillin-resistant Staphylococcus aureus genomic DNA to between 100 and 316 copies in a biplexed reaction containing 105 copies of co-amplifying internal amplification control DNA, and reduced time-to-result from 45 min of amplification to 15–20 min for the positive samples.

Abstract Layered metal chalcogenide materials are exceptionally appealing in optoelectronic devices thanks to their extraordinary optical properties. Recently, their application as flexible and wearable photodetectors have received a lot of attention. Herein, broadband and high-performance paper-based PDs were established in a very facile and inexpensive method by rubbing molybdenum disulfide and titanium trisulfide crystals on papers. Transferred layers were characterized by SEM, EDX mapping, and Raman analyses, and their optoelectronic properties were evaluated in a wavelength range of 405–810 nm. Although the highest and lowest photoresponsivities were respectively measured for TiS3 (1.50 mA/W) and MoS2 (1.13 μA/W) PDs, the TiS3–MoS2 heterostructure not only had a significant photoresponsivity but also showed the highest on/off ratio (1.82) and fast response time (0.96 s) compared with two other PDs. This advantage is due to the band offset formation at the heterojunction, which efficiently separates the photogenerated electron–hole pairs within the heterostructure. Numerical simulation of the introduced PDs also confirmed the superiority of TiS3–MoS2 heterostructure over the other two PDs and exhibited a good agreement with the experimental results. Finally, MoS2 PD demonstrated very high flexibility under applied strain, but TiS3 based PDs suffered from its fragility and experience a remarkable drain current reduction at strain larger than ± 0.33%. However, at lower strains, all PDs displayed acceptable performances.

Abstract Various agents, including ethylenediaminetetraacetic acid, oxalic acid, citric acid, and HCl, were applied to remove heavy metals from raw paper incineration ash and render the ash recyclable. Among these prepared agent solutions, ethylenediaminetetraacetic acid showed the highest efficiency for Pb removal, while oxalic acid showed the highest efficiencies for Cu, Cd, and As removal. Additionally, three modes of an advanced removal method, which involved the use of both ethylenediaminetetraacetic acid and oxalic acid, were considered for use at the end of the rendering process. Among these three modes of the advanced removal method, that which involved the simultaneous use of ethylenediaminetetraacetic acid and oxalic acid, i.e., a mixture of both solutions, showed the best heavy metal removal efficiencies. In detail, 11.9% of Cd, 10% of Hg, 28.42% of As, 31.29% of Cu, and 49.19% of Pb were removed when this method was used. Furthermore, the application of these three modes of the advanced removal method resulted in a decrease in the amounts of heavy metals eluted and brought about an increase in the CaO content of the treated incineration ash, while decreasing its Cl content. These combined results enhanced the solidification effect of the treated incineration ash. Thus, it was confirmed that the advanced removal method is a promising strategy by which recyclable paper incineration ash can be obtained.

Abstract We developed a disposable paper battery aiming to reduce the environmental impact of single-use electronics for applications such as point of care diagnosis, smart packaging and environmental sensing. The battery uses Zinc as a biodegradable metal anode, graphite as a nontoxic cathode material and paper as a biodegradable substrate. To facilitate additive manufacturing, we developed electrodes and current collector inks that can be stencil printed on paper to create water-activated batteries of arbitrary shape and size. The battery remains inactive until water is provided and absorbed by the paper substrate, taking advantage of its natural wicking behavior. Once activated, a single cell provides an open circuit potential of 1.2 V and a peak power density of 150 µW/cm2 at 0.5 mA. As a proof of concept, we fabricated a two cell battery and used it to power an alarm clock and its liquid crystal display.

Abstract The increasing prevalence of antibiotic resistance threatens to make currently treatable bacterial diseases deadly again. As drug resistance rises, antibiotic susceptibility testing needs to adapt to allow for widespread, individualized testing. Paper-based diagnostics offer low-cost, disposable alternatives to traditional time consuming and costly in-house methods. Here, we describe a paper-based microfluidic device, called the Bac-PAC, capable of categorizing the antibiotic susceptibly of individual strains of Carbapenem-resistant Enterobacterales. Each chip provides a colored readout with actionable susceptibility classification of three antibiotics, thus maximizing the chances of identifying a viable therapy. We verified the technology on thirty bacterial strains with two dyes using six clinically relevant antibiotics. We demonstrated that the dried tests are stable for one month and can be incubated in a rechargeable coffee mug that reduces the need for external infrastructure.

Abstract In this work, we demonstrate an effective anion capturing in an aqueous medium using a highly porous carbon paper decorated with ZnO nanorods. A sol–gel technique was first employed to form a thin and compact seed layer of ZnO nanoparticles on the dense network of carbon fibers in the carbon paper. Subsequently, ZnO nanorods were successfully grown on the pre-seeded carbon papers using inexpensive chemical bath deposition. The prepared porous electrodes were electrochemically investigated for improved charge storage and stability under long-term operational conditions. The results show effective capacitive deionization with a maximum areal capacitance of 2 mF/cm2, an energy consumption of 50 kJ per mole of chlorine ions, and an excellent long-term stability of the fabricated C-ZnO electrodes. The experimental results are supported by COMSOL simulations. Besides the demonstrated capacitive desalination application, our results can directly be used to realize suitable electrodes for energy storage in supercapacitors.

Abstract In this study, we introduce a uricase-immobilized paper (UOx­-paper) integrated electrochemical sensor for detection of uric acid (UA) in saliva. The UOx was immobilized on the detection zone in the wax-patterned paper substrate. This UOx-paper was integrated with a Prussian blue­-modified, screen-printed carbon electrode after electropolymerization of o-phenylenediamine to construct an electrochemical cell for small-volume (20 μL) of samples. First, we optimized the fabrication conditions of UOx-paper. Next, the amperometric response of the UOx-paper-based electrochemical UA sensor was analyzed using a known concentration of UA standard solution in artificial saliva at an applied potential of − 0.1 V (versus Ag pseudo-reference electrode). The UOx-­paper based electrochemical UA sensor showed a sensitivity of 4.9 μA·mM−1 in a linear range of 50 to 1000 μM (R2 = 0.998), high selectivity and good reproducibility, as well as a limit of detection of 18.7 μM (0.31 mg/dL) UA. Finally, we quantified the UA levels in undiluted saliva samples of healthy controls (n = 20) and gout patients (n = 8). The levels were correlated with those measured with conventional salivary UA enzymatic assays as well as serum UA levels. The UOx-paper-based electrochemical UA sensor is a user-friendly and convenient tool to assess salivary UA levels.

Introduction The success rate of in vitro fertilisation (IVF) treatment for couples with infertility remains low due to lack of a reliable tool in selecting euploid embryos for transfer. This study aims to compare the efficacy in embryo selection based on morphology alone compared with non-invasive preimplantation genetic testing for aneuploidy (niPGT-A) and morphology in infertile women undergoing IVF.Methods and analysis This is a randomised double-blind controlled trial conducted in two tertiary assisted reproduction centres. A total of 500 infertile women will be recruited and undergo IVF as indicated. They will be randomly assigned on day 6 after oocyte retrieval into two groups: the intervention group using morphology and niPGT-A and the control group based on morphology alone. In the control group, blastocysts with the best quality morphology will be replaced first. In the intervention group, blastocysts with the best morphology and euploid result of spent culture medium will be replaced first. The primary outcome is a live birth per the first embryo transfer. The statistical analysis will be performed with the intention to treat and per protocol.Ethics and dissemination Ethics approval was sought from the institutional review board of the two participating units. All participants will provide written informed consent before joining the study. The results of the study will be submitted to scientific conferences and peer-reviewed journals.Trial registration number NCT04474522.

Introduction The Australian population presenting with surgical pathology is becoming older, frailer and more comorbid. Shared decision-making is rapidly becoming the gold standard of care for patients considering high-risk surgery to ensure that appropriate, value-based healthcare decisions are made. Positive benefits around patient perception of decision-making in the immediacy of the decision are described in the literature. However, short-term and long-term holistic patient-centred outcomes and cost implications for the health service require further examination to better understand the full impact of shared decision-making in this population.Methods We propose a novel multidisciplinary shared decision-making model of care in the perioperative period for patients considering high-risk surgery in the fields of general, vascular and head and neck surgery. We assess it in a two arm prospective randomised controlled trial. Patients are randomised to either ‘standard’ perioperative care, or to a multidisciplinary (surgeon, anaesthetist and end-of-life care nurse practitioner or social worker) shared decision-making consultation. The primary outcome is decisional conflict prior to any surgical procedure occurring. Secondary outcomes include the patient’s treatment choice, how decisional conflict changes longitudinally over the subsequent year, patient-centred outcomes including life impact and quality of life metrics, as well as morbidity and mortality. Additionally, we will report on healthcare resource use including subsequent admissions or representations to a healthcare facility up to 1 year.Ethics and dissemination This study has been approved by the Hunter New England Human Research Ethics Committee (2019/ETH13349). Study findings will be presented at local and national conferences and within scientific research journals.Trial registration number ACTRN12619001543178.

Introduction With technological advancement and the COVID-19 pandemic, paper-based media are giving way to screen-based media to promote healthy ageing. However, there is no review available covering paper and screen media use by older people, so the objective of this review is to map the current use of paper-based and/or screen-based media for health education aimed at older people.Methods and analysis The literature will be searched in Scopus, Web of Science, Medline, Embase, Cinahl, The ACM Guide to Computing Literature and Psyinfo databases. Studies in English, Portuguese, Italian or Spanish published from 2012 to the date of the search will be examined. In addition, an additional strategy will be carried out, which will be a Google Scholar search, in which the first 300 studies according to Google’s relevance algorithm will be verified. The terms used in the search strategy will be focused on older adults, health education, paper-based and screen-based media, preferences, intervention and other related terms. This review will include studies where the average age of the participants was 60 years or older and were users of health education strategies through paper-based or screen-based media. Two reviewers will carry out the selection of studies in five steps: identification of studies and removal of duplicates, pilot test, selection by reading titles and abstracts, full-text inclusion and search for additional sources. A third reviewer will resolve disagreements. To record information from the included studies, a data extraction form will be used. The quantitative data will be presented in a descriptive way and the qualitative data through Bardin’s content analysis.Ethics and dissemination Ethical approval is not applicable to the scoping review. The results will be disseminated through presentations at significant scientific events and published in journals in the area.Protocol registration number Open science framework (DOI: DOI 10.17605/OSF.IO/GKEAH).

Context: Scientific studies are often presented primarily to a group of colleagues at annual scientific meetings. All year rounds are turned into products in congresses. Aims: The aim of the study is to evaluate the extent of the hand surgery in plastic surgery and plastic surgeons' papers related with hand surgery in national congresses; the past eight plastic surgery congresses were classified and presented. Settings and Design: The abstract books of Turkish National Congresses of Plastic, Reconstructive, and Aesthetic Surgery between 2011 and 2018 have been evaluated retrospectively. Subjects and Methods: Distribution of hand surgery according to the topics was evaluated according to the European White Book rules and standards. Distribution of oral and posters and distribution by years were shown. Results: The ratio of hand surgery reports to all reports was 17.3%. Hand and upper extremity surgery topics were presented at 19.7% in the 38th congress, which is the most hand surgery-included congress. The most frequently presented subjects were tumors, flaps, trauma, congenital anomalies, and replantation. Conclusions: Although there are arguments that plastic surgeons have disregarded hand surgery, there is no similar situation for Turkish plastic surgeons in the national platform. It has been found that the most common topics such as tumor excision and repair of the tissue defect were the most presented issues rather than arthroscopy, paralytic hand, and arthritis, which are specific to the hand surgery. Increasing the number of plastic surgery specialists who have been trained with hand surgery as a subspecialty will bring up the subjects that have not been presented in the hand surgery so far, in the future congresses.

Abstract Up-converting nanoparticles can be a demand for requirements in many areas, including bioimaging and conversion of energy, but also in the battle against counterfeiting. The properties of lanthanide ions make falsification difficult or even impossible using appropriately designed systems. The proposition of such an approach is the NaErF4:Tm3+@NaYF4 core@shell up-converting nanoparticles combined with transparent varnishes. Given the spectroscopic properties of Er3+ ions present in the fluoride matrix, the obtained up-converting nanoparticles absorb light by 808 and 975 nm wavelengths. The intentionally co-doped Tm3+ ions enable tuning characteristic green Er3+ emission to red luminescence, particularly desirable in anti-counterfeiting applications. The article includes a thorough analysis of structural and morphological properties. Moreover, this work shows that exclusive luminescent properties of NaErF4:Tm3+@NaYF4 NPs can be given to the transparent varnish, providing an excellent anti-counterfeiting system, revealing red emission under two different excitation wavelengths.

Abstract Milk adulteration is a common problem in developing countries, and it can lead to fatal diseases in humans. Despite several studies to identify different adulterants in milk samples, the effects of multiple adulterants remain unexplored. In this work, a three-dimensional (3D) paper-based microfluidic device is designed and fabricated to simultaneously detect multiple chemical adulterants in milk. This device comprises a top cover, a bottom cover, and a middle layer composed of transportation and a detection zone. By making cuts on the middle layer’s support, the device’s flow path is characterised by optimum and uniform velocity. For the first time, seven adulterants (urea, detergents, soap, starch, hydrogen peroxide, sodium-hydrogen-carbonate, and salt) are detected in the milk sample simultaneously with specificity evaluation and detailed color interference analysis. Only 1–2 mL of sample volume is required to detect 7 adulterants at one time. We have used only 10 $$\upmu$$ μ L of the reagent’s volume for the colorimetric reaction and found the results within a few seconds. Observation reveals that the limit of detection (LOD) of the adulterants lies in the range between $$0.05\%$$ 0.05 % (vol./vol.) to $$0.2\%$$ 0.2 % (vol./vol.) using the colorimetric detection technique. The unknown quantity of the added adulterants is measured using the calibration curves obtained from the experiments results. The repeatability and reproducibility of the process, sensitivity, and the linear range of detection of the calibration curves and the statistical study of the color intensity data are thoroughly analysed herein. In any resource-limited setting, this simple, portable, and user-friendly 3D microfluidic device is expected to be used for testing liquid foods before consumption.

Abstract In this study, the performance of a paper-based, screen-printed biofuel cell with mesoporous MgO-templated carbon (MgOC) electrodes was improved in two steps. First, a small amount of carboxymethyl cellulose (CMC) was added to the MgOC ink. Next, the cathode was modified with bilirubin prior to immobilizing the bilirubin oxidase (BOD). The CMC increased the accessibility of the mesopores of the MgOC, and subsequently, the performance of both the bioanode and biocathode. CMC also likely increased the stability of the electrodes. The pre-modification with bilirubin improved the orientation of the BOD, which facilitated direct electron transfer. With these two steps, an open circuit potential of 0.65 V, a maximal current density of 1.94 mA cm−2, and a maximal power density of 465 μW cm−2 was achieved with lactate oxidase as bioanode enzyme and lactate as fuel. This is one of the highest reported performances for a biofuel cell.

Abstract Asymptomatic visceral leishmaniasis cases increase continuously, particularly among patients with HIV who are at risk to develop further symptoms of leishmaniasis. A simple, sensitive and reliable diagnosis is crucially needed due to risk populations mostly residing in rural communities with limited resources of laboratory equipment. In this study, a highly sensitive and selective determination of Leishmania among asymptomatic patients with Leishmania/HIV co-infection was achieved to simultaneously interpret and semi-quantify using colorimetric precipitates (gold-nanoparticle probe; AuNP-probe) and fluorescence (SYBR safe dye and distance-based paper device; dPAD) in one-step loop-mediated isothermal amplification (LAMP) assay. The sensitivities and specificities of 3 detection methods were equivalent and had reliable performances achieving as high as 95.5%. Detection limits were 102 parasites/mL (0.0147 ng/µL) which were 10 times more sensitive than other related studies. To empower leishmaniasis surveillance as well as prevention and control, this dPAD combined with SYBR safe and gold nanoparticle probe LAMP assay is reliably fast, simple, inexpensive and practical for field diagnostics to point-of-care settings in resource-limited areas which can be set up in all levels of healthcare facilities, especially in low to middle income countries.

Abstract Background Health policy-makers must often make decisions in compressed time frames and with limited resources. Hence, rapid reviews have become a pragmatic alternative to comprehensive systematic reviews. However, it is important that rapid review methods remain rigorous to support good policy development and decisions. There is currently little evidence about which streamlined steps in a rapid review are less likely to introduce unacceptable levels of uncertainty while still producing a product that remains useful to policy-makers. Methods This paper summarizes current research describing commonly used methods and practices that are used to conduct rapid reviews and presents key considerations and options to guide methodological choices for a rapid review. Results The most important step for a rapid review is for an experienced research team to have early and ongoing engagement with the people who have requested the review. A clear research protocol, derived from a needs assessment conducted with the requester, serves to focus the review, defines the scope of the rapid review, and guides all subsequent steps. Common recommendations for rapid review methods include tailoring the literature search in terms of databases, dates, and languages. Researchers can consider using a staged search to locate high-quality systematic reviews and then subsequently published primary studies. The approaches used for study screening and selection, data extraction, and risk-of-bias assessment should be tailored to the topic, researcher experience, and available resources. Many rapid reviews use a single reviewer for study selection, risk-of-bias assessment, or data abstraction, sometimes with partial or full verification by a second reviewer. Rapid reviews usually use a descriptive synthesis method rather than quantitative meta-analysis. Use of brief report templates and standardized production methods helps to speed final report publication. Conclusions Researchers conducting rapid reviews need to make transparent methodological choices, informed by stakeholder input, to ensure that rapid reviews meet their intended purpose. Transparency is critical because it is unclear how or how much streamlined methods can bias the conclusions of reviews. There are not yet internationally accepted standards for conducting or reporting rapid reviews. Thus, this article proposes interim guidance for researchers who are increasingly employing these methods.

Abstract As members of a social species, we spend most of our time interacting with others. In interactions, we tend to mutually align our behavior and brain responses to communicate more effectively. In a semi-computerized version of the Rock-Paper-Scissors game, we investigated whether people show enhanced interpersonal neural synchronization when making explicit predictions about others’ actions. Across four experimental conditions, we measured the dynamic brain activity using the functional near-infrared spectroscopy (fNIRS) hyperscanning method. Results showed that interpersonal neural synchrony was enhanced when participants played the game together as they would do in real life in comparison to when they played the game on their own. We found no evidence of increased neural synchrony when participants made explicit predictions about others’ actions. Hence, neural synchrony may depend on mutual natural interaction rather than an explicit prediction strategy. This study is important, as it examines one of the presumed functions of neural synchronization namely facilitating predictions.

Abstract Social insects are highly diverse in their social structures, aside from the consistent presence of reproductive castes. Among social insects, the Australian paper wasp Ropalidia plebeiana constructs extremely dense colony aggregations consisting of hundreds of colonies within a few square meters; however, little is known about the aggregation structures. We genetically analyzed the colony and population structure of R. plebeiana, and concomitant variations in colony sex ratios. In spring, the foundress (candidate queen) group started their colonies on a single old comb from the previous season, subsequently dividing these old combs via relatedness-based comb-cutting. Female philopatry, a prerequisite condition of Local Resource Competition (LRC), was confirmed. The colony sex ratio of reproductive individuals (male and female offspring for the next generation) became slightly male-biased in larger colonies, as predicted under LRC. However, the number of foundresses was positively associated with the number of reproductive individuals, suggesting that Local Resource Enhancement (LRE) also operates. Although the population structure appears to meet the prerequisites of LRC, the sex ratio appears to be modulated by factors other than LRC. Rather, through LRE, the availability of female helpers at the founding stage is likely to mitigate the sex ratios predicted under LRC.

Abstract Oxazolidine is a new category of stimuli-chromic organic compounds with unique characteristics in response to polarity, pH changes, water, light, and metal ions that were well-known as solvatochromism, acidochromism, hydrochromism, photochromism, and ionochromism, respectively. Therefore, oxazolidine derivatives have been developed for their potential applications in chemosensors, anticounterfeiting, and rewritable hydrochromic papers. In this study, various oxazolidine derivatives containing hydroxyl and naphthalene substituted groups were synthesized by using two different indolenine compounds. The synthesized oxazolidine derivatives were used for investigation of solvatochromism in different solvents, and also acidochromism in various pHs by using UV–Vis and fluorescence spectroscopies. In addition, the oxazolidine derivatives were coated on cellulosic papers using a layer-by-layer strategy to develop rewritable acidochromic papers for printing of security tags on cellulosic papers by using acidic and alkaline solutions as water-based inks. Therefore, the developed rewritable acidochromic papers could be used as security papers.

Abstract Paper-based biosensors featuring immunoconjugated gold nanoparticles have gained extraordinary momentum in recent times as the platform of choice in key cases of field applications, including the so-called rapid antigen tests for SARS-CoV-2. Here, we propose a revision of this format, one that may leverage on the most recent advances in materials science and data processing. In particular, we target an amplifiable DNA rather than a protein analyte, and we replace gold nanospheres with anisotropic nanorods, which are intrinsically brighter by a factor of ~ 10, and multiplexable. By comparison with a gold-standard method for dot-blot readout with digoxigenin, we show that gold nanorods entail much faster and easier processing, at the cost of a higher limit of detection (from below 1 to 10 ppm in the case of plasmid DNA containing a target transgene, in our current setup). In addition, we test a complete workflow to acquire and process photographs of dot-blot membranes with custom-made hardware and regression tools, as a strategy to gain more analytical sensitivity and potential for quantification. A leave-one-out approach for training and validation with as few as 36 sample instances already improves the limit of detection reached by the naked eye by a factor around 2. Taken together, we conjecture that the synergistic combination of new materials and innovative tools for data processing may bring the analytical sensitivity of paper-based biosensors to approach the level of lab-grade molecular tests.

Abstract The homeostatic control of Sodium (Na+) ion in the human body assumes paramount relevance owing to its physiological importance. Any deviation from the normal level causes serious health problems like hypernatremia, hyponatremia, stroke, kidney problems etc. Therefore, quantification of Na+ levels in body fluids has significant diagnostic and prognostic importance. However, interfering ions like Potassium ion (K+) is the major hurdle in sodium detection. In this work, we synthesized the clusters of 3–9 nm-sized highly stable and pure Copper nanoparticles surface functionalised with curcumin, through chemical reduction method. Each cluster of particles is encapsulated in a curcumin layer which is clearly visible in TEM images. The results show that these curcumin functionalized Cu NPs (CuC) are highly selective to the colorimetric detection of Na+. The ions like K+, Mg2+ and Zn2+ did not interfere with the Na+ in this sensing technique. Low-cost paper-based sensor strips are fabricated and calibrated for the sensing of sodium in the physiological range and shade cards were developed as a calorimetric guide for estimation of Na+ which makes them ideal point of care diagnostic platform. We demonstrate that the proposed CuC paper strip can be used for detecting Na+ concentration within the whole physiological range in both blood serum and urine.