Search Results (2,611)

Amyotrophic Lateral Sclerosis (ALS) is increasingly recognized as a multisystem disorder. However, SOD1-associated ALS has traditionally been regarded as an exclusively motor phenotype. This systematic review challenges that paradigm by characterizing the cognitive and behavioural profiles of SOD1 mutation-related ALS. Following PRISMA guidelines, a systematic PubMed search identified 17 eligible studies. Across the included studies, encompassing 222 patients with SOD1 variants, three of the analyzed subjects fulfilled the diagnostic criteria for frontotemporal dementia (FTD), and a larger proportion exhibited multidomain cognitive deficits, including executive dysfunction, language impairment, and working memory decline. Behavioural disturbances, such as apathy, emotional lability, and mental rigidity, were also prominent. The historical assumption that SOD1 mutations completely spare cognitive networks likely reflects an under-recognition of subtle manifestations, compounded by the limited sensitivity of earlier screening tools. These findings indicate that cognitive and behavioural involvement can occur in SOD1-ALS, highlighting a highly heterogeneous phenotype. Encompassing varying degrees of severity—from subtle differences in neuropsychological test scores to formal FTD diagnoses—the current evidence points towards possible variant-specific phenotypes rather than a uniform cognitive syndrome. Routine multidomain cognitive screening is crucial in this population. Properly characterizing these non-motor features allows for more accurate disease staging, better monitoring of clinical progression, and the implementation of truly personalized care strategies. Full article

Background: Major spine surgery carries an inherent risk of hemodynamic instability due to prone positioning, significant blood loss, and the strict necessity to maintain adequate spinal cord perfusion. Hemodynamic management mainly relies on a reactive approach, treating hypotension only after it occurs, which increases the risk of postoperative complications such as acute kidney injury and ischemic events. This narrative review evaluates the clinical impact, current evidence, and future perspectives of integrating Artificial Intelligence (AI) and Machine Learning (ML) algorithms into perioperative hemodynamic care. Methods: A comprehensive literature search was conducted through PubMed, EMBASE, and the Cochrane Library, spanning from inception to January 2026. The search strategy employed combinations of Medical Subject Headings terms and keywords related to “Artificial Intelligence,” “Machine Learning,” “Hypotension Prediction Index,” “hemodynamic monitoring,” and “major spine surgery.” Studies were selected based on their relevance to predictive hemodynamic algorithms, goal-directed fluid therapy (GDFT), and automated closed-loop systems within the perioperative setting of complex spinal interventions. Results: Five studies show that AI/ML tools can improve hemodynamic management in spine surgery: an hypotension prediction index (HPI)-guided algorithm reduced intraoperative hypotension during prone spinal fusion; a machine learning model accurately predicted massive blood loss in metastatic spinal disease; an AutoML framework linked intraoperative hypertension to worse neurological recovery after spinal cord injury (SCI); a case report showed HPI-guided goal-directed therapy enabled safe, transfusion-free major spine surgery; and topological network analysis identified a narrow optimal mean arterial pressure (MAP) range for neurological recovery after SCI. Collectively, these preliminary findings suggest a potential role for AI/ML in reducing hemodynamic instability and enabling more individualized perioperative management in spine surgery. Rather than converging on a single verdict, these five studies fall into three distinct evidentiary categories when appraised using a structured model-validation (V1–V4) and clinical-translation (T0–T4) framework applied within each category: a real-time monitoring technology (HPI) with a substantial extra-spinal evidence base but a limited spine-specific replication record; a single, externally validated but clinically unproven preoperative prediction model; and two retrospective, hypothesis-generating discovery frameworks that remain exploratory irrespective of surgical domain. Conclusions: The evidence identified does not support a single, unified statement about “AI/ML in spine surgery.” Instead, it points to three distinct situations that warrant separate research priorities: consolidating spine-specific replication of an otherwise mature monitoring technology (HPI); externally confirming the clinical utility, rather than only the discriminative accuracy, of a single preoperative prediction model; and prospectively testing the retrospectively derived targets generated by discovery-oriented analytic frameworks. Considered together, these findings should inform hypothesis-driven research design rather than a single implementation-readiness judgment. Full article

Background/Objectives: The integration of artificial intelligence (AI) and digital technologies into dental practice is reshaping clinical workflows, administrative processes, and, increasingly, the patient experience and the doctor–patient relationship. While prior research has documented the attitudes of clinicians and practice managers, the perspective of the patient remains comparatively underexplored. This study examined how dental patients perceive AI integration and digital tools across the dental care pathway, together with the associated implications for data security, cost, and the human dimension of care. Methods: A cross-sectional, questionnaire-based study was conducted among 200 dental patients in Bucharest, Romania, and the surrounding region. The instrument assessed perceived difficulty and availability regarding digital technology, current use of digital tools, demographic and educational characteristics (age, gender, practice environment, educational level), and two attitudinal dimensions, namely digital prudence and concern for technological sustainability, across five subdomains of the dental care pathway: scheduling, diagnosis, treatment planning, feedback, and follow-up (dispensarization). Responses were analyzed using non-parametric tests and exploratory principal component analysis with internal-consistency validation. Results: Patients expressed moderate-to-high interest in AI support during the diagnostic (median = 3.3, IQR = 2.7–3.9) and feedback (median = 3.11, IQR = 2.78–3.67) stages and the lowest interest in scheduling (median = 2.7, IQR = 2.0–3.3). A marked level of digital prudence was observed (median = 3.24, IQR = 2.82–3.61), reflecting concerns about data security, automation, and a possible weakening of the clinician–patient bond. Younger and academically educated patients reported lower perceived difficulty, higher availability, and greater current use of digital tools (all p ≤ 0.001); counterintuitively, the same patients scored significantly higher on digital prudence (Spearman’s ρ = −0.260, p < 0.001). Greater familiarity with digital tools was therefore accompanied by a more critical awareness of their informational risks rather than by uncritical acceptance. Conclusions: Dental patients approach AI through a dual lens of openness and informed caution, welcoming efficiency gains in the clinical and continuity-of-care stages while voicing measured concerns about data security, affordability, and the preservation of human contact. To interpret this profile, we propose two conceptual contributions: a mapping of patient needs onto Maslow’s hierarchy in the context of AI-mediated care and the Informational VUCA framework, which characterizes the volatility, uncertainty, complexity, and ambiguity that patients face when navigating AI-generated information. The findings point to a clear practical agenda of transparent communication, robust data governance, and education strategies adapted to patients’ educational and demographic profiles, so that AI-enhanced workflows strengthen rather than erode the doctor–patient relationship. Full article

Antimicrobial resistance (AMR) is a growing global health threat driven in part by inappropriate and unnecessary antibiotic use resulting from diagnostic uncertainty at the point of care. In outpatient and acute-care settings, clinicians are often unable to rapidly distinguish between viral and bacterial infections, leading to empiric antibiotic prescribing that contributes to the emergence and spread of resistant pathogens. This review examines current and emerging rapid diagnostic technologies for differentiating bacterial and viral infections, including molecular assays, rapid antigen tests, biomarker-based diagnostics, host-response platforms, hematologic methods, and artificial intelligence-based decision-support systems. These technologies are evaluated based on diagnostic accuracy, turnaround time, cost, accessibility, and clinical actionability within real-world healthcare settings. Although several emerging and point-of-care (POC) technologies can provide results within approximately 6–15 min, their ability to consistently align with the timing, workflow, and clinical decision-making requirements of frontline outpatient and emergency-care settings remains variable and incompletely established. Future progress in antimicrobial stewardship will depend on developing rapid, clinically actionable diagnostic systems that integrate seamlessly into patient care and reduce unnecessary antibiotic use. Full article

Background/Objectives: Person-centered care (PCC) and the Technological Competency as Caring in Nursing (TCCN) theory are increasingly emphasized in nursing leadership, but no published study has evaluated a PCC/TCCN training program among Mongolian nurse managers. This uncontrolled, single-group pilot pre–post study examined immediate changes in nurse managers’ self-reported PCC and TCCN perceptions following a one-day collective training program. Methods: The program was delivered on 30 October 2025 during the 2nd International Nursing Symposium in Mongolia. Using convenience sampling, hospitals were invited to send nurse managers who were currently in post or senior nurses who had been formally nominated for such a role. Of 50 attendees, 30 met a pre-specified role-eligibility criterion and formed the matched pre–post analytic sample. Participants completed Mongolian versions of the Person-Centered Care Instrument (PCCI) and the Perceived Technological Competency as Caring in Healthcare Providers Instrument (TCCHI) immediately before and after the program. Pre–post differences were assessed with Wilcoxon signed-rank tests, effect sizes for the Wilcoxon signed-rank test (r = z/√N), and Holm–Bonferroni correction across 16 comparisons. Results: Total and all concept-level PCCI and TCCHI scores were higher after the program than before it, all 16 comparisons remained significant after correction, and the effect sizes were moderate to large (r = 0.41–0.61). The median within-person change was +22.0 points (95% CI 7.0 to 35.5) for the total PCCI score and +24.0 points (95% CI 10.5 to 38.0) for the total TCCHI score (Hodges–Lehmann estimates). Conclusions: In this small convenience sample of Mongolian nurse managers and senior nurses formally nominated for managerial roles, self-reported PCCI and TCCHI scores increased immediately after a one-day training program. Because the study used a single-group design without a control group, employed instruments not yet fully validated in Mongolian, and included no follow-up, these findings are preliminary evidence of an association rather than proof of program effectiveness. Larger, controlled studies with follow-up are needed. Trial Registration: TCTR20260513001, registered retrospectively on 13 May 2026, after data collection had been completed. Full article

Background: Acute brain injury, including traumatic brain injury (TBI), stroke, subarachnoid hemorrhage and secondary neurological injury, such as sepsis-associated encephalopathy (SAE) and delirium, is a major cause of morbidity in the intensive care unit (ICU), and few treatments alter its course once it is established. Critical illness, and brain injury in particular, rapidly disrupts the gut microbiome (GM) and the production of its metabolites. This dysbiosis matters most in neurologically injured patients, because microbial metabolites and a leaky intestinal barrier feed neuroinflammation through the gut–brain axis. Feeding timing and fasting affect circadian biology, the daily rhythm of the GM, and host metabolic pathways, such as ketogenesis, insulin signaling and autophagy. This review asks whether time-restricted or fasting-mimicking strategies can preserve these functions and reduce neuroimmune dysregulation after brain injury. Methods: In this narrative review, we searched the literature for randomized trials, crossover pilot studies, mechanistic human research, and guideline statements comparing continuous, cyclic, and intermittent enteral strategies, and evaluated translational pathways for GM-targeted feeding interventions. Results: Available studies showed no consistent difference in mortality between continuous and intermittent gastric feeding in ICU adults on mechanical ventilation, although the largest pooled analyses report more diarrhea, more abdominal distension and longer ICU stay with intermittent schedules, most pronounced in ventilated patients. While intermittent/cyclic regimens were not associated with an improvement of patient-centered outcomes, pilot studies demonstrated that short macronutrient interruptions (e.g., 12 h) reliably induced a metabolic fasting response in patients with a prolonged ICU stay. One randomized controlled trial (RCT) had GM end-points and reported feasible modulation of gut taxa and 58 differentially abundant serum metabolites with sequential (continuous-to-intermittent) feeding. Only five studies enrolled dedicated brain-injured cohorts; none was designed around neurological or gut–brain mechanistic outcomes, and none measured GM or neuroinflammation. Conclusions: Time-restricted, microbiome-protecting approaches are biologically plausible and deserve a phased translational program to test them in clinical trials. Future trials should focus on brain-injured and other neurologically relevant ICU patients, in whom the gut–brain axis is most engaged, and should pair mechanistic endpoints with clinical safety and proper control for confounders. No clinical study has yet tested whether non-continuous feeding alters neuroinflammatory or neurological outcomes after acute brain injury. There is currently no direct evidence supporting the effectiveness of this intervention in this population, and the case made here is mechanistic, not empirical. Full article

Background/Objectives: Traumatic intracranial hemorrhage (tICH) in older adults following low-energy falls (LEF) represents a common yet diagnostically challenging condition in the emergency department (ED), where predicting injury prior to computed tomography (CT) remains difficult. Machine learning (ML) has been proposed to support CT decision-making, but its feasibility using routinely available pre-CT clinical variables in this specific population remains unclear. This study presents a systematic exploratory benchmarking of ML pipeline configurations for pre-CT tICH prediction in a well-defined retrospective cohort of older emergency patients following LEF. Methods: We performed a secondary analysis from a retrospective observational bicentric study from two university hospital EDs, including 2250 patients aged ≥65 years presenting after an LEF and undergoing cranial CT. Clinical data were extracted manually from electronic health records (EHRs). Eighteen pre-CT clinical features retrieved from electronic health records were selected based on routine availability and ≤10% missingness. Overall, 1224 valid ML pipeline configurations, combining nine classification algorithms, six imputation strategies, four class-balancing approaches, and optional hyperparameter tuning, were evaluated using 10-fold stratified cross-validation on a training set. The 20 highest-ranked configurations by cross-validation AUC were then assessed on a previously inspected exploratory hold-out test set (n = 563); training-derived rule-out operating points were evaluable for 17 of these 20, as three tuned SVM configurations lacked stored out-of-fold predictions. Results: tICH prevalence was 7.0% (n = 158). Across the 20 highest-ranked configurations, hold-out AUC ranged from 0.517 to 0.585, with Matthews correlation coefficient near zero and balanced accuracy of approximately 50% throughout, indicating differences in operating point rather than in discriminative ability. Some of these top-ranked pipelines reached higher cross-validation AUC (up to 0.679) but detected no cases at the default 0.5 threshold—an effect of the decision threshold under class imbalance rather than of the models’ rank-order discrimination, which was itself limited (hold-out AUC of 0.517–0.585). Conclusions: Despite comprehensive exploratory benchmarking across 1224 ML pipelines, routinely available pre-CT clinical features did not provide sufficient discriminatory signal to develop a clinically useful tICH prediction model in this cohort of CT-imaged older adults following LEF. These findings indicate that none of the evaluated configurations produced clinically adequate performance; this near-chance result persisted across all pipelines and most plausibly reflects a combination of limited feature signal, low outcome prevalence, and a sample size below the level required for reliable model development at this event rate. Future studies should target substantially larger prospective multicenter cohorts and evaluate additional feature domains, including structured clinical examination findings, point-of-care biomarkers, and imaging features. Full article

Background: Rapid screening of acetylcholinesterase (AChE) inhibition is essential for monitoring exposure to organophosphate compounds, particularly in field settings where access to laboratory infrastructure is limited. This study aimed to develop a portable paper-based colorimetric biosensor for the semi-quantitative detection of AChE activity in blood samples. Methods: The biosensor was based on a pH-dependent color change adapted from the modified Edson method. The platform was first optimized using experimental models and then evaluated in human capillary blood samples collected under real field conditions. Reference serum cholinesterase activity was determined by a certified clinical laboratory and used for comparison with the colorimetric response of the biosensor. RGB (red, green, and blue) image analysis was performed in a subset of samples to digitally characterize the chromatic response of the device. Results: Samples with preserved AChE activity showed a visible color shift associated with substrate hydrolysis, whereas samples with reduced or inhibited activity maintained darker blue-dominant tones. RGB analysis of human samples revealed significant associations between AChE activity and the R and G channels, supporting the ability of the platform to distinguish between chromatic patterns associated with different ranges of enzymatic activity. Conclusions: The proposed platform demonstrated the feasibility of translating a pH-based AChE assay into a portable paper-based format for semi-quantitative visual and RGB-assisted screening. Its evaluation in human samples demonstrated the feasibility of its use under field conditions as a proof-of-concept. Further studies are needed to optimize its analytical performance and validate its application in larger and more diverse populations. Full article

The clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas) system began as a tool for programmable genome editing. CRISPR/ Cas technologies have evolved into a versatile platform for functional genomic screening, epigenome editing, therapeutic target discovery, and highly sensitive molecular diagnostics. New effectors and engineered variants continue to push these applications into personalized medicine and point-of-care testing. Here, this review highlights recent advances in therapeutic target discovery and therapeutic and molecular diagnostic development utilizing CRISPR/Cas technologies. We discuss how CRISPR interference (CRISPRi), CRISPR activation (CRISPRa), base editing, and prime editing have improved our understanding of disease mechanisms, while creating new opportunities for therapeutic intervention. Current applications in cancer immunotherapy, infectious disease, and neurological disorders are also discussed. In diagnostics, CRISPR-based platforms enable sensitive detection of infectious pathogens, cancer biomarkers, and genetic disorders using programmable nuclease activity in both laboratory and point-of-care settings. Collectively, these advances continue to expand the role of CRISPR/Cas technology across biological discovery, disease diagnostics, and therapeutic development, driving progress in precision medicine. Full article

Early detection of colorectal cancer (CRC) is challenging in low-resource settings because access to colonoscopy and centralized laboratory testing is limited. Urine-based metabolite biomarkers offer a non-invasive alternative for CRC triage, but translating a laboratory assay into a point-of-care (PoC) system requires standardized fluid handling, operator-independent timing, field-compatible reagents, and quantitative calibration. Here, we present a low-cost, semi-automated PoC platform integrating a validated, sequential, three-metabolite CRC-biomarker assay with robotic fluid handling, a motorized chromatographic module, an optical reader, Bluetooth electronics, and tablet-guided control. The platform measures urinary diacetylspermine and hippuric acid, with creatinine serving as a normalization reference, and reports absolute quantitative concentrations. Automated dilution, tube positioning, timed incubation, controlled column elution, and software-guided transfer reduce operator-dependent variation. Using pooled urine samples spiked at clinically relevant concentrations, the creatinine assay showed a strong quadratic response (0–50 mM, R² = 0.998), as did the diacetylspermine assay (0–4 μM, R² = 0.979), while the hippuric acid assay showed a linear response of R² = 0.989. The RGB sensor tracked the concentration-dependent trend observed with a laboratory microplate reader (R² = 0.968–0.999). Reagents reformulated as lyophilized or pre-weighed, vacuum-sealed kits withstood accelerated heat and humidity (45 °C/70% RH) testing and international shipping to the pilot site very well. At approximately USD 490 for the complete instrument (including tablet) and roughly USD 7.65 in consumables per screening test, the platform offers a practical, quantitative, and portable route for decentralized CRC screening. Full article

Background: Missed Nursing Care is a comprehensive, multidimensional, and frequently occurring phenomenon in various clinical contexts in Portugal. Objective: This study aimed to translate, adapt, and cross-culturally validate the MISSCARE Survey-Patient for the Portuguese population and to analyze the quality of its measurement properties. Methods: An exploratory–descriptive, quantitative, cross-sectional validation study was conducted. The questionnaire underwent cross-cultural adaptation through translation, translation synthesis, and back-translation procedures, followed by harmonization by an expert committee, pre-testing, and field testing. Results: Ten hospitalized persons and ten nurses participated in the pre-test as experts, while 135 hospitalized persons were included in the field testing. In the pre-testing, excellent content validity indices were obtained for clarity (S-CVUI/Med of 0.98 and S-CVI/UA of 0.84) and cultural relevance (S-CVUI/Med and S-CVI/UA of 1.00) for the overall instrument. In the field testing, a final three-dimensional model (Basic Care, Communication, and Time to Response) was obtained, explaining 66.7% of the total variance. Evidence based on internal structure was supported by Structural Validity indices from the confirmatory factor analysis [X²(56) = 52.421, p < 0.001, χ²/df = 2.722; PCFI = 0.640 and CFI = 0.892]. Convergent Validity was demonstrated through a moderate correlation between the instrument and a question assessing satisfaction with care (r = −0.677; p < 0.001). For the overall instrument, Cronbach’s α was 0.818, indicating very good Internal Consistency, while values for the dimensions ranged between 0.766 and 0.902. Minimal Important Change exceeded the Smallest Detectable Change by seven points for the total instrument, suggesting good potential to detect meaningful changes. Conclusions: The MISSCARE Survey-Patient-PT demonstrates good measurement properties for assessing hospitalized patients’ perceptions of the occurrence of Missed Nursing Care in Portuguese health services. Full article

The central point of evolutionary ecology is understanding the drivers of variation in life-history strategies among organisms. The post-fledging dependence period is a critical life-history stage in the life cycle of altricial birds, influencing their future long-term survival, fitness, and reproduction. This period represents the transition between fledging and the onset of natal dispersal or migration, when offspring are highly dependent on parental care. In this study, we used GPS-GSM telemetry to analyze for the first time the duration of this phase and the size of the ranging area of Lesser Spotted Eagles during the dependence period, testing the importance of various extrinsic (habitat type, territory, region) and intrinsic (body condition, sex, fledging date, fledging age) factors. Our survey was conducted between 2020 and 2025 in Bulgaria, SoutheastEurope. The mean duration of the post-fledging dependence period (PFDP) in the juveniles was 47 ± 5 days (SD) (n = 14). The age of independence of eagles ranged from 71 to 110 days (median = 95 days). Our results show that the fledging date is the main determinant shaping the dependence period both temporally and spatially. The size of the ranging area (90% home range) of juveniles during the PFDP varied from 0.03 to 16.72 km², with a mean value of 2.41 km² ± 4.34 SD (n = 14). Home range was influenced mainly by surrounding habitats (grassland types and forests). In line with our hypothesis, we found that birds are habitat-selective, strongly preferring forests and avoiding human-modified landscapes (infrastructure and agricultural fields) during this early life-history stage. We established a relatively small ranging area inhabited by eagles and a low-mobility pattern with a gradual increase in movements that is highly individual-specific. In general, forests occupied the largest share of the home range of eagles, ranging from 0.38% to 87.45%, with a mean value of 49.47% ± 26.57. The duration of the post-fledging dependence period and the size of the ranging area were constrained by the onset of first migration, coinciding with the beginning of birds’ independence. The home range overlap of eagles varied from 56.35% to 100%, with an average value of 87.94%. The high similarity among ranging areas identified in this study emphasizes the importance and consistency of environmental conditions, such as habitat features, compared to others that would vary yearly. The key aspects (spatial and temporal) of the post-fledging dependence pattern, identified by our study, are important for species conservation and must be integrated into future landscape planning. Our results also contribute to a better understanding of the complex factors shaping raptors’ space-use pattern in this key, a poorly studied life-history trait of raptors, thus enhancing knowledge for similar species of conservation concern. Full article

Background: Accurate early identification of sepsis remains a major clinical challenge due to its heterogeneous presentation and overlap of clinical signs with the non-infectious systemic inflammatory response syndrome (SIRS). Timely differentiation is crucial for improving patient outcomes, meeting sepsis bundle requirements and reducing inappropriate antimicrobial use. We hypothesized that clinical–laboratory data available within the first three hours of patient presentation could be used to identify patients with sepsis at a clinically useful level of diagnostic accuracy, in lieu of traditional microbiology results which would not become available until at least 12–24 h. Data from two independent studies were used to quantify the diagnostic value of demographic, vital, clinical–laboratory, and microbiological data available at three time points for distinguishing retrospectively diagnosed critically ill patients with either sepsis or non-infectious SIRS. A particular focus of this work was an assessment of the utility of SeptiCyte RAPID (Immunexpress Inc., Seattle, WA, USA) as an aid to sepsis diagnosis, producing actionable data within one hour. Methods: Data from two independent study cohorts were analyzed. The “510(k) cohort” consisted of 419 adult patients in intensive care (ICU) (MARS, VENUS, and NEPTUNE studies). The “Andalusian cohort” consisted of 353 ICU patients from the PANGEA study. Logistic regression models, selected by a greedy search algorithm and validated by repeated cross-validation, were used to determine the contributions of different variables to diagnostic accuracy. Diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC). Results: For the 510(k) cohort, a baseline AUC of 0.69–0.73 was observed using five to seven vital and demographic variables assessed immediately upon presentation (time T1). The addition of clinical–laboratory variables, in particular SeptiCyte RAPID, within one to three hours post-presentation (time T2) increased the AUC to 0.85–0.86. Finally, the addition of microbiological data 12–24 h post-presentation (time T3) further improved the AUC to 0.90–0.91. Similar results were obtained for the Andalusian cohort. AUC values at the three time points were as follows: At time T1, AUC = 0.67 based solely on vital signs and demographics; at time T2, AUC = 0.87 based on vitals + demographics + SeptiCyte RAPID ± other clinical–laboratory data; at time T3, AUC = 0.93 based on vitals + demographics + SeptiCyte RAPID ± other clinical–laboratory data + microbiology results. For both cohorts, the most significant variables included temperature, mean arterial pressure, respiratory rate, suspected infection site, SeptiCyte RAPID, procalcitonin, confirmed bacterial infection and positive blood culture confirmation. In summary, the AUC for diagnosing sepsis rose progressively from T1 (510(k) 0.69–0.73; Andalusian 0.67) to T2 (510(k) 0.85–0.86; Andalusian 0.87) with the addition of SeptiCyte RAPID to T3 (510(k) 0.90–0.91; Andalusian 0.93) as more clinical information became available over time. Conclusions: The accuracy of identification of sepsis increases markedly as demographics and vital signs are supplemented with clinical–laboratory information, and ultimately with microbiological culture results. The AUC improves in the shortest time within the first three hours when laboratory data, and particularly SeptiCyte RAPID results, become available. Integrating rapid host response testing with SeptiCyte RAPID into time-based diagnostic frameworks may enhance early sepsis recognition, improve antimicrobial stewardship, and support guideline-driven clinical decisions. Full article

Background/Objectives: C-reactive protein point-of-care tests (CRP POCTs) have become a useful tool in reducing inappropriate prescribing of antibiotics in the management of respiratory tract infections (RTIs). This review examined the barriers and enablers of CRP POCT implementation in primary care using the Reach, Effectiveness, Adoption, Implementation and Maintenance (RE-AIM) framework. Methods: A search was conducted in six electronic databases (PubMed, Scopus, CINAHL (EBSCOhost), Medline (EBSCOhost), ProQuest and CENTRAL) for studies up to December 2025 on CRP POCT implementation for RTIs in primary care. Eligible studies included quantitative randomised controlled trials (RCTs), qualitative studies, cost-effectiveness studies, mixed-methods and observational studies. Only English-language studies were included. Results: The review included 35 studies. CRP POCT was generally found to be an effective and acceptable tool due to reductions in antibiotic prescribing, playing a role in supporting clinical decision-making and patient communication. However, widespread adoption and usage were inconsistent across studies. Further, qualitative findings raised operational and financial constraints as key barriers to sustained implementation. Reporting of RE-AIM domains varied across study type. Notable gaps were identified in reporting of the maintenance domain along with population representativeness, non-participation, and device uptake. Of the 35 studies, 13 included ‘operational’ and/or ‘financial constraints’ as identified themes or concerns about wider implementation. Conclusions: Although CRP POCT has routinely been found to be effective, a wider comprehensive assessment of implementation is restricted due to gaps in reporting. Key barriers to sustained and scalable global implementation of CRP POCT in primary care are predominantly financial and operational. Full article

Sexually transmitted infections (STIs) remain a public health challenge, with rising incidence rates and significant loss to follow-up in traditional testing models. Point-of-care (POC) testing promises same-day diagnosis and treatment, potentially transforming STI management. We conducted a narrative review with perspective elements of commercially available POC and near-POC tests for STIs, identifying tests through regulatory and product-specific sources including the Food and Drug Administration (FDA), World Health Organization (WHO) prequalification list, Australia’s Therapeutic Goods Administration (TGA), China’s National Medical Products Administration (NMPA), publicly available European regulatory and manufacturer sources for CE-marked in vitro diagnostic devices under the EU In Vitro Diagnostic Regulation framework, and the published literature. Several nucleic acid amplification test (NAAT)-based platforms now deliver results rapidly with excellent sensitivity and specificity for common bacterial and protozoal STIs, including Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis. For viral STIs, POC testing is most mature for human immunodeficiency virus (HIV), with numerous approved rapid antibody tests, although viral load and resistance testing remain laboratory-based. Most NAAT platforms require dedicated instruments, specialized training, and significant infrastructure. At-home testing options are emerging but face challenges with sensitivity, public health surveillance, and regulatory oversight. In conclusion, POC testing for STIs is advancing but not yet fully realized, and true POC tests (those usable at the bedside without laboratory support) remain limited. While rapid NAAT platforms represent significant progress over traditional laboratory-based testing, barriers to true POC implementation persist. Future developments in antimicrobial resistance detection, multiplex testing, instrument-free platforms, and integration of at-home testing with public health surveillance will be critical to achieving broader STI testing and control. Full article