Point of care testing

How to Realize the Benefits of Point-of-Care Testing at the General Practice: A Comparison of Four High-Income Countries

BACKGROUND

In some countries, such as the Netherlands and Norway, point-of-care testing (POCT) is more widely implemented in general practice compared to countries such as England and Australia. To comprehend what is necessary to realize the benefits of POCT, regarding its integration in primary care, it would be beneficial to have an overview of the structure of healthcare operations and the transactions between stakeholders (also referred to as value networks). The aim of this paper is to identify the current value networks in place applying to POCT implementation at general practices in England, Australia, Norway and the Netherlands and to compare these networks in terms of seven previously published factors that support the successful implementation, sustainability and scale-up of innovations.

METHODS

The value networks were described based on formal guidelines and standards published by the respective governments, organizational bodies and affiliates. The value network of each country was validated by at least two relevant stakeholders from the respective country.

RESULTS

The analysis revealed that the biggest challenge for countries with low POCT uptake was the lack of effective communication between the several organizations involved with POCT as well as the high workload for general practitioners (GPs) aiming to implement POCT. It is observed that countries with a single national authority responsible for POCT have a better uptake as they can govern the task of POCT roll-out and management and reduce the workload for GPs by assisting with set-up, quality control, training and support.

CONCLUSION

Setting up a single national authority may be an effective step towards realizing the full benefits of POCT. Although it is possible for day-to-day operations to fall under the responsibility of the GP, this is only feasible if support and guidance are readily available to ensure that the workload associated with POCT is limited and as low as possible.

CRISPR-Cas12a-Assisted Multicolor Biosensor for Semiquantitative Point-of-Use Testing of the Nopaline Synthase Terminator in Genetically Modified Crops by Unaided Eyes

Existing methods of detecting foreign genes and their expression products from genetically modified organisms (GMOs) suffer from the requirement of professional equipment and skillful operators. The same problem stays for the CRISPR-Cas12a system, although it has been emerging as a powerful tool for nucleic acid detection due to its remarkable sensitivity and specificity. In this report, a portable platform for the visible detection of GMOs based on CRISPR-Cas12a was established, which relies on a color change of gold nanorods (GNRs) caused by the invertase-glucose oxidase cascade reaction and the Fenton reaction for signal readout. A nopaline synthase (NOS) terminator was employed as a model target commonly existing in foreign genes of GMOs. With the help of recombinase-aided amplification, this platform achieved comparable sensitivity of DNA targets (1 aM) with that of a fluorescence reporting assay. As low as 0.1 wt % genetically modified (GM) content in Bt-11 maize was visually observed by unaided eyes, and the semiquantitation of GM ingredients can be obtained within the range of 0.1 to 40 wt % through the absorption measurement of GNRs. Furthermore, five real samples were tested by our method, and the results indicated that the GM ingredient percentages of GMO samples were 2.24 and 24.08 wt %, respectively, while the other three samples were GMO-free. With the advantages of a simple procedure, no need for large or professional instruments, high sensitivity, and selectivity, this platform is expected to provide reasonable technical support for the safe supervision of GMOs.

Oliveira O, Mejía-Salazar JR. Chiral Plasmonics and Their Potential for Point-of-Care Biosensing Applications

There has been growing interest in using strong field enhancement and light localization in plasmonic nanostructures to control the polarization properties of light. Various experimental techniques are now used to fabricate twisted metallic nanoparticles and metasurfaces, where strongly enhanced chiral near-fields are used to intensify circular dichroism (CD) signals. In this review, state-of-the-art strategies to develop such chiral plasmonic nanoparticles and metasurfaces are summarized, with emphasis on the most recent trends for the design and development of functionalizable surfaces. The major objective is to perform enantiomer selection which is relevant in pharmaceutical applications and for biosensing. Enhanced sensing capabilities are key for the design and manufacture of lab-on-a-chip devices, commonly named point-of-care biosensing devices, which are promising for next-generation healthcare systems.

Staining Traditional Colloidal Gold Test Strips with Pt Nanoshell Enables Quantitative Point-of-Care Testing with Simple and Portable Pressure Meter Readout

Traditional immunochromatographic test strips based on colloidal gold are effective devices for portable and low-cost point-of-care (POC) testing. Nevertheless, they still suffer from the limitation of qualitative or semiquantitative tests via naked-eye detection. Replacement of gold with other signal entities, such as magnetic particles or fluorescent particles, requires professional instrumentation to obtain quantitative results. A pressure-based assay with platinum nanoparticles (PtNPs) can provide quantitative results using a portable pressure meter but is also hampered by the long-term instability of PtNPs. Consequently, we developed a Pt-staining method based on test strips to create platinum nanoshells on the surface of colloidal gold. This method not only preserves the original advantages of colloidal gold with easy synthesis and decoration but also introduces PtNPs with excellent catalytic activity as signal labels to achieve sensitive quantitative detection. Myoglobin was tested as a model target, and the limit of detection was 5.47 ng/mL in 20% diluted serum samples, which satisfies the requirements for clinical monitoring of acute myocardial infarction. In addition, the two most common colloidal gold strips available in the marketplace were applied to demonstrate the compatibility of Pt-staining. Taking advantage of low cost, user-friendliness, compatibility, simplicity, and stability, colloidal gold test strips with Pt-staining are expected to satisfy the need for quantitative POC testing of biomarkers, especially in resource-limited regions.