Home Testing Research Articles

A novel internet sampling for HIV surveillance: feasibility of self-sampling and preparation of DBS for delivery detection of HIV total nucleic acid and complementarity to sentinel surveillance

BackgroundTo propose a new mode of HIV test and surveillance among population of men who have sex with men (MSM): Internet-based Self-sampling at home plus Laboratory testing of HIV total nucleic acid (TNA) in dried blood spot (DBS) (ISL of DBS TNA). Feasibility of ISL of DBS TNA was studied. Characteristics of the new mode and that of conventional surveillance mode at HIV voluntary counseling and testing clinic (VCT) were compared.MethodsA non-governmental organization (NGO) published the recruitment information on the WeChat public account. MSM filled in the questionnaire online, applied for self-sampling service package, and mailed the self made DBS to professional laboratory. The laboratory performed HIV TNA test and submitted the test results to online platform. Participants queried test results online with their unique ID. Center for Disease Control and Prevention (CDC) followed up participants with positive nucleic acid results using IDs and contact information. Rates were compared by using the Chi-Square test or Fisher's exact test.ResultsFour hundred twenty-three questionnaires were completed. 423 self-sampling service packages were sent out and 340 DBSs were returned to professional laboratory within one month with qualified rate of sampling as high as 95.0% (323/340). Seven samples were found to be TNA positive. Comparing ISL of DBS TNA with sentinel surveillance, it was found that there was a significant difference in the composition ratio of the two modes of surveillance population (P < 0.05). HIV prevalence of ISL of DBS as 2.17% was significantly lower than sentinel site as 8.96% (χ2 = 14.953, P = 0.000 < 0.05).ConclusionsISL of DBS TNA proposed is feasible and has a high self-sampling qualification rate, good confidentiality. It is an effective supplement to routine sentinel surveillance and has important promotion value.

Diagnosis of Paediatric Obstructive Sleep-Disordered Breathing beyond Polysomnography.

Obstructive sleep-disordered breathing (SDB) has significant impacts on health, and therefore, a timely and accurate diagnosis is crucial for effective management and intervention. This narrative review provides an overview of the current approaches utilised in the diagnosis of SDB in children. Diagnostic methods for SDB in children involve a combination of clinical assessment, medical history evaluation, questionnaires, and objective measurements. Polysomnography (PSG) is the diagnostic gold standard. It records activity of brain and tibial and submental muscles, heart rhythm, eye movements, oximetry, oronasal airflow, abdominal and chest movements, body position. Despite its accuracy, it is a time-consuming and expensive tool. Respiratory polygraphy instead monitors cardiorespiratory function without simultaneously assessing sleep and wakefulness; it is more affordable than PSG, but few paediatric studies compare these techniques and there is optional recommendation in children. Nocturnal oximetry is a simple and accessible exam that has high predictive value only for children at high risk. The daytime nap PSG, despite the advantage of shorter duration and lower costs, is not accurate for predicting SDB. Few paediatric data support the use of home testing during sleep. Finally, laboratory biomarkers and radiological findings are potentially useful hallmarks of SDB, but further investigations are needed to standardise their use in clinical practice.

Impact of the physicochemical parameters on the sensory characterization of Brazilian coffee by the CATA method

This research aims to evaluate the sensory description of arabica and canephora coffee by consumers, identify how and canephora coffee by consumers, and identify how physicochemical variables affect sensory perception. Three Brazilian coffees (two arabica and one canephora) were determined sensorial attributes by the Check-All-That-Apply (CATA) method with 190 consumers in a home test, and physicochemical (pH and caffeine content) and chromatic parameters. The results showed that visual perception, brightness, and orange coloration are the main means used to distinguish arabica coffee from commercial coffee. In addition, the perception of sweeter aromas (toffee, vanilla, and caramel spread), chocolate with greater intensity, and the less intense bitterness taste were important typicality markers to differentiate arabica coffee (cv. Typica). The analysis of the correlations between caffeine and bitterness, sweetness, and acidity demonstrates the consumer's ability to perceive basic tastes in the different coffee samples. The chromatic parameters obtained significant correlations with visual, olfactory, and gustatory attributes. This study indicated the consumer's ability to establish typical traits for Arabica coffee depending on the place of cultivation. In addition, consumers perceive the influence of physicochemical variables on sensory attributes, highlighting the need for quality in an increasingly demanding and globalized market.

Relationship between Consumers' Perceptions about Goat Kid Meat and Meat Sensory Appraisal.

The goat meat preferred by consumers in Spain comes from suckling goat kids, slaughtered at a live weight of 8-10 kg. However, consumption of this meat is very uncommon, so it is necessary to show its value. To achieve this, we planned to investigate consumers' perceptions about goat kid meat and to study whether their perceptions are related to their sensory appraisal of the meat, measured by the mean of the consumers' home tests. The experiment was conducted with 30 volunteer families (from two cities with different consumption patterns), who were surveyed regarding their sociodemographic parameters, purchasing and eating habits, and the importance of the meat's attributes. As a result, four clusters were obtained, which were labeled "negative," "idealistic," "positive," and "concerned about fat content". The parameters of the animal production system were valued differently by the clusters. Meat tenderness, taste, and amount of fat were considered very decisive factors by most respondents. When the goat kid meat was valued, tenderness was considered more important than taste among older people ("negative" cluster), whereas there was not so much difference between the appraisal of all parameters for the other three clusters. We conclude that it is necessary to improve the information received by consumers about goat production systems and meat quality parameters. There is certainly potential for creating new markets, especially targeted toward young consumers and considering specific strategies for the different groups of consumers, depending on the region and habits of consumption.

Implementing and Maintaining a SARS-CoV-2 Exposure Notification Application for Mobile Phones: The Finnish Experience.

Exposure notification applications (ENAs) or digital proximity tracing apps were used in several countries during the COVID-19 pandemic. In this viewpoint, we share our experience of implementing and running the Finnish ENA (Koronavilkku), one of the national ENAs with the highest proportion of users during the pandemic. With the aim of strengthening public trust and increasing app uptake, there was a strong prioritization of privacy and data security for the end user throughout the ENA development. This, in turn, limited the use of the app as a tool for health care professionals and deeper insight into its potential effectiveness. The ENA was designed to supplement conventional contact tracing, rather than replace it, and to serve as an early warning system and a trigger for action for the user in case of potential exposure. The predefined target of 40% uptake in the population was achieved within 3 months of the ENA launch. We consider easy-to-understand information produced together with communication experts crucial during the changing pandemic situation. This information educated people about the app as one component in mitigating the pandemic. As the pandemic and its mitigation evolved, the ENA also needed adapting and updating. A few months after its launch, Finland joined European interoperability, which allowed the ENA to share information with ENAs of other countries. We added automatic token issuing to the ENA as of mid-2021. If added earlier and more comprehensively, automatization could have more effectively saved resources in health care services and prevented overburdening contact tracing teams, while also notifying potentially exposed individuals quicker and more reliably. In the spring of 2021, the number of active apps started to gradually decline. Quarantine and testing practices for asymptomatic vaccinated individuals following exposure to the virus were eased and home tests became more common, eventually replacing laboratory testing for much of the population. Taken together, this led to decreased token issuance, which weakened the potential public health usefulness of the app. A self-service option for token issuance would likely have prolonged the lifespan of the app. The ENA was discontinued in mid-2022. Regularly conducted surveys would have helped gain timely knowledge on the use and effectiveness of the app for better responding to the changing needs during the pandemic.

National Surveillance of Home-Based HIV Testing Among Australian Gay and Bisexual Men, 2018–2020: Uptake After Commercial Availability of HIV Self-Tests

HIV self-testing allows people to collect samples and test themselves at home, addressing known barriers to facility-based testing. We aimed to measure the uptake of home HIV testing among Australian gay and bisexual men (GBM). Using national cross-sectional data from the Australian Gay Community Periodic Surveys, we assessed trends in home HIV testing among non-HIV positive GBM between 2018 and 2020. Overall, the use of home HIV testing was low, but slightly increased during 2018–2020 (from 0.3 to 0.8%, RR = 1.54, 95%CI = 1.23–1.92, p-trend < 0.001). Testing at home was more likely among non-HIV-positive GBM who were born overseas and recently arrived in Australia, at higher risk of HIV, and infrequent HIV testers. Given the greater use of home testing by men at higher risk of HIV, recent migrants and infrequent testers, all priority groups in Australia’s HIV epidemic, we recommend increasing access to HIV self-testing to enhance uptake in these and other groups of GBM.

HIV prevention and the impact of It’s a Sin in Scotland

HIV prevention services across the United Kingdom received unprecedented requests for home testing kits following the airing of Russell T. Davies’s television series It’s a Sin (IAS) in January and February 2021. Professionals suggested a link between IAS’s retelling of AIDS crisis histories and people’s fears of ongoing HIV transmission, thus leading to increased online searches about HIV/AIDS. Little has been written about this impact of IAS on HIV health promotion practices specifically. Thus, in this article, I analyse a series of interviews with HIV health promoters in Scotland to detail how IAS has influenced HIV intervention techniques and health promotion strategies. I demonstrate how IAS provoked local and national dialogues about the contemporary context of HIV/AIDS in Scotland. I argue that it enabled conversations about the need for new media resources that accurately represent the specific and localized histories of HIV/AIDS. More directly, IAS in small part illuminated differences in intervention strategies between England and Scotland. Hence, it foregrounded the need for re-distributed institutional and material resources to streamline a Scottish agenda for ‘ending HIV’ by 2030.

Children’s visual acuity tests without professional supervision: a prospective repeated measures study

BackgroundHome visual acuity tests could ease pressure on ophthalmic services by facilitating remote review of patients. Home tests may have further utility in giving service users frequent updates of vision outcomes during therapy, identifying vision problems in an asymptomatic population, and engaging stakeholders in therapy.MethodsChildren attending outpatient clinics had visual acuity measured 3 times at the same appointment: Once by a registered orthoptist per clinical protocols, once by an orthoptist using a tablet-based visual acuity test (iSight Test Pro, Kay Pictures), and once by an unsupervised parent/carer using the tablet-based test.ResultsIn total, 42 children were recruited to the study. The mean age was 5.6 years (range 3.3 to 9.3 years). Median and interquartile ranges (IQR) for clinical standard, orthoptic-led and parent/carer-led iSight Test Pro visual acuity measurements were 0.155 (0.18 IQR), 0.180 (0.26 IQR), and 0.300 (0.33 IQR) logMAR respectively. The iSight Test Pro in the hands of parents/carers was significantly different from the standard of care measurements (P = 0.008). In the hands of orthoptists. There was no significant difference between orthoptists using the iSight Test Pro and standard of care (P = 0.289), nor between orthoptist iSight Test Pro and parents/carer iSight Test Pro measurements (P = 0.108).ConclusionThis technique of unsupervised visual acuity measures for children is not comparable to clinical measures and is unlikely to be valuable to clinical decision making. Future work should focus on improving the accuracy of the test through better training, equipment/software or supervision/support.

Smartphone-based point-of-care testing of the SARS-CoV-2: A systematic review

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus's worldwide pandemic has highlighted the urgent need for reliable, quick, and affordable diagnostic tests for comprehending and controlling the epidemic by tracking the world population. Given how crucial it is to monitor and manage the pandemic, researchers have recently concentrated on creating quick detection techniques. Although PCR is still the preferred clinical diagnostic test, there is a pressing need for substitutes that are sufficiently rapid and cost-effective to provide a diagnosis at the time of use. The creation of a quick and simple POC equipment is necessary for home testing. Our review's goal is to provide an overview of the many methods utilized to identify SARS-CoV 2 in various samples utilizing portable devices, as well as any potential applications for smartphones in epidemiological research and detection. The point of care (POC) employs a range of microfluidic biosensors based on smartphones, including molecular sensors, immunological biosensors, hybrid biosensors, and imaging biosensors. For example, a number of tools have been created for the diagnosis of COVID-19, based on various theories. Integrated portable devices can be created using loop-mediated isothermal amplification, which combines isothermal amplification methods with colorimetric detection. Electrochemical approaches have been regarded as a potential substitute for optical sensing techniques that utilize fluorescence for detection and as being more beneficial to the Minimizing and simplicity of the tools used for detection, together with techniques that can amplify DNA or RNA under constant temperature conditions, without the need for repeated heating and cooling cycles. Many research have used smartphones for virus detection and data visualization, making these techniques more user-friendly and broadly distributed throughout nations. Overall, our research provides a review of different novel, non-invasive, affordable, and efficient methods for identifying COVID-19 contagious infected people and halting the disease's transmission.

Antibody There? Mapping the Human Proteome with Mathias Uhlén

Antibody There? Mapping the Human Proteome with Mathias Uhlén

MINDER Smart home test bed site – embedding dementia research into primary health and social care. Wingfield, D. Daniels, S. Norman, C. Lai, H. Hassim, N. Nilforooshan, R. Barnarghi, P. Sharp, D

AbstractBackgroundDigitally enabled healthcare is becoming mainstream NHS (1) and adoption has been accelerated in response to the COVID‐19 pandemic (2) The UK Dementia Research Institute Care Research &amp; Technology Centre, established in 2019, explores the value of using technology in people’s homes to improve care and has developed a system (MINDER) using IOT/smart home technology and medical devices, integrating activity and health data for research purposes and generating health alerts to the mainstream provider via a clinical monitoring team. Initially launched in Surrey and Borders Partnership NHS Trust (n = 40); in April 2021, an additional research site was established within primary care in North West London.MethodWe collated data from both sites and describe an integrated delivery model for research within primary health and social care. Cohort description and case studies illustrate the challenges and benefits of conducting this research across urban and sub‐urban settings.ResultsOver 55 participants are currently enrolled on the study. 15 of these from primary care/general practice in the London Borough of Hammersmith and Fulham. Opportunities arising from this setting include leveraging the patient – provider (nurse/doctor/allied health professional/social care) relationship to introduce the study and recruit, and rapid escalation of any problems arising in a research context to the clinical/care teams responsible to delivering care (for example; potential urinary tract infections). Challenges to recruitment have included lack of specialist confirmation of dementia diagnosis in primary care records, lack of consistent engagement/availability of the required MINDER study partner as well as the impact of the COVID 19 pandemic limited face to face contact.ConclusionEarly data suggests that a complex dementia study can be embedded successfully in General Practice and leads to strengthening of relations with care giving bodies. This offers the opportunity for development and translation of new technologies within front line primary and social care, that can be fully evaluated within the real world context of service delivery.References 1)The NHS Long Term Plan (2019) gov.uk 2) Baird B, Maguire D. Understanding factors that enabled digital service change in general practice during the Covid‐19 pandemic. London: The King’s Fund. 2021 Feb.

Stratum Griseum Periventriculare-mediated Fear Emotion Regulates Motor Behavior in Pigeons

A pigeon robot is an ideal experimental animal for research in flying animal robots. The majority of current research publications have entailed electrical stimulation of the motor nuclei to regulate movement forcibly, and although a “virtual fear” behavior model has been proposed, the structure, location, and function of the nuclei that generate fear emotions remain obscure. Previous studies have shown that the Stratum Griseum Periventriculare (SGP) of pigeons is homologous to the mammalian periaqueductal gray (PAG), which plays an essential role in mammalian fear. To reveal the role of fear mediated by the SGP in behavioral regulation, we evaluated the structure and location of the SGP by histologic identification combined with magnetic resonance imaging, and analyzed the behavior of the SGP by electrical stimulation. Finally, the function of the SGP was verified with escape testing and homing experiments in an open field. Our results showed that the SGP is located in the pigeon midbrain and divided into two subregions, the dorsal part of the stratum griseum periventriculare (SGPd) and the ventral part of the stratum griseum periventriculare (SGPv) (the ranges were AP1.5–4.75 mm, ML1.75–6.75 mm, and DV2.2–7.1 mm), and that wired and wireless electrical stimulation freezing was the dominant behavior. In the escape test, SGP electrical stimulation caused the pigeons to flee to a safe place, while in the open-field homing test, electrical stimulation of the SGP induced evasive behavior in pigeons away from their original homing route. These results confirm that the SGP plays a crucial role in fear, and that electrical stimulation of this nucleus induces corresponding fear behaviors.

Detection of Carbamates and Nitrites with a Linear Transport Unit Connected to a Paper-Based Multiplexed Colorimetric Platform for Food Safety

The COVID-19 pandemic and its associated restrictions made the concept of home testing increasingly popular. Here, we designed a linear transport unit connected to a paper-based multiplexed colorimetric platform, which can be used to test for food safety and physiological status. The device is composed of a linear transport unit and a paper-based multiplexed colorimetric reaction unit. The linear transporting unit uses the capillary phenomenon to collect samples, and the multiplexed colorimetric reaction unit can be used to detect different targets using a hydrophilic area and wax as the hydrophobic barrier. A rapid and multiplexed naked-eye readout of the colorimetric response is achieved in a few minutes. In this study, we demonstrate that the device can be used to detect nitrite, pesticides, lactate, and glycogen. It is a convenient and cheap home self-testing device that can be applied to different situations. This device could lead to earlier screening and, consequently, earlier referrals for further confirmation and treatment.

Passive swab versus grab sampling for detection of SARS-CoV-2 markers in wastewater

Early detection of the COVID-19 virus, SARS-CoV-2, is key to mitigating the spread of new outbreaks. Data from individual testing is increasingly difficult to obtain as people conduct non-reported home tests, defer tests due to logistics or attitudes, or ignore testing altogether. Wastewater based epidemiology is an alternative method for surveilling a community while maintaining individual anonymity; however, a problem is that SARS-CoV-2 markers in wastewater vary throughout the day. Collecting grab samples at a single time may miss marker presence, while autosampling throughout a day is technically challenging and expensive. This study investigates a passive sampling method that would be expected to accumulate greater amounts of viral material from sewers over a period of time. Tampons were tested as passive swab sampling devices from which viral markers could be eluted with a Tween-20 surfactant wash. Six sewersheds in Detroit were sampled 16–22 times by paired swab (4 h immersion before retrieval) and grab methods over a five-month period and enumerated for N1 and N2 SARS-CoV-2 markers using ddPCR. Swabs detected SARS-CoV-2 markers significantly more frequently (P < 0.001) than grab samples, averaging two to three-fold more copies of SARS-CoV-2 markers than their paired grab samples (p < 0.0001) in the assayed volume (10 mL) of wastewater or swab eluate. No significant difference was observed in the recovery of a spiked-in control (Phi6), indicating that the improved sensitivity is not due to improvements in nucleic acid recovery or reduction of PCR inhibition. The outcomes of swab-based sampling varied significantly between sites, with swab samples providing the greatest improvements in counts for smaller sewersheds that otherwise tend to have greater variation in grab sample counts. Swab-sampling with tampons provides significant advantages in detection of SARS-CoV-2 wastewater markers and are expected to provide earlier detection of new outbreaks than grab samples, with consequent public health benefits.

Probiotic Therapy with Lactobacillus reuteri Rescues Social and Emotional Recognition Behavior in an Environmental Mouse Model of Autism

Introduction: Polybrominated diphenyl ethers (PBDEs) are neuroendocrine disrupting chemicals with adverse neurodevelopmental effects in children. Our group has previously shown that PBDEs produce autistic-like traits in developmentally exposed mice offspring (Kozlova et al. 2022 Arch Tox; PMID: 34687351). Our pilot data suggests that PBDEs reduce hypothalamic oxytocin expression. Moreover, PBDEs are well established disruptors of thyroid hormones. Lactobacillus reuteri (LR) is a beneficial probiotic that can increase oxytocin and thyroid hormones in other ASD mouse models. Therefore, we hypothesized that LR can restore PBDE-induced deficits in social behavior. Methods: C57BL/6N dams were dosed with a commercial mixture of PBDE congeners, DE-71, at 0.1 mg/kg/d (DE-71), or corn oil vehicle control (VEH/CON) for 10 wk (preconception: 4 wk; gestation: 3 wk; lactation: 3 wk). Dams were gavaged with L. reuteri (LR) ATCC 6475 (gift of Biogaia, Sweeden) at 10 8 CFU/mL. Cohort 1 pups (C1-LR) received LR via dam until weaning (PND 21). Cohort 2 pups (C2-LR) continued to receive gavage of LR post-weaning, daily, through 6 mo of age. Results: PCR analysis showed increased gene expression of fecal LR 6475 in feces collected from LR offspring and dams confirming efficacy of maternal LR supplementation. Compared to VEH/CON neither DE-71 nor LR disrupted normal maternal behavior. In offspring, DE-71 produced deficient short- (SRT, 30 min retention) and long-term social recognition memory (SRMT, 24 h retention) in adult females (short- and long-term) and adult males (short-term). LR normalized these deficits. The social recognition deficit was not present at PND 11 as measured on a maternal attachment homing test. On an emotional recognition test DE-71 exposed male and female offspring did not prefer investigation of stimulus mice subjected to 15 min restraint stress vs neutral conditions (normalized with LR). In a marble burying test, compared to VEH/CON, DE-71 exposed offspring showed abnormally elevated scores, which were normalized by LR treatment only in females. Developmental benchmarks that are likely affected by the TH-disruptive effects of DE-71 showed complex interactions between DE-71 and LR. LR normalized delayed (vs VEH/CON) incisor eruption in DE-71 females and improved latency of righting reflex in DE-71 males. LR normalized DE-71-induced hyperactivity on an open field test in females. Ongoing studies are focused on exploring possible mechanisms underlying the normalization provided by LR. However, our early data suggest a potential role of 1) OXT confirmed by increased plasma OXT in DE-71 male (C1-LR) mice and normalized with LR, and 2) maternal THs since LR supplementation elevated plasma T4 in DE-71 pregnant dams. Conclusions: These results suggest that maternal LR treatment during developmental PBDE exposure provides normalization of autistic-like features in a sex-dependent manner. This work is supported by a Danone North America Gut Microbiome, Yogurt and Probiotics Fellowship Grant and a University of California President's Pre-Professoriate Fellowship to E.V.K. This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Use of COVIDTests.gov At-Home Test Kits Among Adults in a National Household Probability Sample — United States, 2022

At-home rapid antigen COVID-19 tests were first authorized by the Food and Drug Administration in late 2020 (1-3). In January 2022, the White House launched COVIDTests.gov, which made all U.S. households eligible to receive free-to-the-user at-home test kits distributed by the U.S. Postal Service (2). By May 2022, more than 70 million test kit packages had been shipped to households across the United States (2); however, how these kits were used, and which groups were using them, has not been reported. Data from a national probability survey of U.S. households (COVIDVu), collected during April-May 2022, were used to evaluate awareness about and use of these test kits (4). Most respondent households (93.8%) were aware of the program, and more than one half (59.9%) had ordered kits. Among persons who received testing for COVID-19 during the preceding 6 months, 38.3% used a COVIDTests.gov kit. Among kit users, 95.5% rated the experience as acceptable, and 23.6% reported being unlikely to have tested without the COVIDTests.gov program. Use of COVIDTests.gov kits was similar among racial and ethnic groups (42.1% non-Hispanic Black or African American [Black]; 41.5% Hispanic or Latino [Hispanic]; 34.8% non-Hispanic White [White]; and 53.7% non-Hispanic other races [other races]). Use of other home COVID-19 tests differed by race and ethnicity (11.8% Black, 44.4% Hispanic, 45.8% White, 43.8% other races). Compared with White persons, Black persons were 72% less likely to use other home test kits (adjusted relative risk [aRR]=0.28; 95% CI=0.16-0.50). Provision of tests through this well-publicized program likely improved use of COVID-19 home testing and health equity in the United States, particularly among Black persons. National programs to address availability and accessibility of critical health services in a pandemic response have substantial health value.

Snapshots of ID Week 2022

Snapshots of ID Week 2022

Evaluation of Machine Learning to Detect Influenza Using Wearable Sensor Data and Patient-Reported Symptoms: Cohort Study.

Machine learning offers quantitative pattern recognition analysis of wearable device data and has the potential to detect illness onset and monitor influenza-like illness (ILI) in patients who are infected. This study aims to evaluate the ability of machine-learning algorithms to distinguish between participants who are influenza positive and influenza negative in a cohort of symptomatic patients with ILI using wearable sensor (activity) data and self-reported symptom data during the latent and early symptomatic periods of ILI. This prospective observational cohort study used the extreme gradient boosting (XGBoost) classifier to determine whether a participant was influenza positive or negative based on 3 models using symptom-only data, activity-only data, and combined symptom and activity data. Data were collected from the Home Testing of Respiratory Illness (HTRI) study and FluStudy2020, both conducted between December 2019 and October 2020. The model was developed using the FluStudy2020 data and tested on the HTRI data. Analyses included participants in these studies with an at-home influenza diagnostic test result. Fitbit (Google LLC) devices were used to measure participants' steps, heart rate, and sleep parameters. Participants detailed their ILI symptoms, health care-seeking behaviors, and quality of life. Model performance was assessed by area under the curve (AUC), balanced accuracy, recall (sensitivity), specificity, precision (positive predictive value), negative predictive value, and weighted harmonic mean of precision and recall (F2) score. An influenza diagnostic test result was available for 953 and 925 participants in HTRI and FluStudy2020, respectively, of whom 848 (89%) and 840 (90.8%) had activity data. For the training and validation sets, the highest performing model was trained on the combined symptom and activity data (training AUC=0.77; validation AUC=0.74) versus symptom-only (training AUC=0.73; validation AUC=0.72) and activity-only (training AUC=0.68; validation AUC=0.65) data. For the FluStudy2020 test set, the performance of the model trained on combined symptom and activity data was closely aligned with that of the symptom-only model (combined symptom and activity test AUC=0.74; symptom-only test AUC=0.74). These results were validated using independent HTRI data (combined symptom and activity evaluation AUC=0.75; symptom-only evaluation AUC=0.74). The top features guiding influenza detection were cough; mean resting heart rate during main sleep; fever; total minutes in bed for the combined model; and fever, cough, and sore throat for the symptom-only model. Machine-learning algorithms had moderate accuracy in detecting influenza, suggesting that previous findings from research-grade sensors tested in highly controlled experimental settings may not easily translate to scalable commercial-grade sensors. In the future, more advanced wearable sensors may improve their performance in the early detection and discrimination of viral respiratory infections.

Abstract 3334: Epigenetic immune cell markers for CLL

Abstract CLL is a rare hematological cancer and is classified as low-malignancy non-Hodgkin lymphoma. While rare, it is the most frequent form of leukemia in Europe and US accounting for approximately a quarter of all leukemias. As it is a slowly growing tumor, its 5-year survival rate is high compared to faster developing B cell tumors and survival has further improved since introduction of Anti-CD20 Antibody therapies. However, overall the 5-year survival of rare cancers (49%) is significantly lower than for their common counterparts (63%), even though hematological cancers improved outcome over the last years. Due to the currently very late and often incidental diagnosis, some cases turn into aggressively progressing cancers prior to treatment and with concomitant poor outcome. Therefore, diagnosis of CLL and other B cell leukemias remains a challenge. To further improve outcome of CLL and other lymphatic leukemias earlier diagnosis is important. To this end, simple home testing could broaden access to diagnostic tools, but no current method would provide adequate remote initial screening of lymphatic leukemia in populations at risk, such as persons older than 65 years. Epigenetic qPCR has been shown to detect and quantify immune cell populations efficiently from liquid and dried blood samples (DBS). This system is based on specifically unmethylated regulatory elements in gene loci associated with certain cell types. These unique methylation patterns allow specific quantification of cells of interest via qPCR. Different epigenetic qPCR systems were developed for total B cells, naïve and memory B cells as well as IgM producing B cells. While these gene loci are fully unmethylated in the respective target cells, they are fully methylated in all relevant control cell types. The cell type specificity of these markers was shown using bisulfite specific sequencing using purified cells from healthy donors. Here, we investigated blood samples from healthy donors (n = 112) as well as patients at the time of their initial CLL diagnosis. The mean total B cell count of healthy donors at 5.7% was clearly lower than the 60.4% obtained for CLL patients. Similarly drastic differences were observed for naïve B (2.3% normal vs. 20.8% CLL) and IgM (3.3% vs. 49.5%) as well as memory B cells (1.6% vs. 32.6%). All differences were statistically significant. To investigate if these mean differences may also lead to differential (and potentially early) diagnosis, we designed receiver operator characteristics and contingency tables, both indicating near perfect segregation between CLL patients and healthy donors in Ig M, memory and all B cells. Our data indicate applicability of epigenetic immune cell counting as easy, potentially DBS- and home-based approach to test increase of immune cells in people potentially at risk of hematological cancers. Citation Format: Janine Jung, Jeannette Werner, Konstantin Schildknecht, Janika Schulze, Steffi Walter, Christoph Sachsenmaier, Deborah Phippard, Barbara Seliger, Claudia Wickenhauser, Sven Olek. Epigenetic immune cell markers for CLL [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3334.

Using functional near-infrared spectroscopy to study the early developing brain: future directions and new challenges.

Functional near-infrared spectroscopy (fNIRS) is a frequently used neuroimaging tool to explore the developing brain, particularly in infancy, with studies spanning from birth to toddlerhood (0 to 2 years). We provide an overview of the challenges and opportunities that the developmental fNIRS field faces, after almost 25 years of research. We discuss the most recent advances in fNIRS brain imaging with infants and outlines the trends and perspectives that will likely influence progress in the field in the near future. We discuss recent progress and future challenges in various areas and applications of developmental fNIRS from methodological and technological innovations to data processing and statistical approaches. The major trends identified include uses of fNIRS "in the wild," such as global health contexts, home and community testing, and hyperscanning; advances in hardware, such as wearable technology; assessment of individual variation and developmental trajectories particularly while embedded in studies examining other environmental, health, and context specific factors and longitudinal designs; statistical advances including resting-state network and connectivity, machine learning and reproducibility, and collaborative studies. Standardization and larger studies have been, and will likely continue to be, a major goal in the field, and new data analysis techniques, statistical methods, and collaborative cross-site projects are emerging.