Laboratory-based Tests Research Articles

Review and Development of Best Practices for Toxicity Tests with Dreissenid Mussels.

Since their introduction to North America in the 1980s, research to develop effective control tools for invasive mussels (Dreissena polymorpha and D. rostriformis bugensis) has been ongoing across various research institutions using a range of testing methods. Inconsistencies in experimental methods and reporting present challenges for comparing data, repeating experiments, and applying results. The Invasive Mussel Collaborative established the Toxicity Testing Work Group (TTWG) in 2019 to identify "best practices" and guide development of a standard framework for dreissenid mussel toxicity testing protocols. We reviewed the literature related to laboratory-based dreissenid mussel toxicity tests and determined the degree to which standard guidelines have been used and their applicability to dreissenid mussel testing. We extracted detailed methodology from 99 studies from the peer-reviewed and gray literature and conducted a separate analysis for studies using presettlement and postsettlement mussels. We identified specific components of methods and approaches that could be refined or standardized for dreissenid mussels. These components included species identification, collection methods, size/age class distinction, maintenance practices, testing criteria, sample size, response measures, reporting parameters, exposure methods, and mortality criteria. We consulted experts in the field of aquatic toxicology and dreissenid mussel biology on our proposed. The final recommendations contained in the present review are based on published standard guidelines, methods reported in the published and gray literature, and the expertise of TTWG members and an external panel. In addition, our review identifies research needs for dreissenid mussel testing including improved methods for early-life stage testing, comparative data on life stages and between dreissenid mussel species, inclusion of a reference toxicant, and additional testing of nontarget species (i.e., other aquatic organisms). Environ Toxicol Chem 2023;42:1649-1666. © 2023 His Majesty the King in Right of Canada. Environmental Toxicology and Chemistry published by Wiley Periodicals LLC on behalf of SETAC. Reproduced with the permission of the Minister of Environment and Climate Change Canada. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.

Development of a dynamic ice penetration model for runway de-icing products through performance experimental characterization

During winter, the clear runway concept is crucial to airports for maintaining passenger and employee safety. Research can optimize de-icing product application rates, thereby reducing costs and environmental impact. Currently, three aerospace standards exist for evaluating the performance of runway de-icing products. These comparative tests—ice melting, ice undercutting, and ice penetration tests—are carried out jointly in a systematic way and indicate whether a runway de-icing product is effective in actively reducing the presence of ice. Here we present a numerical model for the ice penetration method, for fluid runway de-icing product, with the goal of deepening the knowledge in this field. We apply a series of laboratory-based tests to measure the performance of runway de-icing products, and develop a new model to analyze the behavior of each product. The principal observation is that the product is more effective at 1 min and effectiveness decreases following an inverse logarithmic curve trend to 30 min. Through modeling, we observe that the dominant mode of heat transfer is natural laminar convection, and the model predicts a uniform melt length for the entire tube section. Thus, simplified ice penetration modeling using AS6211 can acceptably predict the rate of ice penetration as a function of time (mm/min), with the modeling confirmed by our experimental results. The future application of our simplified model to other existing de-icing fluid characterization test methods could identify the effects of diluted or undiluted solid runway de-icing products on ice penetration rates and ultimately on spreading rates.

Rapid diagnostic testing for syphilis in Arctic communities (the STAR study): a multisite prospective field diagnostic accuracy study in an intended-use setting

ObjectivesWe evaluated the field diagnostic accuracy of a syphilis rapid test (RDT), using serum and whole blood by non-laboratorians in two Canadian Arctic communities. MethodsWe implemented a multisite prospective field evaluation wherein patients were screened by an RDT containing treponemal and non-treponemal components (Chembio DPP® Syphilis Screen & Confirm) between January 2020 and December 2021. Venous whole blood and serum were collected for rapid testing and compared with laboratory-based serology reference testing using a reverse sequence algorithm of treponemal and rapid plasma reagin (RPR) testing. ResultsOverall, 135 whole blood and 139 serum specimens were collected from 161 participants during clinical encounters. Treponemal-RDT sensitivity against a treponemal-reference standard (38/161 confirmed cases) was similar for serum (78% [95% CI: 61–90%]) and whole blood (81% [95% CI: 63–93%]). In those with RPR titres ≥1:8 (i.e. suggestive of recent/active infection), sensitivity increased to 93% (95% CI: 77–99%) for serum and 92% (95% CI: 73–99%) for whole blood. Treponemal-RDT specificity was excellent (99% [95% CI: 95–100%]) for both specimen types. Non-treponemal-RDT sensitivity against RPR was 94% (95% CI: 80–99%) for serum and 79% (95% CI: 60–92%) for whole blood. Sensitivity increased to 100% (95% CI: 88–100%) for serum and 92% (95% CI: 73–99%) for whole blood when RPR titres ≥1:8. RDT performance with whole blood was similar to that with serum. DiscussionNon-laboratorians using the RDT accurately identified individuals with infectious syphilis under real-world conditions in an intended-use setting at the point of care. Implementing the RDT can eliminate treatment delays and may enhance disease control.

Seroprevalence of SARS-CoV-2 antibodies and retrospective mortality in two African settings: Lubumbashi, Democratic Republic of the Congo and Abidjan, Côte d'Ivoire.

Although seroprevalence studies have demonstrated the wide circulation of SARS-COV-2 in African countries, the impact on population health in these settings is still poorly understood. Using representative samples of the general population, we evaluated retrospective mortality and seroprevalence of anti-SARS-CoV-2 antibodies in Lubumbashi and Abidjan. The studies included retrospective mortality surveys and nested anti-SARS-CoV-2 antibody prevalence surveys. In Lubumbashi the study took place during April-May 2021 and in Abidjan the survey was implemented in two phases: July-August 2021 and October-November 2021. Crude mortality rates were stratified between pre-pandemic and pandemic periods and further investigated by age group and COVID waves. Anti-SARS-CoV-2 seroprevalence was quantified by rapid diagnostic testing (RDT) and laboratory-based testing (ELISA in Lubumbashi and ECLIA in Abidjan). In Lubumbashi, the crude mortality rate (CMR) increased from 0.08 deaths per 10 000 persons per day (pre-pandemic) to 0.20 deaths per 10 000 persons per day (pandemic period). Increases were particularly pronounced among <5 years old. In Abidjan, no overall increase was observed during the pandemic period (pre-pandemic: 0.05 deaths per 10 000 persons per day; pandemic: 0.07 deaths per 10 000 persons per day). However, an increase was observed during the third wave (0.11 deaths per 10 000 persons per day). The estimated seroprevalence in Lubumbashi was 15.7% (RDT) and 43.2% (laboratory-based). In Abidjan, the estimated seroprevalence was 17.4% (RDT) and 72.9% (laboratory-based) during the first phase of the survey and 38.8% (RDT) and 82.2% (laboratory-based) during the second phase of the survey. Although circulation of SARS-CoV-2 seems to have been extensive in both settings, the public health impact varied. The increases, particularly among the youngest age group, suggest indirect impacts of COVID and the pandemic on population health. The seroprevalence results confirmed substantial underdetection of cases through the national surveillance systems.

HIV infection and engagement in the care continuum among migrants and refugees from Venezuela in Colombia: a cross-sectional, biobehavioural survey

Venezuela has experienced substantial human displacement since 2015. To inform HIV programmes and treatment distribution, we aimed to estimate HIV prevalence and associated indicators among migrants and refugees from Venezuela residing in Colombia, the largest receiving country. We conducted a biobehavioural, cross-sectional survey using respondent-driven sampling among Venezuelan people aged 18 years or older who had arrived in Colombia since 2015 and resided in four cities (ie, Bogotá, Soacha, Soledad, and Barranquilla). Participants completed sociobehavioural questionnaires and rapid HIV and syphilis screening with laboratory-based confirmatory testing, CD4 cell counts, and viral load quantification. Policies related to migration status affect access to insurance and HIV services in Colombia, as in many receiving countries, so we provided legal assistance and navigation support to participants with HIV for sustained access to treatment. Population-based estimates were weighted for the complex sampling design. Penalised multivariable logistic regression analysis was used to identify correlates of viral suppression (HIV-1 RNA <1000 copies per mL). Between July 30, 2021, and Feb 5, 2022, 6506 participants were recruited through respondent-driven sampling, of whom 6221 were enrolled. 4046 (65·1%) of 6217 were cisgender women, 2124 (34·2%) of 6217 were cisgender men, and 47 (0·8%) of 6217 were transgender or non-binary people. 71 (1·1%) of all 6221 participants had laboratory-confirmed HIV infection, resulting in a weighted population HIV prevalence of 0·9% (95% CI 0·6-1·4). Among participants living with HIV, 34 (47·9%) of 71 had been previously diagnosed with HIV and 25 (35·7%) of 70 had viral suppression. Individuals with irregular migration status compared with individuals with regular migration status (adjusted odds ratio 0·3, 95% CI 0·1-0·9) and with a most recent HIV test in Colombia compared with a most recent test in Venezuela (0·2, 0·1-0·8) were less likely to have suppressed viral loads. HIV prevalence among migrants and refugees from Venezuela in Colombia suggests the HIV epidemic is close to being generalised, which could be addressed by the inclusion of migrants and refugees from Venezuela in local HIV services, improved access to and navigation support for HIV testing and care, and coordination with humanitarian programmes. There is an association between migration status and viral suppression, conferring both clinical and epidemiological implications. Therefore, legal support and access to insurance might lead to early detection of HIV and timely treatment for people with irregular migration status. US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention. For the Spanish translation of the abstract see Supplementary Materials section.

Reliability and Validity of Noncognitive Ecological Momentary Assessment Survey Response Times as an Indicator of Cognitive Processing Speed in People's Natural Environment: Intensive Longitudinal Study.

Various populations with chronic conditions are at risk for decreased cognitive performance, making assessment of their cognition important. Formal mobile cognitive assessments measure cognitive performance with greater ecological validity than traditional laboratory-based testing but add to participant task demands. Given that responding to a survey is considered a cognitively demanding task itself, information that is passively collected as a by-product of ecological momentary assessment (EMA) may be a means through which people's cognitive performance in their natural environment can be estimated when formal ambulatory cognitive assessment is not feasible. We specifically examined whether the item response times (RTs) to EMA questions (eg, mood) can serve as approximations of cognitive processing speed. This study aims to investigate whether the RTs from noncognitive EMA surveys can serve as approximate indicators of between-person (BP) differences and momentary within-person (WP) variability in cognitive processing speed. Data from a 2-week EMA study investigating the relationships among glucose, emotion, and functioning in adults with type 1 diabetes were analyzed. Validated mobile cognitive tests assessing processing speed (Symbol Search task) and sustained attention (Go-No Go task) were administered together with noncognitive EMA surveys 5 to 6 times per day via smartphones. Multilevel modeling was used to examine the reliability of EMA RTs, their convergent validity with the Symbol Search task, and their divergent validity with the Go-No Go task. Other tests of the validity of EMA RTs included the examination of their associations with age, depression, fatigue, and the time of day. Overall, in BP analyses, evidence was found supporting the reliability and convergent validity of EMA question RTs from even a single repeatedly administered EMA item as a measure of average processing speed. BP correlations between the Symbol Search task and EMA RTs ranged from 0.43 to 0.58 (P<.001). EMA RTs had significant BP associations with age (P<.001), as expected, but not with depression (P=.20) or average fatigue (P=.18). In WP analyses, the RTs to 16 slider items and all 22 EMA items (including the 16 slider items) had acceptable (>0.70) WP reliability. After correcting for unreliability in multilevel models, EMA RTs from most combinations of items showed moderate WP correlations with the Symbol Search task (ranged from 0.29 to 0.58; P<.001) and demonstrated theoretically expected relationships with momentary fatigue and the time of day. The associations between EMA RTs and the Symbol Search task were greater than those between EMA RTs and the Go-No Go task at both the BP and WP levels, providing evidence of divergent validity. Assessing the RTs to EMA items (eg, mood) may be a method of approximating people's average levels of and momentary fluctuations in processing speed without adding tasks beyond the survey questions.

Evaluation of Static and Dynamic Stability and Its Relationship With Fear of Falling in Patients With Mild to Moderate Knee Osteoarthritis

Objective Knee osteoarthritis is one of the most common musculoskeletal disorders affecting balance. It is also a risk factor for falling in older people. People with a history of falling, whether being injured or not, acquire a fear of potential falling, so they limit their functional activities, leading to decreased mobility, muscle weakness, and increased risk of falling in the future. Evaluating the relationship between balance and fear of falling in these patients can detect the disability mechanisms and falling and also help find more effective therapeutic methods for these patients. Some previous studies evaluated the stability of patients by clinical methods in static situations and related it to fear of falling. However, the walking stability of patients was not assessed by laboratory-based systems in previous studies. Therefore, we aimed to evaluate dynamic (during walking and based on the center of mass sways) and static stability (based on the center of pressure sways) and their relationship with falling risk in patients with knee osteoarthritis. Materials &amp; Methods This is a descriptive cross-sectional study. A group of 15 subjects with mild to moderate knee osteoarthritis with a Mean±SD age of 50±3.22 years and 15 normal subjects with comparable age, height, and weight participated in this study. The subjects’ standing stability was evaluated using a Kistler force plate based on mediolateral (ML) and anteroposterior (AP) displacements of the center of pressure. Also, the dynamic stability of the subjects was evaluated during walking and based on the center of mass-base of support relationship in AP and ML directions. Kinematic data were collected using a motion analysis system with 7 high-speed cameras and a Kistler force plate. To model the body segments, the output of Qualisys track manager software was exported to Visual 3D software. Fear of falling was assessed by the native version of the fall efficacy scale (FES-I). The normal distribution of data was checked by the Shapiro-Wilk test. The independent samples t-test was used to compare the stability of patients and normal subjects. The Pearson correlation coefficient was used to evaluate the relationships between static and dynamic stability parameters and fear of falling in patients with knee osteoarthritis. Results Patients with knee osteoarthritis had less stability during standing and walking than healthy subjects (P&lt;0.05). Moreover, based on the results of this study, there was a linear relationship between the center of body pressure (COP) excursions in the AP direction and the fear of falling scale. Still, it was not significant (r=0.416, P=0.123), and there was no correlation between the other COP parameters with FES (r=0, P&gt;0.05). The correlations between mean center of mass (COM) excursion in AP and ML directions and FES were 0.309 and -0.123, respectively; however, these correlations were also not statistically significant (P&gt;0.05). Conclusion Based on the results of this study, there is no significant relationship between static and dynamic stability of the patients with mild to moderate knee osteoarthritis (based on COP-COM variables) and the fall efficiency scale. So, it seems that to improve these patients’ functional abilities, and the therapists must focus on the other parameters that affect the falling, such as reducing pain, improving proprioception, and enhancing muscle strength. It is suggested that future studies include a more varied age range of elderly people and evaluate all contributing factors in falling of patients with knee osteoarthritis (such as pain, proprioception, vision, and muscle strength) and also evaluate the stability of patients with both laboratory-based and clinical tests.

Selecting police super-recognisers.

People vary in their ability to recognise faces. These individual differences are consistent over time, heritable and associated with brain anatomy. This implies that face identity processing can be improved in applied settings by selecting high performers-'super-recognisers' (SRs)-but these selection processes are rarely available for scientific scrutiny. Here we report an 'end-to-end' selection process used to establish an SR 'unit' in a large police force. Australian police officers (n = 1600) completed 3 standardised face identification tests and we recruited 38 SRs from this cohort to complete 10 follow-up tests. As a group, SRs were 20% better than controls in lab-based tests of face memory and matching, and equalled or surpassed accuracy of forensic specialists that currently perform face identification tasks for police. Individually, SR accuracy was variable but this problem was mitigated by adopting strict selection criteria. SRs' superior abilities transferred only partially to body identity decisions where the face was not visible, and they were no better than controls at deciding which visual scene that faces had initially been encountered in. Notwithstanding these important qualifications, we conclude that super-recognisers are an effective solution to improving face identity processing in applied settings.

Posterior hippocampal CA2/3 volume is associated with autobiographical memory recall ability in lower performing individuals

People vary substantially in their capacity to recall past experiences, known as autobiographical memories. Here we investigated whether the volumes of specific hippocampal subfields were associated with autobiographical memory retrieval ability. We manually segmented the full length of the two hippocampi in 201 healthy young adults into DG/CA4, CA2/3, CA1, subiculum, pre/parasubiculum and uncus, in the largest such manually segmented subfield sample yet reported. Across the group we found no evidence for an association between any subfield volume and autobiographical memory recall ability. However, when participants were assigned to lower and higher performing groups based on their memory recall scores, we found that bilateral CA2/3 volume was significantly and positively associated with autobiographical memory recall performance specifically in the lower performing group. We further observed that this effect was attributable to posterior CA2/3. By contrast, semantic details from autobiographical memories, and performance on a range of laboratory-based memory tests, did not correlate with CA2/3 volume. Overall, our findings highlight that posterior CA2/3 may be particularly pertinent for autobiographical memory recall. They also reveal that there may not be direct one-to-one mapping of posterior CA2/3 volume with autobiographical memory ability, with size mattering perhaps only in those with poorer memory recall.

Overview of a Sleep Monitoring Protocol for a Large Natural Population.

A standard operating procedure for studying the sleep phenotypes in a large population cohort is proposed. It is intended for academic researchers in investigating the sleep phenotypes in conjunction with the clinical sleep disorders assessment guidelines. The protocol refers to the definitive American Academy of Sleep Medicine (AASM) manual for setting polysomnography (PSG) technical specifications, scoring of sleep and associated events, etc. On this basis, it not only provides a standardized procedure of sleep interview, sleep-relevant questionnaires, and laboratory-based PSG test, but also offers a comprehensive process of sleep data analysis, phenotype extraction, and data storage. Both the objective sleep data recorded by PSG test and subjective sleep information obtained by the sleep interview and sleep questionnaires are involved in the data acquisition procedure. Subsequently, sleep phenotypes can be characterized by observable/inconspicuous physiological patterns during sleep from PSG test or can be marked by sleeping habits like sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, daytime dysfunction, etc., from sleep interview or questionnaires derived. In addition, solutions to the problems that may be encountered during the protocol are summarized and addressed. With the protocol, it can significantly improve scientific research efficiency and reduce unnecessary workload in large population cohort studies. Moreover, it is also expected to provide a valuable reference for researchers to conduct systematic sleep research.

Role of Recent PCR Tests for Infectious Ocular Diseases: From Laboratory-Based Studies to the Clinic.

Infectious uveitis is a vision-threatening condition that requires prompt clinical diagnosis and proper treatment. However, rapid and proper diagnosis in infectious uveitis remains challenging. Several examination tests, including polymerase chain reaction (PCR) tests, are transitioning from laboratory-based basic research-level tests to bedside clinical tests, and recently tests have changed to where they can be performed right next to clinicians. In this review, we introduce an updated overview of recent studies that are representative of the current trends in clinical microbiological techniques including PCR tests for infectious uveitis.

Economics of point-of-care infant HIV tests

Economics of point-of-care infant HIV tests

Area-based comparison of risk factors and testing rates to improve sexual health care access: cross-sectional population-based study in a Dutch multicultural area

ObjectivesAreas with high sexually transmitted infection (STI) testing rates may not require additional strategies to improve testing. However, it may be necessary to intervene in areas with elevated STI risk,...

Cost-effectiveness of point-of-care versus centralised, laboratory-based nucleic acid testing for diagnosis of HIV in infants: a systematic review of modelling studies

Point-of-care (POC) nucleic acid testing for diagnosis of HIV in infants facilitates earlier initiation of antiretroviral therapy (ART) than with centralised (standard-of-care, SOC) testing, but can be more expensive. We evaluated cost-effectiveness data from mathematical models comparing POC with SOC to provide global policy guidance. In this systematic review of modelling studies, we searched PubMed, MEDLINE, Embase, the National Health Service Economic Evaluation Database, Econlit, and conference abstracts, combining terms for "HIV" + "infant"/"early infant diagnosis" + "point-of-care" + "cost-effectiveness" + "mathematical models", without restrictions from database inception to July 15, 2022. We selected reports of mathematical cost-effectiveness models comparing POC with SOC for HIV diagnosis in infants younger than 18 months. Titles and abstracts were independently reviewed, with full-text review for qualifying articles. We extracted data on health and economic outcomes and incremental cost-effectiveness ratios (ICERs) for narrative synthesis. The primary outcomes of interest were ICERs (comparing POC with SOC) for ART initiation and survival of children living with HIV. Our search identified 75 records through database search. 13 duplicates were excluded, leaving 62 non-duplicate articles. 57 records were excluded and five were reviewed in full text. One article was excluded as it was not a modelling study, and four qualifying studies were included in the review. These four reports were from two mathematical models from two independent modelling groups. Two reports used the Johns Hopkins model to compare POC with SOC for repeat early infant diagnosis testing in the first 6 months in sub-Saharan Africa (first report, simulation of 25 000 children) and Zambia (second report, simulation of 7500 children). In the base scenario, POC versus SOC increased probability of ART initiation within 60 days of testing from 19% to 82% (ICER per additional ART initiation range US$430-1097; 9-month cost horizon) in the first report; and from 28% to 81% in the second ($23-1609, 5-year cost horizon). Two reports compared POC with SOC for testing at 6 weeks in Zimbabwe using the Cost-Effectiveness of Preventing AIDS Complications-Paediatric model (simulation of 30 million children; lifetime horizon). POC increased life expectancy and was considered cost-effective compared with SOC (ICER $711-850 per year of life saved in HIV-exposed children). Results were robust throughout sensitivity and scenario analyses. In most scenarios, platform cost-sharing (co-use with other programmes) resulted in POC being cost-saving compared with SOC. Four reports from two different models suggest that POC is a cost-effective and potentially cost-saving strategy for upscaling of early infant testing compared with SOC. Bill & Melinda Gates Foundation, Unitaid, National Institute of Allergy and Infectious Diseases, National Institute of Child Health and Human Development, WHO, and Massachusetts General Hospital Research Scholars.

Fibcare® shows correlation with fibrinogen levels by the Clauss method during cardiopulmonary bypass.

Central laboratory measurements are time consuming, while rapid fibrinogen level measurements within the operating room improve transfusion strategies. We aimed to clarify the correlation between fibrinogen concentrations (measured using Fibcare® and the Clauss fibrinogen assay in a central laboratory) during cardiovascular surgery with cardiopulmonary bypass. Data of patients whose Fibcare, traditional laboratory-based testing, and thromboelastographic results were measured using the same blood sample during cardiopulmonary bypass from February 2021 to January 2022 were retrospectively examined. We analyzed correlation in categories of body temperature during cardiopulmonary bypass: total cases, mild hypothermia (28-34°C), and moderate or severe hypothermia (<28°C). The Clauss fibrinogen assay was performed in 123 cases, Fibcare in 107, and thromboelastography in 91. For mild hypothermia, moderate or severe hypothermia, and overall, the root mean squared error and R-square in Fibcare were 16.1 and 0.86, 13.1 and 0.87, and 14.9 and 0.87, respectively, and for thromboelastography, they were 3.26 and 0.74, 2.70 and 0.79, and 3.08 and 0.75, respectively. A significant relationship was noted between Fibcare and Claus fibrinogen analysis regardless of body temperature during cardiopulmonary bypass. The measurement of fibrinogen levels using Fibcare allows for faster transfusion preparation than that of the traditional Clauss fibrinogen assay.

Relationship Between Heart Rate and Perceived Exertion in Neuromuscular Diseases: How do Laboratory-Based Exercise Testing Results Translate to Home-Based Aerobic Training Sessions?

To examine the heart rate-perceived exertion relationship between maximal exercise testing and home-based aerobic training in neuromuscular diseases. Multicentre randomized controlled trial, intervention group data. Individuals with Charcot-Marie-Tooth disease (n = 17), post-polio syndrome (n = 7) or other neuromuscular diseases (n = 6). Participants followed a 4-month, homebased aerobic training programme guided by heart rate. Heart rate and ratings of perceived exertion (6-20 Borg Scale) were assessed for each minute during a maximal exercise test, and at the end of each exercise interval and recovery period during training. Heart rate and corresponding ratings of perceived exertion values of individual participants during training were visualized using plots, together with the exercise testing linear regression line between heart rate and ratings of perceived exertion. High correlation coefficients (i.e. > 0.70) were found between heart rate and ratings of perceived exertion, in all participants during testing (n = 30), and in 57% of the participants during training. Based on the plots the following distribution was found; participants reporting lower (n = 12), similar (n = 10), or higher (n = 8) ratings of perceived exertion values for corresponding heart rates during training compared with testing. Most participants had a different perception of effort for corresponding heart rates during training in comparison with exercise testing. Healthcare professionals should be aware that this may imply under- and over-training.

Differential screening for non-viral sexually transmitted infections by type of vaginitis testing.

Data are lacking on adherence to Centers for Disease Control and Prevention testing guidelines among insured US women presenting with vaginal health complaints; thus, we quantified vaginitis testing frequency and assessed the co-testing rate for causes of vaginitis and Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG). This was a retrospective analysis of de-identified data from a medical database. Information from women, ages 18-50 years, was obtained from the Truven MarketScan Commercial Database (2012-2017) using Current Procedural Technology codes; chi-square testing was applied to determine co-testing differences for CT/NG based on vaginitis test type. Odds ratios were calculated to determine the association with CT/NG screening across vaginitis testing categories. Approximately 48% of 1,359,289 women received a vaginitis diagnosis that involved a laboratory-based test. Of these women only 34% were co-tested for CT/NG. CT/NG co-testing was highest for those with nucleic acid amplification testing for vaginitis and lowest for those with no vaginitis testing Current Procedural Technology code (respectively, 71% vs 23%, P < 0.0001). The vaginitis nucleic acid amplification test, indicated by CPT code, was associated with statistically significant, higher CT/NG testing rates. Molecular diagnostics may support vaginitis testing in settings that have limited opportunities for microscopy and clinical exams and offer greater opportunity to offer comprehensive women's healthcare that includes testing for chlamydia and/or gonorrhea infections.

Quality assessment of higher resolution images and videos with remote testing

In many research fields, human-annotated data plays an important role as it is used to accomplish a multitude of tasks. One such example is in the field of multimedia quality assessment where subjective annotations can be used to train or evaluate quality prediction models. Lab-based tests could be one approach to get such quality annotations. They are usually performed in well-defined and controlled environments to ensure high reliability. However, this high reliability comes at a cost of higher time consumption and costs incurred. To mitigate this, crowd or online tests could be used. Usually, online tests cover a wider range of end devices, environmental conditions, or participants, which may have an impact on the ratings. To verify whether such online tests can be used for visual quality assessment, we designed three online tests. These online tests are based on previously conducted lab tests as this enables comparison of the results of both test paradigms. Our focus is on the quality assessment of high-resolution images and videos. The online tests use AVrate Voyager, which is a publicly accessible framework for online tests. To transform the lab tests into online tests, dedicated adaptations in the test methodologies are required. The considered modifications are, for example, a patch-based or centre cropping of the images and videos, or a randomly sub-sampling of the to-be-rated stimuli. Based on the analysis of the test results in terms of correlation and SOS analysis it is shown that online tests can be used as a reliable replacement for lab tests albeit with some limitations. These limitations relate to, e.g., lack of appropriate display devices, limitation of web technologies, and modern browsers considering support for different video codecs and formats.

Near point-of-care HIV viral load testing: Cascade after high viral load in suburban Yangon, Myanmar.

HIV viral load (VL) testing in resource-limited settings is often centralised, limiting access. In Myanmar, we assessed outcomes according to VL access and the VL cascade (case management after a first high VL result) before and after near point-of-care (POC) VL was introduced. Routine programme data from people living with HIV (PLHIV) on antiretroviral therapy (ART) were used. We assessed the odds of getting a VL test done by year. Attrition and mortality two years after ART initiation were compared between three groups of PLHIV with different access to VL testing using Kaplan-Meier analysis. We compared VL cascades in those with a first VL result before and after near POC VL testing became available. With logistic regression, predictors of confirmed virological failure after a first high VL in the POC era were explored. Among 4291 PLHIV who started ART between July 2009 and June 2018, 794 (18.5%) became eligible for VL testing when it was not available, 2388 (55.7%) when centralised laboratory-based VL testing was available, and 1109 (25.8%) when near POC VL testing was available. Between 2010 and 2019, the odds of getting a VL test among those eligible increased with each year (OR: 5.21 [95% CI: 4.95-5.48]). Attrition and mortality were not different in the three groups. When comparing PLHIV with a first VL result before and after implementation of the near POC VL testing, in the latter, more had a first VL test (92% versus 15%, p<0.001), less had a first high VL result (5% versus 14%, p<0.001), and more had confirmed virological failure (67% versus 47%, p = 0.013). Having a first VL ≥5000 copies/mL after near POC implementation was associated with confirmed virological failure (adjusted OR: 2.61 [95% CI: 1.02-6.65]). Near POC VL testing enabled rapid increase of VL coverage and a well-managed VL cascade in Myanmar.

Optimizing point-of-care testing strategies for diagnosis and treatment of hepatitis C virus infection in Australia: a model-based cost-effectiveness analysis

Timely diagnosis and treatment of hepatitis C virus (HCV) is critical to achieve elimination goals. This study evaluated the cost-effectiveness of point-of-care testing strategies for HCV compared to laboratory-based testing in standard-of-care. Cost-effectiveness analyses were undertaken from the perspective of Australian Governments as funders by modelling point-of-care testing strategies compared to standard-of-care in needle and syringe programs, drug treatment clinics, and prisons. Point-of-care testing strategies included immediate point-of-care HCV RNA testing and combined point-of-care HCV antibody and reflex RNA testing for HCV antibody positive people (with and without consideration of previous treatment). Sensitivity analyses were performed to investigate the cost per treatment initiation with different testing strategies at different HCV antibody prevalence levels. The average costs per HCV treatment initiation by point-of-care testing, from A$890 to A$1406, were up to 35% lower compared to standard-of-care ranging from A$1248 to A$1632 depending on settings. The average costs per treatment initiation by point-of-care testing for three settings ranged from A$1080 to A$1406 for RNA, A$960-A$1310 for combined antibody/RNA without treatment history consideration, and A$890-A$1189 for combined antibody/RNA with treatment history consideration. When HCV antibody prevalence was <74%, combined point-of-care HCV antibody and point-of-care RNA testing were the most cost-effective strategies. Modest increases in treatment uptake by 8%-31% were required for immediate point-of-care HCV RNA testing to achieve equivalent cost per treatment initiation compared to standard-of-care. Point-of-care testing is more cost-effective than standard of care for populations at risk of HCV. Testing strategies combining point-of-care HCV antibody and RNA testing are likely to be cost-effective in most settings. National Health and Medical Research Council.