One-time Testing Research Articles

Facile preparation of hollow covalent organic frameworks as superior and universal matrix clean-up micro-structures for high throughout determination of food hazards

The complicated food matrix seriously limits the one-time test for the potential food hazards in non-targeted analysis. Accordingly, developing advanced sample pretreatment strategy to reduce matrix effects is of great significance. Herein, newly-integrated hollow-structured covalent organic frameworks (HCOFs) with large internal adsorption capacity and target-matched pore size were synthesized via etching the core-shell structured COFs. The as-prepared HCOFs could be directly applied for matrix clean-up of vegetable samples, while further modification of polydopamine (PDA) network facilitated application for animal samples. Both HCOFs and HCOFs@PDA with the comparable sizes to the matrix interference gave excellent adsorption performance to targets, achieving satisfied recoveries (70%–120%) toward 90 pesticides and 44 veterinary drugs in one-test, respectively. This work showed the great potential of the facile-integrated HCOFs with high stability and customized size to remove interference matrix and offered a universal strategy to achieve simultaneous screening of hazards with considerable quantity in high-throughput non-targeted analysis.

Cost effectiveness and decision analysis for national airport screening options to reduce risk of COVID-19 introduction in Uganda, 2020

IntroductionEarly during the COVID-19 outbreak, various approaches were utilized to prevent COVID-19 introductions from incoming airport travellers. However, the costs and effectiveness of airport-specific interventions have not been evaluated.MethodsWe evaluated policy options for COVID-19-specific interventions at Entebbe International Airport for costs and impact on COVID-19 case counts, we took the government payer perspective. Policy options included; (1)no screening, testing, or mandatory quarantine for any incoming traveller; (2)mandatory symptom screening for all incoming travellers with RT-PCR testing only for the symptomatic and isolation of positives; and (3)mandatory 14-day quarantine and one-time testing for all, with 10-day isolation of persons testing positive. We calculated incremental cost-effectiveness ratios (ICERs) in US$ per additional case averted.ResultsExpected costs per incoming traveller were $0 (Option 1), $19 (Option 2), and $766 (Option 3). ICERs per case averted were $257 for Option 2 (which averted 4,948 cases), and $10,139 for Option 3 (which averted 5,097 cases) compared with Option I. Two-week costs were $0 for Option 1, $1,271,431 Option 2, and $51,684,999 Option 3. The per-case ICER decreased with increase in prevalence. The cost-effectiveness of our interventions was modestly sensitive to the prevalence of COVID-19, diagnostic test sensitivity, and testing costs.ConclusionScreening all incoming travellers, testing symptomatic persons, and isolating positives (Option 2) was the most cost-effective option. A higher COVID-19 prevalence among incoming travellers increased cost-effectiveness of airport-specific interventions. This model could be used to evaluate prevention options at the airport for COVID-19 and other infectious diseases with similar requirements for control.

Certificateless Searchable Encryption With Trapdoor Unlinkability for Industrial Internet of Things

Industrial Internet of Things (IIoT) is a promising application of Internet of Things (IoT) in the industrial sector, which greatly improves the manufacturing efficiency and enables the intelligent production. Nowadays, cloud computing has been introduced to handle the data management problem in IIoT. Nevertheless, how to retrieve ciphertext data remains a challenging problem. Recently, certificateless searchable encryption (CLSE) was proposed to tackle with this problem. CLSE allows the receiver to search the ciphertext data directly, meanwhile it protects the data privacy. However, existing CLSE schemes do not achieve the trapdoor unlinkability since deterministic algorithms are used to generate the trapdoors. Additionally, they cannot support multiple keywords search in one-time test operation. To address these issues, we propose a certificateless searchable encryption scheme with trapdoor unlinkability (CLSETU) for IIoT. We then demonstrate the semantic security of our scheme against insider keyword guessing attacks (KGA). Finally, the performance evaluation shows its feasibility in the deployment of IIoT.

Clinical utility of inflammatory and genetic biomarkers for cardiovascular disease prevention, categorization, and treatment.

The complex interplay of increased atherogenic lipoproteins, inflammation, and immune activation hallmarks the pathogenesis of atherosclerotic cardiovascular disease (ASCVD). Atherosclerotic cardiovascular disease remains a leading cause of death, yet risk estimator tools lack comprehensiveness for genetic/inflammatory biomarkers associated with ASCVD. Unexplained ASCVD risk necessitates a better understanding of primary, secondary, and tertiary prevention variables. This article discusses the clinical utility of genetic and inflammatory biomarkers for ASCVD risk prediction, management, treatment, and recategorization into primary, secondary, and tertiary prevention. Furthermore, nurse practitioners (NPs) should use a ternary prevention classification system instead of the current binary system to mitigate risk in the large group of patients with subclinical ASCVD. High-sensitivity C-reactive protein (hs-CRP)-linearly associated with ASCVD-and lipoprotein-associated phospholipase-A 2 (Lp-PLA 2 ) and myeloperoxidase (MPO), both associated with plaque vulnerability/rupture, are inflammatory biomarkers. Elevated hs-CRP, MPO, and Lp-PLA 2 treatment requires addressing root causes of elevation (e.g., obesity, insulin resistance, tobacco use, gingival disease, and chronic autoimmune/infectious conditions). In addition, haptoglobin (Hp) phenotype determines the antioxidant potential of Hp. Haptoglobin phenotype, a root cause of ASCVD, is a one-time test. Individuals with Hp 2-2 should adopt a gluten-free diet to reduce endothelial and intestinal inflammation. Nurse practitioners should use stricter glycemic goals (hemoglobin A1c ≤6.5%) and add daily vitamin E if this group has type 2 diabetes. Genetic/inflammatory biomarkers should be used to better predict ASCVD risk and tailor primary, secondary, and tertiary prevention treatment. Clinical use of these biomarkers reaches beyond the standard of care to reduce residual ASCVD risk.

Acute effect of breathing exercises on muscle tension and executive function under psychological stress.

Intensive and long-lasting office work is a common cause of muscular and mental disorders due to workplace stressors. Mindful and slow breathing exercises decrease psychological stress and improve mental health, whereas fast breathing increases neuronal excitability. This study aimed to explore the influence of 5 min of mindful breathing (MINDFUL), slow breathing (SLOW), fast breathing (FAST), and listening to music (MUSIC) on muscle tension and executive function during an intensive psychological task. Forty-eight participants (24 men and 24 women) were enrolled. Muscle tension was recorded using surface electromyography, and executive function was assessed using the Stroop Color and Word Test (Stroop Test). The respiration rate (RR), oxygen saturation (SpO2), end-tidal carbon dioxide (EtCO2), and the subjects' preferred method were also recorded. During the experiment, participants performed a one-time baseline test (watching a neutral video for 5 min) and then completed 5 min of MUSIC, MINDFUL, SLOW, and FAST in a random sequence. The Stroop Test was performed after each intervention, including the baseline test, and was followed by a 5 min rest before performing the next intervention. None of the methods significantly influenced muscular activity and performance of the Stroop Test in both men and women, based on the average 5 min values. However, at the fifth minute, men's accuracy rate in the Stroop Test was significantly higher after SLOW than after MUSIC and FAST, and the reaction time after the SLOW was the shortest. SpO2 was significantly higher during SLOW than during MUSIC, and RR was relatively lower after SLOW than after MUSIC. Most men preferred SLOW, and most women preferred MUSIC, whereas FAST was the most unfavorable method for both men and women. Brief breathing exercises did not substantially affect muscle tension under psychological stress. SLOW demonstrated greater potential for sustaining executive function in men, possibly via its superior respiration efficiency on SpO2 and inhibition of RR.

Prediction of respiratory impairment in myotonic dystrophies using the ‘Respiratory involvement symptom checklist’ (Respicheck)

Chronic hypoventilation due to involvement of respiratory muscles is a frequent symptom in autosomal dominant inherited myotonic dystrophies, especially in type 1 (DM1), leading to a severely reduced quality of life, an early need for ventilatory support, or premature death. Thus, early knowledge of respiratory muscle weakness is essential to initiate further diagnostic and therapeutic measures.To get early, simple, and reliable information about respiratory impairment in DM patients, we performed a prospective controlled cohort study with DM1 and DM2 patients analysing the suitability of ‘Respiratory involvement symptom checklist (Respicheck) as a clinically meaningful screening questionnaire for ventilatory impairment in patients with DM1 or DM2. Clinical assessments included a one-time pulmonary function test (spirometry and manometry) and the completion of the Respicheck.172 participants were enrolled in this study (74 DM1, 72 DM2, 26 healthy controls). With a cut-off RespicheckCAT score of 4, the Respicheck can distinguish between patients with and without respiratory impairment with higher sensitivity and positive predictive value for DM1 than DM2 patients (DM1: sensitivity 77–87; positive predictive value 50–94%; DM2: sensitivity 67–80%; positive predictive value 14–38).In summary, our results confirm a clinically meaningful use of the Respicheck to detect respiratory impairments predominantly in DM1 patients.

Design of the Integrated Performance Testing Device for Electromagnetic and Static Relays Based on Single Chip Microcomputer

In order to improve the action performance of the relay, this paper designs an electromagnetic static relay comprehensive performance testing device based on MCU. First of all, a master-slave design structure is proposed, which is composed of a low-power, high-performance Cortex-M3 core high-speed microcontroller. Then, the one-time test model and control logic suitable for testing coil resistance, action/return voltage, coil action power, action/recovery time, contact resistance and working power consumption of AC and DC relays are emphatically introduced. Finally, through experiment testing in substations and power plants, the intelligence, rapidity and integrity of the device are verified.

Reproducibility of Glycemic Measures Among Dysglycemic Youth and Adults in the RISE Study.

Previous work found poor reproducibility for measures of glycemia in individuals at risk for dysglycemia. Differences between youth and adults have not been assessed. Using youth and adults in the Restoring Insulin Secretion Study, we tested variability and classification concordance for hemoglobin A1C (HbA1c), fasting and 2-hour glucose from oral glucose tolerance tests (OGTTs). HbA1c and glucose on repeated samples obtained ∼6 weeks apart were compared in 66 youth (mean age 14.2 years) and 354 adults (52.7 years). Changes, coefficient of variation (CV), and concordance of diagnostic categories between the 2 visits were compared. Mean difference between the 2 visits in HbA1c was higher in youth than adults (P < .001), while fasting glucose was similar and 2-hour glucose was lower in youth (P = .051). CV was smallest for HbA1c compared to fasting and 2-hour glucose. For HbA1c, youth had higher CV (P < .001); whereas CV for 2-hour glucose was lower for youth (P = .041). Classification concordance by HbA1c was lower in youth (P = .004). Using OGTT or HbA1c for classification, intervisit variability produced discordant classification in 20% of youth and 28% of adults. Using both fasting glucose and HbA1c, intervisit variability reduced discordant classification to 16% of adults while not improving classification in youth. Poor reproducibility and lack of classification concordance highlight the limitations of one-time testing, with important implications for assessing eligibility in clinical trials. Consideration should be given to using more than a single parameter for screening and diagnosis, especially when classification category is important.

Performance characteristics of a tumor-informed circulating tumor DNA (ctDNA) minimal residual disease (MRD) assay in invasive bladder cancer in clinical practice.

542 Background: Detection of minimal residual disease (MRD) is emerging as a potential risk stratification and surveillance tool in patients with resected bladder cancer to potentially direct adjuvant therapy and early intervention. Recently, the sensitivity of MRD testing for early detection of recurrence has been questioned. We sought to evaluate the real world diagnostic performance characteristics of the Signatera ctDNA assay in patients with stage 1-4 bladder cancer who either had transurethral resection of bladder tumor (TURBT) in addition to either chemoradiation or radical cystectomy. Methods: Patients with bladder cancer who underwent ctDNA MRD testing after resection for stage 1-4 disease from 03/2021 to 09/2022 were evaluated retrospectively. Both patients with single and serial ctDNA assays were included. Individual chart review was performed to collect demographic and clinical variables such as diagnosis, stage, pathology, imaging results, and treatment course. Results: MRD results from 19 patients were available, 9 of which had serial assays. 13/19 patients were found to have ctDNA positive results at any time point. The positivity rate at initial testing was associated with stage: Stage 1: 3/5 patients, of which 2 had TURBT and 1 Radical cystectomy, stage 2: 2/5, stage 3: 6/8, and stage 4: 0/1. Notably, of the 9 patients with serial assays, one patient’s result converted from negative to highly positive during surveillance, with subsequent decrease to low positive after adjuvant therapy. One patient had a result of 2 consecutive low positives initially, which was converted to negative after systemic therapy and radiation. 7/19 patients completed testing 3 or more times over a span of approximately 4-13 months, 2 of whom had negative results throughout. Most patients who were found to have positive ctDNA did demonstrate radiographic recurrence within 2-3 months of ctDNA detection. Conclusions: Positive ctDNA MRD after resection is common in bladder cancer. Tumor-informed ctDNA MRD testing has very high sensitivity, but a one-time negative test result does not exclude the presence of metastatic disease. The above data shows an association between cancer stage and positivity results, particularly for advanced stages. Stage I cases with positive results can likely be explained by inadequate resection. Increases in ctDNA may represent early recurrence and can potentially be salvaged with early systemic therapy reverting to negative ctDNA. Prospective randomized and non-randomized studies are evaluating the clinical utility of ctDNA MRD testing in bladder cancer, and analysis of Signatera ctDNA assays will largely contribute to these efforts.

Low risk of human T-lymphotropic virus infection in U.S. blood donors; Is it time to consider a one-time selective testing approach?

U.S. blood donors are tested at each donation for human T-lymphotropic virus (HTLV) antibodies. Depending on donor incidence and other mitigation/removal technologies, a strategy of one-time selective donor testing should be considered. Antibody seroprevalence was calculated for HTLV-confirmed-positive American Red Cross allogeneic blood donors from 2008 to 2021. Incidence was estimated for seven 2-year time periods using confirmed-positive repeat donors having seroconverted in 730 days. Leukoreduction failure rates were obtained from internal data from July 1, 2008-June 30, 2021. Residual risks were calculated using a 51-day window period. Between 2008 and 2021, >75 million donations (>18 million donors) yielded 1550 HTLV seropositives. HTLV seroprevalence was 2.05 antibody-positives per 100,000 donations (0.77 HTLV-1, 1.03 HTLV-2, 0.24 HTLV-1/2), and 10.32 per 100,000 among >13.9 million first-time donors. Seroprevalence differed significantly by virus type, sex, age, race/ethnicity, donor status, and U.S. census region. Over 14 years and 24.8 million person-years of observation, 57 incident donors were identified (25 HTLV-1, 23 HTLV-2, and 9 HTLV-1/2). Incidence decreased from 0.30 (13 cases) in 2008-2009 to 0.25 (7 cases) in 2020-2021. Female donors accounted for most incident cases (47 vs. 10 males). In the last 2-year reporting period, the residual risk was 1 per 2.8 million donations and 1 per 3.3 billion donations when coupled with successful leukoreduction (0.085% failure rate). HTLV donation seroprevalence for the years 2008-2021 varied by virus type and donor characteristics. Low HTLV residual risk and use of leukoreduction processes support the conclusion that a selective one-time donor testing strategy should be considered.

Fluctuations of Ability Estimates in Testing in Item Response Theory

By analyzing the fluctuations of ability estimates in testing, we first obtain the purely probabilistic fluctuations of ability estimates in a one-time testing under the condition that the students' abilities can be estimated by using the item response theory, and next, by taking into account such the probabilistic fluctuations, we find students who reveal the discrepancies of observed abilities between two separated testings. When such discrepancies of abilities are observed, test results are considered to be affected by some factors such as the physical conditions of the examinees, the teacher's teaching skills, and students' study skill developments. To describe such a phenomenon, we proposed a basic formula. The accuracies are obtained under the situation that the observed data follows the item response theory. To investigate whether we can assume such a condition or not, we have introduced the matrix decomposition perspective, and confirmed that the item response theory were used properly. Using an example case took in a university mathematics testing, we have shown how we have extracted the purely probabilistic fluctuations and segregated fluctuations due to other factors.

Workflow assessment of an augmented reality application for planning of perforator flaps in plastic reconstructive surgery: Game or game changer?

In contrast to the rising amount of financial investments for research and development in medical technology worldwide is the lack of usability and clinical readiness of the produced systems. We evaluated an augmented reality (AR) setup under development for preoperative perforator vessel mapping for elective autologous breast reconstruction. In this grant-supported research pilot, we used magnetic resonance angiography data (MR-A) of the trunk to superimpose the scans on the corresponding patients with hands-free AR goggles to identify regions-of-interest for surgical planning. Perforator location was assessed using MR-A imaging (MR-A projection) and Doppler ultrasound data (3D distance) and confirmed intraoperatively in all cases. We evaluated usability (System Usability Scale, SUS), data transfer load and documented personnel hours for software development, correlation of image data, as well as processing duration to clinical readiness (time from MR-A to AR projections per scan). All perforator locations were confirmed intraoperatively, and we found a strong correlation between MR-A projection and 3D distance measurements (Spearman r = 0.894). The overall usability (SUS) was 67 ± 10 (=moderate to good). The presented setup for AR projections took 173 min to clinical readiness (=availability on AR device per patient). In this pilot, we calculated development investments based on project-approved grant-funded personnel hours with a moderate to good usability outcome resulting from some limitations: assessment was based on one-time testing with no previous training, a time lag of AR visualizations on the body and difficulties in spatial AR orientation. The use of AR systems can provide new opportunities for future surgical planning, but has more potential for educational (e.g., patient information) or training purposes of medical under- and postgraduates (spatial recognition of imaging data associated with anatomical structures and operative planning). We expect future usability improvements with refined user interfaces, faster AR hardware and artificial intelligence-enhanced visualization techniques.

Rancang Bangun Alat Pengukur Suhu Badan Tanpa Kontak Berbasis Arduino dengan Modul Inframerah dan Bluetooth

The measurement of body temperature is necessary to prevent the spread of Covid-19. However, it must be conducted without any physical contact. This study aims to help users measure body temperature more quickly and accurately to detect Covid-19 suspects at a safe distance. The monitoring processes use the HC-05 bluetooth module and an application made with the MIT App Inventor is installed on an Android smartphone. This experiment uses an Arduino Uno with MLX90614 infrared temperature sensor, 16x2 LCD for text display, a buzzer as a warning alarm if the temperature is over 38ºC, and a tripod slot. The test conducted for MLX90614 sensor involved temperature measurement for a heated tap water object and three participants. The results indicated that the instrument can measure temperature with an accuracy of 98.63% to 99.55% through an effective distance of 5 cm. The designed software ran well on several versions of Android devices. Bluetooth connection test results in a maximum distance of 20 m with an obstacle and 25 m without an obstacle. A one-time battery endurance test is also carried out, which shows that the device can run for 165 minutes, while the bluetooth module is able to transmit the data to smartphone for 210 minutes.

A fundamental study on the relationship between cognitive function and psychological load while driving in older adult drivers.

Although many media outlets have sounded the alarm about dangerous driving by elderly drivers, serious accidents do not occur on a daily basis, and the dangerous events of daily driving have not been clarified. However, serious accidents do not occur on a daily basis, and the risk events of daily driving have not been clarified. Also, the relationship between cognitive function and drivers' cognitive function has not been clarified. In addition, cognitive function fluctuates from day to day, and it is difficult to obtain an accurate picture of cognitive function from a one-time test. However, in Japan, the system currently determines whether a driver's license is revoked or not depending on the results of the test, and it is difficult to say that we can properly diagnose the driving of elderly drivers. In this study, we observed the heart rate during driving and examined the changes in psychological load that occur during driving. I observed 80 subjects' driving data. As a result, it was found that the heart rate of drivers with cognitive decline increased when they were approached by a trivial voice or an unexpected obstacle, followed by a rapid decrease in the heart rate and a state of excessive relaxation.In addition, when they were in the state of excessive relaxation, they slowed down their obstacle avoidance behavior and forgot to activate the blinker. Therefore, it is necessary to find a way to equalize the tension during driving in order to support the safe driving of elderly drivers.

S1441 Improving Rate of Compliance With Hepatitis C Virus Screening

Introduction: Screening patients for hepatitis C virus infection is frequently overlooked. This is a leading cause of chronic liver disease in the US. The US Preventive Services Task Force determined screening is beneficial in patients aged 18-79. Previously, only those born between 1945-1965. The American Association for the Study of Liver Diseases recommends a one-time antibody test in adults 18 years and older. Even though treaTable, screening rate of hepatitis C virus antibody in patients aged 18-55 or 77-79 is only 70% in the primary care settings in Syracuse, Rome, and Binghamton. Inadequate detection leads to missed treatment opportunities and contributes to significant liver disease. Our quality improvement initiative aims to increase compliance rate with hepatitis C virus screening for all outpatient primary care visits for patients aged 18-55 or 77-79 by 20% from baseline of 70% to 90% in 6 months. Methods: Data was obtained from internal medicine and family medicine outpatient clinics at three locations (Syracuse, Rome, and Binghamton). Eligible patients were divided into two groups: 18-55 or 77-79 years was the group of interest and 56-76 years (born between years 1945-1965) was the reference group as testing in this group of patients had previously been practiced. Completed testing from July-September 2021 served as baseline. Gap analysis was performed identifying causes of reduced compliance. Interventions were taken at the patient level (distribution of informational flyers and provider education), provider level (education on guidelines), and system level (electronic medical record alerts). Interventions were initiated in October 2021 and testing rates were tracked until the end of February 2022. IRB approval was not pursued. Results: The rate of screening with hepatitis C virus antibody in patients aged 18-55 or 77-79 improved by 2.3% from 70% to 72.3% from October 1, 2021, to March 31, 2022, across three sites. Binghamton's rate improved by 5%. 397 tests have been ordered during this time and 240 were for the age group of interest. (Figure) Conclusion: Compliance with hepatitis C viral screening is suboptimal in outpatient settings. Focused and simple interventions at the patient, provider, and system levels can increase compliance and help reduce the burden of significant liver disease. We hypothesize continued education and monitoring of data will demonstrate improved rates due to long time between primary care visits. Additional interventions may improve rates further.Figure 1.: Hepatitis C Virus Screening Rates Between July 2021-March 2022 in the Syracuse, Rome, and Binghamton Primary Care Clinics

CT STUDY OF PRODUCTS FROM NON-METALLIC COMPOSITES REINFORCED BY CARBON FIBERS

Computerized tomography is used to study products from non-metallic composites reinforced by carbon fibers. It is demonstrated that samples do not rotate during the analysis process and can have diameter not exceeding the gantry hole (75 cm) of the unit. The weight of samples can be up to 200 kg, and the length during one-time testing does not exceed 150 cm. The results of spatial calibration of the technology are shown using a set of copper wires with diameters from 0.56 to 0.05 mm. The paper presents the results of defects detecting in products in the form of gas pores and metal inclusions.

P-283 Performance characteristics of a tumor-informed circulating tumor DNA (ctDNA) minimal residual disease (MRD) assay in stage 1-3 colorectal cancer (CRC) in clinical practice

Detection of MRD has emerged as a tool for risk stratification in patients with early stage CRC with potential implication for adjuvant therapy. Recently, the sensitivity of MRD testing for early detection of tumor recurrence/ metastasis compared with conventional imaging has been questioned. We sought to evaluate the diagnostic performance characteristics of the Signatera™ ctDNA assay in patients with stage 1-3 CRC at West Cancer Center and Research Institute (WCCRI). Patients with CRC who received ctDNA MRD testing 3-8 weeks after curative surgical resection for stage 1-3 disease from 12/2019 to 02/2022 were evaluated. Both patients with single testing and serial ctDNA assays were included. Individual chart review was performed to collect demographic information, verify diagnosis, stage, pathology, ctDNA and imaging results, and treatment course. ctDNA positivity rates were calculated and analyzed by diagnosis, stage, and clinical course. MRD results from 104 patients were available, 64 of which had sequential results. Positivity rate at initial testing was associated with stage: stage 1 0/9 pts, stage 2 5/40 (12.5%), stage 3 15/55 (27%). In the 64 patients with sequential data, conversion from negative to positive occurred in 7/50 (14%), 8/14 patients initially positive results converted to negative after adjuvant therapy, 5 of which developed ctDNA positivity in further monitoring after 3-14 months (range) with to date 4 recurrences confirmed by imaging. 27/104 patients were found to be ctDNA positive at any time point of which 2 patients were initially ctDNA negative with presence of overt disease (1 small pulmonary metastases, 1 incidentally found peritoneal nodule). In sequential ctDNA monitoring, both patients eventually showed positive ctDNA results. Only 1 patient had a false positive result at low Mean Tumor Molecule level (0.06 MTM/mL). Tumor-informed ctDNA MRD testing has very high sensitivity and specificity, but a one-time negative test result does not preclude the presence of metastatic disease, in particular with regard to pulmonary and peritoneal tumor manifestations. Prospective randomized and non-randomized studies are underway to further assess the clinical utility of ctDNA MRD testing in early stage CRC.

Cost-Effectiveness of Hepatitis B Testing and Vaccination of Adults Seeking Care for Sexually Transmitted Infections.

The estimated number of people living with hepatitis B virus (HBV) infection acquired through sexual transmission was 103,000 in 2018, with an estimated incidence of 8300 new cases per year. Although hepatitis B (HepB) vaccination is recommended by the Advisory Committee for Immunization Practices for persons seeking evaluation and treatment for sexually transmitted infections (STIs), prevaccination testing is not yet recommended. Screening may link persons with chronic hepatitis B to care and reduce unnecessary vaccination. We used a Markov model to calculate the health impact and cost-effectiveness of 1-time HBV testing combined with the first dose of the HepB vaccine for adults seeking care for STI. We ran a lifetime, societal perspective analysis for a hypothetical population of 100,000 aged 18 to 69 years. The disease progression estimates were taken from recent cohort studies and meta-analyses. In the United States, an intervention that costs less than $100,000 per quality-adjusted life-year (QALY) is generally considered cost-effective. The strategies that were compared were as follows: (1) vaccination without HBV screening, (2) vaccination and hepatitis B surface antigen (HBsAg) screening, (3) vaccination and screening with HBsAg and anti-HBs, and (4) vaccination and screening with HBsAg, anti-HBs, and anti-HBc. Data were obtained from Centers for Medicare & Medicaid services reimbursement, the Centers for Disease Control and Prevention vaccine price list, and additional cost-effectiveness literature. Compared with current recommendations, the addition of 1-time HBV testing is cost-saving and would prevent an additional 138 cases of cirrhosis, 47 cases of decompensated cirrhosis, 90 cases of hepatocellular carcinoma, 33 liver transplants, and 163 HBV-related deaths, and gain 2185 QALYs, per 100,000 adults screened. Screening with the 3-test panel would save $41.6 to $42.7 million per 100,000 adults tested compared with $41.5 to $42.5 million for the 2-test panel and $40.2 to $40.3 million for HBsAg alone. One-time HBV prevaccination testing in addition to HepB vaccination for unvaccinated adults seeking care for STI would save lives and prevent new infections and unnecessary vaccination, and is cost-saving.

Резултати от външното оценяване по биология и здравно образование – 8. клас (2018 – 2019 г.)

The article presents the results of the external assessment in Biology and Health Education – 8. grade during the 2018 – 2019 school year, in representative sample of 2682 students from all administrative regions. The sample is representative for the country, but not representative for the regions. The research is purposefully oriented to the acquired knowledge, skills, attitudes and attitudes of students, as well as deficits in the process of teaching Biology. In quality as real unit of measure achievements we perceive the assessment task. The length of the test is 15 tasks - 13 with optional answer and 2 with free answer. The results of the one-time testing of the test show that the tasks have good statistical characteristics. There is a statistically significant difference in student achievements, in favor of those with intensive foreign language learning.

Understanding Compliance, Practice Patterns, and Barriers Among Gastroenterologists and Primary Care Providers Is Crucial for Developing Strategies to Improve Screening for Barrett’s Esophagus

Understanding Compliance, Practice Patterns, and Barriers Among Gastroenterologists and Primary Care Providers Is Crucial for Developing Strategies to Improve Screening for Barrett’s Esophagus