Specific Instruments Research Articles

Prehydrated collagenated cortico-cancellous heterologous bone gel and papillae tunneling for isolated intrabony defects: 12-month noninferiority trial.

This study assessed the effectiveness of prehydrated collagenated xenogenic bone gel and a collagenated cortico-cancellous heterologous bone mixture in conjunction with papillae tunneling techniques (PTT) for treating isolated periodontal intraosseous defects. Twenty patients with periodontitis stage III/IV and at least one deep isolated interdental 2/3-wall intraosseous defect were included in the study. Surgical incisions were made vertically at the adjacent tooth or horizontally at the mucogingival junction. A full-thickness flap was then carefully lifted under the papillae using special tunneling instruments. The root surfaces were completely cleaned, and the defects were randomly filled with either prehydrated collagenated bone gel (test group; n = 10) or collagenated cortico-cancellous heterologous bone mixture (control group; n = 10). Wounds were closed with microsurgical sutures. We predicted that the lower 95% confidence interval for the difference between the two procedures would exceed a prespecified noninferiority threshold. All wounds closed sufficiently to prevent biomaterial exposure. The test and control groups showed similar mean pocket depth reduction (3.5 ± 1.0vs. 3.9 ± 1.7 mm; p = 0.52), similar gingival recession (-0.10 ± 0.99vs. 0.2 ± 0.8 mm; p = 0.46), and similar clinical attachment gain (3.6 ± 1.51vs. 3.7 ± 1.8 mm; p = 0.89) at the 12-month follow-up. All results were below the noninferiority margin of the sample. At 12 months, prehydrated collagenous bone gel performed similarly to collagenous heterologous bone granules in the treatment of intraosseous lesions with PTT. In addition, both biomaterials preserved soft tissue with minimal further recession at 1 year. When combined with PTT, collagenous xenogeneic bone granules and prehydrated collagenous bone gel achieve comparable clinical outcomes in intrabony defects.The study was registered under the NCT04782921 on ClinicalTrails.

Managing health through environmental policies. Analysis for European Union countries

PurposeEnvironmental degradation resulting from human activities may adversely affect human health in multiple ways. Until now, policies aimed at mitigating environmental problems such as climate change, environmental pollution and damage to biodiversity have failed to clearly identify and drive the potential benefits of these policies on health. The conducted study assesses and demonstrates how specific environmental policies and instruments influence perceived human health in order to ensure input for a data-driven decision process.Design/methodology/approachThe study was conducted for the 2004–2020 period in European Union (EU) countries with the use of dynamic panel data modeling. Verification of specific policies' impact on dependent variables allows to indicate this their effectiveness and importance. As a result of the computed dynamic panel data models, it has been confirmed that a number of significant and meaningful relationships between the self-perceived health index and environmental variables can be identified.FindingsThere is a strong positive impact of environmental taxation on the health index, and the strength of this relationship causes effects to be observed in the very short term, even the following year. In addition, the development of renewable energy sources (RES) and the elimination of fossil fuels from the energy mix exert positive, although milder, effects on health. The reduction of ammonia emissions from agriculture and reducing noise pollution are other health-supporting factors that have been shown to be statistically valid. Results allow to identify the most efficient policies in the analyzed area in order to introduce those with the best results or a mix of such measures.Originality/valueThe results of the authors' research clearly indicate the health benefits of measures primarily aimed at improving environmental factors, such as environmental taxes in general. The authors have also discovered an unexpected negative impact of an increase in the share of energy taxes in total taxes on the health index. The presented study opens several possibilities for further investigation, especially in the context of the rapidly changing geopolitical environment and global efforts to respond to environmental and health challenges. The authors believe that the outcome of the authors' study may provide new arguments to policymakers pursuing solutions that are not always easily acceptable by the public.

Cross-cultural validation of the Portuguese version of the Dialysis Symptom Index for haemodialysis patients.

Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) are associated with low quality of life (QoL) and high disease-related symptoms. The patient self-report instruments can assess the burden of physical and psychological symptoms. The Dialysis Symptom Index (DSI) is a specific instrument to evaluate the multidimensional reported symptoms by patients undergoing HD. To translate, validate and assess the psychometric properties of the Portuguese version of the DSI. A cross-cultural adaptation process from English to Portuguese and a validation study (n = 156) were conducted. Reliability, validity and responsiveness were assessed. The patients' most reported symptoms were, nausea (n = 86, 55%), muscle cramps (n = 92, 59%), feeling tired or lack of energy (n = 92, 59%), bone or joint pain (n = 88, 56%) and trouble staying asleep (n = 95, 60%). Cronbach's alpha of the DSI was 0.87, and intraclass correlation coefficient was 0.868 (95%CI 0.836-0.896). The smallest detectable change was 28.32. The Portuguese DSI demonstrates excellent psychometric properties for assessing HD patients' reported symptoms. It highlights symptom severity and impact, providing valuable insights for healthcare practitioners. Nurses can use the DSI to tailor interventions and enhance patient-centred care.

Dupilumab treatment improves signs, symptoms, quality of life, and work productivity in patients with atopic hand and foot dermatitis: Results from a phase 3, randomized, double-blind, placebo-controlled trial

Despite high disease burden, systemic treatment options for patients with atopic hand and/or foot dermatitis (H/F AD) are limited. To evaluate efficacy and safety of dupilumab in H/F AD using specific instruments for assessing disease severity on hands and feet. In this multicenter phase 3 trial, adults and adolescents with moderate-to-severe H/F AD were randomized to dupilumab monotherapy (regimen approved for generalized AD), or matched placebo. The primary endpoint was proportion of patients achieving Hand and Foot Investigator's Global Assessment score 0 or 1 at week 16. Secondary prespecified endpoints assessed the severity and extent of signs, symptom intensity (itch, pain), quality of life, and sleep. A total of 133 patients (adults=106, adolescents=27) were randomized to dupilumab (n=67) or placebo (n=66). At week 16, significantly more patients receiving dupilumab (n=27) than placebo (n=11) achieved Hand and Foot Investigator's Global Assessment score 0 or 1 (40.3% vs 16.7%; P=.003). All other prespecified endpoints were met. Safety was consistent with the known AD dupilumab profile. Short-term, 16-week treatment period. Dupilumab monotherapy resulted in significant improvements across different domains of H/F AD with acceptable safety, supporting dupilumab as a systemic treatment approach for this often difficult to treat condition.

The Non-Speech Oral Movement Assessment for Children

Introduction: Examination of oral movements is often part of an assessment undertaken by a speech and language therapist (SLT). Until now, there have been no specific instruments or tests with reference values for typically developing children in Dutch that exclusively evaluate non-speech oral movements in young children. Therefore, a non-speech oral motor observation list was designed to attempt to bridge this gap: the Non-Speech Oral Movement Assessment for Children (NOMAC). The aim of this study was to evaluate the psychometric properties of the NOMAC in terms of inter-rater reliability and its’ construct validity. In addition, we aimed to collect reference values for non-speech oral movements in children. Methods: Data from typically developing Dutch children aged 2–8 years were collected. Inter-rater reliability was studied by estimating the intra-class correlation coefficient (ICC). Construct validity was investigated by assessing the effect of age group and gender on the mean execution score per item (general linear model). To present normative data, the percentage of the children performing a normal oral motor execution was calculated. Results: The study includes a total of 318 children, divided into 9 age groups. The inter-rater reliability shows a moderate to excellent ICC for most items. A significant effect of the factor age group on almost all items was seen, confirming robust construct validity. Normative data are presented with the percentage of the children performing a normal oral movement execution. Conclusion: Non-speech oral movements can be assessed with the NOMAC in children between 2 and 8 years old and can be compared with values obtained from a normative group. It should be used as part of a clinical feeding and speech assessment. Despite the fact that current insights indicate that oral motor training has no value for improving mastication, swallowing, and speech, it is important to know the status of non-speech oral motor capabilities. With this assessment, a complete profile of the child’s oral motor abilities can be achieved, supportive of clinical decision making in SLT.

Secondary Ion Mass Spectral Imaging of Metals and Alloys.

Secondary Ion Mass Spectrometry (SIMS) is an outstanding technique for Mass Spectral Imaging (MSI) due to its notable advantages, including high sensitivity, selectivity, and high dynamic range. As a result, SIMS has been employed across many domains of science. In this review, we provide an in-depth overview of the fundamental principles underlying SIMS, followed by an account of the recent development of SIMS instruments. The review encompasses various applications of specific SIMS instruments, notably static SIMS with time-of-flight SIMS (ToF-SIMS) as a widely used platform and dynamic SIMS with Nano SIMS and large geometry SIMS as successful instruments. We particularly focus on SIMS utility in microanalysis and imaging of metals and alloys as materials of interest. Additionally, we discuss the challenges in big SIMS data analysis and give examples of machine leaning (ML) and Artificial Intelligence (AI) for effective MSI data analysis. Finally, we recommend the outlook of SIMS development. It is anticipated that in situ and operando SIMS has the potential to significantly enhance the investigation of metals and alloys by enabling real-time examinations of material surfaces and interfaces during dynamic transformations.

Validation of China Health-Related Outcomes Measures-Cardiovascular Disease

ObjectivesChina Health-Related Outcomes Measures (CHROME) was an initiative aimed at developing a system of preference-based health-related quality of life instruments for China. CHROME-cardiovascular disease (CVD) is a CVD-specific instrument with 14 items developed under this initiative. This study aimed to test the psychometric properties of CHROME-CVD. MethodsThis validation study was conducted using cross-sectional questionnaire survey in China. Eligible patients with CVD were recruited and asked to complete the CHROME-CVD, the EQ-5D-5L, and a CVD-specific nonpreference-based health-related quality of life instrument selected according to the confirmed diagnosis of the patients. Item evaluation, internal consistency, measurement invariance, test-retest reliability, structural validity, and construct validity were tested using classic test theory. Item response theory was used to evaluate item-level performance. ResultsA total of 444 patients with CVD (coronary artery disease, n = 276, heart failure, n = 104, angina, n = 33, and atrial fibrillation, n = 16) from 6 provinces in China were enrolled for the validation. Exploratory factor analysis identified 4 factors: chest pain, other symptoms, physical health, and mental and social health. Cronbach’s alpha and intraclass correlation coefficient were >0.8. A total of 20 of 26 (76.9%), and 90 of 95 (94.7%) predefined hypotheses were met for convergent and discriminant validities, respectively. No important difference was identified between subgroups of gender and residency. Response options of 10 items were found overlapped based on categorical response curves, which led to modification to 4-level response options. Wording of 3 items were modified by referring wordings of reference instruments. ConclusionThe validation of the CHROME-CVD demonstrated generally good psychometric properties. Further validation on the modified CHROME-CVD is needed.

Knowledge, practices and barriers to access sexual health of women in the menopausal stages: a cross-sectional study with Brazilian gynecologists

BackgroundSexual health access and care for women in the menopausal stages face significant barriers, presenting deficits in relation to diagnosis and treatment. Although epidemiological data indicate high prevalence of problems related to sexual health in this population, traditionally, the theme is not discussed in health care settings. This study aimed to analyze knowledge, practices and barriers to access sexual health of women in the menopausal stages in the context of women’s health care in Brazil.MethodsWith a cross-sectional design, a questionnaire was distributed electronically, encompassing variables related to knowledge; practices; and barriers to access sexual health of women in the menopausal stages. The data obtained were subjected to analysis using both descriptive and inferential statistics. Specifically, we employed multivariate analysis, employing multiple linear regression models, to discern potential factors associated with outcomes concerning the level of knowledge and the frequency of addressing the topic in professional practice.ResultsThe sample included 70 physicians with specialization in obstetrician/gynecologists who work in health care with women in the menopausal transition or postmenopausal women. A high level of self-reported knowledge about sexual health was identified. Regarding the practices, most of them reported directly proposing the subject and not using instruments. Although they reported frequently addressing the topic in general, topics related to vaginal lubrication, dyspareunia, and sexual dysfunction have been more present in the clinic compared to sexual orientation and women’s relationship with themselves. The main barriers were time limitation and patient discomfort with the topic. The multivariate models indicated that female gynecologists and professionals with higher levels of knowledge on the subject had a higher frequency of addressing sexual health in clinical practice with women in menopausal stages.ConclusionsSexual health access and care for brazilian women in the menopausal stages presents discrepancies in the frequency of approach between the various topics, in addition to the predictive character of technical knowledge in the practices of professionals. To ensure universal access to sexual health services for this population, an active approach through specific instruments is important, as well as the reinforcement of strategies to improve the level of knowledge of professionals.

Transosseous wiring method for simple transverse shaft fracture of the upper extremity

Purpose: A diaphyseal simple transverse fracture (DSTF) of the upper extremity (UE) requires direct anatomical reduction and absolute stability. No standard efficient method exists for reducing and maintaining a DSTF, despite its importance. Here, we introduce our transosseous wiring (TOW) method for UE-DSTFs.Methods: To maintain reduction, the UE-DSTF was first fixed with TOW before definitive fixation with a locking plate across the fracture. We retrospectively reviewed 15 patients with at least 1 year of postoperative follow-up treatment from 2019 to 2021.Results: All patients had achieved anatomical reduction and bone union at the final follow-up. Three patients had hardware removed because of irritation caused by the plate and screws. However, none of those three patients complained of irritation from the wire. One patient experienced refracture at the same site after hardware removal after a fall. The same technique was used in this case, and the bone union was observed 6 months after surgery.Conclusion: TOW is a simple straightforward method that can be applied without special instruments. It could be an efficient method for interfragmentary compression and attachment of a locking plate without the burden of maintaining the reduction of UE-DSTFs.

Upper partial sternal split for pediatric cardiac surgery

ObjectivesWe introduced the use of an upper partial sternal split for pediatric cardiac surgical procedures in our unit in 2016. We report the outcomes of our experience in 51 patients using this approach.MethodsFrom February 2016 to September 2022, 51 patients underwent congenital cardiac surgical procedures using an upper partial sternal split including vascular ring repair (n = 20), subaortic membrane (n = 12), ventricular septal defect closure with aortic valve resuspension (n = 9), aortic arch repair (n = 4), pulmonary artery band (n = 2), pulmonary artery sling (n = 1), supravalvular aortic stenosis (n = 1), aortic valve replacement (n = 1), and pulmonary artery plasty (n = 1). The surgical approach involved a midline skin incision, based on the manubrium, followed by an upper manubriotomy. No special surgical instrumentation was required. Median patient age was 2.9 years (IQR 1.3, 6.0); median body weight was 15 kg (IQR 9.8, 20).ResultsThere was no mortality and no patient required intraoperative conversion to full sternotomy. One patient required re-exploration for bleeding when the incision was converted to a full sternotomy. There were no wound complications in any patient. Twenty-one patients (41%) were extubated on the table and of the remaining 30 patients, 23 patients (76%) were extubated within 24 h of surgery. Eleven patients did not require intensive care unit (ICU) admission. Median ICU and hospital stay was 1 day (IQR 1, 1.25) and 5 days (IQR 4, 8) ,respectively.ConclusionAn upper partial sternal split approach is straightforward and can be performed safely with a preferable cosmetic result in selected pediatric cardiac operations.

The 2030 Agenda in Uruguay: critical aspects of its implementation during the period 2015-2020

We are facing a time of multidimensional crisis that demands new policy responses that place sustainable development at the centre. The 2030 Agenda was born in 2015 as a framework for collective action in response to the challenge of the multidimensional crisis, with the aim of serving as a guide for all countries to move towards sustainable development. This article addresses this challenge by studying the implementation of the 2030 Agenda in Uruguay between 2015 and 2020. It analyses the deployment of this agenda with reference to six critical areas for the success of the 2030 Agenda: the visions and narratives of the agenda, the institutional framework, the strategic vision, coordination and coherence between actors, the role of civil society and the specific instruments for its implementation. The article focuses on the strengths and weaknesses of this process, highlighting the excessive focus on the dynamics of technocratisation and accountability that can undermine efforts for achieving sustainable development.

Biomechanical phenotyping pipeline for stalk lodging resistance in maize

Stalk lodging (structural failure crops prior to harvest) significantly reduces annual yields of vital grain crops. The lack of standardized, high throughput phenotyping methods capable of quantifying biomechanical plant traits prevents comprehensive understanding of the genetic architecture of stalk lodging resistance. A phenotyping pipeline developed to enable higher throughput biomechanical measurements of plant traits related to stalk lodging is presented. The methods were developed using principles from the fields of engineering mechanics and metrology and they enable retention of plant-specific data instead of averaging data across plots as is typical in most phenotyping studies. This pipeline was specifically designed to be implemented in large experimental studies and has been used to phenotype over 40,000 maize stalks. The pipeline includes both lab- and field-based phenotyping methodologies and enables the collection of metadata. Best practices learned by implementing this pipeline over the past three years are presented. The specific instruments (including model numbers and manufacturers) that work well for these methods are presented, however comparable instruments may be used in conjunction with these methods as seen fit.•Efficient methods to measure biomechanical traits and record metadata related to stalk lodging.•Can be used in studies with large sample sizes (i.e., > 1,000).

A visualized hybrid PCR-LAMP assay for the detection of human Plasmodium species

Combining the advantages of PCR and LAMP, we described a new technique, namely PCR-LAMP, for malaria diagnosis. The whole process of DNA amplification can be completed in 35 min. This hybrid amplification technique markedly improved the sensitivity of detection compared to the classic single PCR or LAMP assay alone. PCR-LAMP assay had a detection limit of 1 copy/µL for P. knowlesi and P. ovale, 0.1 copy/µL for P. vivax, P. falciparum and P. malariae, respectively. To facilitate the endpoint detection, xylenol orange was added. Positive samples were indicated in orange while negative reactions were violet. The inclusion of xylenol orange into the LAMP reaction mix significantly reduces the post-amplification workload. Without relying on the use of specific instruments, the color changes of the amplicons could be visualized directly through the naked eye. In conclusion, PCR-LAMP poses the potential to be developed as a new malaria molecular diagnosis tool.

“IN DER KRISE STECKEN” – ON THE WORD “CRISIS” AND ITS VERBAL COLLOCATIONS IN GERMAN AND ROMANIAN FROM THE PERSPECTIVE OF TEACHING GERMAN AS A FOREIGN LANGUAGE

The aim of this study is to analyze the verb collocations of the word “crisis” both in German and Romanian, through the lens of DaF teaching. The 24 German and 22 Romanian verb collocations of the analysed word were determined both from the dictionaries and with the help of specific instruments for determining the statistically significant combination partners of search words in corpora. The verbal combinations are analysed in terms of action-oriented DaF teaching by relating them to the communicative needs of a foreign language learner. From a phraseological point of view, more than half of the analysed word combinations function as collocations.

The effect of service quality on the safety of boxing athletes' training in Indonesia

This descriptive correlational study aimed at investigating the correlation between service quality and training safety, elucidating the significance of service quality in ensuring the safety of boxing athletes during their training. The study used a Structural Equation Model (SEM) approach. The data was collected from 220 boxers, averaging an age of 21±2.0 years and possessing an average training experience of 8±0.8 years. The data analysis in this research utilized the assistance of Smart PLS. Researchers categorized service quality variables into five distinct factors: tangible, empathy, reliability, responsiveness, and assurance. Safety variables were divided into two categories: health and comfort. This categorization resulted in a total of 25 indicators reflected in the questionnaire results. The outcomes of hypothesis testing indicate significant relationships: tangible and empathy factors significantly impact both health and comfort, while reliability and responsiveness notably influence comfort. Additionally, the factor of assurance demonstrates a substantial influence on health (p<0.05). However, there were observations where reliability and responsiveness did not exhibit a significant impact on health, and assurance did not significantly affect comfort (p>0.05). These instances suggest a lack of statistical relationship between the independent and dependent variables in these specific cases. The training facilities used by boxers must pay attention to the level of safety by improving the quality of service from the club or organization. The results of this research are expected to be a reference for sports practitioners, academics, facility owners or sports clubs, to pay more attention to service quality to increase safety when practicing. Further research is expected to ensure that training safety variables can be studied in more detail by developing special instruments and larger specific populations, especially combat sports.

Diameter Measurement for Micro-Spheres via Coherent Scanning Interferometry with Reference to Gauge Block

This paper describes a diameter measurement method for micro-spheres via coherent scanning interferometry (CSI) with a gauge block as the reference. The CSI system measures the height difference between the sphere and gauge block surface from both the front and back sides; then, the diameter is calculated from the measured heights via CSI and the gauge block length. For the glass sphere measured in this study, the diameter was found to be 270.556 µm with an uncertainty of 0.16 µm (k=2). Interestingly, by selecting a gauge block that matches the sphere diameter, the measurement uncertainty remained virtually unchanged, even for different sphere diameters; the proposed method achieved a relative uncertainty of 10-3–10-4. By utilizing the calibrated reference and the highly sensitive CSI system, and based on the comparator principle, the proposed method enables accurate diameter measurement without requiring specific measurement instruments.

Urban Heat Islands in Tirana, Albania - Analysis and Potential Solutions

Cities and towns are expanding and thriving as a result of urbanization, which also significantly changes the local climate. One of the most significant phenomena associated with urbanization is the Urban Heat Island (UHI) effect. This phenomenon is increasingly being studied worldwide. The paper aims to investigate the UHI phenomenon in the metropolitan area of Tirana, Albania. It analyses the impact of the UHI on four specific locations in Tirana, its causes and mitigation measures, as well as variations in surface temperature, CO2 emissions, and relative humidity. The regions are measured and observed using a specific instrument such as the Testo 435. Considering the mean surface temperature variations between urban and rural regions ranging from 28.4°C to 33.7 °C, CO2 emissions from 302.9 ppm to 416.2 ppm, and relative humidity from 34.1% to 41.2%, it is found that the UHI impact in Tirana is significant. The lack of green spaces, high building density, urban patterns, building materials used, transport, and energy use are the main contributors to the UHI in central Tirana. Increasing green spaces, using reflective materials, and promoting sustainable urban design are some of the mitigation techniques suggested to reduce the UHI effect in Tirana.

Studying industrial financial portfolio perspectives - BOXPI for the environmental transition of China.

To ease the process of environmental transformation, this study thoroughly examines industrial, financial portfolio views using the novel BOXPI framework. This study uses a secondary data research methodology to investigate how investors have adjusted their portfolios in light of urgent ecological concerns. It uses case studies from various sectors to illuminate the intersection of economics, ecology, and corporate responsibility. This study highlights the need to balance economic goals and environmental concerns, revealing potential routes to sustainable growth. Industries, investors, and legislators are all affected somehow, which can only lead to better, more sustainable decisions overall. Policymakers, financial institutions, and industry stakeholders are navigating this vital confluence of environmental transition; the research might give significant insights and ideas to help them. Future research might look at the long-term financial resilience of sectors undergoing significant environmental shifts or investigate the unique consequences of specific financial instruments.

Developing competencies through flow, gamification and cultural integration: an analysis of the potential of games in teaching/learning

Much has been done to recover from the effects of the COVID-19 pandemic on school and university education, both in filling gaps in learning and in social integration and motivation of students post-pandemic. The need to transition from conventional teaching to remote learning has led students and teachers in a spiral of evolution in the development of digital skills due to the urgent adaptability required by the situation. The search for new technologies and didactics that seemed difficult at the time because many were not yet expecting such a sudden change, now takes advantage of that experience to create projects and courses that allow for accelerated recovery and thus transform what was once a complicated task into a new perspective on teaching and learning. One of these ways is the use of epistemic games and gamification to maintain ‘flow’. Flow is a combination of skill development through challenges and the pleasure of completing tasks. In this work, we will discuss a project that, with the union of remote and face-to-face teaching & learning, allowed university students to use the knowledge received during an intensive course on environmental radiation to design an escape room-style game with the aim of teaching students at other levels of education. CERAMUG, a Blended Intensive Programme (BIP) in partnership with ERASMUS+, aimed at two-way learning, to learn to use specific instruments for measuring natural environmental radiation and to teach, through a game, the existence of this natural radiation in order to inform and raise awareness of high school students on the subject. The aim of this course was to promote the development of competencies that allow students to succeed in their future professional challenges. The impact of the project is not only the innovative experience for students to learn specialized nuclear measurement techniques, but also to encourage other employability competencies and digital skills necessary for their careers, as well as promoting integration among students from different cultures and countries.

A novel label-free capillary electrophoresis LED-induced fluorescence platform based on catalytic hairpin assembly for sensitive detection of multiple circulating tumor DNA.

Circulating tumor DNA (ctDNA) is a highly promising biomarker for the early diagnosis and treatment of gastric cancer (GC). However, there is still a lack of effective and practical ctDNA detection methods. In this work, a simple and economical capillary non-gel sieving electrophoresis-LED induced fluorescence detection (NGCE-LEDIF) platform coupled with catalytic hairpin assembly (CHA) as the signal amplification strategy is proposed for quantitative detection of PIK3CA E542K and TP53 (two types of ctDNA associated with GC). We have reasonably designed two pairs of programmable oligonucleotide hairpin probes for PIK3CA E542K and TP53. Using a one-pot reaction, the presence of ctDNA triggers the cyclic amplification of CHA, forming numerous thermodynamically stable H1/H2 double-strands. The H1/H2 double-stranded DNA catalyzed by PIK3CA E542K and TP53 can be easily separated by NGCE due to their different lengths, enabling simultaneous detection of both ctDNAs. Under optimal experimental conditions, the detection limits of this strategy for detecting GC-related biomarkers PIK3CA E542K and TP53 are 20.35 pM and 19.61 pM, respectively, and can achieve 730-fold signal amplification. This strategy has a good recovery in the serum matrix. The results of this study show that this strategy has significant advantages such as high selectivity, a simple process, no special instruments and equipment, no need for fluorescence modification of hairpin probes in advance, high automation, low cost, and minimal sample consumption. This provides a powerful method for the detection of trace cancer biomarkers in the serum matrix with good application prospects.