Testing Capabilities Research Articles

Development of a risk assessment model for cardiac injury in patients newly diagnosed with acute myeloid leukemia based on a multicenter, real-world analysis in China

BackgroundStudies have revealed that acute myeloid leukemia (AML) patients are prone to combined cardiac injury. We aimed to identify hematological risk factors associated with cardiac injury in newly diagnosed AML patients before chemotherapy and develop a personalized predictive model.MethodsThe population baseline, blood test, electrocardiogram, echocardiograph, and genetic and cytogenetic data were collected from newly diagnosed AML patients. The data were subdivided into training and validation cohorts. The independent risk factors were explored by univariate and multivariate logistic regression analysis respectively, and data dimension reduction and variable selection were performed using the least absolute shrinkage and selection operator (LASSO) regression models. The nomogram was generated and the reliability and generalizability were verified by receiver operating characteristic (ROC) curves, the area under the curve (AUC) and calibration curves in an external validation cohort.ResultsFinally, 499 AML patients were included. After univariate logistic regression, LASSO regression and multivariate logistic regression analysis, abnormal NT-proBNP, NPM1 mutation, WBC, and RBC were independent risk factors for cardiac injury in AML patients (all P < 0.05). The nomogram was constructed based on the above four variables with high accuracy. The area under the curve was 0.742, 0.750, and 0.706 in the training, internal validation, and external validation cohort, respectively. The calibration curve indicated that the model has good testing capability. The Kaplan-Meier curve showed that the higher the risk of combined cardiac injury in AML patients, the lower their probability of survival.ConclusionsThis prediction nomogram identifies hematological risk factors associated with cardiac injury in newly diagnosed AML patients and can help hematologists identify the risk and provide precise treatment options.

Diagnostic Performance of Saliva Samples in Asymtomatic COVID-19 Infected Patients in Kakamega Kenya

The pandemic coronavirus SARS‐CoV‐2 in the world has caused a large infected population suffering from COVID‐19. To curb the spreading of the virus, WHO urgently demanded an extension of screening and testing; thus, a rapid and simple diagnostic method is needed which is non-invasive. Use of self-collected saliva can minimize healthcare worker exposure and expand testing capabilities for symptomatic and asymptomatic patients. The main aim of this study was to document the ability of patients to self-collect sufficient saliva specimens for SARS-CoV-2 in the quantitative detection by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in asymptomatic patients by themselves under observation by a healthcare provider. The researcher recorded whether the patients were confident and the suitability of the specimen for laboratory testing that would inform clinical decision making. Seventy-one patients aged from 13 years and above were included between December 2020 and July, 2021. Saliva samples and Nasopharyngeal samples were taken from each patient. Quantitative PCR was performed to detect SARS-CoV-2 viral load in the nasopharyngeal samples and qualitative Reverse Transcriptase Loop-mediated isothermal amplification (RT-LAMP) was used to detect the presence of the virus in saliva samples. Results of saliva vs. nasopharyngeal samples testing using the two different methods were compared. Statistical analyses were performed. Out of the 350 samples tested, 314 samples were found to be Covid 19 positive. Result of the test was validated by the RT-PCR test. This showed that only 314 samples were tested both by saliva rapid test and PCR test while the rest 36 samples were not tested using RT-PCR method but were tested using saliva test. Thus, the salivary test based on pure oral saliva samples easily obtained by noninvasive techniques using RT-LAMP has the same agreement with the nasopharyngeal technique using RT-PCR one in asymptomatic COVID-19 patients.

Label-free and early detection of HER2 breast cancer biomarker based on UiO-66-NH2 modified gold chip (Au/UiO-66-NH2) using surface plasmon resonance technique

Breast cancer is one of the leading causes of cancer death for women worldwide. This cancer occurs when the breast cells grow abnormally and spread uncontrolled. Although there are several treatments, including chemotherapy, radiation, and surgery in a clinical setting to cure cancer, these treatments cannot provide a 100 % success rate in eliminating cancer, mainly due to the late diagnosis of the disease. Thus, early detection is the key to provide better breast cancer treatment and a higher chance for survival. Herein, simple and sensitive biosensor by combining the emerging multifunctional materials of metal-organic frameworks (MOFs) with a label-free surface plasmon resonance (SPR) instrument was developed. Two types of stable Zirconium (Zr)-based MOFs, namely Zr benzene dicarboxylic acid (Zr-BDC or UiO-66) and Zr 2-amino-benzene dicarboxylic acid (Zr-BDC-NH2 or UiO-66-NH2) were synthesized using the solvothermal method. X-ray diffractometer (XRD) and fourier transform infra red (FTIR) confirmed the formation of the prepared UiO-66 and UiO-66-NH2. The electron microscopy and nitrogen adsorption desorption isotherm characterization reveal that the MOFs have a cubic crystal structure with a high surface area of 672.4 m2/g for UiO-66 and 286.1 m2/g for UiO-66-NH2. The MOFs are then functionalized on the SPR gold (Au) chip surface to serve as a matrix of Human Epidermal Growth Factor Receptor 2(HER2) antibody receptors. Interestingly, the functionalized SPR biosensors could detect the HER2 protein target with high sensitivity in the ng/mL range and a remarkable detection limit, which is 0.457 ng/mL for UiO-66-NH2. This LOD value is significantly lower than clinical concentrations of HER2 proteins in human blood (∼15 ng/mL), which indicate that the biosensor can offer the capability of early detection test.

Prior austenite grain measurement: A direct comparison of EBSD reconstruction, thermal etching and chemical etching

It is well known that the prior austenite grain (PAG) microstructure of steels has a significant impact on their microstructure evolution and mechanical properties. Many PAG measuring techniques have been developed over many decades, with the effectiveness of each varying alloy-to-alloy. Some of the more common techniques, specifically for bainitic and martensitic grades, are thermal etching and picric acid etching, which both involve the preferential etching of PAG boundaries in order to reveal the austenitic microstructure. More recently, parent grain reconstruction techniques using EBSD (electron backscatter diffraction) mapping have shown good promise in recreating PAG microstructures from BCC-FCC orientation relationships, and can now be deployed at speed with the advent of rapid detectors (1000s of pixels per second). This study aims to compare the accuracy and relative advantages/disadvantages of picric acid etching, thermal etching and EBSD reconstruction methods. A TESCAN and NewTec In-Situ Testing (TANIST) capability was used to directly observe and measure the true high-temperature PAG structure during the austenitisation of SA-540 B24 low alloy steel. These high-temperature PAG measurements were then compared to measurements from the same area obtained using thermal etching, picric acid etching and EBSD parent grain reconstructions after quenching to room temperature. Reconstructing the parent austenite grains from EBSD data resulted in the closest measurement of PAG size. PAG boundaries were delineated well by thermal etching but surface effects (such as surface relief and ghost traces) created complexities when identifying the exact position of boundaries. Picric acid etching, which produced the least accurate measurement, was found to reveal PAG boundaries well, however it was limited by its ability to sufficiently etch annealing twin boundaries and its susceptibility to microsegregational effects. EBSD reconstruction and thermal etching were more consistent at reconstructing/revealing these boundaries, although inaccuracies with the techniques were still observed.

The first clinical validation of whole-genome screening on standard trophectoderm biopsies of preimplantation embryos

The first clinical validation of whole-genome screening on standard trophectoderm biopsies of preimplantation embryos

Combined obesity- and lipid-related indices are associated with hypogonadism in Chinese male patients with type 2 diabetes: a cross-sectional study.

There is insufficient attention to hypogonadism in Chinese males with type 2 diabetes mellitus (T2DM). We evaluated the relationship between Combined obesity- and lipid-related indices [Visceral Adiposity Index (VAI), Chinese Visceral Adiposity Index (CVAI), Triglyceride Glucose Index (TyG) and Lipid Accumulation Product (LAP)] with total testosterone (TT) and analyzed the predictive capability of the respective cut-off values. We recruited 958 hospitalized male patients with T2DM at the Affiliated Hospital of Qingdao University, collected baseline data and four calculated indices, and obtained their dominance ratio (OR) and corresponding 95% confidence intervals (CI) with TT by multivariate logistic regression. Receiver operating characteristic (ROC) curves were then used to determine cutoff values in predicting hypogonadism (TT< 12 nmol/L), and we also analyzed the combinations between the different indices. VAI, CVAI, TyG, and LAP all have satisfactory predictive capabilities. The test capability (sensitivity and specificity) of all four indices was better or not worse than that of body mass index (BMI), homeostasis model assessment of insulin resistance (HOMA-IR) and waist circumference (WC). All four indices were effective predictors of hypogonadism at their respective cutoff values (VAI ≥ 2.284, CVAI ≥ 145.779, TyG ≥ 4.308, and LAP ≥ 59.850). Of these, LAP had the largest area under the curve (AUC, AUC = 0.852, Std. Error = 0.014, 95% CI = 0.818-0.873). However, the predictive capability of the combined indices was not significantly improved over the individual indices. VAI, CVAI, TyG, and LAP are sensitive indices for predicting hypogonadism in Chinese male patients with T2DM. Considering the need for concise and accurate indices in clinical practice, we suggest LAP as a commonly used index.

Genetic profile of syndromic retinitis pigmentosa in Portugal

PurposeRetinitis pigmentosa (RP) comprises a genetically and clinically heterogeneous group of inherited retinal degenerations, where 20–30% of patients exhibit extra-ocular manifestations (syndromic RP). Understanding the genetic profile of RP has important implications for disease prognosis and genetic counseling. This study aimed to characterize the genetic profile of syndromic RP in Portugal.MethodsMulticenter, retrospective cohort study. Six Portuguese healthcare providers identified patients with a clinical diagnosis of syndromic RP and available genetic testing results. All patients had been previously subjected to a detailed ophthalmologic examination and clinically oriented genetic testing. Genetic variants were classified according to the American College of Medical Genetics and Genomics; only likely pathogenic or pathogenic variants were considered relevant for disease etiology.ResultsOne hundred and twenty-two patients (53.3% males) from 100 families were included. Usher syndrome was the most frequent diagnosis (62.0%), followed by Bardet-Biedl (19.0%) and Senior-Løken syndromes (7.0%). Deleterious variants were identified in 86/100 families for a diagnostic yield of 86.0% (87.1% for Usher and 94.7% for Bardet-Biedl). A total of 81 genetic variants were identified in 25 different genes, 22 of which are novel. USH2A and MYO7A were responsible for most type II and type I Usher syndrome cases, respectively. BBS1 variants were the cause of Bardet-Biedl syndrome in 52.6% of families. Best-corrected visual acuity (BCVA) records were available at baseline and last visit for 99 patients (198 eyes), with a median follow-up of 62.0 months. The mean BCVA was 56.5 ETDRS letters at baseline (Snellen equivalent ~ 20/80), declining to 44.9 ETDRS letters (Snellen equivalent ~ 20/125) at the last available follow-up (p < 0.001).ConclusionThis is the first multicenter study depicting the genetic profile of syndromic RP in Portugal, thus contributing toward a better understanding of this heterogeneous disease group. Usher and Bardet-Biedl syndromes were found to be the most common types of syndromic RP in this large Portuguese cohort. A high diagnostic yield was obtained, highlighting current genetic testing capabilities in providing a molecular diagnosis to most affected individuals. This has major implications in determining disease-related prognosis and providing targeted genetic counseling for syndromic RP patients in Portugal.

Autonomous swab robot for naso- and oropharyngeal COVID-19 screening

The COVID-19 outbreak has triggered a global health and economic crisis, necessitating widespread testing to control viral spread amidst rising cases and fatalities. The recommended testing method, a combined naso- and oropharyngeal swab, poses risks and demands limited protective gear. In response to the COVID-19 pandemic, we developed and tested the first autonomous swab robot station for Naso- and Oropharyngeal Coronavirus Screening (SR-NOCS). A force-sensitive robot running under a Cartesian impedance controller is employed to drive the swab to the sampling area. This groundbreaking device underwent two clinical studies-one conducted during the initial pandemic lockdown in Europe (early 2021) and the other, more recently, in a public place after the pandemic had subsided earlier in the year 2023. In total, 52 patients suspected of COVID-19 infection were included in these clinical studies. The results revealed a complete positive correlation between autonomous and manual sampling. The test subjects exhibited a high acceptance rate, all expressing a willingness to undergo future tests with SR-NOCS. Based on our findings, such systems could enhance testing capabilities, potentially conducting up to 300 tests per robot per day with consistent precision. The tests can be carried out with minimal supervision, reducing infection risks and effectively safeguarding patients and healthcare workers.

Detection Technologies for Secondary Switching Components in Power Generation

In the operation of secondary circuits for power generation, a substantial number of various types of switching components are utilized. The primary types of secondary switching components employed include time relays, intermediate relays, auxiliary switches, and limit switches. These components occupy critical positions in the secondary circuit, where failures can easily lead to accidents affecting the safety of power generation. The testing institutions of power generation enterprises face challenges such as inadequate capabilities for component verification and testing, resulting in uncontrollable component performance. This paper discusses the necessary aspects of detecting secondary switching components, explores detection methods, and addresses the lack of self-inspection schemes for enterprises in conducting secondary switching component detection.

Results of a Pilot External Quality Assessment Scheme for Genetic Testing of Newborns with Spinal Muscular Atrophy.

This study aims to evaluate the ability of laboratories to perform spinal muscular atrophy (SMA) genetic testing in newborns based on dried blood spot (DBS) samples, and to provide reference data and advance preparation for establishing the pilot external quality assessment (EQA) scheme for SMA genetic testing of newborns in China. The pilot EQA scheme contents and evaluation principles of this project were designed by National Center for Clinical Laboratories (NCCL), National Health Commission. Two surveys were carried out in 2022, and 5 batches of blood spots were submitted to the participating laboratory each time. All participating laboratories conducted testing upon receiving samples, and test results were submitted to NCCL within the specified date. The return rates were 75.0% (21/28) and 95.2% (20/21) in the first and second surveys, respectively. The total return rate of the two examinations was 83.7% (41/49). Nineteen laboratories (19/21, 90.5%) had a full score passing on the first survey, while in the second survey twenty laboratories (20/20, 100%) scored full. This pilot EQA survey provides a preliminary understanding of the capability of SMA genetic testing for newborns across laboratories in China. A few laboratories had technical or operational problems in testing. It is, therefore, of importance to strengthen laboratory management and to improve testing capacity for the establishment of a national EQA scheme for newborn SMA genetic testing.

APPLICATION OF TEMPERATURE DEPENDANCES OF PARAMETERS IN A SINGLE-DIODE FIVE-PARAMETER MODEL OF SOLAR PANELS

Memory built-in self-test (MBIST) continues to have its unique place in IC industry. It provides test and repair capabilities which significantly increase IC manufacturing yield. In general, the integration of MBIST solutions in a system on chip (SoC) is done via automated flows. Possible issues occurring in the flow should not be skipped as it will degrade the performance of SoC or even may disrupt its functioning. The probability of issues is increased if the SoC has specific structure adding limitations for MBIST solution such as testing the memories by shared interface. Dedicated validation environments (VE) help to overcome these issues. Validation challenges of the MBIST solution via a shared interface for a specific case of multi memory bus BIST engines (MMBBE) are discussed, and a solution is proposed. To avoid the exhaustion increase for the integration scenarios random choices combined with some exhaustions are done depending on a given feature’s priority. Meantime, it is mentioned that for big configurations the usage of random values of parameters might bring to missing some corner cases. Due to that it is recommended to use further some learning methods for reducing the VE iterations and exhaustion within a given iteration. In all the cases, a targeted analysis should be done and decisions should be additionally taken to find out a reasonable number of these iterations. In this paper, a methodology is proposed to soften the mentioned above exhausti-on. A new algorithm of learning is proposed, and the results of the algorithm application are adduced which justify its efficiency in reducing the exhaustion.

A wax chalk and self-heating paper-based analytical device (SH-PAD) for the detection of bisphenol A.

Bisphenol A (BPA) is a synthetic xenoestrogen widely present in the environment, known for its toxicity, endocrine-disrupting nature, carcinogenicity, and mutagenic effects on living organisms. The detection of BPA is essential as it infiltrates the human body through food, water, dust and dermal contact. Conventional methods currently in use are inadequate for on-the-spot detection. Consequently, there is a pressing need to build an all-in-one device that can be quickly fabricated using readily available and cost-effective off-the-shelf materials for the detection of BPA. Firstly, we have leveraged wax chalk for fabricating hydrophobic barriers on paper, which offers a hydrophilic channel resolution of 1.64 mm ± 0.05 mm and also the ability to confine major aqueous solvents without leakage. The fabricated device was used to detect BPA using the Folin-Ciocalteu reagent and sodium carbonate (in the presence of heat). Secondly, we have developed a self-heating paper-based analytical device (SH-PAD) using masking tape, lamination paper and Whatman filter paper. This cost-effective approach (0.017$) is based on an exothermic reaction caused by sodium hydroxide and a small quantity of aluminium in the paper layers and can retain heat adequately for more than 5 minutes, addressing the challenge of external heat sources and enabling effective and rapid colorimetric detection of BPA using the Folin-Ciocalteu reagent and sodium carbonate. Both methods can detect up to 2 μg mL-1 in spiked water samples. This developed method's user-friendliness and cost-effectiveness make it a promising candidate for point-of-care diagnostics or detection, providing testing capabilities in areas with limited resources.

From barriers to opportunities from COVID-19 pandemic: Stakeholder perspectives on cervical cancer screening programs in LMICs of the Asia-Pacific region.

Cervical cancer is preventable, yet it remains the fourth most common cancer in women globally. The highest incidence and mortality occur in low- and middle-income countries (LMICs), where over 70% of women have never been screened, and 58% of the cases are in Asia. While the COVID-19 pandemic caused significant disruptions to cervical screening programs, particularly for LMICs, there were opportunities that emerged from the pandemic that were enablers of program recovery. Stakeholders played key roles in materialising strategy into implementation. Therefore, in this study, we examined the barriers and facilitators to implementing recovery strategies from the stakeholders' perspectives. We interviewed fifteen stakeholders from nine LMICs in the Asia-Pacific region directly involved in the implementation of the cervical screening program. A total of 23 barriers and 21 facilitators were identified, of which seven barriers and nine facilitators related directly to the pandemic. Pandemic-related barriers included movement restrictions, resource diversion, cancelled campaigns and training, deprioritisation of HPV prevention efforts, and a reduced health workforce. Stakeholders concurred that most barriers had predated the pandemic and remained as the pandemic eased. Conversely, the pandemic introduced facilitators such as means for targeted campaigns, improved understanding of viruses, accessible training with online platforms, better PCR testing capabilities, a shift in the government's position towards preventive health services, and openness to HPV testing and self-swabs. The emerging facilitators offered opportunities to address some of the persistent barriers, such as limited cervical cancer awareness and insufficient healthcare providers in screening programs. However, effective implementation of these emerging facilitators requires improved communication and collaboration between policymakers and implementers to accelerate the recovery of screening programs in LMICs. Further work is necessary to align emerging facilitators with the health system goals and resource settings of each country in turning these opportunities into actions.

Situational Analysis of Malaria Incidence Under Integrated Malaria Service in Hotspot Township - Minbya Township, Rakhine State, Myanmar, 2017-2020.

Malaria is a significant public health concern and tropical disease, particularly affecting Myanmar within the Greater Mekong Subregion. The annual parasite index (API) exceeds 1 per 10,000 population in the northern seven townships of Rakhine State, with Minbya Township designated as a high-burden area for malaria by the World Health Organization (WHO) Myanmar and the National Malaria Control Programme (NMCP). Since 2017, the Malaria reduction intensification plan has been in place in this township to combat the high disease transmission rates. This study aims to assess the malaria epidemiology in Minbya Township from 2017 to 2020 under the intensification plan for elimination, as well as to evaluate the effectiveness of the integrated strategy in reducing cases in hotspot areas. The study utilized a surveillance study design to collect secondary data from the Malaria surveillance system (MSS) and the epidemiologic monitoring dashboard of Minbya Township, Maruk-U District, located in Rakhine State. Since 2017, the Malaria prevention and control (P&C) Program in Minbya Township has successfully decreased malaria morbidity, eliminated malaria-related deaths, and bolstered malaria testing capabilities through the participation of village health volunteers (VHVs). Approximately 87% of malaria prevention and control services are executed by the township's malaria elimination and disease control programs, with additional support from stakeholders. The API dropped from 13 in 2017 to 2.5 in 2020, with Plasmodium vivax being the most prevalent malaria species, accounting for 55% of cases. The study suggests that early diagnosis and promotion of artemisinin-based combination treatment (ACT), along with strategic planning including expanding active case detection in rural health centers and implementing a community-based integrated healthcare approach, are effective and efficient strategies for malaria elimination.

Multiplexed electrical detection of whole viruses from plasma in a microfluidic platform.

The advancement of point-of-care diagnostics is crucial to improving patient outcomes, especially in areas with low access to hospitals or specialized laboratories. In particular, rapid, sensitive, and multiplexed detection of disease biomarkers has great potential to achieve accurate diagnosis and inform high quality care for patients. Our Coulter counting and immunocapture based detection system has previously shown its broad applicability in the detection of cells, proteins, and nucleic acids. This paper expands the capability of the platform by demonstrating multiplexed detection of whole-virus particles using electrically distinguishable hydrogel beads by demonstrating the capability of our platform to achieve simultaneous detection at clinically relevant concentrations of hepatitis A virus (>2 × 103 IU mL-1) and human parvovirus B19 virus like particles (>106 IU mL-1) from plasma samples. The expanded versatility of the differential electrical counting platform allows for more robust and diverse testing capabilities.

Severe acute respiratory syndrome coronavirus 2-reactive salivary antibody detection in South Carolina emergency healthcare workers, September 2019-March 2020.

On 19 January 2020, the first case of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was identified in the United States, with the first cases in South Carolina confirmed on 06 March 2020. Due to initial limited testing capabilities and potential for asymptomatic transmission, it is possible that SARS-CoV-2 may have been present earlier than previously thought, while the immune status of at-risk populations was unknown. Saliva from 55 South Carolina emergency healthcare workers (EHCWs) was collected from September 2019 to March 2020, pre- and post-healthcare shifts, and stored frozen. To determine the presence of SARS-CoV-2-reactive antibodies, saliva-acquired post-shift was analysed by enzyme-linked immunosorbent assay (ELISA) with a repeat of positive or inconclusive results and follow-up testing of pre-shift samples. Two participants were positive for SARS-CoV-2 N/S1-reactive IgG, confirmed by follow-up testing, with S1 receptor binding domain (RBD)-specific IgG present in one individual. Positive samples were collected from medical students working in emergency medical services (EMSs) in October or November 2019. The presence of detectable anti-SARS-CoV-2 antibodies in 2019 suggests that immune responses to the virus existed in South Carolina, and the United States, in a small percentage of EHCWs prior to the earliest documented coronavirus disease 2019 (COVID-19) cases. These findings suggest the feasibility of saliva as a noninvasive tool for surveillance of emerging outbreaks, and EHCWs represent a high-risk population that should be the focus of infectious disease surveillance.

SOFTWARE TESTING AND ITS ASPECTS

The software testing topic is becoming more and more popular. This article discusses the software testing concept, software testing types, how it works and where it is applied. Software testing is the most important phase of the software development life cycle, so this article is about ensuring the quality of all software applications types by executing certain types of testing methods and streamlined software testing processes. The object of the work is the software testing process. The subject of the research is software testing and its life cycle. The purpose of the work is to review the software testing con-cept, testing types, software testing capabilities, software testing stages, as well as current state presentation of issue. The theoretical method was chosen as the research method. In this paper, an optimized testing process is considered, which considers all testing life cycle stages and also considers the testing types. The article describes the current state of issue. The work objectives have been achieved. The assigned tasks have been completed.

Additive-manufactured paper-PMMA hybrid microfluidic chip for simultaneous monitoring of creatinine and pH in artificial urine.

Nowadays, kidney dysfunction is a common health issue due to the modernized lifestyle. Even though medications are commercially available to treat kidney diseases, early diagnosis is crucial and challenging. Clinically, measuring urine creatinine and pH has gained significant interest as a way to diagnose kidney diseases early. In the present work, we attempted to develop a low-cost, robust, accurate and naked-eye colorimetric method to determine both creatinine levels and pH variations in artificial urine samples using a simple 3D-printed hybrid microfluidic device. Creatinine was detected by the incorporation of the traditional Jaffe test onto the hybrid paper-PMMA microfluidic device and pH (4-8) was measured by a simple anthocyanin test. Notably, the tests were established without employing any sophisticated or costly instrument clusters. The developed 3D-printed microfluidic probe showed a limit of detection (LOD) of 0.04 mM for creatinine over a concentration range of 1-10 mM, with a regression coefficient (R2) of 0.995 in laboratory conditions. Interestingly, the experimental data obtained with artificial urine exhibited a wide linear range from 0.1 mM to 5 mM under different pH values ranging from 4 to 8 in the presence of matrices commonly found in urine samples other than proteins, indicating the potential use of this method in pre-clinical analysis. Since the wide linear range of urine creatinine in artificial urine samples falls well below the clinically relevant concentrations in humans (0.07-0.27 mM), the developed lab-on-chip device is further suitable for clinical evaluation with proper ethical clearance. This 3D-printed hybrid microfluidic colorimetry-based creatinine detection and pH indicator platform can be beneficial in the healthcare sector due to the on-site testing capability, cost-effectiveness, ease of use, robustness, and instrument-free approach.

A population-based study of the trend in SARS-CoV-2 diagnostic modalities from the beginning of the pandemic to the Omicron surge in Kyoto City, Kyoto, Japan

BackgroundThe coronavirus disease 2019 (COVID-19) presents critical diagnostic challenges for managing the pandemic. We investigated the 30-month changes in COVID-19 testing modalities and functional testing sites from the early period of the pandemic to the most recent Omicron surge in 2022 in Kyoto City, Japan.MethodsThis is a retrospective-observational study using a local anonymized population database that included patients' demographic and clinical information, testing methods and facilities from January 2020 to June 2022, a total of 30 months. We computed the distribution of symptomatic presentation, testing methods, and testing facilities among cases. Differences over time were tested using chi-square tests of independence.ResultsDuring the study period, 133,115 confirmed COVID-19 cases were reported, of which 90.9% were symptomatic. Although nucleic acid amplification testing occupied 68.9% of all testing, the ratio of lateral flow devices (LFDs) rapidly increased in 2022. As the pandemic continued, the testing capability was shifted from COVID-19 designated facilities to general practitioners, who became the leading testing providers (57.3% of 99,945 tests in 2022).ConclusionsThere was a dynamic shift in testing modality during the first 30 months of the pandemic in Kyoto City. General practitioners increased their role substantially as the use of LFDs spread dramatically in 2022. By comprehending and documenting the evolution of testing methods and testing locations, it is anticipated that this will contribute to the establishment of an even more efficient testing infrastructure for the next pandemic.

Providing Hemodialysis in Unstable Areas: An Assessment and Framework for Effective Care

Providing hemodialysis to patients with kidney failure (KF) in conflict-affected areas poses a significant challenge. Achieving and sustaining reasonable quality hemodialysis operations in such regions necessitates a comprehensive approach. In the conflict area of Northwest (NW) Syria, a 3-phase project was initiated to address the quality of hemodialysis operations. The assessment phase involved the examination of infection prevention and control (IPC) protocols, staff training, medical protocols, individualized hemodialysis prescriptions, and laboratory testing capabilities. The second phase involved activities toward capacity building and implementing an action plan based on feasibility and sustainability. The assessment phase revealed that only 7 of 14 centers had IPC protocols, and 8 centers provided IPC training for their staff. Furthermore, only 7 centers had medical protocols, and 5 used individualized hemodialysis prescriptions. Difficulties in testing for potassium was reported in 7 centers and the inability to perform hepatitis B and C serologies was reported in 3 centers. Only 2 centers adhered to machine and water treatment system maintenance guidelines, and 4 conducted daily water quality checks. Recommendations were formulated, and an action plan was developed for implementation in the second phase. The plan encompassed enhancements in IPC practices, medical protocols, record-keeping, laboratory testing, and equipment maintenance. This project underscores that hemodialysis services in conflict-affected areas do not meet the standards for quality care. It emphasizes the necessity of implementing a comprehensive framework that engages relevant stakeholders in defining and upholding quality care, a model that should be extended to other protracted conflict-affected regions.