Quality assurance for HIV point-of-care testing and treatment monitoring assays

In 2015, UNAIDS launched the 90-90-90 targets aimed at increasing the number of people infected with HIV to become aware of their status, access antiretroviral therapies and ultimately be virally suppressed. To achieve these goals, countries may need to scale up point-of-care (POC) testing in addition to strengthening central laboratory services. While decentralising testing increases patient access to diagnostics, it presents many challenges with regard to training and assuring the quality of tests and testing. To ensure synergies, the London School of Hygiene & Tropical Medicine held a series of consultations with countries with an interest in quality assurance and their implementing partners, and agreed on an external quality assessment (EQA) programme to ensure reliable results so that the results lead to the best possible care for HIV patients. As a result of the consultations, EQA International was established, bringing together EQA providers and implementers to develop a strategic plan for countries to establish national POC EQA programmes and to estimate the cost of setting up and maintaining the programme. With the dramatic increase in the number of proficiency testing panels required for thousands of POC testing sites across Africa, it is important to facilitate technology transfer from global EQA providers to a network of regional EQA centres in Africa for regional proficiency testing panel production. EQA International will continue to identify robust and cost-effective EQA technologies for quality POC testing, integrating novel technologies to support sustainable country-owned EQA programmes in Africa

ANALYSIS OF MULTIPLE CO-PLANAR SURFACE BREAKING FLAWS LOADED IN TENSION UNDER CLEAVAGE FAILURE CONDITIONS

ABSTRACT In procedures such as R6 and BS 7910 for assessing the structural integrity of structures, complex multiple flaws located in close proximity to each other are generally characterised as one, larger, single flaw. Recent studies have shown that the current characterisation rules may be non-conservative under some circumstances. Concurrent experimental and analytical programmes are being undertaken in order to further investigate this potential non-conservatism for situations where the possibility of cleavage failure has to be taken into account when assessing structures or components containing multiple flaws. The analytical work has involved inelastic finite element modelling in conjunction with numerical analysis based on the weakest link methodology for cleavage initiation to determine the probability of cleavage failure. This has allowed the probability of failure for the situation of multiple adjacent flaws to be compared with that for the single characterised flaw to determine whether the characterisation rules are conservative. Initial results from the cases studied so far indicate that

Whole Body Screening Using High-Temperature Superconducting MR Volume Resonators: Mice Studies

High temperature superconducting (HTS) surface resonators have been used as a low loss RF receiver resonator for improving magnetic resonance imaging image quality. However, the application of HTS surface resonators is significantly limited by their filling factor. To maximize the filling factor, it is desirable to have the RF resonator wrapped around the sample so that more nuclear magnetic dipoles can contribute to the signal. In this study, a whole new Bi2Sr2Ca2Cu2O3 (Bi-2223) superconducting saddle resonator (width of 5 cm and length of 8 cm) was designed for the magnetic resonance image of a mouse's whole body in Bruker 3 T MRI system. The experiment was conducted with a professionally-made copper saddle resonator and a Bi-2223 saddle resonator to show the difference. Signal-to-noise ratio (SNR) with the HTS saddle resonator at 77 K was 2.1 and 2 folds higher than that of the copper saddle resonator at 300 K for a phantom and an in-vivo mice whole body imaging. Testing results were in accordance with predicted ones, and the difference between the predicted SNR gains and measured SNR gains were 2.4%∼2.7%. In summary, with this HTS saddle system, a mouse's whole body can be imaged in one scan and could reach a high SNR due to a 2 folds SNR gain over the professionally-made prototype of copper saddle resonator at 300 K. The use of HTS saddle resonator not only improves SNR but also enables a mouse's whole body screen in one scan

Failure of A Novel, Rapid Antigen and Antibody Combination Test to Detect Antigen-Positive HIV Infection in African Adults with Early HIV Infection

BACKGROUND: Acute HIV infection (prior to antibody seroconversion) represents a high-risk window for HIV transmission. Development of a test to detect acute infection at the point-of-care is urgent. METHODS: Volunteers enrolled in a prospective study of HIV incidence in four African cities, Kigali in Rwanda and Ndola, Kitwe and Lusaka in Zambia, were tested regularly for HIV by rapid antibody test and p24 antigen ELISA. Five subgroups of samples were also tested by the Determine Ag/Ab Combo test 1) Antigen positive, antibody negative (acute infection); 2) Antigen positive, antibody positive; 3) Antigen negative, antibody positive; 4) Antigen negative, antibody negative; and 5) Antigen false positive, antibody negative (HIV uninfected). A sixth group included serial dilutions from a p24 antigen-positive control sample. Combo test results were reported as antigen positive, antibody positive, or both. RESULTS: Of 34 group 1 samples with VL between 5x105 and >1.5x107 copies/mL (median 3.5x106), 1 (2.9%) was detected by the Combo antigen component, 7 (20.6%) others were positive by the Combo antibody component. No group 2 samples were antigen positive by the Combo test (0/18). Sensitivity of the Combo antigen test was therefore 1.9% (1/52, 95% CI 0.0, 9.9). One false positive Combo antibody result (1/30, 3.3%) was observed in group 4. No false-positive Combo antigen results were observed. The Combo antigen test was positive in group 6 at concentrations of 80 pg/mL, faintly positive at 40 and 20 pg/mL, and negative thereafter. The p24 ELISA antigen test remained positive at 5 pg/mL. CONCLUSIONS: Although the antibody component of the Combo test detected antibodies to HIV earlier than the comparison antibody tests used, less than 2% of the cases of antigen-positive HIV infection were detected by the Combo antigen component. The development of a rapid point-of-care test to diagnose acute HIV infection remains an urgent goal

Early Diagnosis of HIV Infection in Infants - One Caribbean and Six Sub-Saharan African Countries, 2011-2015.

Pediatric human immunodeficiency virus (HIV) infection remains an important public health issue in resource-limited settings. In 2015, 1.4 million children aged 50% decline. The most common challenges for access to testing for early infant diagnosis included difficulties in specimen transport, long turnaround time between specimen collection and receipt of results, and limitations in supply chain management. Further reductions in HIV mortality in children can be achieved through continued expansion and improvement of services for early infant diagnosis in PEPFAR-supported countries, including initiatives targeted to reach HIV-exposed infants, ensure access to programs for early infant diagnosis of HIV, and facilitate prompt linkage to treatment for children diagnosed with HIV infection

Cognitive profiles in Asperger's disorder and autism

The profiles of 16 children with autism and 23 children with Asperger's disorder were compared on the Kaufman-Assessment Battery for Children (K-ABC), a standardised instrument used to measure general intelligence. Children's diagnoses were assigned in accordance with DSM-IV criteria for Pervasive Developmental Disorders. Significant differences in absolute terms were seen between the two groups. Subjects with Asperger's disorder had significantly higher Mental Processing Composite Scores (considered the best measure of overall intelligence provided by the K-ABC). The groups profiles were compared using chi-square, anovas of deviation from mean subtest scores and repeated measures anova to examine differences in the relative strengths and weaknesses characteristic of each group. A number of findings pointed to possible qualitative differences between the two groups. Asperger's disorder showed a preference for sequential over simultaneous processing, and the possibility that a field dependent cognitive style impaired performance on a group of three subtests. In contrast, a less pervasive preference in the opposite direction was seen for autism (simultaneous over sequential), and no impairment was seen on the three subtests, supporting the notion that individuals with autism may have field independent styles or weak central coherence. A subsidiary study of nine subjects with Asperger's disorder and eleven subjects with autism examined performance on theory of mind, executive function and central coherence measures, and placed the individuals in subgroups according to social type. Conclusions from this part of the study were severely limited by sampling problems

Distance Estimation: Exploring Gestalt Principles When Engaging in Tree Thinking

PSY-PC-4999-01 Honor Thesis, Dr. Laura NovickGestalt principles of grouping have been widely studied in diagrammatic reasoning because diagrams that follow these principles are easier to understand than those that are not (Lemon et al 2007, Stieff 2007, Novick and Catley 2007). In the present study, I investigate how Gestalt principles of grouping can be applied to the distances between the branches of a cladogram. Participants were shown an image of a cladogram with two arrows pointing to two branches and were asked to estimate the distance between them using the arrow keys. I hypothesized that same group trials, or distances that followed the Gestalt grouping principles would be estimated as shorter than those that were not aligned with the Gestalt grouping principles or different group trials. The results were broken out by size and trial type in order to provide more clarity to the data, but were ultimately inconclusive due to the many significant interactions between the variables studied. Future improvements to this study include rewriting the program, increasing the amount of time participants have to encode the structure of the cladogram, and decreasing the size differences between the cladograms.Thesis completed in partial fulfillment of the requirements of the Honors Program in Psychological Science