Smartphone-assisted point-of-care testing of nucleic acids based on hybridization chain reaction, magnetic beads, and gold nanorods etching

Colorimetric biosensors are simple but effective tools that are gaining popularity due to their ability to provide low-cost, rapid, and accurate detection for viruses like the Novel coronavirus, Influenza A, and Dengue virus, especially in point-of-care testing (POCT) and visual detection. In this study, a smartphone-assisted nucleic acid POCT was built using hybridization chain reaction (HCR), magnetic beads (MBs), and oxidized 3,3′,5,5′-tetramethylbenzidine (TMB2+)-mediated etching of gold nanorods (GNRs). The application of HCR without enzyme isothermal characteristics and MBs with easy separation, can quickly amplify nucleic acid signal and remove other reaction components. The blue shift of longitudinal localized surface plasmon resonance (LSPR) based on GNRs showed significant differences in etching color for different concentrations of target nucleic acid, which convert the signal into a visually semi-quantitative colorimetric result, achieving quantitative analysis with the color recognition software built into smartphones. This strategy, which only takes 40 min to detect and is two-thirds less time than the PCR, was successfully applied for the detection of the Dengue target sequence with a detection limit of 1.25 nM and exhibited excellent specificity for distinguishing single-base mutations, indicating broad application prospects in clinical laboratory diagnosis and enriching the research of nucleic acid POCT.

Impacts of COVID-19 on reproductive health and prenatal genetics

COVID-19 has a dramatic impact on human health, besides respiratory system, reproduction system would be impaired by SARS-CoV-2. For male, the virus has various negative impacts on testes, including overheating and hormone level fluctuation, which have impacts on the spermatogenesis or spermatogonia development. For female, COVID-19 may increase the risk of endocrine and metabolic dysfunction. However, the impact of SARS-CoV-2 on the ovaries is not clear, and further researches are needed to clarify it. Nearly 60% of the pregnant women develop symptoms of infection and more attention should be paid to the increased risk of adverse pregnancy outcomes including preeclampsia, eclampsia, and severe infection. For the newborns of infected pregnant women, vertical transmission of SARS-CoV-2 is still unclear, and further evaluation are required. Meantime, the pregnant women's fear of the potential infection may reduce their access to the prenatal genetic test. In this chapter, we summarize the latest basic and clinical researches on COVID-19 impacts on male, female reproduction, and prenatal genetic test, hoping to provide guidance and advice for people of reproductive age and reproductive healthcare practitioners. © 2023 Elsevier Inc. All rights reserved.

Patients Characteristics, Vaccine Uptake, Healthcare Resource Utilization and Costs Associated with Acute COVID-19 during the Omicron Predominant Period in Brazil: A Nationwide Database Study

Objectives: The coronavirus disease 2019 (COVID-19) pandemic has imposed significant burden on Brazil's health system. The present study aims to describe patients' demographic and clinical characteristics, vaccine uptake and assess healthcare resource utilization (HCRU) and costs associated with acute COVID-19 in Brazil during the Omicron predominant period. Method(s): A population-based retrospective study was conducted using the National Health Data Network (RNDS), National Vaccination Campaign against COVID-19 data and surveillance data in public setting. Individuals with positive COVID-19 test results between January-April 2022 were identified. Patients' demographics, comorbidities, vaccination status, HCRU for those who were admitted to hospitals and their associated costs were described by age groups. Result(s): A total of 8,160,715 COVID-19 cases were identified and 2.7% were aged <5 years, 11.6% were 5-19 years, 76.9% were 20-64 years and 8.7% were >= 65 years. The presence of comorbidity was 23.1% with a higher prevalence of comorbidities in the elderly (61.8% for 65-74 years and 71.2% for >=75 years). Regarding COVID -19 vaccination uptake, among those aged <=19 years, 20-64 years and >=65 years, 40.6%, 86.5% and 92.2% had primary series, respectively. Among adults, the booster uptake was 47.3% and 75.8% for those aged 20-64 years and >= 65 years, respectively. Among those with confirmed COVID-19, regardless of vaccination status, 87% were being symptomatic and 1.7% were hospitalized (3.8% in aged <5 years, 4.2% in 5-19 years, 34.3% in 20-64 years and 57.6% in >= 65 years). Among hospitalized patients, 32,6% were admitted to ICU and 80% required mechanical ventilation support. The average cost per day in normal wards and ICU without ventilation was R$291,89 and R$923,90, respectively. Conclusion(s): Our results quantify the public health and economic burden of COVID-19 in Brazil, suggesting substantial healthcare resources required to manage the COVID-19 pandemic.Copyright © 2023

The DRACO Door: Design, Test, and Integration of the Mechanism on the DART Spacecraft

The Double Asteroid Redirection Test (DART) mission is NASA's first planetary defense mission to demonstrate the viability of kinetically impacting an asteroid and deflecting its trajectory. The DART spacecraft successfully launched on November 24, 2021 from the Vandenberg Space Force Base and successfully made impact on Dimorphos, the smaller asteroid in the Didymos system, on September 26, 2022. The DART spacecraft has one instrument called Didymos Reconnaissance and Asteroid Camera for Optical navigation (DRACO). DRACO is an imaging telescope that, in conjunction with the SMART Navigation algorithm, autonomously guided the DART spacecraft to the asteroid. Because DRACO is a mission critical and light sensitive instrument, the DRACO Door mechanism was designed as the protective cover. The door functions to shield DRACO from stray light during launch, to deploy in space once when commanded, and to stay 180 degrees open for the duration of the mission. The DRACO Door went through several iterations during the design phase with decisions on various components such as Frangibolts ®, torsion springs, hardstops, and latches. After fabrication and assembly, the door went through a rigorous environmental testing plan, which included deployment testing, vibration testing, and thermal vacuum testing. After successful qualification of the mechanism, the door was installed and integrated into the DART spacecraft. It should be noted that during the fabrication of the mechanism piece-parts, the COVID-19 pandemic began, and the effects of the pandemic were seen in the challenges faced during the DRACO door assembly and testing. Under the constraints of the pandemic, the DART spacecraft was successfully built, tested, and launched, and the DRACO door was successfully deployed on December 7, 2021. The door has continued to function as intended. This paper will discuss the design choices behind the door components, the environmental qualification test program, and the installation of the door onto the DART spacecraft. In addition, this paper will discuss the lessons learned and the challenges of fabricating and testing the flight hardware. © 2023 IEEE.

Acute or chronic? Failing left ventricle in a 34 year old

Submission content Introduction: An unusual case of a very young patient without previously known cardiac disease presenting with severe left ventricular failure, detected by a point of care echocardiogram. Main Body: A 34 year old previously well man was brought to hospital after seeing his general practitioner with one month of progressive shortness of breath on exertion. This began around the time the patient received his second covid-19 vaccination. He was sleeping in a chair as he was unable to lie flat. Abnormal observations led the GP to call an ambulance. In the emergency department, the patient required oxygen 5L/min to maintain SpO2 >94%, but he was not in respiratory distress at rest. Blood pressure was 92/53mmHg, mean 67mmHg. Point of care testing for COVID-19 was negative. He was alert, with warm peripheries. Lactate was 1.0mmol/L and he was producing more than 0.5ml/kg/hr of urine. There was no ankle swelling. ECG showed sinus tachycardia. He underwent CT pulmonary angiography which demonstrated no pulmonary embolus, but there was bilateral pulmonary edema. Troponin was 17ng/l, BNP was 2700pg/ml. Furosemide 40mg was given intravenously by the general medical team. Critical care outreach asked for an urgent intensivist review given the highly unusual diagnosis of pulmonary edema in a man of this age. An immediate FUSIC Heart scan identified a dilated left ventricle with end diastolic diameter 7cm and severe global systolic impairment. The right ventricle was not severely impaired, with TAPSE 18mm. There was no significant pericardial effusion. Multiple B lines and trace pulmonary effusions were identified at the lung bases. The patient was urgently discussed with the regional cardiac unit in case of further deterioration, basic images were shared via a cloud system. A potential diagnosis of vaccination-associated myocarditis was considered,1 but in view of the low troponin, the presentation was felt most likely to represent decompensated chronic dilated cardiomyopathy. The patient disclosed a family history of early cardiac death in males. Aggressive diuresis was commenced. The patient was admitted to a monitored bed given the potential risk of arrhythmia or further haemodynamic deterioration. Advice was given that in the event of worsening hypotension, fluids should not be administered but the cardiac centre should be contacted immediately. Formal echocardiography confirmed the POCUS findings, with ejection fraction <35%. He was initiated on ACE inhibitors and beta adrenergic blockade. His symptoms improved and he was able to return home and to work, and is currently undergoing further investigations to establish the etiology of his condition. Conclusion(s): Early echocardiography provided early evidence of a cardiac cause for the patient's presentation and highlighted the severity of the underlying pathology. This directed early aggressive diuresis and safety-netting by virtue of discussion with a tertiary cardiac centre whilst it was established whether this was an acute or decompensated chronic pathology. Ultrasound findings: PLAX, PSAX and A4Ch views demonstrating a severely dilated (7cm end diastolic diameter) left ventricle with global severe systolic impairment.

Evaluating the Federal Innovative Assessment Demonstration Authority: Early Implementation and Progress of State Efforts to Develop New Statewide Academic Assessments. Evaluation Report. NCEE 2023-004

Education officials have long hoped that the statewide academic assessments most students take each year could be used not only for accountability but also to guide instruction. Congress established the Innovative Assessment Demonstration Authority (IADA) program in 2015 to help address this goal, offering up to seven states temporary flexibility from federal testing requirements so that they may more easily make progress toward replacing their current assessments with more innovative ones. The key incentive to participate in IADA is that students trying out the innovative assessment are not required to also take the state's current assessment. However, states approved for IADA must still show that their innovative assessments meet most requirements for federal accountability, and they are expected to implement the new assessments statewide within 5 years. This report describes the progress of the first five assessment systems approved under IADA in order to help policymakers consider expanding the program to more states. The report is primarily based on an analysis of states' IADA applications and performance reports to the U.S. Department of Education through the 2020-2021 school year and is part of a broader evaluation of IADA required by Congress. [For the Appendix, see ED627873. For the Study Highlights, see ED627880.]

Dried Blood Spot Analyses for the Diagnosis of Anti-cytokine Autoantibodies

Background: High-titer neutralizing anti-cytokine autoantibodies have been shown to be involved in several acquired diseases, including pulmonary alveolar proteinosis, cryptococcal meningitis, and disseminated/extrapulmonary Nocardia infections (anti-GM-CSF autoantibodies), disseminated mycobacterial disease (anti-IFN-gamma autoantibodies), and some cases of severe COVID-19 infection (anti-type 1 interferons). Currently, patient blood samples are shipped via courier and require temperaturecontrolled conditions for transfer. This method is expensive and requires patients to have access to medical personnel to draw the blood. However, the well-established technique of collecting blood on a paper card as a dried blood spot (DBS) for diagnosis offers a point of care alternative which can be performed with a simple finger prick. This method is less invasive, cheaper, and allows for easy transport of patient samples. Method(s): 30 uL of whole blood from patients was blotted on filter paper and stored at 4C until use. The filter paper was hole punched and each punched spot was eluted with 150 uL of a 0.05% Tween PBS solution at room temperature overnight. The eluate was screened for anti-cytokine autoantibodies using a particle-based approach. Patient plasma was also screened in conjunction for comparison. Result(s): We confirmed the presence of autoantibodies in the DBS eluate from 4 previously diagnosed patients with anti-GM-CSF autoantibodies and 2 patients with anti-IFN-gamma autoantibodies. Functional studies showed the DBS eluate from a patient with anti-GM-CSF autoantibodies was able to block GM-CSF-induced STAT-5 phosphorylation in normal PBMC. As a proof of concept and to increase the number of patients evaluated, we also confirmed the presence of anti-cytokine autoantibodies using dried plasma eluate from 9 patients with known anti-GM-CSF autoantibodies and 9 patients with anti-IFN-gamma autoantibodies. Levels detected in DBS analyses were comparable to the levels found in plasma from the same patients not subjected to blotting and elution. Temperature studies showed that the autoantibodies were detected at similar levels when stored at 4C, 25C, and 40C for a week. Conclusion(s): The diagnosis of pathogenic anti-cytokine autoantibodies should be considered in the context of unusual or adult-onset infections, and screening for this diagnosis can be performed with dried blood spot testing.Copyright © 2023 Elsevier Inc.

Preoperative COVID-19 RT-PCR Testing of Asymptomatic Patients for Ophthalmic Surgery: Experience from Two Tertiary Referral Centers

Purpose: The aim of this study was to evaluate how prevalent asymptomatic SARS-CoV-2 virus infection (COVID-19) is among patients undergoing ophthalmic surgery at two tertiary referral hospitals. Material(s) and Method(s): This retrospective study included patients without COVID-19 symptoms who underwent preoperative screening using reverse transcription-polymerase chain reaction (RT-PCR) before ophthalmic surgery at the Kocaeli University and Gaziantep University departments of ophthalmology [between September 1, 2020, and December 15, 2020 (group 1);between March 1, 2021, and May 30, 2021 (group 2)]. Patients scheduled for surgery and followed up in the retina, glaucoma, pediatric ophthalmology and strabismus, cataract and refractive surgery, and cornea departments were examined. Result(s): RT-PCR was positive for SARS-CoV-2 in 12 (1.4%) of 840 patients in group 1 and 7 (1.1%) out of 600 patients in group 2. None of the patients were symptomatic of COVID-19. The majority of the patients were scheduled for retina or cataract and refractive surgery in both groups (group 1;retina: 29.2%, cataract and refractive: 57.0%, group-2;retina: 31.3%, cataract and refractive: 54.5%). SARS-CoV-2 RT-PCR testing was positive for seven patients in group 1 (7/245, 2.9%) and five patients in group 2 (5/188, 2.6%) who were scheduled for retinal surgery. Conclusion(s): The necessity, availability, and practicality of COVID-19 RT-PCR testing prior to ophthalmic surgeries varies depending on the protocols of each institution. COVID-19 RT-PCR testing is suggested especially before vitreoretinal surgeries and general anesthesia procedures, because of the difficulty in managing postoperative complications.Copyright © 2023 Gazi Eye Foundation. All rights reserved.

Topical lidocaine anesthesia for nasopharyngeal sampling - a double-blind randomized placebo-controlled trial

Introduction and aim. The aim of this study is to evaluate the effects of topical lidocaine application for nasopharyngeal sampling, on pain perception, the comfort of the patients, and the application difficulty for healthcare staff. Material and methods. This study conducted with 100 healthy volunteers (50 participants in Lidocaine group and 50 participants in Placebo group). Two ml of a solution containing 10 mg/ml of lidocaine was applied to each nostril of the participants in the Lidocaine group, and the same dose of 0.9% NaCl to the Placebo group. We compared the changes in pain intensity and discomfort intensity using two numerical rating scales, the frequency of undesirable reactions, and the judgment of the practitioner staff. Results. There were statistically significant decreases in pain and discomfort scores in the Lidocaine group. Similarly, there were statistically significant decreases in the frequency of all undesirable reactions except "grimace”, in the second sampling in the Lidocaine group, however, there was a statistically significant decrease only in "holding staff's hand” in second sampling in the Placebo group. Conclusion. Intranasal lidocaine application reduces the pain that occurs during nasopharyngeal sampling and makes the procedure easier for the patient and the healthcare worker. © 2022 Publishing Office of the University of Rzeszow. All Rights Reserved.

The temporal evolution in disease phenotype of COVID-19 hospitalisation, intensive care and case fatality rates in cancer patients across the United Kingdom (UKCCP)

Background: People living with cancer are reported to be at increased risk of hospitalization and death following infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This is proposed to be dependent on a combination of intrinsic patient and cancer factors such as cancer subtype, and emerging SARS-CoV-2 variants with differing pathogenicity. However, COVID-19 phenotype evolution across the pandemic from 2020 has not yet been systematically evaluated in cancer patients. Method(s): This study is a population-scale real-world evaluation of Coronavirus outcomes in the United Kingdom for cancer patients from 1st November 2020-31st August 2022. The cancer cohort comprises individuals from Public Health England's national cancer dataset, excluding individuals less than 18 years old. Case-outcome rates, including hospitalization, intensive care and casefatality rates were used to assess the evolution in disease phenotype of COVID-19 in cancer patients. Multivariable logistic regression models were fitted to compare risk of Coronavirus outcomes in the cancer cohort relative to the non-cancer population during the Omicron wave in 2022. Result(s): The cancer cohort comprised of 198,819 positive SARS-CoV-2 tests from 127,322 individual infections. Coronavirus case-outcome rates were evaluated by reference to 18,188,573 positive tests from 15,801,004 individual infections in the non-cancer population. From 2020 to 2022, the SARS-CoV-2 disease phenotype became less severe in both patients with cancer and the non-cancer population, though cancer patients remain at higher risk. In 2022, the relative risk of Coronavirus hospital admission, inpatient hospitalization, intensive care admission and mortality in cancer patients was 3.02x, 2.10x, 2.53x and 2.54x compared to the non-cancer population following multivariable adjustment, respectively. Higher risk of hospital admission and inpatient hospitalization were associated with receipt of B/T cell antibody and/or targeted therapy which also corresponded with an increased risk of Coronavirus mortality. Conclusion(s): The disease phenotype of SARS-CoV-2 in cancer patients in 2022 has evolved significantly from the disease phenotype in 2020. Direct effects of the virus in terms of SARS-CoV-2 hospitalization, intensive care and case fatality rates have fallen significantly over time. However, relative to the general population, people living with cancer and hematological malignancies remain at elevated risk. In order to mitigate the indirect effects of the SARS-CoV-2 pandemic in terms of disruption to cancer care, there should be increased focus on preventative measures. Used in conjunction with vaccination and early treatment programs, this will maximize quality of life for those with cancer during the ongoing pandemic and ensure the best cancer outcomes.

Point-of-Care Testing in Primary Care

Point-of-care testing (POCT) in pediatric primary care is essential for clinicians to make a timely and accurate diagnosis. The COVID-19 pandemic has highlighted the importance of timely and accurate testing strategies to correctly identify the etiology of upper and lower respiratory infections. Additionally, pediatric POCT continues to be important in rural and underserved communities where access to hospital laboratories may be less available. This chapter will focus on seven rapid tests: Group A streptococcus (GAS), influenza A & B, SARS-CoV-2 (COVID-19), human immunodeficiency virus (HIV), C-reactive protein (CRP), human chorionic gonadotropin (hCG), and hemoglobin A1c (HbA1c). © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Non-trauma uses of viscoelastic hemostatic assays in critical care: A narrative review and primer for pharmacists

Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) are point-of-care viscoelastic tests of whole blood that provide real-time analyses of coagulation. TEG and ROTEM are often used to guide blood product administration in the trauma and surgical settings. These tests are increasingly being explored for their use in other disease states encountered in critically ill patients and in the management of antithrombotic medications. As the medication experts, pharmacists should be familiar with how to interpret and apply viscoelastic tests to disease state and medication management. The purpose of this narrative review is to provide a primer for pharmacists on viscoelastic tests and their interpretation and to explore non-trauma indications for viscoelastic testing in critical care. Literature evaluating the use of TEG and ROTEM for patients with acute and chronic liver disease, ischemic and hemorrhagic stroke, myocardial infarction, cardiac arrest, coronavirus disease 2019, and extracorporeal membrane oxygenation are described. Current applications of viscoelastic tests by pharmacists and potential future roles of critical care pharmacists in expanding the use of viscoelastic tests are summarized.Copyright © 2023 The Authors. JACCP: Journal of the American College of Clinical Pharmacy published by Wiley Periodicals LLC on behalf of Pharmacotherapy Publications, Inc.

Cross Infection Control Awareness During 5th Wave of Covid 19 Pandemic, Omicron Variant Amongst the Dental Health Care Professionals of Government Sector University in Karachi, Pakistan

Objective: The objective of this study is to evaluate the awareness of cross-infection control measures followed by DHCPs during the 5th wave of Covid-19 pandemic, Omicron variant in a government sector university of Karachi, Pakistan. Method(s): A Cross-sectional study was conducted from June till September 2022 at Sindh Institute of Oral Health Science during the 5th wave of Covid 19 pandemic, Omicron variant. Data was collected from 153 DHCPs from government sector university using a self-administered questionnaire, comprising of 20 closed ended question to assess the awareness and practice of cross infection protocols by DHCPs. Result(s): 98.7% of the participants were vaccinated against Covid 19. 96% of the participants used surgical gowns, face shields, and face masks as part of PPE during examining patients and while performing procedure. After treatment 99.3% of participants washed hands with hand wash, soap or used antiseptic solution. 77.1% of participants asked for Covid 19 test report and 68.6% of participants asked for proof of vaccination against covid 19 before treating patients. 96.1% of participants recommended disinfection of dental unit after every patient. 98% of participants changed glove after every patient. 88.2% of the participants said they would carry all elective and emergency procedures. Conclusion(s): The results of this study show that DHCPs practicing at government sector university have adequate knowledge regarding prevention of cross infection protocols and their importance to limit spread of infections. But their practice of prevention of cross infection during Covid 19 pandemic is not ideal as percentage of DHCPs requiring proof of vaccination or negative reports for Covid 19 were rather low and the percentage of DHCPs willing to carry elective procedures along with emergency ones was rather high.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Molecular Diagnostics on Smartphone

During the COVID-19 pandemic, point-of-care genetic testing (POCT) devices were used for on-time and on-site detection of the virus, which helped to prevent and control the spread of the pandemic. Smartphones, which are widely used electronic devices with many functions, have the potential to be used as a molecular diagnostic platform for universal healthcare monitoring. Several integrated diagnostics platforms for the real-time and end-point detection of COVID-19 were developed using the functions of smartphones, such as the operating system, power, sound, camera, data storage, and display. These platforms use the 5V output power of smartphones, which can be amplified to power a micro-capillary electrophoresis system or a thin-film heater, and the CMOS camera of smartphones can capture the color change during a colorimetric loop-mediated isothermal amplification test and detect fluorescence signals. Smartphones can also be used with self-written web-based apps to enable automatic and remote pathogen analysis on POCT platforms. Our lab developed a handheld micro-capillary electrophoresis device for end-point detection of SARS-CoV-2, as well as an integrated smartphone-based genetic analyzer for the qualitative and quantitative colorimetric detection of foodborne pathogens with the help of a custom mobile app. © 2023 SPIE.

Rapid and Low-Cost Detection of Human Corona Virus Using MEMS ATR-FTIR Spectroscopy

The conventional methods used for the diagnostics of viral infection are either expensive and time-consuming or not accurate enough and dependent on consumable reagents. In the presence of pandemics, a fast and reagent-free solution is needed for mass screening. Recently, the diagnosis of viral infections using infrared spectroscopy has been reported as a fast and low-cost method. In this work a fast and low-cost solution for corona viral detection using infrared spectroscopy based on a compact micro-electro-mechanical systems (MEMS) device and artificial intelligence (AI) suitable for mass deployment is presented. Among the different variants of the corona virus that can infect people, 229E is used in this study due to its low pathogeny. The MEMS ATR-FTIR device employs a 6 reflections ZnSe crystal interface working in the spectral range of 2200-7000 cm-1. The virus was propagated and maintained in a medium for long enough time then cell supernatant was collected and centrifuged. The supernatant was then transferred and titrated using plaque titration assay. Positive virus samples were prepared with a concentration of 105 PFU/mL. Positive and negative control samples were applied on the crystal surface, dried using a heating lamp and the spectrum was captured. Principal component analysis and logistic regression were used as simple AI techniques. A sensitivity of about 90 % and a specificity of about 80 % were obtained demonstrating the potential detection of the virus based on the MEMS FTIR device. © 2023 SPIE.

PLANT TESTING MAGNETIC CONDITIONING ON KENNECOTT'S Cu-Mo PORPHYRY ORE

Over it's more than 100-year history, the Kennecott operation has often been at the forefront of innovation;driven by the demands of the lower grade ore-body and the higher costs of operating in the US where wages are generally higher and regulation more restrictive. One way of reducing operating costs in c/lb is to increase the lbs produced at minimal cost. Despite the relatively coarse grind at Kennecott - about 30% >150μm, approximately 20% of the Cu lost to tail is liberated chalcopyrite in the <20μm fraction, and about 30%-40% in the <37μm fraction. In 2020 Kennecott undertook a detailed plant scale test of the magnetic aggregation technology to increase copper recovery by reducing fine copper losses. A paired statistical plant test of magnetic conditioning on one rougher line showed a 1.12% increase in Cu recovery to 97% statistical confidence. The next challenge, unforeseen at the start of the project, was the fabrication and transportation to site of the equipment for the three remaining rougher rows, during the severe supply-chain constraints of the Covid pandemic in 2021. This resulted in delays and unforeseen costs as world-wide transportation became chaotic, particularly transportation via west coast USA. Nevertheless, the project was completed and commissioned, with only minor delays and cost increases, due to a flexible approach to overcoming the hurdles encountered. Copyright © 2023 by SME.

Influence of Transformational Leadership on Organizational Citizenship Behavior and Organizational Task Performance Cross Level Analysis on Micro Small and Medium Enterprises in Indonesia: Acces la Success

In industry 4.0, individual behavior in organization is still very much considered as the main determinant of organizational performance. Organizational citizenship behavior (OCB) is one of the unique behavior of individuals affecting the effectivity of the organization. This study focuses on organizational citizenship behavior (OCB) based on the aspects of antecedents and their consequences. This study aims at examining (1) the indirect influence of transformational leadership on individual performance through organizational citizenship behavior motivation (OCBM) and OCB, (2) the direct influence of OCB on individual performance and organizational performance, (3) the direct influence of OCB for individual performance and organizational performance. This study was conducted to 66 heads of small business and 410 employee at small business in West Sumatera and analyzed using cross level methods and hypothesis testing using hierarchical linear modeling (HLM). This study found that 1). OCBM and OCB simultaneously mediate the relation between transformational leadership with individual performance and also have role in elevating the individual performance, 2) individual performance is the mediator between OCBM with organizational performance and it contributes in elevating the organizational performance. The theoretical and practical implications of this study are the tranformational leadership (TL) is able to motivate the members to carry out OCB actively in organizations. Some limitations and future research directions are discussed.

You & type 2 @ home: Testing a fully remote model for diabetes annual reviews using the you & type 2 personalised care and support planning pathway in combination with remote monitoring technologies at two primary care practices in South London

Aims: A proof-of- concept pilot investigating the profile of person who engaged with remote testing for their annual diabetes review, and service user (SU) and primary care practice acceptability for completing annual diabetes review tests remotely (blood pressure, finger-stick blood test and urine test). Method(s): A mixed methods evaluation based on SU surveys sent to all 144 pilot participants, semi-structured SU and staff interviews, and demographic and clinical data extraction from primary care electronic patient record system. Result(s): Profile: The pathway was considered suitable for people who were working, digitally capable, younger, had household support to complete the tests, had non-complex diabetes, or a combination of these attributes. It was deemed less suitable for the very elderly, the less digitally capable, those with complex health needs or socially isolated. SU Acceptability: Interviewees and survey respondents overall deemed the remote tests acceptable for use. Convenience and reduced exposure to Covid-19 were motivating factors for participation. Preference for face-to- face care or concerns around using digital technologies were key reasons for decline. Staff Acceptability: The pathway was deemed acceptable and was successfully implemented at both practices. Support from a designated pathway co-ordinator and project manager were key factors linked to acceptability and success. The remote pathway was seen as an opportunity to reduce primary care pressures on in-person care. Conclusion(s): It is possible to successfully conduct annual diabetes reviews remotely. Although not appropriate nor desirable to everyone, remote testing provides a viable alternative to in-person testing for certain individuals.

Disease X Testing: The results of an international external quality assessment exercise

The United Nations Secretary-General Mechanism (UNSGM) for investigation of the alleged use of chemical and biological weapons is the only established international mechanism of this type under the UN. The UNGSM may launch an international investigation, relying on a roster of expert consultants, qualified experts, and analytical laboratories nominated by the member states. Under the framework of the UNSGM, we organized an external quality assurance exercise for nominated laboratories, named the Disease X Test, to improve the ability to discover and identify new pathogens that may cause possible epidemics and to determine their animal origin. The "what-if" scenario was to identify the etiological agent responsible for an outbreak that has tested negative for many known pathogens, including viruses and bacteria. Three microbes were added to the samples, Dabie bandavirus, Mammarenavirus, and Gemella spp., of which the last two have not been taxonomically named or published. The animal samples were from Rattus norvegicus, Marmota himalayana, New Zealand white rabbit, and the tick Haemaphysalis longicornis. Of the 11 international laboratories that participated in this activity, six accurately identified pathogen X as a new Mammarenavirus, and five correctly identified the animal origin as R. norvegicus. These results showed that many laboratories under the UNSGM have the capacity and ability to identify a new virus during a possible international investigation of a suspected biological event. The technical details are discussed in this report.Copyright © 2022