Building Integrated Testing Programs for Infectious Diseases.

In the past 2 decades, testing services for diseases such as human immunodeficiency virus (HIV), tuberculosis, and malaria have expanded dramatically. Investments in testing capacity and supportive health systems have often been disease specific, resulting in siloed testing programs with suboptimal capacity, reduced efficiency, and limited ability to introduce additional tests or respond to new outbreaks. Emergency demand for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing overcame these silos and demonstrated the feasibility of integrated testing. Moving forward, an integrated public laboratory infrastructure that services multiple diseases, including SARS-CoV-2, influenza, HIV, tuberculosis, hepatitis, malaria, sexually transmitted diseases, and other infections, will help improve universal healthcare delivery and pandemic preparedness. However, integrated testing faces many barriers including poorly aligned health systems, funding, and policies. Strategies to overcome these include greater implementation of policies that support multidisease testing and treatment systems, diagnostic network optimization, bundled test procurement, and more rapid spread of innovation and best practices across disease programs.

Fiber Optic Sensors for Harsh and High Radiation Environments in Aerospace Applications.

In the upcoming space revolutions aiming at the implementation of automated, smart, and self-aware crewless vehicles and reusable spacecraft, sensors play a significant role in the control systems. In particular, fiber optic sensors, with their small footprint and electromagnetic immunity, represent a great opportunity in aerospace. The radiation environment and the harsh conditions in which these sensors will operate represent a challenge for the potential user in the aerospace vehicle design and the fiber optic sensor specialist. We present a review that aims to be a primer in the field of fiber optic sensors in radiation environments for aerospace. We review the main aerospace requirements and their relationship with fiber optics. We also present a brief overview of fiber optics and sensors based on them. Finally, we present different examples of applications in radiation environments for aerospace applications.

Fiber Bragg Grating Sensor Networks Enhance the In Situ Real-Time Monitoring Capabilities of MLI Thermal Blankets for Space Applications.

The utilization of Fiber Bragg Grating (FBG) sensors in innovative optical sensor networks has displayed remarkable potential in providing precise and dependable thermal measurements in hostile environments on Earth. Multi-Layer Insulation (MLI) blankets serve as critical components of spacecraft and are employed to regulate the temperature of sensitive components by reflecting or absorbing thermal radiation. To enable accurate and continuous monitoring of temperature along the length of the insulative barrier without compromising its flexibility and low weight, FBG sensors can be embedded within the thermal blanket, thereby enabling distributed temperature sensing. This capability can aid in optimizing the thermal regulation of the spacecraft and ensuring the reliable and safe operation of vital components. Furthermore, FBG sensors offer sev eral advantages over traditional temperature sensors, including high sensitivity, immunity to electromagnetic interference, and the ability to operate in harsh environments. These properties make FBG sensors an excellent option for thermal blankets in space applications, where precise temperature regulation is crucial for mission success. Nevertheless, the calibration of temperature sensors in vacuum conditions poses a significant challenge due to the lack of an appropriate calibration reference. Therefore, this paper aimed to investigate innovative solutions for calibrating temperature sensors in vacuum conditions. The proposed solutions have the potential to enhance the accuracy and reliability of temperature measurements in space applications, which can enable engineers to develop more resilient and dependable spacecraft systems.

The value of point-of-care CD4+ and laboratory viral load in tailoring antiretroviral therapy monitoring strategies to resource limitations.

OBJECTIVE: To examine the clinical and economic value of point-of-care CD4 (POC-CD4) or viral load monitoring compared with current practices in Mozambique, a country representative of the diverse resource limitations encountered by HIV treatment programs in sub-Saharan Africa. DESIGN/METHODS: We use the Cost-Effectiveness of Preventing AIDS Complications-International model to examine the clinical impact, cost (2014 US$), and incremental cost-effectiveness ratio [$/year of life saved (YLS)] of ART monitoring strategies in Mozambique. We compare: monitoring for clinical disease progression [clinical ART monitoring strategy (CLIN)] vs. annual POC-CD4 in rural settings without laboratory services and biannual laboratory CD4 (LAB-CD4), biannual POC-CD4, and annual viral load in urban settings with laboratory services. We examine the impact of a range of values in sensitivity analyses, using Mozambique's 2014 per capita gross domestic product ($620) as a benchmark cost-effectiveness threshold. RESULTS: In rural settings, annual POC-CD4 compared to CLIN improves life expectancy by 2.8 years, reduces time on failed ART by 0.6 years, and yields an incremental cost-effectiveness ratio of $480/YLS. In urban settings, biannual POC-CD4 is more expensive and less effective than viral load. Compared to biannual LAB-CD4, viral load improves life expectancy by 0.6 years, reduces time on failed ART by 1.0 year, and is cost-effective ($440/YLS). CONCLUSION: In rural settings, annual POC-CD4 improves clinical outcomes and is cost-effective compared to CLIN. In urban settings, viral load has the greatest clinical benefit and is cost-effective compared to biannual POC-CD4 or LAB-CD4. Tailoring ART monitoring strategies to specific settings with different available resources can improve clinical outcomes while remaining economically efficient.