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Planning and communicating prototype tests for the Nano Membrane Toilet: A critical review and proposed strategy.

ABSTRACT: Urban sanitation in growing cities of the Global South presents particular challenges. This led to the Bill & Melinda Gates Foundation's Reinvent The Toilet Challenge, which sparked the development of various non-sewered sanitation technologies like the Nano Membrane Toilet. Complex disruptive technologies like this entail an extensive product development process, including various types of prototype tests. While there is an abundance of literature discussing how to build prototypes, and the optimal number of tests, there has been little focus on how to plan and conduct tests, especially in a development endeavour of this complexity. Four approaches to testing are reviewed, and their strengths and weaknesses compared. A visualised testing strategy is proposed that encompasses the entire product development process and can be used to plan and communicate prototype tests for the Nano Membrane Toilet to ultimately achieve compliance with international standards.

SUBMITTER: Hennigs J

PROVIDER: S-EPMC6974809 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Planning and communicating prototype tests for the Nano Membrane Toilet: A critical review and proposed strategy.

Hennigs Jan J Parker Alison A Collins Matt M Jiang Ying Y Kolios Athanasios A McAdam Ewan E Williams Leon L Tyrrel Sean S

Gates open research 20190830

Urban sanitation in growing cities of the Global South presents particular challenges. This led to the Bill & Melinda Gates Foundation's Reinvent The Toilet Challenge, which sparked the development of various non-sewered sanitation technologies like the Nano Membrane Toilet. Complex disruptive technologies like this entail an extensive product development process, including various types of prototype tests. While there is an abundance of literature discussing how to build prototypes, and the opt ...[more]

PMID: 32025631

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Project description:BackgroundDiagnosis of human African trypanosomiasis (HAT) remains a challenge both for active screening, which is critical in control of the disease, and in the point-of-care scenario where early and accurate diagnosis is essential. Recently, the first field deployment of a lateral flow rapid diagnostic test (RDT) for HAT, "SD BIOLINE HAT" has taken place. In this study, we evaluated the performance of "SD BIOLINE HAT" and two new prototype RDTs.Methodology/principal findingsThe performance of "SD BIOLINE HAT" and 2 prototype RDTs was tested using archived plasma from 250 Trypanosoma brucei gambiense patients, and 250 endemic controls. As well as comparison of the sensitivity and specificity of each device, the performance of individual antigens was assessed and the hypothetical performance of novel antigen combinations extrapolated. Neither of the prototype devices were inferior in sensitivity or specificity to "SD BIOLINE HAT" (sensitivity 0.82±0.01, specificity 0.97±0.01, 95% CI) at the 5% margins, while one of the devices (BBI) had significantly superior sensitivity (0.88±0.03). Analysis of the performance of individual antigens was used to model new antigen combinations to be explored in development of the next generation of HAT RDTs. The modelling showed that an RDT using two recombinant antigens (rLiTat1.5 and rISG65) would give a performance similar to the best devices in this study, and would also offer the most robust performance under deteriorating field conditions.Conclusions/significanceBoth "SD BIOLINE HAT" and the prototype devices performed comparably well to one another and also to the published performance range of the card agglutination test for trypanosomiasis in sensitivity and specificity. The performance of individual antigens enabled us to predict that an all-recombinant antigen RDT can be developed with an accuracy equivalent to " SD BIOLINE HAT." Such an RDT would have advantages in simplified manufacture, lower unit cost and assured reproducibility.

Project description:Noncompaction cardiomyopathy (NCCM) is a rare condition characterized by prominent trabeculae, deep intertrabecular recesses, and a left ventricular myocardium with a two-layered structure, characterized by a spongy endocardial layer and a thinner and compacted epicardial one. NCCM can be isolated or associated with other congenital heart diseases and complex syndromes involving neuromuscular disorders and facial dysmorphisms. To date, more than 40 genes coding for sarcomeric, cytoskeletal, ion channels, and desmosomal proteins have been identified. Clinical presentation is also highly variable, ranging from no symptoms to end-stage heart failure (HF), lethal arrhythmias, sudden cardiac death, or thromboembolic events. In particular, the prevalence of thromboembolism in NCCM patients appears to be higher than that of a similar, age-matched population without NCCM. Thromboembolism has a multifactorial aetiology, which is linked to genetic, as well as traditional cardiovascular risk factors. In previous studies, atrial fibrillation (AF) was observed in approximately 25-30% of adult NCCM patients and embolism had a cardiac source in ~63-69% of cases; therefore, AF represents a strong predictor of adverse events, especially if associated to HF and neuromuscular disorders. Left ventricular dysfunction is another risk factor for thromboembolism, as a result of blood stagnation and local myocardial injury. Moreover, it is not completely clarified if the presence of deep intertrabecular recesses causing stagnant blood flow can constitute per se a thrombogenic substrate even in absence of ventricular dysfunction. For the clinical management of NCCM patients, an appropriate stratification of the thromboembolic risk is of utmost importance for a timely initiation of anticoagulant therapy. The aim of the present study is to review the available literature on NCCM with particular attention on thromboembolic risk stratification and prevention and the current evidence for oral anticoagulation therapy. The use of direct oral anticoagulants vs. vitamin K antagonists is also discussed with important implications for patient treatment and prognosis.

Dataset Information

Planning and communicating prototype tests for the Nano Membrane Toilet: A critical review and proposed strategy.

Publications

Planning and communicating prototype tests for the Nano Membrane Toilet: A critical review and proposed strategy.

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