翻译一篇论文:在家和在工作地点也能做的适合性试验——不需要专业套件的定性测试

这篇论文(https://doi.org/10.1017/dmp.2020.35)是我Fit Test视频中试验方法的来源,它提供了一个简单、便宜、易操作的定性适合性试验QLFT)方法,让更多的人评估自己佩戴的口罩/呼吸器是否密合成为了可能。但如论文中所说,这是一个很初级的研究,方法的安全性需要进一步评估。但对一些人来说,未经安全性认证但行之有效的QLFT方法带来的风险,跟不确定自己用的呼吸器能否密合带来的风险相比,前者或许会小得多。

请注意:论文中的试验方法存在风险,请读者仔细阅读论文中的“讨论”及其他部分标红的风险提示语,并谨慎使用试验方法,自担风险。


论文中提到的传统QLFT套件都可以在中看到。


由于译者水平有限,部分翻译可能存在不准确、不到位的情况。个别地方译者不知道怎么翻,有摆烂行为,请读者谅解,欢迎在评论区补充合适的翻译。埋了几个小梗,但估计没几个人能看到,无所谓了。术语第一次出现时会用方括号写出缩写,再次出现会直接使用缩写


以下是全文搬运+正文翻译,星号(*)是译者添加的备注,论文原文中的括号在译文中仍使用圆括号,译者补充的括号为方括号。由于专栏不能添加上标,论文中表示引用的数字均用小一号的字体展现。译文约4300字,大约需要11-14分钟阅读。

在家和在工作地点也能做的适合性试验——不需要专业套件的定性测试

Performing Qualitative Mask Fit Testing Without a Commercial Kit: Fit Testing Which Can Be Performed at Home and at Work

作者团队:Eugenia O’Kelly, BA ; Anmol Arora ; Charlotte Pearson; James R. Ward, PhD ;
P. John Clarkson, ScD


摘要

目的:定性的适合性试验[QLFT]是一种确认面罩适合性[fit]的手段,常用于如N95和FFP3这类紧贴面部的面罩。由于冠病-19造成对测试设备的需求增加,进一步引起了设备短缺,许多机构不得不放弃适合性试验。QLFT需要用到三种关键材料:测试溶液、喷雾器[nebulizer]和测试头罩。由于已经有了对测试溶液替代品的研究,本研究将评估喷雾器和头罩的替代方案。

方法:我们为专业套件中的喷雾器选用了四种替代方案,为头罩选了两种方案。三名研究人员佩戴不同口罩评估替代品的实用性和准确性,以选出最可行的方案。

结果:香薰机和较小的头罩具有较高的灵敏度和准确性。

结论:香薰机在QLFT中具有迅速、简便、便宜的显著优势。我们的研究指出,在无法获取传统的测试套件时,香薰机和自制头罩是很好的替代品,它们的安全性和可靠性还需要后续的实验来评估

关键词:behavioral risk factor surveillance, safety management, health communication, quality of health care, risk assessment

 

ABSTRACT

Objective: Qualitative fit testing is a popular method of ensuring the fit of sealing face masks such as N95 and FFP3 masks. Increased demand due to the coronavirus disease 2019 (COVID-19) pandemic has led to shortages in testing equipment and has forced many institutions to abandon fit testing. Three key materials are required for qualitative fit testing: the test solution, nebulizer, and testing hood. Accessible alternatives to the testing solution have been studied. This exploratory qualitative study evaluates alternatives to the nebulizer and hoods for performing qualitative fit testing.

Methods: Four devices were trialed to replace the test kit nebulizer. Two enclosures were tested for their ability to replace the test hood. Three researchers evaluated promising replacements under multiple mask fit conditions to assess functionality and accuracy.

Results: The aroma diffuser and smaller enclosures allowed participants to perform qualitative fit tests quickly and with high accuracy.

Conclusions: Aroma diffusers show significant promise in their ability to allow individuals to quickly, easily, and inexpensively perform qualitative fit testing. Our findings indicate that aroma diffusers and homemade testing hoods may allow for qualitative fit testing when conventional apparatus is unavailable. Additional research is needed to evaluate the safety and reliability of these devices.

Key Words: behavioral risk factor surveillance, safety management, health communication, quality of health care, risk assessment

QLFT可以用来评估诸如N95和FFP3这类紧贴面部的口罩的适合性,但不幸的是,在冠病-19大流行期间,对个人防护设备及适合性试验[FT]设备需求的剧增,以及需求剧增后供应的不足,迫使许多机构放弃了FT1

Qualitative fit testing provides the ability to ensure acceptable fit of a sealing face mask such as an N95 or FFP3. Unfortunately, during the coronavirus disease 2019 (COVID-19) pandemic, a dramatic increase in the demand and use of protective equipment and fit testing equipment, coupled with severe supply shortages, has forced many institutions to abandon fit testing.1

 

适合性是一个重要指标,它决定了口罩能不能阻止细颗粒物的呼出和吸入。此前的研究提到,即便口罩材料本身有高过滤效率,如果不能密合,那么口罩的防护能力也会大打折扣。Huff等人的研究中通过使用雾化后的锝[含放射性],发现佩戴呼吸器时不能有效密封是导致沾染的主要原因2。这个发现被Cooper等人的研究结果所支持。Cooper团队在研究中发现,从外科口罩边缘泄露的气流量是总气流量的三分之一;对于紧贴面部的呼吸器来说,泄露量是总气流量的六分之一3

Fit is a primary factor in determining whether a mask is capable of reducing the spread and inhalation of fine particles. Previous studies have noted that, even if the materials of a mask have high filtration efficiency, the effectiveness of the mask is hampered by an imperfect seal. A study by Huff et al., using nebulized radioactive technetium, found that an ineffective seal is the principal cause of airborne contamination among those wearing respirators.2 This finding is supported by the findings of Cooper et al., who found that leakage around masks accounted for one-third of the airflow across the mask for surgical masks and one-sixth of the flow for respirators.3

 

QLFT为半面罩(如N95、FFP3*)测试适合性的情况最多见,因为它相比起定量的适合性试验[QNFT]来说,更便宜、[设备和材料]更易得、更快,也占用更少的人员时间[staff time]4。正因如此,在医院这种高吞吐率对于facility performance**至关重要的机构,QLFT得到了广泛应用5

[*译者:这里原文是FPP3,显然是手误,应为FFP3。]

[**不会翻,摆烂]

Qualitative testing is most commonly adopted to assess the fit of half-face respirators such as N95 and FPP3 masks4 as it is less expensive, more accessible, faster, and less demanding of staff time than the alternative of quantitative fit testing.4 Qualitative testing is widely used in hospitals, where a high throughput rate is critical for facility performance.5

 

在正常情况下,QLFT需要的设备既不贵,又不难获得。QLFT通常需要三件道具:一个测试用的头罩、一种测试溶液雾化器,以及用于雾化的溶液。不幸的是,断裂的供应链和激增的需求使得这些设备一套难求。在美国,购买这些设备的人要面临缺货的问题,或至少等待8周[才能拿到货]。

Under normal circumstances, the equipment required for qualitative fit testing is affordable and accessible. The tests usually require 3 items: a wearable testing hood; a testing solution aerosolizer; and an aerosolized test solution. Unfortunately, disruption to supply chains and a surge in demand has limited their availability. Those seeking to purchase such equipment currently face out of stock notices or wait times, in the United States, of up to and over 8 wk.

 

为了医院和其他行业能为他们的员工提供应有的保护,解决FT设备供应危机变得至关重要。此前的研究已经展示了自制FT溶液的可行性6,7,本研究就作为一个初始的、探索性质的研究,评估QLFT中头罩和雾化器的替代品的有效性。

Solving the fit testing supply crisis is critical to enable hospitals and businesses to properly protect their workers. Prior studies have already shown the feasibility of making a homemade fit testing solution.6,7 This initial exploratory study aims to assess the effectiveness of alternatives to the mechanical elements of the qualitative fit test: the fit testing hood and nebulizer.


方法

测试与验证

三位测试人员在进行QLFT前先接受了QNFT,来评估他们佩戴的口罩的适合性。相比起QLFT,计算口罩内外颗粒物数量的比值的QNFT准确性更佳,是一种非常准确的衡量呼吸器适合性的方法6,8。QNFT的结果将用来判断QLFT的结果(有味道vs无味道)是否准确。我们将使用Portacount 8038+——一套能测试N95口罩的设备,依照OSHA protocol 29CFR1910.134来执行QNFT。团队中的一位成员先接受测试,其他人随后接受相同的测试,以确认设备的确实有效*。更多信息可以在线上的Supplemental Data上获取。

[*译者:这里应该说的是QLFT的设备]

METHODS

Testing and Verification

Three testers underwent quantitative fit tests to assess the fit of the masks on their face before assessing qualitative fit methods. Quantitative fit testing, which measures the number of particles inside and outside of a face mask, is a highly accurate means of measuring fit and is more accurate than qualitative fit testing.6,8 Results from the quantitative fit tests were used to determine what sensation (taste vs no taste) would be considered the correct response in the qualitative fit testing. Quantitative fit tests were conducted with a Portacount 8038+ using OSHA protocol 29CFR1910.134 and the settings that allow the testing of N95 masks. One member of the team performed initial testing. Additional testers were brought in to confirm and assess promising devices. More information can be found in the online Supplemental Data.


测试溶液

Fakherpour团队和Mitchell团队已经找到了既有效又能在家中简单制作的糖精钠溶液配方6,9,在本研究中使用的配方正是基于他们的研究结果。正式测试溶液由830毫克糖精钠和100毫升蒸馏水混合而成;灵敏度测试溶液由415毫克糖精钠和100毫升蒸馏水混合而成,该溶液的浓度在Fakherpour和Mitchel两个团队使用的阈值浓度之间。

Testing Solution

Fakherpour et al. and Mitchell et al. have developed effective sodium saccharin testing formulas which can easily be made at home.6,9 Our formula was based on these studies. The testing solution consists of 830-mg sodium saccharin to 100-mL distilled water. Our sensitivity/threshold solution contained a sodium saccharin concentration between the threshold solution of Fakherpour et al. and Mitchel et al., using 415-mg sodium saccharin per 100 mL. A commercial fit test nebulizer was used to ensure each test subject could detect

the saccharin solution.

设备

我们测试了四种用来代替原版灯泡状雾化器的设备,它们分别是:超声波雾化器(品牌AGPTEK,总部在中国广东)、小喷瓶、迷你棍状加湿器(品牌JISULIFE,总部在中国广东)和一个香薰机(品牌VicTsing,总部在加州的森尼维尔)。小喷瓶和迷你加湿器的喷雾量并不可知,JISULIFE的迷你加湿器外包装上声称喷雾量在25-40毫升每小时*。AGPTEK的超声波雾化器声称喷雾量至少是400毫升每小时。

[*译者:看起来前后文冲突对吧?原文如此,我也不知道怎么回事。]

 

三种设备持续运行60秒,而小喷瓶则朝着头罩里喷10次。如果在这期间没有尝出味道,那么测试结果记为“无味道”。

 

Devices

Four devices were tested for their ability to replace the bulb nebulizer used for qualitative test kits. These included an ultrasonic mist maker (from AGPTEK, headquarters Guangdong, China), a spray bottle, a miniature wand humidifier (from JISULIFE, headquarters Guangdong, China), and an essential oil diffuser (from VicTsing, headquarters Sunnyvale, CA). Flow rate information was not available for the spray bottle or miniature humidifier. The mini humidifier by JISULIFE packaging stated a diffusion rate of 25-40 mL/h. The ultrasonic mist maker by AGPTEK claims to produce at least 400 mL/h.

 

Devices were run for 60s, or in the case of the spray bottle, for up to 10 sprays. If no taste could be detected within that period, the test condition was judged as “no taste”.

试验用Enclosures

在QLFT中,传统的enclosure是一个头罩,带有一个可供挤压式雾化器伸进去产生雾气的圆形小洞(小洞同时也有通风的作用)。跟其他的设备一样,这头罩挺贵,并且在大流行期间也很难买到。我们测试了两种替代品:一个边长11.81英寸[译者:约30厘米]的透明[clear]方形储物盒,以及一个结实的、容积2加仑[译者:约10升]的塑料袋。我们同时也测试了传统的FT头罩。传统头罩上的小洞是为水平出雾的雾化器设计的,因此我们把一根PVC弯管接到小洞上,让垂直出雾的设备产生的雾气能顺利进入头罩里。

Testing Enclosures

In qualitative testing, a hood with a small circular opening for ventilation and insertion of the squeeze nebulizer is used to concentrate the testing mist. Like the rest of the testing equipment, these hoods are expensive and, under these pandemic conditions, difficult to obtain. We tested 2 alternative testing enclosures to replace the hood: a clear storage cube measuring 11.81 inches square and a sturdy 2-gallon plastic bag. We also tested the devices with a commercial fit test hood. When testing the hood, which is designed for a horizontally discharging aerosolizing device, we used a piece of curved PVC fit to the hole in the testing hood to help direct the mist from the vertically discharging devices.

口罩

测试中使用了两种口罩,一种是3M的N95,一种是中国制造商生产的KN95。

Mask

Two different masks were worn during testing, an N95 mask manufactured by 3M and a KN95 mask from a Chinese manufacturer.

为了评估雾化设备和头罩的性能并准确预测适合性的问题,我们设计了几种不同的适合性状态,进行了五次测试,测试使用的口罩是未加改动的N95和KN95。测试人员会佩戴N95进行三次额外的测试,这三次测试中,佩戴者的面部和N95之间会故意留出缝隙。第一次[额外]测试中,测试人员会把手指伸到眼睛下方的皮肤与口罩之间,在鼻子附近制造一个空隙;第二次[额外]测试中,他们会把手指伸到下巴与口罩之间,制造一个空隙;终极[额外]测试中,他们会在脸颊和口罩侧面之间用手指制造一个空隙。这三个测试能让我们知道,我们用的测试设备检测适合性问题的能力究竟有多强。

To assess the ability of the device and enclosure to accurately predict fit issues, 5 tests were conducted in different fit states. Tests were performed with the unmodified N95 and KN95.

The wearer then performed 3 additional tests with the N95 while intentionally causing a fit gap. For 1 test, they placed the tip of their finger between the mask and the skin beneath

their eye, causing a gap in the nose area. For the other test, they placed the tip of their finger between the bottom of the mask and their chin area, causing a chin gap. Finally, they placed the tip of their finger between the cheeks and edge of the mask. These 3 tests enabled us to assess how well the testing setup could detect specific fit issues.

结果

雾化设备

四种设备中的三种都能让测试人员尝到灵敏度测试溶液的味道(见图一)。棍状加湿器不好用,没能让测试人员尝到明显的味道;雾化器和喷瓶能让测试人员尝到味道,但会有糟糕的副作用,比如让口罩变湿;香薰机能产生准确的结果,其准确性与商用的QLFT设备一致6

RESULTS

Aerosolization Devices

The testers were able to taste the sensitivity solution with 3 of the devices used (see Figure 1). The wand humidifier proved difficult to use and did not produce a clear taste sensation. The mist maker and spray bottle produced a taste sensation but had undesirable side effects such as causing the mask to become wet. The aroma diffuser produced accurate responses. The accuracy using this aroma diffuser was in line with the reported accuracy of commercial qualitative fit testing kits.6

头罩

小一点的头罩在和某些设备(不是所有设备)搭配时能有更迅速的结果。喷瓶在传统头罩里表现不佳,在10升塑料袋里则完全没法用。

 

在同香薰机和超声波雾化器搭配时,头罩小一点,准确性会更高,出结果的速度也更快。最小的头罩——塑料袋,在试验中出现不准确结果的次数最少,得出正确结果的速度最快;更大的头罩会有更低的准确性,也需要更长的测试时间才能出结果。

 

Testing Enclosures

Smaller testing enclosures allowed for faster detection of the testing solution in some, but not all, devices. The spray bottle did not function well in the hood and was unable to fit into the 2-gallon bag.

 

The smaller testing enclosures benefited both the accuracy and the detection speed when using the aroma diffuser and ultrasonic mist maker. The smallest enclosure, the plastic bag, produced the fewest inaccurate results and allowed for correct detection in the shortest period of time. Larger testing enclosures incurred greater inaccuracy and longer times to detection.

讨论

总结一下重要发现

我们的结果显示,便宜的自制溶液和家用设备可以有效地执行QLFT,并且这套容易重复的试验,能让面罩佩戴者在家或在工作地点就能简单、快速地检查面罩的适合性状态(见图2)。我们发现香薰机和带拉链的储物袋分别是传统雾化器和头罩的最佳替代品,能产出最准确的结果,它们的准确程度、可靠性和易用性都超出了我们的预期。在无法获得/买不起传统QLFT套件的时候,它们是挺有用的替代品。不过必须强调的一点是,我们的这项研究还很初级,使用的方法并没有依照美国国家职业安全卫生研究所(NIOSH)的规定,我们不能确定这个QLFT方法同使用商业套件的、标准的NIOSH方法相比,是不是同样有效、同样安全。将其他设备改造并用于QLFT可能会对使用者带来风险,我们建议谨慎使用这套方法,使用者自负风险,我们概不负责。

DISCUSSION

Summary of Key Findings

Our results indicate that qualitative fit testing can be conducted effectively using inexpensive homemade testing solutions and household testing devices. Moreover, a simple, quick, and easily replicated at-home or work setup may enable users to test for proper fit of sealing face masks (see Figure 2). We found that aroma diffusers and zipper storage bags were the most accurate alternatives to typical solution nebulizers and testing hoods, respectively. The degree of success, reliability, and ease of set up for our homemade testing apparatus exceeded our expectations and suggests that alternative testing enclosures and nebulizers may prove useful where conventional apparatus is unavailable or unaffordable. However, it must be emphasized that this research is preliminary. The method proposed is not National Institute for Occupational Safety and Health (NIOSH) compliant. We cannot be sure if this method of qualitative testing is as effective or safe as standard NIOSH testing methods using commercially available equipment. Repurposing equipment for qualitative fit testing may come with risks to the wearer. We advise anyone who intends to use this method to proceed with caution and at their own risk.

表现不佳的设备和头罩

我们不建议在FT中使用喷瓶和超声波雾化器,它们会让口罩肉眼可见地变湿,影响口罩的后续使用。

 

我们的结果显示,加湿器不适合用来做定性测试*。原因可能是我们测试棍状加湿器的出雾量太小,也许出雾量更大的加湿器会更合适;当然也可能是大多数加湿器内部都含有的过滤元件将溶液里的糖精钠过滤到了人能尝出来的阈值之下,所以它不能用于FT。香薰机在没有头罩的情况下就已经良好了,与小头罩搭配时表现还有提升。在不用头罩进行测试时,让香薰机的雾气与口罩接触能提升测试的准确性。如果用方形储物盒做头罩,跟无头罩相比,提升并不大,因为它既过于大,又过于通风,使得雾化的糖精钠溶液没法在口罩附近有足够的浓度。一个更小的、更不透风的盒子也许会更有效。

[*译者:原文写的是quantitative定量的,显然是错误,应为qualitative定性的。]

 

Poorly Functioning Devices and Enclosures

We do not recommend the use of the spray bottle or the ultrasonic mist maker for fit testing as both made the mask visibly wet and consequently compromised the future use of the mask.

 

Our results indicate that humidifiers may not be fit for quantitative testing. While it is possible that the wand humidifier we tested provided an insufficient flow rate and that a more powerful humidifier might be adequate, it is likely that filters included with most humidifiers removed enough of the sodium saccharin to prevent the device from working as a fit testing device. The aroma diffuser was effective at testing masks without an enclosure but improved with a smaller space. Passing the aroma diffuser around the face so that the fog comes in contact with the mask improves the accuracy when no enclosure is used. The box we used provided little benefit over no enclosure. It was not small enough nor airtight enough to create a concentration of aerosolized sodium saccharin around the mask area. A smaller or more airtight box might be more effective.

表现出色的设备和头罩

市面上能买到的香薰机能非常有效地雾化测试溶液。

 

小头罩,或者那些跟传统头罩尺寸相近的头罩,跟香薰机配合时能最快得出最准确的结果。

 

如果没有传统头罩,我们推荐使用容积至少为2加仑、鲁棒的结实的freezer拉链储物袋。一个大的freezer塑料袋,简单扣在头上,保持袋口敞开,就是一个便宜好用的头罩了。由于潜在的窒息风险,将塑料袋用于QLFT的时候要格外小心。这类头罩只能用于知晓风险并能随时取下塑料袋的成人。只有重结构的塑料袋——比如Ziplock freezer塑料袋(品牌SC Johnson,总部在威斯康辛州的拉辛)才能用于FT,因为这些塑料袋比较硬的结构和较重的塑料拉链能避免走形后堵住口鼻处的气流。塑料袋在脖颈处绝对不能封上,应保持敞开以供气体交换。[拉链塑料袋]的重量和结构也能避免和测试的设备缠绕在一起,或在受试者脖颈附近封闭。轻、几乎无结构的塑料袋——比如保鲜袋和购物塑料袋及任何产品的外包装袋,会有更大的窒息风险,在任何情况下都绝对不能用于FT。塑料袋在任何时候都应与佩戴者的口罩保持2英寸(约5厘米)的距离。为了保证测试者的安全,[进行QLFT时]应有另一名知晓风险的成人在场,这名成人要能随时取下测试者头上的塑料袋,以防任何可能的意外发生。在QLFT中使用任何未经认证的头罩可能会带来危险,使用者后果自负。

 

Successful Devices and Enclosures

Commercial aroma diffusers proved highly effective in aerosolizing the testing solution.

 

Small enclosures, or those most similar to the conventional testing hood, produced the fastest and most accurate results when using an aroma diffuser.

 

If a testing hood is not available, we recommend using a robust freezer zipper storage bag with at least a 2-gallon capacity. A large freezer plastic bag, kept open and placed over the head, proved an inexpensive and highly effective option. Due to the possible risk of suffocation, it is vital that extra caution is taken while using a plastic bag in this manner. This type of enclosure should only be used by risk-aware adults who are able to quickly and safely maneuver the bag on and off. Only plastic bags with heavier structure, such as Ziplock freezer bags (from SC Johnson, headquarters in Racine, WI), should be used. Their more rigid form and heavy plastic zipper resists deforming and blocking the air flow, nose, or mouth. Bags should never be sealed around the neck. The entirety of the bottom of the bag should be left open to promote airflow. The weight and structure also help prevent the bag from becoming tangled with the testing equipment or closing around the tester’s neck. Light, poorly structured bags, such as plastic takeout or grocery bags, garbage bags, or product packaging bags should never, under any circumstances, be used as these bags have a higher chance of causing suffocation. Bags should always be large enough to provide at least 2 inches in front of the mask when worn. For safety, a second adult should be present and aware at all times the bag is worn and able to quickly remove the bag in case of any issue. Testing with any enclosure not approved for qualitative fit testing may be hazardous and is undertaken at the risk of the user.

结论

尽管QLFT跟QNFT比起来准确性更差,但它仍是评估面罩的适合性并确认佩戴者得到保护的重要工具。人们可以用便宜的FT方案,让他们能像其他人[指有专业套件的人]一样保护自己,这比以往任何时候都重要。

 

我们这项初始的研究说明,用香薰机来代替昂贵的专业雾化器有一定可行性。在我们的测试中,香薰机的准确性与专业套件的准确性一致,甚至前者有时还更高。新的QLFT方法看起来前景不错,但需要进一步的研究来确认它的有效性和安全性。鉴于新冠病毒在全世界引起的持续增长的风险,部分人可能会认为未经认证的FT方法带来的风险,要比戴着不密合、无法提供保护的呼吸器的风险小得多。不过,虽然本研究里展现的方法似乎表现不错,但不能认为这个方法能够替代传统的QLFT方法,也绝对不能用在高危环境下(如health-care facilities*)。这个替代方法的安全性,以及使用包括苦味剂在内的其他测试溶液的有效性,甚至使用苦味剂的替代溶液(比如aloe vera[译者:芦荟汁?])的有效性,需要进一步的研究10

[*译者:中文里好像没有对应的词?这个词通常包括医院、诊所、护理院、生殖中心这类地方,叫“卫生保健机构”?]

 

CONCLUSIONS

Despite being less accurate than quantitative fit testing, qualitative testing remains a vital tool to ensure mask-wearers are protected by assessing mask fit. It is currently more important than ever that people have access to inexpensive fit testing protocols so that they can protect themselves as well as others.

 

Our initial tests indicate that replacing the expensive test kit nebulizer with an aroma diffuser may be feasible. The accuracy of our tests were in line with, and often exceeded, the accuracy of qualitative fit tests performed with commercial solutions and equipment.6 This new qualitative testing method shows promise but requires additional research to ensure its effectiveness and safety. Given the growing risk the SARS-CoV-2 poses around the world, some may judge the potential risk of using this unproven testing method less severe than the risk of wearing a respirator whose poor fit does not protect the wearer. However, although the results presented in this study appear promising, the methods should not be interpreted as being a substitutable for conventional certified testing procedures and they must not be used in high-risk environments, such as health-care facilities. Future work is needed to assess the safety and efficacy of using alternative methods, as well as their ability to function with other testing solutions including bitter solutions and alterative testing solutions, such as aloe vera.10

关于作者(不翻)

About the Authors

Department of Engineering, Engineering Design Centre, Cambridge University, United Kingdom (Ms O’Kelly, Dr Ward, Prof Clarkson); Department of Medicine, Cambridge University, United Kingdom (Mr Arora) and Charles H Lundquist College of Business, University of Oregon, Eugene, Oregon (Ms Pearson).

 

Correspondence and reprint requests to Eugenia O’Kelly, 999 Green Street, Apt 1505, San Francisco, CA USA 94133 (e-mail: [email protected]).

致谢(不翻)

Acknowledgments

We give special thanks to Dr Ming Jeffrey Kao, who introduced us to the problem that motivated this study. We also thank Corinne O’Kelly for making this research possible.

补充材料

本论文的补充材料见https://doi.org/10.1017/dmp.2020.352

Supplementary Material

To view supplementary material for this article, please visit https://doi.org/10.1017/dmp.2020.352

参考文献

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https://doi.org/10.1017/dmp.2020.35

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