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The direct integration of paper-based microfluidic fuel cells (µFC's) toward creating autonomous lateral flow assays has attracted attention. Here, we show that an air-breathing paper-based µFC could be used as a power supply in pregnancy tests by oxidizing the human urine used for the diagnosis. We present an air-breathing paper-based µFC connected to a pregnancy test, and for the first time, as far as we know, it is powered by human urine without needing any external electrolyte. It uses TiO2-Ni as anode and Pt/C as cathode; the performance shows a maximum value of voltage and current and power densities of ∼0.96 V, 1.00 mA cm-2, and 0.23 mW cm-2, respectively. Furthermore, we present a simple design of a paper-based µFC's stack powered with urine that shows a maximum voltage and maximum current and power densities of ∼1.89 V, 2.77 mA cm-2 and 1.38 mW cm-2, respectively, which powers the display of a pregnancy test allowing to see the analysis results.

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We aimed to evaluate the accuracy of Interferon-tau stimulated genes (ISG) abundance in peripheral blood polymorphonuclear cells (PMNs) on D20 after fixed-time artificial insemination (FTAI; D0) as a pregnancy diagnosis method against CL evaluation by Doppler ultrasonography and progesterone (P4) concentrations on D20, as well as Pregnancy Associated Glycoproteins (PAG) concentrations on D25. Additionally, we evaluated the potential of ISG abundance in PMNs as pregnancy loss predictors. Nelore heifers (n = 103) and cows (n = 144) underwent estrous synchronization and were artificially inseminated on D0. Pregnancy was diagnosed by B-mode ultrasonography on D30 and D70, and after the final diagnosis, females were classified in four groups: Pregnant; Non-pregnant; Functional CL on D20 but non-pregnant (CL-NP) and Pregnancy loss between D30 and D70 (PL). After determining cutoff values, the Sensitivity (SE), Specificity (SP), Positive Predictive Value (PPV), Negative Predictive Value (NPV) and Accuracy (ACC) were determined for each method. All methods were classified as significant (P < 0.05) predictors of pregnancy. Both ISG expression and PAG concentrations were greater (P < 0.05) in pregnant females than in non-pregnant and CL-NP females but did not differ (P > 0.05) from the PL group. ISG15 expression was greater (P < 0.05) in heifers than in cows, but this difference was not found in OAS1 expression and PAG concentrations. All the methods evaluated were proven to be adequate predictors of pregnancy, but greater accuracies were obtained through PAG concentrations and Doppler-US, due to the decreased number of false positive and false negative results.

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Assessing the viability of a blastosyst is still empirical and non-reproducible nowadays. We developed an algorithm based on artificial vision and machine learning (and other classifiers) that predicts pregnancy using the beta human chorionic gonadotropin (b-hCG) test from both the morphology of an embryo and the age of the patients. We employed two high-quality databases with known pregnancy outcomes (n = 221). We created a system consisting of different classifiers that is feed with novel morphometric features extracted from the digital micrographs, along with other non-morphometric data to predict pregnancy. It was evaluated using five different classifiers: probabilistic bayesian, Support Vector Machines (SVM), deep neural network, decision tree, and Random Forest (RF), using a k-fold cross validation to assess the model's generalization capabilities. In the database A, the SVM classifier achieved an F1 score of 0.74, and AUC of 0.77. In the database B the RF classifier obtained a F1 score of 0.71, and AUC of 0.75. Our results suggest that the system is able to predict a positive pregnancy test from a single digital image, offering a novel approach with the advantages of using a small database, being highly adaptable to different laboratory settings, and easy integration into clinical practice.

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BACKGROUND: Large-scale deworming programs have, to date, mostly targeted preschool- and school-age children. As community-based deworming programs become more common, deworming will be offered to women of reproductive age. The World Health Organization recommends preventive chemotherapy be administered to pregnant women only after the first trimester. It is therefore important for deworming programs to be able to identify women in early pregnancy. Our objective was to validate a short questionnaire which could be used by deworming program managers to identify and screen out women in early pregnancy. METHODOLOGY/PRINCIPAL FINDINGS: In May and June 2018, interviewers administered a questionnaire, followed by a pregnancy test, to 1,203 adult women living in the Peruvian Amazon. Regression analyses were performed to identify questions with high predictive properties (using the pregnancy test as the gold standard). Test parameters were computed at different decision tree nodes (where nodes represented questions). With 106 women confirmed to be pregnant, the positive predictive value of asking the single question 'Are you pregnant?' was 100%, at a 'cost' of a false negative rate of 1.9% (i.e. 21 women were incorrectly identified as not pregnant when they were truly pregnant). Additional questions reduced the false negative rate, but increased the false positive rate. Rates were dependent on both the combination and the order of questions. CONCLUSIONS/SIGNIFICANCE: To identify women in early pregnancy when deworming programs are community-based, both the number and order of questions are important. The local context and cultural acceptability of different questions should inform this decision. When numbers are manageable and resources are available, pregnancy tests can be considered at different decision tree nodes to confirm pregnancy status. Trade-offs in terms of efficiency and misclassification rates will need to be considered to optimize deworming coverage in women of reproductive age.

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The early pregnancy diagnosis allows optimizing production and timely management correction, with a greater reproductive output of livestock. The Idexx Rapid Visual Pregnancy Test® consists of an ELISA for visual reading which does not require the use of readers in the laboratory, with satisfactory pregnancy diagnoses at 28 days of pregnancy in cattle. Therefore, the aim of this study was to evaluate this rapid test and to verify the most appropriate day for the diagnosis of pregnancy in the ovine species. For this purpose, 98 serum samples from pregnant sheep and 36 from non-pregnant were used, with duplicate samples, and diagnosis was confirmed by ultrasound examination, used as the gold standard. The numbers of positive samples obtained at 26, 28, and 30 days of pregnancy were 26, 27, and 45, respectively. The Rapid Visual Pregnancy Test correctly identified 100% of the samples as positive at pregnancy of days 26, 28, and 30. The sensitivity and specificity of the test were also 100%. The Idexx Rapid Visual Pregnancy Test, initially indicated for cattle, is effective for the detection of pregnancy in the ovine species, enabling diagnosis of pregnant sheep from the 26th day of pregnancy.

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OBJECTIVE: To assess the feasibility of using an at-home multilevel pregnancy test (MLPT) and interactive voice response (IVR) call-in system for remote follow-up of medical abortion. METHODS: A prospective pilot study was conducted among women who had a medical abortion at up to 70 days at a clinic in Mexico City, Mexico, between June 1, 2015, and January 30, 2016. Participants took an MLPT at the initial clinic visit and another MLPT at home 2 weeks later. They were requested to report their MLPT results via the IVR system and attend the clinic for follow-up evaluation. RESULTS: Of 200 women considered for inclusion, 163 (81.5%) were included in the analysis. Only 10 (6.6%) of the 152 women who had a medical abortion on or before 63 days from last menstrual period reported MLPT results to the IVR system that required clinical evaluation to assess medical abortion outcome. The remaining 142 (93.4%) women in this group reported MLPT results that ruled out ongoing pregnancy (confirmed at clinical evaluation). Reported MLPT results ruled out ongoing pregnancy among the 11 women who had a medical abortion after 63 days; however, 1 (9%) had an ongoing pregnancy at clinical evaluation. CONCLUSION: Use of MLPTs and the IVR system provided a streamlined approach to follow-up after medical abortion.

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OBJECTIVE: To evaluate the predictive efficiency of serum estradiol (E2) concentration in the mid-luteal phase regarding chemical, clinical, and ongoing pregnancies, in patients subjected to IVF/ICSI with fresh embryo transfer. METHODS: One hundred and forty-three patients undergoing IVF/ICSI met all the inclusion criteria for the present study. Most of the patients used antagonists, final maturation was achieved with recombinant chorionic gonadotrophin (HCG), and embryo transfer took place on days 3 to 5, but mostly on day 4. The luteal phase was supplemented with estradiol valerate 6 mg/day and vaginal micronized progesterone 600 mg/day. There was no exclusion of patients in the embryo transfer group due to age or ovarian reserve. All patients with estradiol and chorionic gonadotrophin (ßHCG) dosage on the day of transfer, day 7, were included. We assessed the following variables, initially regarding age: number of eggs collected, formed embryos, embryos transferred, day of transfer, transfer type, estradiol and chorionic gonadotropin. Next, we evaluated these elements at three different ranges of estradiol concentrations (<200 pg/ml, 200-500 pg/ml, and >500 pg/ml), comparing these parameters in pregnant (P) and non-pregnant (NP) patients. RESULTS: Data analysis by age group in P and NP patients showed significant differences in the mean values of the variables E2 and ßHCG, TD7. Mean serum estradiol levels in P and NP in the three age groups were: <35 years, 835/417 p=0.0006, 35-39 years 833/434 p=0.0118, >39 years, 841/394 p=0.0012. There was also a significant difference in pregnancy rates in the group >500 pg/ml of estradiol concentration (63.4%, p=0.0096). The likelihood of chemical and clinical abortions for the estradiol ranges were: 38.46%, involving the two first ranges versus 15.15% for a concentration >500 pg/ml, p=0.0412 and 5.26% for a concentration >900 pg/ml, p=0.0105. The Pearson correlation coefficient for HCG and estradiol was r=0.5108. CONCLUSION: This study showed the prognostic value of E2 in the mid-luteal phase (TD7) for chemical, clinical, and ongoing pregnancies, and its concentration suggested that there is a moderately positive correlation with ßHCG levels.

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Os serviços de Atenção Básica à Saúde (ABS) do Sistema Único de Saúde são responsáveis pela maioria dos atendimentos pré-natais no Brasil. O pré-natal alcançou elevada cobertura no país, contudo, atingir um número mínimo de consultas não garante a qualidade da atenção. Ademais, permanecem iniquidades no acesso ao cuidado pré-natal, sendo que, as regiões mais pobres possuem mais difícil acesso, persistindo desfechos maternos e perinatais negativos. O objetivo geral desse estudo foi avaliar o cuidado pré-natal nos serviços de ABS que participaram do segundo ciclo do Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica (PMAQ-AB) no estado do Piauí. Trata-se de uma pesquisa avaliativa do tipo análise da implantação, subtipos 1-a, 1-b e 3, de corte tranversal. Elaborou-se os modelos lógico teórico e operacional do cuidado pré-natal nos serviços de ABS. A população desse estudo consistiu em 865 equipes de ABS que participaram da avaliação externa no segundo ciclo do programa, 788 unidades de saúde e 235 mulheres grávidas ou com filhos até dois anos de idade que responderam um questionário na ocasião da avaliação externa. Utilizou-se dados secundários provenientes do banco de dados da avaliação externa do Ministério da Saúde, coletados de janeiro a setembro de 2014. Descreveu-se a estrutura das unidades de saúde, o processo de trabalho das equipes e o cuidado recebido durante o pré-natal pelas mulheres entrevistadas. Analisou-se a prevalência da adequação da estrutura e do processo de trabalho para o cuidado pré-natal segundo as macrorregiões administrativas do estado, Índice de Desenvolvimento Humano municipal (IDHm), porte populacional e atendimento à população rural. Somente 3,7% das unidades de saúde possuíam estrutura adequada para o cuidado pré-natal, sendo as menores frequências as dos testes rápidos de gravidez (10,3%), HIV (8,6%) e sífilis (7,4%). O processo de trabalho foi adequado para 20,8% das equipes e a menor frequência foi da administração de penicilina G benzatina nas unidades de saúde (55,0%). Das mulheres entrevistadas, 10,6% receberam todos os cuidados pré-natais selecionados. A macrorregião dos Cerrados se destacou quanto à adequação da estrutura para o cuidado pré-natal. Em relação à adequação dos equipamentos e materiais para a realização de procedimentos clínicos-obstétricos e suprimento de vacinas, as unidades de saúde dos municípios com maior IDHm são mais prevalentes. Considerando a adequação do processo de trabalho, as equipes da macrorregião do Semiárido são mais prevalentes e quando analisada a solicitação de exames, as equipes com maior IDHm e que não atendem população rural são mais prevalentes. Os resultados apontam que o maior desafio é ofertar todos os cuidados preconizados para o pré-natal, o que distancia a prática desses serviços de saúde da integralidade. Observa-se que, quando a prestação de um cuidado depende de maior infraestrutura, os serviços dos municípios de maior IDHm são mais prevalentes. São necessários esforços para incrementar a estrutura das unidades de saúde e estimular as equipes a explorarem mais as tecnologias leves no cuidado. Ressalta-se a premência em suprir as unidades com os testes rápidos e realizar a administração da penicilina G benzatina nas unidades de saúde

The services of Primary Health Care (PHC) of the Unifield Health System [Sistema Único de Saúde] are responsible for the majority of the prenatal care in Brazil. Prenatal care has reached high levels of coverage in the country; however, reaching a minimum of doctor's visits does not guarantee the quality of care. Moreover, inequalities in access to prenatal care remain, given that the poorest regions have the most difficult access to care, and adverse maternal and perinatal outcomes persist. The general aim of this study was to evaluate the prenatal care in the services of PHC providers that participated of the second cycle of the National Program to Improve Access and Quality of Primary Care [Programa Nacional de Melhoria do Acesso e da Qualidade da Atenção Básica - PMAQ-AB] in the state of Piauí. This consists of an evaluative research of the analysis of implementation type, subtypes 1-a, 1-b and 3, cross sectional study. The study elaborated the logical, theoretical, and operational models of prenatal care in the services of PHC. The population of this study consisted of 865 teams of PHC providers that participated of the external evaluation in the second cycle of the program, 788 healthcare facilities, and 235 pregnant women or women with children up to two years of age who answered a questionnaire when the external evaluation took place. The study used secondary data from the Ministry of Health's external evaluation, which was collected from January to September 2014. The study described the structure of the healthcare facilities, the teams' work processes, and the care the interviewed women received during their prenatal care. The study analyzes the prevalence of the structure and the work process adjustment for prenatal care according to the macro administrative regions of the state, the, the municipal Index of Human Development (IHDm), population size, and services to the rural population. Only 3.7% of the healthcare facilities had the appropriate structure for prenatal care, the lowest frequencies were for rapid pregnancy tests (10.3%), HIV (8.6%), and syphilis testing (7.4%). The work process was appropriate in 20.8% of the teams and the lowest frequency was that of the administration of Penicillin G Benzathine in the healthcare facilities (55.0%). 10.6% of the women interviewed received all the selected prenatal care. The Cerrados macro-region stood out in terms of the structure for prenatal care. Concerning the suitability of the equipment and materials for the implementation of clinical-obstetrical procedures and vaccine supplies, the healthcare facilities of the municipalities with the highest IHDm prevail. Considering the suitability of the work process, the teams of the Semiárido macro-region prevail, and when the requests for tests is analyzed, the teams with the highest IHDm, and who do not serve rural populations, prevail. The results point out that the greatest challenge is to offer all recommended prenatal care, which distances the practice of these healthcare services from completeness. It can be observed that, when the care provision depends on greater infrastructure, the services of the municipalities with the highest IHDm prevail. There is a need for efforts to increase the structure of the healthcare facilities and to stimulate the teams to explore more soft technologies in care. The study emphasizes the urgency in supplying facilities with rapid tests, and carrying out the administration of Penicillin G Benzathine in the healthcare facilities

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Pregnancy detection has evolved over the last few decades and the importance of early pregnancy detection is critical to minimize the amount of time a cow spends not pregnant. Embryonic mortality (EM) is generally considered to be the primary factor limiting pregnancy rates in cattle and occurs early (

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