Intended to be combined with an electricity-free sample preparation technology to enable same day

Same-visit testing and treatment of infants to greatly improve child health outcomes and substantially reduce loss to follow-up. Previously, we reported on the development of a non-instrumented TH-302 moa nucleic acid amplification platform and we proposed an LRS-appropriate workflow for an electricity-free kit. Since then, we have advanced the design from the proof-of-concept stage to an optimized, robust alpha prototype with significant improvements in performance and usability. The improved NINA design we report on in this study requires fewer activation steps, and accordingly affords significantly less opportunity for user-introduced error and variation. Incorporating magnesium iron alloy into a diagnostic technology has been previously reported. In the experimental device described here, replacing calcium oxide with magnesium iron alloy for the exothermic reaction offers several distinct advantages: MgFe has significantly higher energy density, reducing the mass of the fuel pouch from 20 g to 1 g; MgFe is commercially available at a very low cost with very little batch-to-batch variation; and MgFe can be milled to a specific particlesize range to further control the heat profile of the chemical reaction. Additional improvements in this prototype include packaging the MgFe fuel in a hydrophilic, heat-sealable membrane and containing the liquid reactant in an easy-to-use blow-fill-seal container. These design enhancements greatly improve ease of use by minimizing user steps and eliminating the post-amplification heater cleaning that was required with previous designs. The improved design also incorporates a smaller vacuum-insulated housing to reduce heat loss and decrease the overall size of the heater. Finally, we incorporated an improved phase change material with very high latent heat to meet the thermal requirements of an HIV-1 LAMP assay. To demonstrate the robustness of the improved heater design, we evaluated its thermal performance over a wide ambient temperature range that represents LRS conditions. In addition to testing a new design and alternative heater materials, we further demonstrated the utility of the platform by incorporating a biplexed internal control as well as a nucleic acid lateral flow visual detection method. Multiplexed assays are commonly used in PCR for the detection of an internal control to confirm absence of inhibition. However, only a limited number of studies have examined multiplexed LAMP, and to our knowledge, none have used NALF as the detection method. To demonstrate the utility of this evolving platform, we paired the technology with a NALF-detection cassette and evaluated the performance of the combined components using a biplexed LAMP assay for the detection of HIV-1 and a ß-actin internal control. Performance of the assay in the non-instrumented system was compared to parallel assays assessed in real-time on a thermocyler, with the sensitivity, reproducibility, and repeatability of the assay evaluated via melt curve analysis, NALF detection, and agarose gel electrophoresis of reaction products. Species identification and clear understanding of genetic relationship of Echinochloa are very important to control effectively these weeds.