Testing is an integral part of software development.Current fastpaced system developments have rendered traditional testing techniques obsolete.Therefore,automated testing techniques are needed to adapt to such system...Testing is an integral part of software development.Current fastpaced system developments have rendered traditional testing techniques obsolete.Therefore,automated testing techniques are needed to adapt to such system developments speed.Model-based testing(MBT)is a technique that uses system models to generate and execute test cases automatically.It was identified that the test data generation(TDG)in many existing model-based test case generation(MB-TCG)approaches were still manual.An automatic and effective TDG can further reduce testing cost while detecting more faults.This study proposes an automated TDG approach in MB-TCG using the extended finite state machine model(EFSM).The proposed approach integrates MBT with combinatorial testing.The information available in an EFSM model and the boundary value analysis strategy are used to automate the domain input classifications which were done manually by the existing approach.The results showed that the proposed approach was able to detect 6.62 percent more faults than the conventionalMB-TCG but at the same time generated 43 more tests.The proposed approach effectively detects faults,but a further treatment to the generated tests such as test case prioritization should be done to increase the effectiveness and efficiency of testing.展开更多
As production automation systems have been and are becoming more and more complex, the task of quality assurance is increasingly challenging. Model-based testing is a research field addressing this challenge and many ...As production automation systems have been and are becoming more and more complex, the task of quality assurance is increasingly challenging. Model-based testing is a research field addressing this challenge and many approaches have been suggested for different applications. The goal of this paper is to review these approaches regarding their suitability for the domain of production automation in order to identify current trends and research gaps. The different approaches are classified and clustered according to their main focus which is either testing and test case generation from some form of model automatons, test case generation from models used within the development process of production automation systems, test case generation from fault models or test case selection and regression testing.展开更多
<p align="left"> <span style="font-family:Verdana;">During the model-based software testing process, test cases are generated from modeled requirements to conduct acceptance testing. Ho...<p align="left"> <span style="font-family:Verdana;">During the model-based software testing process, test cases are generated from modeled requirements to conduct acceptance testing. However, existing approaches generate erroneous test cases, lack full coverage criteria and prototype tools. Therefore, the aim of this research is to develop an approach capable of reducing erroneous test case generation based on full coverage criteria and a prototype tool. The method employed was to develop a parser to extract information from the XMI file of a modeling diagram where a tree is constructed and a traversal operation executed on the nodes and edges to generate test cases. The results obtained from the proposed approach showed that 97.35% of the generated test cases were precise and comprehensive enough to conduct testing because 99.01% of all the nodes and edges were fully covered during the traversal operations.</span> </p>展开更多
In late 2001, the Object Management Group issued a Request for Proposal to develop a testing profile for UML 2.0. In June 2003, the work on the UML 2.0 Testing Profile was finally adopted by the OMG. Since March 2004,...In late 2001, the Object Management Group issued a Request for Proposal to develop a testing profile for UML 2.0. In June 2003, the work on the UML 2.0 Testing Profile was finally adopted by the OMG. Since March 2004, it has become an official standard of the OMG. The UML 2.0 Testing Profile provides support for UML based model-driven testing. This paper introduces a methodology on how to use the testing profile in order to modify and extend an existing UML design model for test issues. The application of the methodology will be explained by applying it to an existing UML Model for a Bluetooth device.展开更多
Recently,researchers have shown increasing interest in combining more than one programming model into systems running on high performance computing systems(HPCs)to achieve exascale by applying parallelism at multiple ...Recently,researchers have shown increasing interest in combining more than one programming model into systems running on high performance computing systems(HPCs)to achieve exascale by applying parallelism at multiple levels.Combining different programming paradigms,such as Message Passing Interface(MPI),Open Multiple Processing(OpenMP),and Open Accelerators(OpenACC),can increase computation speed and improve performance.During the integration of multiple models,the probability of runtime errors increases,making their detection difficult,especially in the absence of testing techniques that can detect these errors.Numerous studies have been conducted to identify these errors,but no technique exists for detecting errors in three-level programming models.Despite the increasing research that integrates the three programming models,MPI,OpenMP,and OpenACC,a testing technology to detect runtime errors,such as deadlocks and race conditions,which can arise from this integration has not been developed.Therefore,this paper begins with a definition and explanation of runtime errors that result fromintegrating the three programming models that compilers cannot detect.For the first time,this paper presents a classification of operational errors that can result from the integration of the three models.This paper also proposes a parallel hybrid testing technique for detecting runtime errors in systems built in the C++programming language that uses the triple programming models MPI,OpenMP,and OpenACC.This hybrid technology combines static technology and dynamic technology,given that some errors can be detected using static techniques,whereas others can be detected using dynamic technology.The hybrid technique can detect more errors because it combines two distinct technologies.The proposed static technology detects a wide range of error types in less time,whereas a portion of the potential errors that may or may not occur depending on the 4502 CMC,2023,vol.74,no.2 operating environment are left to the dynamic technology,which completes the validation.展开更多
The beyond-dripline oxygen isotopes^(27,28)O were recently observed at RIKEN,and were found to be unbound decaying into^(24)O by emitting neutrons.The unbound feature of the heaviest oxygen isotope,^(28)O,provides an ...The beyond-dripline oxygen isotopes^(27,28)O were recently observed at RIKEN,and were found to be unbound decaying into^(24)O by emitting neutrons.The unbound feature of the heaviest oxygen isotope,^(28)O,provides an excellent test for stateof-the-art nuclear models.The atomic nucleus is a self-organized quantum manybody system comprising specific numbers of protons Z and neutrons N.展开更多
Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic st...Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic stress conditions.Under these conditions,it is assumed that the intermediate principal stress(σ_(2))equals the minimum principal stress(σ_(3)).This assumption overlooks the potential variations in magnitudes of in situ stress conditions along all three directions near an underground opening where a rock bolt is installed.In this study,a series of push tests was meticulously conducted under triaxial conditions.These tests involved applying non-uniform confining stresses(σ_(2)≠σ_(3))to cubic specimens,aiming to unveil the previously overlooked influence of intermediate principal stresses on the strength properties of rock bolts.The results show that as the confining stresses increase from zero to higher levels,the pre-failure behavior changes from linear to nonlinear forms,resulting in an increase in initial stiffness from 2.08 kN/mm to 32.51 kN/mm.The load-displacement curves further illuminate distinct post-failure behavior at elevated levels of confining stresses,characterized by enhanced stiffness.Notably,the peak load capacity ranged from 27.9 kN to 46.5 kN as confining stresses advanced from σ_(2)=σ_(3)=0 to σ_(2)=20 MPa and σ_(3)=10 MPa.Additionally,the outcomes highlight an influence of confining stress on the lateral deformation of samples.Lower levels of confinement prompt overall dilation in lateral deformation,while higher confinements maintain a state of shrinkage.Furthermore,diverse failure modes have been identified,intricately tied to the arrangement of confining stresses.Lower confinements tend to induce a splitting mode of failure,whereas higher loads bring about a shift towards a pure interfacial shear-off and shear-crushed failure mechanism.展开更多
Edge devices,due to their limited computational and storage resources,often require the use of compilers for program optimization.Therefore,ensuring the security and reliability of these compilers is of paramount impo...Edge devices,due to their limited computational and storage resources,often require the use of compilers for program optimization.Therefore,ensuring the security and reliability of these compilers is of paramount importance in the emerging field of edge AI.One widely used testing method for this purpose is fuzz testing,which detects bugs by inputting random test cases into the target program.However,this process consumes significant time and resources.To improve the efficiency of compiler fuzz testing,it is common practice to utilize test case prioritization techniques.Some researchers use machine learning to predict the code coverage of test cases,aiming to maximize the test capability for the target compiler by increasing the overall predicted coverage of the test cases.Nevertheless,these methods can only forecast the code coverage of the compiler at a specific optimization level,potentially missing many optimization-related bugs.In this paper,we introduce C-CORE(short for Clustering by Code Representation),the first framework to prioritize test cases according to their code representations,which are derived directly from the source codes.This approach avoids being limited to specific compiler states and extends to a broader range of compiler bugs.Specifically,we first train a scaled pre-trained programming language model to capture as many common features as possible from the test cases generated by a fuzzer.Using this pre-trained model,we then train two downstream models:one for predicting the likelihood of triggering a bug and another for identifying code representations associated with bugs.Subsequently,we cluster the test cases according to their code representations and select the highest-scoring test case from each cluster as the high-quality test case.This reduction in redundant testing cases leads to time savings.Comprehensive evaluation results reveal that code representations are better at distinguishing test capabilities,and C-CORE significantly enhances testing efficiency.Across four datasets,C-CORE increases the average of the percentage of faults detected(APFD)value by 0.16 to 0.31 and reduces test time by over 50% in 46% of cases.When compared to the best results from approaches using predicted code coverage,C-CORE improves the APFD value by 1.1% to 12.3% and achieves an overall time-saving of 159.1%.展开更多
Intelligent penetration testing is of great significance for the improvement of the security of information systems,and the critical issue is the planning of penetration test paths.In view of the difficulty for attack...Intelligent penetration testing is of great significance for the improvement of the security of information systems,and the critical issue is the planning of penetration test paths.In view of the difficulty for attackers to obtain complete network information in realistic network scenarios,Reinforcement Learning(RL)is a promising solution to discover the optimal penetration path under incomplete information about the target network.Existing RL-based methods are challenged by the sizeable discrete action space,which leads to difficulties in the convergence.Moreover,most methods still rely on experts’knowledge.To address these issues,this paper proposes a penetration path planning method based on reinforcement learning with episodic memory.First,the penetration testing problem is formally described in terms of reinforcement learning.To speed up the training process without specific prior knowledge,the proposed algorithm introduces episodic memory to store experienced advantageous strategies for the first time.Furthermore,the method offers an exploration strategy based on episodic memory to guide the agents in learning.The design makes full use of historical experience to achieve the purpose of reducing blind exploration and improving planning efficiency.Ultimately,comparison experiments are carried out with the existing RL-based methods.The results reveal that the proposed method has better convergence performance.The running time is reduced by more than 20%.展开更多
Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains...Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains exploring solutions to increase the testing capacity with more cost-effective approaches. Pooled methodology was one of the methods which many have validated and used. It is evident that in case of pooled sample testing the sensitivity becomes lower, however the variation highly depends on the pool size as well as the incidence rate at the certain point. Armenia as well as many other countries has adopted regulations for mandatory COVID-19 PCR testing for all the travelers. Current study aimed to explore the efficiency of COVID-19 pooled PCR testing for nasopharyngeal swabs of individuals with no symptoms in a time period with good epidemiological state of the infection. Nasopharingeal swab samples from individuals were collected. The manual extraction of RNAs of samples was performed after pooling up to 5 samples. The pools with Cycle Threshold (CT) of < 37 were considered positive and were retested individually. In total 28,015 samples were grouped in 667 pools of which 57 were positive. The total number of positive samples was 65. The median difference (CT-pool–CT samples) was 2.4 (ranging from–3.0 to 8.9). The correlation of CT of pools and positive samples was positive. The correlation coefficient r = 0.84, P < 0.000, 95% CI range 0.7423 to 0.9243). The total economic saving when using pools compared to the individual testing was 72%. The minor difference between CT values of pools and samples can be explained by the dilution effect in the pool. However, the positive correlation between the values as well as the amount of cost saving demonstrate that pooling on nasopharyngeal samples for COVID-19 PCR testing can be a good method for efficient screening with significant resource saving. One of the most important advantages of the proposed method is the fact that samples are pooled prior extraction, which avoids the possibilities with misinterpretation of IC due to low yield of RNA in the extraction process.展开更多
Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countrie...Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.展开更多
Rapid and timely testing is essential to minimize the COVID-19 spread. Decision makers and policy planners need to determine the equal distribution and accessibility of testing sites. This study mainly examines the sp...Rapid and timely testing is essential to minimize the COVID-19 spread. Decision makers and policy planners need to determine the equal distribution and accessibility of testing sites. This study mainly examines the spatial equality of COVID-19 testing sites that maintain a zero COVID policy in Guangzhou City. The study has identified the spatial disparities of COVID testing sites, characteristics of testing locations, and accessibility. The study has obtained information on COVID testing sites in Guangzhou City and population data. Point pattern analyses, Euclidian distance and allocation, and network analyses are the main methods used to achieve the research objectives, and 1183 total COVID testing sites can be recognized in Guangzhou City. Results revealed that spatial disparities could be noticed over the study area. Testing locations of Guangzhou City are highly clustered. The most significant testing sites are located in Haizhu District, which has the third largest population. The highest population density can be identified in Yuexiu District. However, only 94 testing sites are located there. According to all the results, higher disparities can be identified, and a lack of testing sites is located in the north part of the study area. Some people in the northern part have to travel more than 10 km to reach a testing site. Finally, this paper suggests increasing the number of testing sites in the north and south parts of the study area and keeping the same distribution, considering the area, total population, and population density. This kind of research will be helpful to decision-makers in making proper decisions to maintain a zero COVID policy.展开更多
Background: When continuous scale measurements are available, agreements between two measuring devices are assessed both graphically and analytically. In clinical investigations, Bland and Altman proposed plotting sub...Background: When continuous scale measurements are available, agreements between two measuring devices are assessed both graphically and analytically. In clinical investigations, Bland and Altman proposed plotting subject-wise differences between raters against subject-wise averages. In order to scientifically assess agreement, Bartko recommended combining the graphical approach with the statistical analytic procedure suggested by Bradley and Blackwood. The advantage of using this approach is that it enables significance testing and sample size estimation. We noted that the direct use of the results of the regression is misleading and we provide a correction in this regard. Methods: Graphical and linear models are used to assess agreements for continuous scale measurements. We demonstrate that software linear regression results should not be readily used and we provided correct analytic procedures. The degrees of freedom of the F-statistics are incorrectly reported, and we propose methods to overcome this problem by introducing the correct analytic form of the F statistic. Methods for sample size estimation using R-functions are also given. Results: We believe that the tutorial and the R-codes are useful tools for testing and estimating agreement between two rating protocols for continuous scale measurements. The interested reader may use the codes and apply them to their available data when the issue of agreement between two raters is the subject of interest.展开更多
Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country ...Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.展开更多
Despite the success of guided wave ultrasonic inspection for internal defect detection in steel pipes,its application on polyethylene(PE)pipe remains relatively unexplored.The growth of internal cracks in PE pipe seve...Despite the success of guided wave ultrasonic inspection for internal defect detection in steel pipes,its application on polyethylene(PE)pipe remains relatively unexplored.The growth of internal cracks in PE pipe severely affects its pressure-holding capacity,hence the early detection of internal cracks is crucial for effective pipeline maintenance strategies.This study extends the scope of guided wave-based ultrasonic testing to detect the growth of internal cracks in a natural gas distribution PE pipe.Laboratory experiments and a finite element model were planned to study the wave-crack interaction at different stages of axially oriented internal crack growth with a piezoceramic transducer-based setup arranged in a pitch-catch configuration.Mode dispersion analysis supplemented with preliminary experiments was performed to isolate the optimal inspection frequency,leading to the selection of the T(0,1)mode at 50-kHz for the investigation.A transmission index based on the energy of the T(0,1)mode was developed to trace the extent of simulated crack growth.The findings revealed an inverse linear correlation between the transmission index and the crack depth for crack growth beyond 20%crack depth.展开更多
For real-time dynamic substructure testing(RTDST),the influence of the inertia force of fluid specimens on the stability and accuracy of the integration algorithms has never been investigated.Therefore,this study prop...For real-time dynamic substructure testing(RTDST),the influence of the inertia force of fluid specimens on the stability and accuracy of the integration algorithms has never been investigated.Therefore,this study proposes to investigate the stability and accuracy of the central difference method(CDM)for RTDST considering the specimen mass participation coefficient.First,the theory of the CDM for RTDST is presented.Next,the stability and accuracy of the CDM for RTDST considering the specimen mass participation coefficient are investigated.Finally,numerical simulations and experimental tests are conducted for verifying the effectiveness of the method.The study indicates that the stability of the algorithm is affected by the mass participation coefficient of the specimen,and the stability limit first increases and then decreases as the mass participation coefficient increases.In most cases,the mass participation coefficient will increase the stability limit of the algorithm,but in specific circumstances,the algorithm may lose its stability.The stability and accuracy of the CDM considering the mass participation coefficient are verified by numerical simulations and experimental tests on a three-story frame structure with a tuned liquid damper.展开更多
The objective of this research was to determine the mechanical parameter from EVA foam and also investigate its behavior by using Blatz-Ko,Neo-Hookean,Mooney model and experimental test.The physical characteristic of ...The objective of this research was to determine the mechanical parameter from EVA foam and also investigate its behavior by using Blatz-Ko,Neo-Hookean,Mooney model and experimental test.The physical characteristic of EVA foam was also evaluated by scanning electron microscopy(SEM).The results show that Blatz-Ko and Neo-Hookean model can fit the curve at 5%and 8%strain,respectively.The Mooney model can fit the curve at 50%strain.The modulus of rigidity evaluated from Mooney model is 0.0814±0.0027 MPa.The structure of EVA foam from SEM image shows that EVA structure is a closed cell with homogeneous porous structure.From the result,it is found that Mooney model can adjust the data better than other models.This model can be applied for mechanical response prediction of EVA foam and also for reference value in engineering application.展开更多
BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detect...BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.展开更多
In today’s era, where mobile devices have become an integral part of our daily lives, ensuring the security of mobile applications has become increasingly crucial. Mobile penetration testing, a specialized subfield w...In today’s era, where mobile devices have become an integral part of our daily lives, ensuring the security of mobile applications has become increasingly crucial. Mobile penetration testing, a specialized subfield within the realm of cybersecurity, plays a vital role in safeguarding mobile ecosystems against the ever-evolving landscape of threats. The ubiquity of mobile devices has made them a prime target for cybercriminals, and the data and functionality accessed through mobile applications make them valuable assets to protect. Mobile penetration testing is designed to identify vulnerabilities, weaknesses, and potential exploits within mobile applications and the devices themselves. Unlike traditional penetration testing, which often focuses on network and server security, mobile penetration testing zeroes in on the unique challenges posed by mobile platforms. Mobile penetration testing, a specialized field within cybersecurity, is an essential tool in the Cybersecurity specialists’ toolkit to protect mobile ecosystems from emerging threats. This article introduces mobile penetration testing, emphasizing its significance, including comprehensive learning labs for Android and iOS platforms, and highlighting how it distinctly differs from traditional penetration testing methodologies.展开更多
Hepatitis D virus(HDV)can infect HBsAg-positive individuals,causing rapid fibrosis progression,early decompensation,increased hepatocellular carcinoma risk,and higher mortality than hepatitis B virus(HBV)mono-infectio...Hepatitis D virus(HDV)can infect HBsAg-positive individuals,causing rapid fibrosis progression,early decompensation,increased hepatocellular carcinoma risk,and higher mortality than hepatitis B virus(HBV)mono-infection.Most countries lack high-quality HDV prevalence data,and the collection techniques employed often bias published data.In recent meta-analyses,HDV prevalence in HBsAg-positive patients reaches 5%-15%and is even significantly higher in endemic areas.Since HBV vaccination programs were implemented,HDV prevalence has decreased among younger populations.However,owing to immigrant influx,it has increased in some Western countries.The current practice of HDV screening in HBsAg-positive individuals is stepwise,based on physician’s discretion,and limited to at-risk populations and may require numerous visits.Double reflex testing,which includes anti-HDV testing in all HBsAg-positive individuals and then HDV RNA testing for anti-HDV-positive ones,is uncommon.Reflex testing can identify more HDV infection cases and link identified patients to further care and follow-up.Moreover,laboratory-based double reflex screening is less biased than physician-led testing.Therefore,health-care providers should learn about reflex testing,and federal and provincial hepatitis control programs should implement laboratory-based double reflex testing to obtain reliable HDV prevalence estimates.The test’s cost-effectiveness depends on the number of HBV-positive patients screened to identify one HDV-positive patient.Such testing may be viable in areas with low HBsAg but high HDV prevalence.However,its economic impact on areas with low HDV prevalence needs further study.展开更多
基金The research was funded by Universiti Teknologi Malaysia(UTM)and the MalaysianMinistry of Higher Education(MOHE)under the Industry-International Incentive Grant Scheme(IIIGS)(Vote Number:Q.J130000.3651.02M67 and Q.J130000.3051.01M86)the Aca-demic Fellowship Scheme(SLAM).
文摘Testing is an integral part of software development.Current fastpaced system developments have rendered traditional testing techniques obsolete.Therefore,automated testing techniques are needed to adapt to such system developments speed.Model-based testing(MBT)is a technique that uses system models to generate and execute test cases automatically.It was identified that the test data generation(TDG)in many existing model-based test case generation(MB-TCG)approaches were still manual.An automatic and effective TDG can further reduce testing cost while detecting more faults.This study proposes an automated TDG approach in MB-TCG using the extended finite state machine model(EFSM).The proposed approach integrates MBT with combinatorial testing.The information available in an EFSM model and the boundary value analysis strategy are used to automate the domain input classifications which were done manually by the existing approach.The results showed that the proposed approach was able to detect 6.62 percent more faults than the conventionalMB-TCG but at the same time generated 43 more tests.The proposed approach effectively detects faults,but a further treatment to the generated tests such as test case prioritization should be done to increase the effectiveness and efficiency of testing.
文摘As production automation systems have been and are becoming more and more complex, the task of quality assurance is increasingly challenging. Model-based testing is a research field addressing this challenge and many approaches have been suggested for different applications. The goal of this paper is to review these approaches regarding their suitability for the domain of production automation in order to identify current trends and research gaps. The different approaches are classified and clustered according to their main focus which is either testing and test case generation from some form of model automatons, test case generation from models used within the development process of production automation systems, test case generation from fault models or test case selection and regression testing.
文摘<p align="left"> <span style="font-family:Verdana;">During the model-based software testing process, test cases are generated from modeled requirements to conduct acceptance testing. However, existing approaches generate erroneous test cases, lack full coverage criteria and prototype tools. Therefore, the aim of this research is to develop an approach capable of reducing erroneous test case generation based on full coverage criteria and a prototype tool. The method employed was to develop a parser to extract information from the XMI file of a modeling diagram where a tree is constructed and a traversal operation executed on the nodes and edges to generate test cases. The results obtained from the proposed approach showed that 97.35% of the generated test cases were precise and comprehensive enough to conduct testing because 99.01% of all the nodes and edges were fully covered during the traversal operations.</span> </p>
文摘In late 2001, the Object Management Group issued a Request for Proposal to develop a testing profile for UML 2.0. In June 2003, the work on the UML 2.0 Testing Profile was finally adopted by the OMG. Since March 2004, it has become an official standard of the OMG. The UML 2.0 Testing Profile provides support for UML based model-driven testing. This paper introduces a methodology on how to use the testing profile in order to modify and extend an existing UML design model for test issues. The application of the methodology will be explained by applying it to an existing UML Model for a Bluetooth device.
基金[King Abdulaziz University][Deanship of Scientific Research]Grant Number[KEP-PHD-20-611-42].
文摘Recently,researchers have shown increasing interest in combining more than one programming model into systems running on high performance computing systems(HPCs)to achieve exascale by applying parallelism at multiple levels.Combining different programming paradigms,such as Message Passing Interface(MPI),Open Multiple Processing(OpenMP),and Open Accelerators(OpenACC),can increase computation speed and improve performance.During the integration of multiple models,the probability of runtime errors increases,making their detection difficult,especially in the absence of testing techniques that can detect these errors.Numerous studies have been conducted to identify these errors,but no technique exists for detecting errors in three-level programming models.Despite the increasing research that integrates the three programming models,MPI,OpenMP,and OpenACC,a testing technology to detect runtime errors,such as deadlocks and race conditions,which can arise from this integration has not been developed.Therefore,this paper begins with a definition and explanation of runtime errors that result fromintegrating the three programming models that compilers cannot detect.For the first time,this paper presents a classification of operational errors that can result from the integration of the three models.This paper also proposes a parallel hybrid testing technique for detecting runtime errors in systems built in the C++programming language that uses the triple programming models MPI,OpenMP,and OpenACC.This hybrid technology combines static technology and dynamic technology,given that some errors can be detected using static techniques,whereas others can be detected using dynamic technology.The hybrid technique can detect more errors because it combines two distinct technologies.The proposed static technology detects a wide range of error types in less time,whereas a portion of the potential errors that may or may not occur depending on the 4502 CMC,2023,vol.74,no.2 operating environment are left to the dynamic technology,which completes the validation.
基金This work was supported by the National Natural Science Foundation of China(Nos.12335007,11835001,11921006,12035001 and 12205340)the State Key Laboratory of Nuclear Physics and Technology,Peking University(No.NPT2020KFY13)Gansu Natural Science Foundation(No.22JR5RA123).
文摘The beyond-dripline oxygen isotopes^(27,28)O were recently observed at RIKEN,and were found to be unbound decaying into^(24)O by emitting neutrons.The unbound feature of the heaviest oxygen isotope,^(28)O,provides an excellent test for stateof-the-art nuclear models.The atomic nucleus is a self-organized quantum manybody system comprising specific numbers of protons Z and neutrons N.
文摘Confining stresses serve as a pivotal determinant in shaping the behavior of grouted rock bolts.Nonetheless,prior investigations have oversimplified the three-dimensional stress state,primarily assuming hydrostatic stress conditions.Under these conditions,it is assumed that the intermediate principal stress(σ_(2))equals the minimum principal stress(σ_(3)).This assumption overlooks the potential variations in magnitudes of in situ stress conditions along all three directions near an underground opening where a rock bolt is installed.In this study,a series of push tests was meticulously conducted under triaxial conditions.These tests involved applying non-uniform confining stresses(σ_(2)≠σ_(3))to cubic specimens,aiming to unveil the previously overlooked influence of intermediate principal stresses on the strength properties of rock bolts.The results show that as the confining stresses increase from zero to higher levels,the pre-failure behavior changes from linear to nonlinear forms,resulting in an increase in initial stiffness from 2.08 kN/mm to 32.51 kN/mm.The load-displacement curves further illuminate distinct post-failure behavior at elevated levels of confining stresses,characterized by enhanced stiffness.Notably,the peak load capacity ranged from 27.9 kN to 46.5 kN as confining stresses advanced from σ_(2)=σ_(3)=0 to σ_(2)=20 MPa and σ_(3)=10 MPa.Additionally,the outcomes highlight an influence of confining stress on the lateral deformation of samples.Lower levels of confinement prompt overall dilation in lateral deformation,while higher confinements maintain a state of shrinkage.Furthermore,diverse failure modes have been identified,intricately tied to the arrangement of confining stresses.Lower confinements tend to induce a splitting mode of failure,whereas higher loads bring about a shift towards a pure interfacial shear-off and shear-crushed failure mechanism.
文摘Edge devices,due to their limited computational and storage resources,often require the use of compilers for program optimization.Therefore,ensuring the security and reliability of these compilers is of paramount importance in the emerging field of edge AI.One widely used testing method for this purpose is fuzz testing,which detects bugs by inputting random test cases into the target program.However,this process consumes significant time and resources.To improve the efficiency of compiler fuzz testing,it is common practice to utilize test case prioritization techniques.Some researchers use machine learning to predict the code coverage of test cases,aiming to maximize the test capability for the target compiler by increasing the overall predicted coverage of the test cases.Nevertheless,these methods can only forecast the code coverage of the compiler at a specific optimization level,potentially missing many optimization-related bugs.In this paper,we introduce C-CORE(short for Clustering by Code Representation),the first framework to prioritize test cases according to their code representations,which are derived directly from the source codes.This approach avoids being limited to specific compiler states and extends to a broader range of compiler bugs.Specifically,we first train a scaled pre-trained programming language model to capture as many common features as possible from the test cases generated by a fuzzer.Using this pre-trained model,we then train two downstream models:one for predicting the likelihood of triggering a bug and another for identifying code representations associated with bugs.Subsequently,we cluster the test cases according to their code representations and select the highest-scoring test case from each cluster as the high-quality test case.This reduction in redundant testing cases leads to time savings.Comprehensive evaluation results reveal that code representations are better at distinguishing test capabilities,and C-CORE significantly enhances testing efficiency.Across four datasets,C-CORE increases the average of the percentage of faults detected(APFD)value by 0.16 to 0.31 and reduces test time by over 50% in 46% of cases.When compared to the best results from approaches using predicted code coverage,C-CORE improves the APFD value by 1.1% to 12.3% and achieves an overall time-saving of 159.1%.
文摘Intelligent penetration testing is of great significance for the improvement of the security of information systems,and the critical issue is the planning of penetration test paths.In view of the difficulty for attackers to obtain complete network information in realistic network scenarios,Reinforcement Learning(RL)is a promising solution to discover the optimal penetration path under incomplete information about the target network.Existing RL-based methods are challenged by the sizeable discrete action space,which leads to difficulties in the convergence.Moreover,most methods still rely on experts’knowledge.To address these issues,this paper proposes a penetration path planning method based on reinforcement learning with episodic memory.First,the penetration testing problem is formally described in terms of reinforcement learning.To speed up the training process without specific prior knowledge,the proposed algorithm introduces episodic memory to store experienced advantageous strategies for the first time.Furthermore,the method offers an exploration strategy based on episodic memory to guide the agents in learning.The design makes full use of historical experience to achieve the purpose of reducing blind exploration and improving planning efficiency.Ultimately,comparison experiments are carried out with the existing RL-based methods.The results reveal that the proposed method has better convergence performance.The running time is reduced by more than 20%.
文摘Since the beginning of COVID-19 pandemics many countries were facing challenges with testing capacity recourse limitations. Throughout the waves of the pandemic countries were trying to address the existing constrains exploring solutions to increase the testing capacity with more cost-effective approaches. Pooled methodology was one of the methods which many have validated and used. It is evident that in case of pooled sample testing the sensitivity becomes lower, however the variation highly depends on the pool size as well as the incidence rate at the certain point. Armenia as well as many other countries has adopted regulations for mandatory COVID-19 PCR testing for all the travelers. Current study aimed to explore the efficiency of COVID-19 pooled PCR testing for nasopharyngeal swabs of individuals with no symptoms in a time period with good epidemiological state of the infection. Nasopharingeal swab samples from individuals were collected. The manual extraction of RNAs of samples was performed after pooling up to 5 samples. The pools with Cycle Threshold (CT) of < 37 were considered positive and were retested individually. In total 28,015 samples were grouped in 667 pools of which 57 were positive. The total number of positive samples was 65. The median difference (CT-pool–CT samples) was 2.4 (ranging from–3.0 to 8.9). The correlation of CT of pools and positive samples was positive. The correlation coefficient r = 0.84, P < 0.000, 95% CI range 0.7423 to 0.9243). The total economic saving when using pools compared to the individual testing was 72%. The minor difference between CT values of pools and samples can be explained by the dilution effect in the pool. However, the positive correlation between the values as well as the amount of cost saving demonstrate that pooling on nasopharyngeal samples for COVID-19 PCR testing can be a good method for efficient screening with significant resource saving. One of the most important advantages of the proposed method is the fact that samples are pooled prior extraction, which avoids the possibilities with misinterpretation of IC due to low yield of RNA in the extraction process.
文摘Introduction: Exercise stress testing (on a treadmill or ergometer bicycle) is an important test in cardiology for diagnosing myocardial ischemia. This test in Mali is still in its beginning compared to other countries in the sub-region. The lack of data in Mali prompted this study, which aimed to evaluate the indications of this activity and its diagnostic contribution to cardiology in Mali. Materials and Methods: This was a retrospective, descriptive study. The study was conducted at the “TOUCAM” medical clinic in Kati based on the analysis of stress test reports between January 2016 and August 2022. Result: During the study period, we documented 73 patients who underwent exercise testing on a bicycle ergometer for suspected coronary heart disease. The mean age of our patients was 47.5 ± 13.8 years (14 and 79 years). Males accounted for the majority (78.1%). The sex ratio is 3.5. More than half of our patients were overweight or obese (77.1%). Hypertension and diabetes affected 52.1% and 25.8% of patients, respectively. 20.8% of patients had coronary artery disease. renin-angiotensin-aldosterone system blockers (56.8%) and beta-blockers (51.3%). The main indications were chest pain (63.0%) and ischemia detection (15.1%). A modified STEEP protocol was used. The majority of our patients (71.2%) achieved at least 85% of their maximum theoretical heart rate. The main reason for the termination of the study was fatigue (57.3%). The average duration was 11.3 ± 4.2 minutes. 24.7% thought the stress tests were positive and 17.8% thought they were controversial. Conclusion: This study demonstrates the importance of stress testing in the diagnosis and treatment of ischemic heart disease, especially in settings where we have very limited access to coronary angiography.
文摘Rapid and timely testing is essential to minimize the COVID-19 spread. Decision makers and policy planners need to determine the equal distribution and accessibility of testing sites. This study mainly examines the spatial equality of COVID-19 testing sites that maintain a zero COVID policy in Guangzhou City. The study has identified the spatial disparities of COVID testing sites, characteristics of testing locations, and accessibility. The study has obtained information on COVID testing sites in Guangzhou City and population data. Point pattern analyses, Euclidian distance and allocation, and network analyses are the main methods used to achieve the research objectives, and 1183 total COVID testing sites can be recognized in Guangzhou City. Results revealed that spatial disparities could be noticed over the study area. Testing locations of Guangzhou City are highly clustered. The most significant testing sites are located in Haizhu District, which has the third largest population. The highest population density can be identified in Yuexiu District. However, only 94 testing sites are located there. According to all the results, higher disparities can be identified, and a lack of testing sites is located in the north part of the study area. Some people in the northern part have to travel more than 10 km to reach a testing site. Finally, this paper suggests increasing the number of testing sites in the north and south parts of the study area and keeping the same distribution, considering the area, total population, and population density. This kind of research will be helpful to decision-makers in making proper decisions to maintain a zero COVID policy.
文摘Background: When continuous scale measurements are available, agreements between two measuring devices are assessed both graphically and analytically. In clinical investigations, Bland and Altman proposed plotting subject-wise differences between raters against subject-wise averages. In order to scientifically assess agreement, Bartko recommended combining the graphical approach with the statistical analytic procedure suggested by Bradley and Blackwood. The advantage of using this approach is that it enables significance testing and sample size estimation. We noted that the direct use of the results of the regression is misleading and we provide a correction in this regard. Methods: Graphical and linear models are used to assess agreements for continuous scale measurements. We demonstrate that software linear regression results should not be readily used and we provided correct analytic procedures. The degrees of freedom of the F-statistics are incorrectly reported, and we propose methods to overcome this problem by introducing the correct analytic form of the F statistic. Methods for sample size estimation using R-functions are also given. Results: We believe that the tutorial and the R-codes are useful tools for testing and estimating agreement between two rating protocols for continuous scale measurements. The interested reader may use the codes and apply them to their available data when the issue of agreement between two raters is the subject of interest.
文摘Background: This study aimed to evaluate the diagnostic value of interferon-γ release assay (IGRA), a sensitive microbiological diagnostic method, in children and adolescents with suspected tuberculosis in a country with a high burden of tuberculosis. Method: This study included 581 children and adolescents aged 4 - 19 years who were suspected of having tuberculosis, were latently infected with Mycobacterium tuberculosis, and had received at least one dose of BCG vaccine between April 17, 2019, and February 24, 2021. The study evaluated the TST results of 106 patients who had a positive Quantiferon test and were suspected of having tuberculosis. Results: The study included 581 patients aged between 4 and 19 years. Of these, 106 patients tested positive for the Quantiferon test, while 19 were indeterminate and 456 were negative. The Quantiferon test positivity rate was 18.24%. Among the 106 QFT-Plus-positive cases, 23 patients also tested positive for TST. The difference in distribution was found to be statistically significant. Conclusion: The QFT-Plus test is considered an alternative to TST and other microbiological diagnostic methods for early tuberculosis diagnosis, particularly in children and adolescents.
基金the financial support provided by USDOT Pipeline and Hazardous Materials Safety Administration (PHMSA)through the Competitive Academic Agreement Program (CAAP)。
文摘Despite the success of guided wave ultrasonic inspection for internal defect detection in steel pipes,its application on polyethylene(PE)pipe remains relatively unexplored.The growth of internal cracks in PE pipe severely affects its pressure-holding capacity,hence the early detection of internal cracks is crucial for effective pipeline maintenance strategies.This study extends the scope of guided wave-based ultrasonic testing to detect the growth of internal cracks in a natural gas distribution PE pipe.Laboratory experiments and a finite element model were planned to study the wave-crack interaction at different stages of axially oriented internal crack growth with a piezoceramic transducer-based setup arranged in a pitch-catch configuration.Mode dispersion analysis supplemented with preliminary experiments was performed to isolate the optimal inspection frequency,leading to the selection of the T(0,1)mode at 50-kHz for the investigation.A transmission index based on the energy of the T(0,1)mode was developed to trace the extent of simulated crack growth.The findings revealed an inverse linear correlation between the transmission index and the crack depth for crack growth beyond 20%crack depth.
基金National Natural Science Foundation of China under Grant Nos.51978213 and 51778190the National Key Research and Development Program of China under Grant Nos.2017YFC0703605 and 2016YFC0701106。
文摘For real-time dynamic substructure testing(RTDST),the influence of the inertia force of fluid specimens on the stability and accuracy of the integration algorithms has never been investigated.Therefore,this study proposes to investigate the stability and accuracy of the central difference method(CDM)for RTDST considering the specimen mass participation coefficient.First,the theory of the CDM for RTDST is presented.Next,the stability and accuracy of the CDM for RTDST considering the specimen mass participation coefficient are investigated.Finally,numerical simulations and experimental tests are conducted for verifying the effectiveness of the method.The study indicates that the stability of the algorithm is affected by the mass participation coefficient of the specimen,and the stability limit first increases and then decreases as the mass participation coefficient increases.In most cases,the mass participation coefficient will increase the stability limit of the algorithm,but in specific circumstances,the algorithm may lose its stability.The stability and accuracy of the CDM considering the mass participation coefficient are verified by numerical simulations and experimental tests on a three-story frame structure with a tuned liquid damper.
基金supported by grants funded by Department of Mechanical Engineering,Faculty of Engineering,Chiang Mai University and the Graduate School of Chiang Mai University.
文摘The objective of this research was to determine the mechanical parameter from EVA foam and also investigate its behavior by using Blatz-Ko,Neo-Hookean,Mooney model and experimental test.The physical characteristic of EVA foam was also evaluated by scanning electron microscopy(SEM).The results show that Blatz-Ko and Neo-Hookean model can fit the curve at 5%and 8%strain,respectively.The Mooney model can fit the curve at 50%strain.The modulus of rigidity evaluated from Mooney model is 0.0814±0.0027 MPa.The structure of EVA foam from SEM image shows that EVA structure is a closed cell with homogeneous porous structure.From the result,it is found that Mooney model can adjust the data better than other models.This model can be applied for mechanical response prediction of EVA foam and also for reference value in engineering application.
文摘BACKGROUND Colorectal cancer(CRC)is one of the most common malignant tumors,and early screening is crucial to improving the survival rate of patients.The combination of colonoscopy and immune fecal occult blood detection has garnered significant attention as a novel method for CRC screening.Colonoscopy and fecal occult blood tests,when combined,can improve screening accuracy and early detection rates,thereby facilitating early intervention and treatment.However,certain risks and costs accompany it,making the establishment of a risk classification model crucial for accurate classification and management of screened subjects.AIM To evaluate the feasibility and effectiveness of colonoscopy,immune fecal occult blood test(FIT),and risk-graded screening strategies in CRC screening.METHODS Based on the randomized controlled trial of CRC screening in the population conducted by our hospital May 2020 to May 2023,participants who met the requirements were randomly assigned to a colonoscopy group,an FIT group,or a graded screening group at a ratio of 1:2:2(after risk assessment,the high-risk group received colonoscopy,the low-risk group received an FIT test,and the FITpositive group received colonoscopy).The three groups received CRC screening with different protocols,among which the colonoscopy group only received baseline screening,and the FIT group and the graded screening group received annual follow-up screening based on baseline screening.The primary outcome was the detection rate of advanced tumors,including CRC and advanced adenoma.The population participation rate,advanced tumor detection rate,and colonoscopy load of the three screening programs were compared.RESULTS A total of 19373 subjects who met the inclusion and exclusion criteria were enrolled,including 8082 males(41.7%)and 11291 females(58.3%).The mean age was 60.05±6.5 years.Among them,3883 patients were enrolled in the colonoscopy group,7793 in the FIT group,and 7697 in the graded screening group.Two rounds of follow-up screening were completed in the FIT group and the graded screening group.The graded screening group(89.2%)and the colonoscopy group(42.3%)had the lowest overall screening participation rates,while the FIT group had the highest(99.3%).The results of the intentional analysis showed that the detection rate of advanced tumors in the colonoscopy group was greater than that of the FIT group[2.76%vs 2.17%,odds ratio(OR)=1.30,95%confidence interval(CI):1.01-1.65,P=0.037].There was no significant difference in the detection rate of advanced tumors between the colonoscopy group and the graded screening group(2.76%vs 2.35%,OR=1.9,95%CI:0.93-1.51,P=0.156),as well as between the graded screening group and the FIT group(2.35%vs 2.17%,OR=1.09%,95%CI:0.88-1.34,P=0.440).The number of colonoscopy examinations required for each patient with advanced tumors was used as an index to evaluate the colonoscopy load during population screening.The graded screening group had the highest colonoscopy load(15.4 times),followed by the colonoscopy group(10.2 times),and the FIT group had the lowest(7.8 times).CONCLUSION A hierarchical screening strategy based on CRC risk assessment is feasible for screening for CRC in the population.It can be used as an effective supplement to traditional colonoscopy and FIT screening programs.
文摘In today’s era, where mobile devices have become an integral part of our daily lives, ensuring the security of mobile applications has become increasingly crucial. Mobile penetration testing, a specialized subfield within the realm of cybersecurity, plays a vital role in safeguarding mobile ecosystems against the ever-evolving landscape of threats. The ubiquity of mobile devices has made them a prime target for cybercriminals, and the data and functionality accessed through mobile applications make them valuable assets to protect. Mobile penetration testing is designed to identify vulnerabilities, weaknesses, and potential exploits within mobile applications and the devices themselves. Unlike traditional penetration testing, which often focuses on network and server security, mobile penetration testing zeroes in on the unique challenges posed by mobile platforms. Mobile penetration testing, a specialized field within cybersecurity, is an essential tool in the Cybersecurity specialists’ toolkit to protect mobile ecosystems from emerging threats. This article introduces mobile penetration testing, emphasizing its significance, including comprehensive learning labs for Android and iOS platforms, and highlighting how it distinctly differs from traditional penetration testing methodologies.
文摘Hepatitis D virus(HDV)can infect HBsAg-positive individuals,causing rapid fibrosis progression,early decompensation,increased hepatocellular carcinoma risk,and higher mortality than hepatitis B virus(HBV)mono-infection.Most countries lack high-quality HDV prevalence data,and the collection techniques employed often bias published data.In recent meta-analyses,HDV prevalence in HBsAg-positive patients reaches 5%-15%and is even significantly higher in endemic areas.Since HBV vaccination programs were implemented,HDV prevalence has decreased among younger populations.However,owing to immigrant influx,it has increased in some Western countries.The current practice of HDV screening in HBsAg-positive individuals is stepwise,based on physician’s discretion,and limited to at-risk populations and may require numerous visits.Double reflex testing,which includes anti-HDV testing in all HBsAg-positive individuals and then HDV RNA testing for anti-HDV-positive ones,is uncommon.Reflex testing can identify more HDV infection cases and link identified patients to further care and follow-up.Moreover,laboratory-based double reflex screening is less biased than physician-led testing.Therefore,health-care providers should learn about reflex testing,and federal and provincial hepatitis control programs should implement laboratory-based double reflex testing to obtain reliable HDV prevalence estimates.The test’s cost-effectiveness depends on the number of HBV-positive patients screened to identify one HDV-positive patient.Such testing may be viable in areas with low HBsAg but high HDV prevalence.However,its economic impact on areas with low HDV prevalence needs further study.