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             In participatory design members of the wider community are also recognized as <b>stakeholders</b> which are able to impact the project. The extent of their involvement can range from being passively informed of a project’s development, to actively sharing their opinions in decision making.

             Participatory design< gives users an opportunity to participate in the design. However, it is important to know that the users involved in the design do not influence the final product development decisions. Also, they do not have the professional knowledge as the product development team to understand the operation and execution of the entire product. </p> <h2 class="SubSectionTitle" style="color: blue"><b>How</b> </h2>

                 <p>Participatory design is used in various design fields, include industrial design, architectural design, software design, and etc. In fact, there is not a specific way to make a participatory research session, that is, the simpler the better.<br>

                     Back to our team, in order to expand our influences and to make sure all our human practice activities reach their maximum efficiencies and values, we 1) evaluate who our potential stakeholders are and make sure they participated in our project design, inspiring product modifies to made final product better-fit user’s needs.2) took the research of Sanders, E. B.-N., Brandt, E., & Binder, T. (2010). “A framework for organizing the tools and techniques of participatory design.” as a reference and developed a systematic structure to help us designing activities for human practice and public engagement, it includes three key points:<br>

                     Moreover, we will set up a goal for each activity that might either benefit our study or can affect the public.

                                     <p>Pediatrician Interview</p>

                                     <p>Doctor Hui-Xian Pan</p>

                                     <h1>Form</h1>

                                     We had an interview with Doctor Hui-Xian Pan(潘蕙嫻) on 14th, March at Chung-Shan Medical University Hospital. Dr. Pan is a pediatrician at Chung-Shan Medical University Hospital and also the clinical lecturer of the department of medicine. Her specialty is of pediatric infection, such as unknown fever, pneumonia, otitis media, skin infection and etc. Vaccine, rapid diagnostic test, prevention and treatment of pediatric infection are also her specialties.

                                     <h1>purpose</h1>

                                     Through the interview, we would like to know more about how clinical doctors deal with influenza and what they think of rapid diagnostic tests. Moreover, since doctors are at the front line facing patients, we can also find out what patients and their families think of the issue through interviewing doctors. Doctors are the middlemen between patients and hospitals and even the government, we want to know doctors' standpoint, what they think of hospitals and the government, and what role they act. We drafted the questions below:

                                     <h1>process</h1>

                                         <li>For the question that if there is a product that can confirm influenza more accurately and more conveniently, Dr. Pan gave us some ideas. First, for patient’s parents or for patients, they can know what exactly their diseases are. Second, doctors can make confirmation if patients get influenza and would not prescribe the wrong medicine. Third, out of the flu season, doctors can only prescribe Tamiflu if the result of rapid tests are positive. If we can elevate the accuracy of the rapid test, we help doctors solve the problems that not allowed to prescribe Tamiflu while they are confident with their diagnosis, but rapid test showing negative results.</li>

                                     <h1>Feeback</h1>

                                     After the interview, we found out that doctors often diagnose patients as flu through their symptoms and confirm by rapid influenza diagnostic tests. However, as the raising of patients' self-consciousness, patients would like to know what disease they exactly have. Therefore, it is important to have a more accurate and faster way to detect influenza to help doctors make the best diagnosis. Moreover, we found that to distinguish the subtype of influenza would help the government for the statistics of epidemiology. Through this interview, we found the importance of developing a rapid influenza diagnostic test with higher sensitivity and accuracy.

                 <img src="https://static.igem.org/mediawiki/2019/3/36/T--CSMU_Taiwan--CSMU.png">

<li><p style="font-size:25px">20th, March</p></li>

<li><p style="font-size:25px">Doctor Yuan-Yen, Chang, professor of Microbiology Department, Chung Shan Medical Universit</p></li>

<li><p style="font-size:25px">We had a clearer idea of our product and made a tentative decision to take swabs as the sample of our device. Our device needs to be fast, accurate and easy-to-use. We can make our product as kits in the near future</li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

                                     <h1>Form</h1>

                                     We had an interview with Doctor Yuan-Yen, Chang on March 20th at Chung-Shan Medical University. Doctor Chang is the professor of microbiology. His specialties are virology, Immunology, and biotechnology.

                                     <h1>Purpose</h1>

                                     As a professor of microbiology, doctor Chang knows well about the knowledge as well as the mechanism of respiratory disease. Through this interview, we would like to know more about the background knowledge of respiratory disease and the diagnosis of influenza. We drafted the questions below:

                                     <h1>Process</h1>

                                         <li>Dr. Chang recommended swab as the sample of our influenza rapid test. Since taking a blood sample needs to penetrate patients’ skin with needles, it is more invasive than taking a swab sample and less accepted by patients. Besides, drawing blood can only be conducted by professionally trained people, it isn’t good for promoting simple use. What’s more, a blood sample is valid only when there is viruses in the blood, or so-called viremia. </li>

                                     <h1>Feedback</h1>

                                     After the interview, we had a clearer idea of our product. We decided to take swabs as the sample of our device. Our device needs to be fast, accurate and easy-to-use. We can make our product as kits in the near future, and we can ask Adimmune Corporation for more details.

 

 

                 <img src="https://static.igem.org/mediawiki/2019/0/09/T--CSMU_Taiwan--doctor.png">

<ul>

<li><p style="font-size:25px">28th, March</p> </li>

<li><p style="font-size:25px">Medical Laboratory of Chung Shan Medical University Hospital</p></li>

<li><p style="font-size:25px">The doctor of the Medical Laboratory thought that our products would be able to help them save time. Through the interview, we confirmed that swabs are a better way for our product and decided to choose swabs instead of blood as the method to get samples.</p></li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

                                  <h1>Form</h1>

On March 28th, we interview the doctor of the Medical Laboratory at Chung Shan Medical University Hospital.

<h1>Purpose</h1>

Our team wanted to know the opinions of the Medical Laboratory scientists for rapid influenza diagnostic test products and ask for some advice. We would like to know how laboratory scientists operate rapid diagnostic tests and if they have confronted any problem. Besides, we wanted to know the methods for testing our finished products and ask for opinions about our conception. To figure out these questions, we drafted the questions below and interview a laboratory scientist.

<ul>

<li>Why are the control lines of rapid test kits designed by many companies different?</li>

<li>Can we get patients’ samples from the Medical Laboratory in order to test our product? Or can we take our product to the medical laboratory to test it?</li>

<li>How can we test our product? </li>

<li>Why does the Medical Laboratory have to use a specific instrument to analyze the result of the rapid test? Can’t the result be read with naked-eyes? </li>

<li>Why do they choose nasal mucus but serum as the sample for rapid influenza diagnostic tests?</li>

<li>What is the mechanism of amplifying the signal of a sample in a rapid influenza diagnostic test?</li>

<li>How high are the sensitivities of rapid influenza diagnostic tests nowadays? </li>

<li>Is there anything of rapid influenza diagnostic tests that you want it to be improved? </li>

</ul>

<h1>Process</h1>

<ul>

<li>Each company designs a different control line because they use different kinds of mice to produce antibodies. Just to make sure the sample can combine with the control line. Usually, they design various control lines, test and check the result, and choose the best one for production. </li>

<li>The Medical Laboratory doesn’t keep samples after testing, and can’t give samples to us for testing our product, either. Without patients’ consent forms, patients’ samples can only be used for diagnosis. Biotechnical companies usually mix two different kinds of viruses as a sample for product testing at an initial stage. Too many different kinds of virus used at once is not recommended because it becomes hard to analyze the effect factors of the results. Types of viruses that will affect results are noted in Instruction manuals for doctors and laboratory scientists. </li>

<li>We have to apply for experimental plans in order to get samples from the Medical Laboratory. </li>

<li>The experiments to test products with different kinds of viruses must be taken in biosafety level-3 laboratories. </li>

<li>Different medical laboratories of hospitals use different rapid influenza diagnostic tests. </li>

<li>As for the data analyzing instrument we saw in the lab, it is used when the amount of the influenza virus in the sample isn’t enough, or for some fluorescence-used products that are hard to read with naked eyes. By using the instrument, there will be a standard for if patients are infected by influenza.</li>

<li>Rapid influenza diagnostic tests always use samples collected from nasal mucus but serum because it is more difficult and more invasive to draw a patient’s blood than doing swabs, and the amount of the virus in nasal mucus is more than in blood, too. That is the reason why products nowadays seldom use samples collected from patients’ serum. </li>

<li>When doing swabs, doctors will get into the patient’s throat as deep as possible to make sure they collect enough samples. The products nowadays seldom have a mechanism to amplify sample signals but they improve sensitivities by getting rid of the impurity. Some products contain enzymes to break down other bacteria or viruses to reduce interference. However not every company does so. </li>

<li>The sensitivities of the products nowadays are not so good. Besides, many factors affect accuracy, for example, the ways doctors collect samples, the false negativity of products, or the disease process of patients is still at an early stage. </li>

<li>It is impossible for patients to use the rapid influenza diagnostic test by themselves because the procedure of collecting samples must be done by well-trained doctors. Also, after using rapid diagnostic tests, patients still need to go see doctors and get treatments. It is worthless to let patients do the rapid test by themselves. </li>

<li>We can try some ways to get rid of the impurity of other viruses or improve the sensitivities of our rapid test. It will benefit clinical medicine. </li>

 

</ul>

<h1>Feedback</h1>

The Medical Laboratory scientists said there were always many samples in the lab waiting for them. He thought that our products would be able to help them save time. Through the interview, we found that swabs are a better way for our product. We then chose swab instead of blood as the method to get samples.

 

 

                 <div id="SOSMorph">

                    <img src="https://static.igem.org/mediawiki/2019/2/20/T--CSMU_Taiwan--teacher.png" style="width: 200px">

                </div>

                              <ul>

<li><p style="font-size:25px">30th, March</p></li>

<li><p style="font-size:25px"> the medical exhibition “ Medical Taiwan”</p></li>

<li><p style="font-size:25px">We saw many different kinds of diagnostic products used not only in hospitals or clinics but also in some institutions, which need more medical care. We found the importance of more rapid and efficient rapid diagnostic tests for epidemic control.</p></li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

<h1>Form</h1>

Our team went to a medical exhibition called “ Medical Taiwan” on March 28th.

<h1>Purpose</h1>

In order to compare the concept of our products with those in the market, we would like to take references from other products and know the needs of the market to see what aspect we can apply to. Through the posters and the reports in the exhibition, we would like to know the opinions the government and the media held for infectious diseases.

<h1>Process</h1>

<ul>

<li> We saw a product called “Redeye”, which can detect invisible blood in our urine. It helps people discover their diseases such as colorectal cancer, kidney disease, bladder cancer earlier. It gives people awareness and makes them go to hospitals earlier for appropriate treatments. We found that early detection is very important in every kind of disease. People can use the device at home, which avoids the inconvenience of going to hospitals or getting invasive examinations. The company which produced “Redeye” wanted to combine their product with smart toilets and helped people examine their health with excreta. The device can connect to smartphones through wifi to get data.</li>

<li> We saw many companies emphasized that their devices can detect many kinds of diseases or abnormal body function index. There was a product called “MSA—Blood” which can detect problems with a very small amount of patients’ blood. It can detect diabetes mellitus, liver function, cardiac function, kidney function, metabolism function and etc. Because of its convenience and fast analyze time, it can be used in some specific places such as clinics, care centers, nursing houses, ambulances, community health centers, schools, or rural areas. With these advantages, it might be possible to use it in every single family in the future. The market strategies and applications of this device are similar to ours.</li>

<li> There were many posters and reports talking about the development of medicine, we were very impressed by one of them. The report was about the history of the development of infectious diseases in Taiwan, from SARS to influenza. The next trend of influenza is often predicted by WHO. But what can we do if WHO doesn’t predict right? The president of Min-Sheng General Hospital—Chiung-Lang Wang pointed out that if there is a shortage of the supplement of vaccines, or WHO predicts the wrong subtype of influenza for us to make vaccines, clinical workers and senior managers in hospitals will be under great pressure. In this situation, what hospitals and the public need are the technique of rapid diagnostic tests to help them figure out whether the disease is serious or slight. He recommended that faster and more efficient rapid diagnostic tests need to be developed. </li>

</ul>

 

<h1>Feedback</h1>

Through visiting the exhibition, we saw many different kinds of diagnostic products. These products could be used not only in hospitals or clinics but also in some institutions which need more medical care, such as nursing houses, community centers and etc. Moreover, we found out the importance of more rapid and efficient rapid diagnostic tests which can help control epidemics.

 

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                              <ul>

<li><p style="font-size:25px">2nd, April</p></li>

<li><p style="font-size:25px">Dr. Feng-Yih Yu, the Department of Biomedical, Chung Shan Medical University</p></li>

<li><p style="font-size:25px">Dr. Yu confirmed that applying aptamers to screening is highly possible. Therefore, we decided to develop our influenza rapid screening test with aptamers.</p></li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

<h1>Form</h1>

Dr. Feng-Yih Yu is the professor of the department of biomedical at Chung Shan Medical University who specializes in screening tests, protein chemistry, food microbiology and toxicology, and immunochemical techniques and so on. We had an interview with him on 2nd, April.  

<h1>Purpose</h1>

After decided our project topic as rapid screening of influenza, we have been looking for a better way to enhance the correctness and accuracy of rapid screening and promoting the convenience of its usage.  

Later, we found several papers which concern aptamers acting the function as antibodies, hence came up with the idea that whether it is possible to develop our influenza rapid screening with aptamers. Therefore, we visited Dr. Yu to ask if our concept is feasible. We drafted the questions below:

<ul>

<li>Are aptamers able to act as antibodies in screening tests?</li>

<li>How to select aptamers and to apply them to our rapid test paper?</li>

 

</ul>

<h1>Process</h1>

<ul>

<li>Dr. Yu was developing screening tests with aptamers </li>

<li>Yes, aptamers can perform the function of protein antibodies. In fact, they perform even better than antibodies since they are smaller in size.</li>

<li>We apply SELEX(Systematic Evolution of Ligands by EXponential enrichment) to select the aptamers that have high affinity with our target proteins. </li>

<li>Since Dr. Yu specialized in the screening tests of toxicant molecules, which are smaller than our target, influenza proteins, he wasn’t 100% sure whether aptamers would fit protein or not. However, Dr, Yu indicated that since the principle is the same it is supposed to work, and encouraged us to take a try. </li>

<li>Aptamers are easier to process. If we want to have the color changed we can add nanogold or other substrates to the tails of aptamers. </li>

</ul>

<h1>Feedback</h1>

After the interview, Dr. Yu confirmed that applying aptamers to screening is highly possible. Therefore, we decided to develop our influenza rapid screening test with aptamers.

 

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<li><p style="font-size:25px">4th, April</p></li>

<li><p style="font-size:25px">Doctor Rung-Tzung, Tsai, a professor of biochemistry</p></li>

<li><p style="font-size:25px">Through this interview, we have a better concept for our experimental direction. Afterdiscussed with teammates, we chose NP as our target protein.</p></li>

</ul>

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

<h1>Form</h1>

We had an interview with Doctor Rung-Tzung, Tsai on April 4th at Chung-Shan Medical University. Dr. Tsai is a professor of biochemistry. His specialty is molecular biology, biochemistry, biotechnology, and structures of proteins.

<h1>Purpose</h1>

As a professor of biochemistry, Dr. Tsai has been studying the structure of proteins for his whole career. He has a thorough understanding of viruses, bacteria, and even animal proteins. The purpose of this interview is to understand how to decide our protein biomarker of influenza. We drafted the questions below:

<ul>

<li>We want to take the proteins of influenza as our target for SELEX. Could you give some advice to us?</li>

<li>We find people often use HA and NP as influenza’s target proteins. If we want to produce them by ourselves, what recommendations or advice would you give us? </li>

<li>How to produce proteins of high purification? </li>

</ul>

<h1>Process</h1>

<ul>

<li>There are many complex chemical reactions in the human body fluid and it’s hard to predict. Aptamers have to bind to target protein when doing SELEX. Dr. Tsai recommended us using purified protein to do SELEX. </li>

 

<li>Generally speaking, the water-soluble ability of HA is worse than NP. Dr. Tsai thought that to easily purify, using proteins that are better water-soluble and add His tag to the tail is a better choice. We can use Nickle columns to purify proteins. </li>

</ul>

<h1>Feedback</h1>

Through this interview, we have a better concept for our experimental direction. After discussed with teammates, we chose NP as our target protein. On one hand, we can use NP to distinguish between influenza type A and B; on the other hand, with the feature of better water-soluble, it’s easier to purify proteins. Last but not least, we invited Doctor Rung-Tzung, Tsai to be our instructor.

 

 

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                              <ul>

<li><p style="font-size:25px">6th , August</p> </li>

<li><p style="font-size:25px">Professor Yu-Ling Chen, the director of Cheng Kung University Graduate Institute of Medicine</p></li>

<li><p style="font-size:25px">We learned the better condition settings during the experimental process of SELEX and were more confident to revise our experimental process.</p></li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

                                 <div class="ModalDescription"><h1>Form</h1>

Our team had an interview with Professor Yu-Ling Chen at Cheng Kung University Hospital on August 6th. Prof. Chen is the director of Cheng Kung University Graduate Institute of Medicine. She had written many papers about aptamer and SELEX, who is one of the authoritarian people in this field.  

<h1>Purpose</h1>

We want to ask questions about our experiment. On one hand, we would like to explain to the professor about the difficulties that we had encountered during the experimental process, and asked the professor for possible reasons and solutions. On the other hand, we wanted to learn and improve our experimental process from the experience of the professor about SELEX experiments. We showed the data of our result (figure1 to figure5) to the professor and drafted the questions below:

<ul>

<li>We have found through experiments that there was an unknown molecule with high molecular weight that appeared after SELEX. It seemed to be related to the template concentration, primer concentration, and the number of cycles. Why? How can we solve it? </li>

<li>From our data, it is found that as the Template concentration or the number of PCR cycles increases, a by-product of about 100 bp would appear first and resulted in the ladder-like band. Then it evolved into a by-product with high molecular weight and resulted in the band gathering near the well that had a strong signal. How can we explain this situation? </li>

Figure 1. Test of template conc. Condition

Figure 2. Test of template and dNTP conc. condition (Wash compared with Probe)

Figure 3. Experiment to find out the best template conc. condition of PCR.

Figure 4 & 5. Test of PCR cycle number.

</ul>

<h1>Process</h1>

<ul>

<li>Template concentration or a high number of Cycles may has confused the Template and the Primer, resulting in incorrect copying or an unexpected secondary structure. </li>

<li>The number of PCR cycles was too high. The general PCR condition after SELEX is 15 cycles. After conducting SELEX for many times, the product was relatively pure, and the number of cycles of PCR could be increased. It is recommended that the PCR part be tested first to find the most suitable conditions. </li>

<li>The band of the product that appeared at about 100 bp may be the result of the double-stranded PCR product which hadn’t denatured, so the position of the band was higher than 87 bp which we expected. If there was no band, it represented that there was no product for PCR. </li>

<li>Although the ladder-like by-products had occurred in the past, it hadn’t occurred that all by-products gathered at the top. However, a strong signal should be caused by its high molecular weight, not its volume.

<li>The professor recommended that we conducted SELEX experiment as follows:

<ul>

<li>Step: SELEX – PCR with Elution – Check by DNA page – Denature – Renature – Purify – Cryopreservation – Denature – Renature – SELEX</li>

<li>Control the number of PCR cycles, template concentration, and primer concentration during PCR to avoid the appearance of by-products. </li>

<li>Prior to each round of SELEX, using a Primer with beads to separate and remove the complementary sequence generated during the PCR process. </li>

<li>Quantify the PCR product before running SELEX to determine how much DNA is added to SELEX. </li>

<li>Increase the volume of PCR for subsequent testing and experimentation. </li>

<li>While denaturing, the recommended temperature is 95 degrees Centigrade and the recommended time is 10 minutes. While Renaturing (folding), it is recommended to slowly return the sample to room temperature from 95 degrees Centigrade instead of putting it on ice. </li>

</ul>

</li>

 

<li>The professor would start the specificity test after 5th round of SELEX. Under normal circumstances, the specificity will be enhanced successively. Usually, we can get the ideal result at the 7th to 8th round, and then we can conduct DNA sequencing. If conducting SELEX above 9-10 round, there may appear some impurities. </li>

<li>Specificity test: Choose an unrelated protein (albumin) as a negative control, run the ELISA test with the proteins of the influenza A and B viruses, and confirm the result of DNA page after PCR. </li>

<li>Affinity test: Conduct sequence dilution with Aptamer or Target. After getting a result of a binding curve, plot with Prism and get the KD value. </li>

<li>The aptamer with good affinity should have a KD value below 10 nm, and an acceptable range for the value falls within 10-100 nm. </li>

</ul>

<h1>Feedback</h1>

Through this interview with Prof. Chen, we learned about better condition settings during the experimental process of SELEX, which coincided with the conclusions that we had gotten from the experiment. We were more confident to revise our experimental process. From the experimental process described by the professor, we obtained some experience and skills about the experimental process of SELEX, which could reduce the time of finding the solution just by ourselves.

 

 

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<li><p style="font-size:25px">7th, August </p></li>

<li><p style="font-size:25px">the Department of Public Health of Taiwan</p></li>

<li><p style="font-size:25px">We found the rapid diagnostic test products nowadays are of low sensitivities. Because the government has the responsibility to prevent the spread of influenza, it is vital to diagnose influenza earlier and correctly. The officials encouraged us to develop our product for epidemiology statistic work.</p></li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

<h1>Form</h1>

On August 7th, we came to visit the Department of Public Health of Taiwan. We had an interview with three government officials.

<h1>Purpose</h1>

In order to know about the prevention work of influenza nowadays and how our product will affect the government, we drafted the questions below:

 

<ul>

 

<li>How does the government collect the data of the influenza subtypes every season? Which department collects and analyzes the data?</li>

<li>What role does the rapid influenza diagnostic test play in the prevention work? </li>

<li>How does the government know which subtype to make for vaccines next season? </li>

<li>What is the countermeasure of the government for preventing influenza? </li>

<li>In what situation should the clinic or hospital report the epidemic of influenza to the government? How do they report? </li>

<li>Were the cases reported to the government diagnosed by using rapid influenza diagnostic tests, or according to their symptoms? </li>

<li>Most of the rapid influenza diagnostic test nowadays have the problem of false negativities. Does it an issue for the government during the prevention works? </li>

<li>Is the disease spreading map helpful for preventing influenza in Taiwan, or in developing countries? </li>

<li>Where are the influenza virus during the rest period between every outbreak? Is it possible to stop the spreading of the virus during the rest period? </li>

<li>If there is a product which can detect influenza more rapidly, correctly, and even cheaper, what impact will it bring to the public or the government? </li>

</ul>

 

<h1>Process</h1>

 

<ul>

<li>Taiwan Centers for Disease Control (CDC) will collect the data from laboratories engaged by special arrangement. These laboratories in every city cultivate the virus and report the data to CDC. After CDC collects and analyzes the data, they announce the subtypes of influenza viruses that are prevalent each week. If there’s a rapid diagnostic test with higher accuracy and efficiency, it would help the government for the statistics of epidemiology. </li>

<li>Most of rapid influenza diagnostic test products nowadays have up to 50% of false negativities. Doctors will take the result of these products as a reference, and consider other factors such as individual symptoms. </li>

<li>There are many subtypes of influenza viruses, so it is hard to combine all of the subtypes in one rapid influenza diagnostic test. If only some common ones, it might be possible. It might have an impact on the type of influenza vaccine the government buys. </li>

<li>WHO announces the subtype of influenza vaccines every season, and the government will take reference from it. Biotechnical companies provide vaccines globally, so it is hard to get specific types only for certain regions. </li>

<li>The Department of Public Health monitors crowded places such as prisons, nursing houses, nurseries, schools. These places have to report if a cluster infection happened. A so-called cluster infection means that there are two or more infected cases each day. The reporting system is online and opens 24/7. After then, the Department of Public Health will conduct environmental disinfection and urge people to put on masks and even prescribe preventive medicine. Besides, the Department of Public Health will send propaganda to non-government institutions, reminding them to carry out preventing measures such as keeping windows open. The Department of Public Health will provide them a checklist to help them make sure that they are prepared for the upcoming outbreak. </li>

<li>For general non-government institutions, the cases reported have to be diagnosed by doctors. Doctors take the results of rapid influenza diagnostic tests as a reference, combined with patients’ symptoms to make diagnoses. </li>

<li>The disease spreading map is not useful for the prevention works in Taiwan. For the one-day-life circle in Taiwan, the virus could spread around Taiwan in a very short time. For the developing countries which their traffic is inconvenient or with broad territories, it may be helpful. </li>

<li>During the rest period between each outbreak, influenza viruses don’t disappear,. However, they exist in human bodies. It is hard to find all of the influenza viruses during the rest period and eliminate them. </li>

<li>If there is a product that can detect influenza more rapidly, correctly, and even cheaper, the clinics will be willing to buy so they can know if the patients are infected by influenza in a more efficient way. The government can also start their prevention works earlier and additionally prevent the widespread of influenza viruses. </li>

</ul>

 

<h1>Feedback</h1>

During the interview, we found that the rapid diagnostic test products nowadays are of low sensitivities. Although doctors make diagnoses combined with patients’ symptoms, they aren’t actually confident if they are always right. While the government has the responsibility to prevent the spread of influenza, it is vital that influenza being diagnosed earlier and correctly to help the government promote preventing work smoothly. Besides, we found that our product could help the statistic of epidemiology. The officials encouraged us to develop our product and it might be helpful for preventing influenza. Last but not least, we learned what exactly the works the government does to fight against influenza.

 

 

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<li><p style="font-size:25px">10th, August</p></li>

<li><p style="font-size:25px">Taiwan Centers for Diseases Control Dengue Vector virus and Rickettsia Laboratory</p></li>

<li><p style="font-size:25px">The scientist of the lab recommended us to test our product with the whole influenza viruses. We had a discussion and decided to test by conducting TCID50 assay and serological test</p>.</li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

                                      

                                <h1>Form</h1>

Our team had an interview on August 10th with Taiwan Centers for Diseases Control Dengue Vector virus and Rickettsia Laboratory, which launched a new type Virus Serotyping rapid test kit this year.

<h1>Purpose</h1>

While searching for factories which produce rapid diagnose test product, we saw the information of the first reagent produced in Taiwan on the webpage of Taiwan Centers for Diseases Control. We found the laboratory that developed the technology. This time, we hope to get to know more about issues we have to be aware of while developing our rapid diagnose test product. Also, the plan after the production is very important, so we drafted the questions below.

<ul>

<li>Rapid diagnose tests could hardly avoid the problem of false negativities. In this situation, what is the position of clinical application?</li>

<li>What kinds of certification should a successfully developed product get before it is launched in the market? </li>

<li>How do general laboratories manufacture and market outsource? </li>

</ul>

 

<h1>Process</h1>

<ul>

<li>Dengue fever is a major project for the prevention of infectious diseases in Taiwan every year. AsiaGen Corporation developed the product “Dengue fever NS1 rapid diagnose test” and it is the only product certificated in Taiwan now. The product can detect 4 types of dengue fever at the same time. While using RT-PCR, it needs 6 hours to get the result, this product only takes 30 minutes to examine dengue fever. It is a very convenient product, consuming little time and saving spaces. The product has 98-99% of sensitivity and has low false negativities. However, it is only for front line examination use. Dengue fever has to be confirmed by rTP—ELISA. </li>

<li>We asked them about how they confirm the sensitivity. They said they have tested it by the dengue virus in their laboratory. Besides, they suggested us test our product with the whole influenza virus. </li>

<li>They suggested we visit the Innovation Incubation Center of our school, for the questions such as applying for patents. </li>

</ul>

 

<h1>Feedback</h1>

Through the interview, we were recommended to test our product with the whole influenza viruses. After then, we discussed this and decided to test our product by conducting TCID50 assay and serological test.

 

 

 

 

                 <img src="https://static.igem.org/mediawiki/2019/0/09/T--CSMU_Taiwan--doctor.png">

<li><p style="font-size:25px">14th, August</p></li>

<li><p style="font-size:25px">Ph.D. Chih-Ming Chen, the Senior Director of the Business Development of TaiGen Biotechnology</p></li>

<li><p style="font-size:25px">We learned the defects of influenza medicine nowadays and the importance of developing better medicine for influenza. Mr. Chen gave us a positive answer to our concept of applying aptamer to treatment.</p></li>

</ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     Team manager

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

                                  <h1>Form</h1>

Our team had an interview with Ph.D. Chih-Ming Chen, who is the Senior Director of the Business Development of TaiGen Biotechnology.

<h1>Purpose</h1>

Through the interview, we would like to know if it’s possible to develop a medicine with aptamers and understand the market of influenza medicine nowadays. We drafted the questions below:

<ul>

 

<li>What is the mechanism of your(TaiGen) new influenza medicine—TG1000? How does it function as a medicine and a vaccine at the same time? </li>

<li>In the industry of influenza medicine, what aspect do the biotechnology companies focus on? What is the present situation of the influenza market? Why does TaiGen choose influenza as the subject to develop? </li>

<li>How do biotechnology companies estimate the potential and prospect of a newly developed product? What aspect should be noticed? </li>

<li>Can aptamers be applied to medicine? </li>

</ul>

<h1>Process</h1>

<ul>

<li>Mr. Chen said that the mechanism of their new medicine—TG-1000 is Cap-snatching. It inhibits the duplication of influenza viruses and has shown well result on animal tests. It resists Type A and B and avian influenza H7N9 infection. Moreover, the validity period of the medicine lasts for 72 hours, which is better than Tamiflu. There isn’t only one molecule of the virus in one cell, so medicines have to reach a certain concentration to have a function. The viral molecules will combine with the medicine through random collision. By measuring the medicine's inhibition constant (IC50) or so-called binding constant can let us know their affinity to viruses. </li>

<li>The influenza virus often infects lung cells, however, the concentration of the medicine in the blood doesn’t represent the same as in the lung. It is important to prove that the concentration in both places is proportional. Also, confirming that whether the medicine can exactly achieve the goal is very important. </li>

<li>The product is design as an oral medicine for easier taking in. Different diseases have different consideration, for example, intravenous injection make medicine spread faster in body but oral medicine is more convenient for patients to take in. </li>

<li>Besides providing community immunity, the advantage of their product is its slow metabolism rate. It keeps the effect even longer than a week, so it doesn’t need to be taken earlier before infection like a vaccine, and the effect is also much better than the vaccine. </li>

<li>The limitation of the medicine is that the safety range of the dosage is narrow. If a child showed resistance to some other flu medicine, doctors can’t increase the dosage for the concern of safety. Although TG100 hasn’t passed a human test, the result of an animal test showed that the dosage can be increased. </li>

<li>The reason why they choose to develop influenza medicine is that there are 3 to 5 million people affected by influenza annually, and Tamiflu, the flu medicine most commonly used, has many limitations needed to be improved. </li>

<li>If technology advanced more in the future, it is possible to design an antibody by just knowing the structure of the protein of a virus. With gene sequencing, we are able to compare the similarity between different viruses similar and apply the same medicine to similar ones, which reduces the cost of the process to develop new medicines. </li>  

<li>As for applying aptamer to medicine, Mr. Chen agreed with our idea. He said medicine is not restricted to only a specific type. He emphasized that collecting data is very important. </li>

</ul>

<h1>Feedback</h1>

Through this interview, we got a lot of information about developing medicine. Besides, we knew more about the defects of influenza medicine nowadays. The importance of developing better medicine for influenza is worth noticing. Mr. Chen gave us a positive answer to our concept of applying aptamer to treatment. We then came up with the idea of applying aptamers to preventive medicine.

 

 

 

                 <img src="https://static.igem.org/mediawiki/2019/0/09/T--CSMU_Taiwan--doctor.png">

         <div class="HPblock">

<li><p style="font-size:25px">18th, Augus</p>t</li>

<li><p style="font-size:25px">Adimmune Corporation's Biotechnological Company</p></li>

<li><p style="font-size:25px">The managers of Adimmune thought it a great advantage that our project can deal with global public health issues. Through the interview, we came up with more application ideas, learned issues of marketing and commercializing, and confirmed that applying aptamers to peptide vaccines is too hard.</p></li></ul>

 

                                     Charlotte de Ceuninck van Capelle

                                     <img src="https://static.igem.org/mediawiki/2019/a/a6/T--CSMU_Taiwan--ihp1.png" alt=""> </div>

                                  <h1>Form</h1>

Our team visited Adimmune Corporation's Biotechnological Company and had an interview with the managers, the senior researchers of R&D division, and the managers of the marketing division on August 8th.

<h1>Purpose</h1>

We wanted to know what would a biotechnological company, the potential stakeholder of our project, think of our research. Besides, we also wanted to know the issue of marketing, commercializing, and possible further applications. We drafted the questions below and separated them into two parts:

<p><b> Influenza and Aptamer </b></p>

 

<ul>

<li>If we would like our rapid diagnostic test product to help the government predict epidemiological trends, will it make the product more valuable if it can distinguish subtypes? </li>

<li>If our product could provide not only AB subtype but also information about the time and places infection occurred. Is it more helpful for predicting epidemiological trends? </li>