scholarly journals SARS-CoV-2 sero-prevalence in the workforces of three large workplaces in South Wales: a sero-epidemiological study

2021 ◽  
Author(s):  
Alice Puchades ◽  
Rhian Daniel ◽  
John Geen ◽  
Jo Peden ◽  
Heather Lewis ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Point Of Care ◽  
Population Level ◽  
Work Role ◽  
Call Centre ◽  
Confounding Factors ◽  
Antibody Prevalence ◽  
Prevalence Studies ◽  
South Wales ◽  
Antibody Tests

Abstract BackgroundSero-prevalence studies quantify the proportion of a population that has antibodies against SARS-CoV-2, and can be used to identify the extent of the COVID-19 pandemic at a population level. The aim of the study was to assess the sero-prevalence of SARS-CoV-2 antibodies in the workforce at three workplaces. Methods993 participants were recruited from three workplaces in South Wales: a food factory, a non-food factory and a call centre. Participants completed a questionnaire and received lateral flow point-of-care SARS-CoV-2 antibody tests. The data were analysed using multivariable logistic regression, both using complete records only and following multiple imputation. ResultsThe sero-prevalence of SARS-CoV-2 antibodies ranged from 4% (n=17/402) in the non-food factory to 10% (n=28/281) in the food factory (OR 2.93; 95% CI 1.26 to 6.81). After taking account of confounding factors evidence of a difference remained (cOR comparing food factory to call centre (2.93; 95% CI 1.26 to 6.81) and non-food factory (3.99; 95% CI 1.97 to 8.08) respectively). The SARS-CoV-2 antibody prevalence also varied between roles within workplaces. People working in office based roles had a 2.23 times greater conditional odds (95% CI 1.02 to 4.87) of being positive for SARS-CoV-2 antibodies than those working on the factory floor.ConclusionThe sero-prevalence of SARS-CoV-2 antibodies varied by workplace and work role. Whilst it is not possible to state whether these differences are due to COVID-19 transmission within the workplaces, it highlights the importance of considering COVID-19 transmission in a range of workplaces and work roles.

scholarly journals Improving sensitivity of oral fluid testing in IgG prevalence studies: application of mixture models to a rubella antibody survey

2003 ◽  
Vol 130 (2) ◽  
pp. 285-291 ◽  
Author(s):  
N. J. GAY ◽  
A. J. VYSE ◽  
F. ENQUSELASSIE ◽  
W. NIGATU ◽  
D. J. NOKES
Keyword(s):  
Oral Fluid ◽  
Maximum Likelihood Estimates ◽  
Antibody Prevalence ◽  
Prevalence Studies ◽  
Oral Fluids ◽  
Specific Distribution ◽  
Modelling Techniques ◽  
Quantitative Results ◽  
Antibody Tests ◽  
Rubella Antibody

A method for the analysis of age-stratified antibody prevalence surveys is applied to a previously reported survey of antibody to rubella virus using oral fluid samples in which the sensitivity of the assay used was shown to be compromised. The age-specific distribution of the quantitative results of antibody tests using oral fluids is modelled as a mixture of strong positive, weak positive and negative components. This yields maximum likelihood estimates of the prevalence at each age and demonstrates that, when used in conjunction with mixture modelling techniques, the results of antibody prevalence studies using oral fluids accurately reflect those obtained using sera.

scholarly journals INSIGHT: A population-scale COVID-19 testing strategy combining point-of-care diagnosis with centralized high-throughput sequencing

2021 ◽  
Vol 7 (7) ◽  
pp. eabe5054
Author(s):  
Qianxin Wu ◽  
Chenqu Suo ◽  
Tom Brown ◽  
Tengyao Wang ◽  
Sarah A. Teichmann ◽  
...  
Keyword(s):  
High Throughput ◽  
High Throughput Sequencing ◽  
Limit Of Detection ◽  
Point Of Care ◽  
Population Level ◽  
Reaction Products ◽  
Testing Strategy ◽  
Asymptomatic Patients ◽  
Testing Stage ◽  
Population Scale

We present INSIGHT [isothermal NASBA (nucleic acid sequence–based amplification) sequencing–based high-throughput test], a two-stage coronavirus disease 2019 testing strategy, using a barcoded isothermal NASBA reaction. It combines point-of-care diagnosis with next-generation sequencing, aiming to achieve population-scale testing. Stage 1 allows a quick decentralized readout for early isolation of presymptomatic or asymptomatic patients. It gives results within 1 to 2 hours, using either fluorescence detection or a lateral flow readout, while simultaneously incorporating sample-specific barcodes. The same reaction products from potentially hundreds of thousands of samples can then be pooled and used in a highly multiplexed sequencing–based assay in stage 2. This second stage confirms the near-patient testing results and facilitates centralized data collection. The 95% limit of detection is <50 copies of viral RNA per reaction. INSIGHT is suitable for further development into a rapid home-based, point-of-care assay and is potentially scalable to the population level.

Serum Bilirubin Levels, Intracranial Hemorrhage, and the Risk of Developmental Problems in Very Low Birth Weight Neonates

PEDIATRICS ◽  
1992 ◽  
Vol 90 (6) ◽  
pp. 888-892
Author(s):  
T. Michael O'Shea ◽  
Robert G. Dillard ◽  
Kurt L. Klinepeter ◽  
Donald J. Goldstein
Keyword(s):  
Logistic Regression ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Intracranial Hemorrhage ◽  
Very Low Birth Weight ◽  
Confounding Factors ◽  
Developmental Problems ◽  
Period Increase ◽  
Developmental Index ◽  
Mental Developmental Index

To study whether elevated levels of bilirubin in the neonatal period increase the risk of developmental problems for very low birth weight neonates, the investigators used data from a geographically based sample of 495 very low birth weight neonates, born January 1, 1985, to December 31, 1989, who survived to 1 year of adjusted age. Maximum neonatal bilirubin levels were found in medical records. A developmental problem was defined as either cerebral palsy or a Bayley Mental Developmental Index of less than 68 at 1 year adjusted age. Potentially confounding factors were controlled using logistic regression. To control for the effects of intracranial abnormalities (eg, intraventricular hemorrhage), separate logistic regression analyses were carried out for three strata, defined according to the results of cranial ultrasonography. In these analyses, the following odds ratios (with 95% confidence limits) were found for the association of maximum neonatal bilirubin concentration and developmental problems: for subjects without intracranial abnormalities, 0.9 (0.7, 1.9); for subjects with uncomplicated intracranial hemorrhage, 1.5 (0.8, 2.5); for subjects with complicated intracranial hemorrhage or intraparenchymal echodensities, 1.2 (0.4, 3.6). In summary, in analyses controlled for confounding factors, maximum neonatal bilirubin level was not consistently associated with the risk of developmental problems identifiable at 1 year.

Diagnostic tests for detecting Chlamydia trachomatis and Neisseria gonorrhoeae in rectal and pharyngeal specimens

2021 ◽  
Author(s):  
Paul C. Adamson ◽  
Jeffrey D. Klausner
Keyword(s):  
Chlamydia Trachomatis ◽  
Neisseria Gonorrhoeae ◽  
Bacterial Infections ◽  
Point Of Care ◽  
High Sensitivity ◽  
Population Level ◽  
The United States ◽  
Nucleic Acid Amplification ◽  
Point Of Care Test ◽  
Control And Prevention

Chlamydia trachomatis and Neisseria gonorrhoeae are two of the most often reported bacterial infections in the United States. The rectum and oropharynx are important anatomic sites of infection and can contribute to ongoing transmission. Nucleic acid amplification tests (NAATs) are the mainstays for the detection of C. trachomatis and N. gonorrhoeae infections owing to their high sensitivity and specificity. Several NAATs have been evaluated for testing in rectal and pharyngeal infections. A few assays recently received clearance by the Food and Drug Administration, including one point-of-care test. Those assays can be used for testing in symptomatic individuals, as well as for asymptomatic screening in certain patient populations. Routine screening for C. trachomatis in pharyngeal specimens is not recommended by the Centers for Disease Control and Prevention, though is often performed due to the use of multiplex assays. While expanding the types of settings for screening and using self-collected rectal and pharyngeal specimens can help to increase access and uptake of testing, additional research is needed to determine the potential benefits and costs associated with increased screening for rectal and pharyngeal C. trachomatis and N. gonorrhoeae infections on a population level.

scholarly journals Assessment of the Field Utility of a Rapid Point-of-Care Test for SARS-CoV-2 Antibodies in a Household Cohort

2021 ◽  
Author(s):  
Mehal Churiwal ◽  
Kelly D. Lin ◽  
Salman Khan ◽  
Srijana Chhetri ◽  
Meredith S. Muller ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Point Of Care ◽  
Natural Infection ◽  
Field Performance ◽  
Antibody Test ◽  
Asymptomatic Infection ◽  
Point Of Care Test ◽  
Antibody Tests ◽  
Rapid Antibody

Point-of-care (POC) tests to detect SARS-CoV-2 antibodies offer quick assessment of serostatus after natural infection or vaccination. We compared the field performance of the BioMedomics COVID-19 IgM/IgG Rapid Antibody Test against an ELISA in 303 participants enrolled in a SARS-CoV-2 household cohort study. The rapid antibody test was easily implemented with consistent interpretation across 14 users in a variety of field settings. Compared with ELISA, detection of seroconversion lagged by 5 to 10 days. However, it retained a sensitivity of 90% (160/177, 95% confidence interval [CI] 85–94%) and specificity of 100% (43/43, 95% CI 92–100%) for those tested 3 to 5 weeks after symptom onset. Sensitivity was diminished among those with asymptomatic infection (74% [14/19], 95% CI 49–91%) and early in infection (45% [29/64], 95% CI 33–58%). When used appropriately, rapid antibody tests offer a convenient way to detect symptomatic infections during convalescence.

scholarly journals Broad Spectrum Epidemiological Contribution of Cannabis, Tobacco and Alcohol to the Teratological Profile of Northern New South Wales: Geospatial and Causal Inference Analysis

2020 ◽  
Author(s):  
Albert Stuart Reece ◽  
Gary Kenneth Hulse
Keyword(s):  
Body Wall ◽  
Septal Defect ◽  
New South ◽  
Ductus Arteriosus ◽  
New South Wales ◽  
Prevalence Ratio ◽  
Population Level ◽  
Cannabis Use ◽  
Anal Stenosis ◽  
South Wales

Abstract Background. Whilst cannabis commercialization is occurring rapidly guided by highly individualistic public narratives, evidence that all congenital anomalies (CA) increase alongside cannabis use in Canada, a link with 21 CA’s in Hawaii, and rising CA’s in Colorado indicate that transgenerational effects can be significant and impact public health. It was therefore important to study Northern New South Wales (NNSW) where cannabis use is high.Methods. Design: Cohort. 2008–2015. Setting: NNSW and Queensland (QLD), Australia. Participants. Whole populations. Exposures. Tobacco, alcohol, cannabis. Source: National Drug Strategy Household Surveys 2010, 2013. Main Outcomes. CA Rates. NNSW-QLD comparisons. Geospatial and causal regression.Results. Cardiovascular, respiratory and gastrointestinal anomalies rose with falling tobacco and alcohol but rising cannabis use rates across Queensland. Maternal age NNSW-QLD was not different (2008–2015: 4,265/22,084 v. 96,473/490,514 > 35 years, Chi.Sq.=1.687, P = 0.194). A higher rate of NNSW cannabis-related than cannabis-unrelated defects occurred (prevalence ratio (PR) = 2.13, 95%C.I. 1.80–2.52, P = 3.24 × 10− 19). CA’s rose more potently with rising cannabis than with rising tobacco or alcohol use. Exomphalos and gastroschisis had the highest NNSW:QLD PR (6.29(2.94–13.48) and 5.85(3.54–9.67)) and attributable fraction in the exposed (84.11%(65.95–92.58%) and 82.91%(71.75–89.66%), P = 2.83 × 10− 8 and P = 5.62 × 10− 15). In multivariable geospatial models cannabis was significantly linked with cardiovascular (atrial septal defect, ventricular septal defect, tetralogy of Fallot, patent ductus arteriosus), genetic (chromosomal defects, Downs syndrome), gastrointestinal (small intestinal atresia), body wall (gastroschisis, diaphragmatic hernia) and other (hypospadias) (AVTPCDSGDH) CA’s. In linear modelling cannabis use was significantly linked with anal stenosis, congenital hydrocephalus and Turner syndrome (ACT) and was significantly linked in borderline significant models (model P < 0.1) with microtia, microphthalmia, and transposition of the great vessels. At robust and mixed effects inverse probability weighted multivariable regression cannabis was related to 18 defects. E-Values in spatial models were generally > 1.3 ranging up to 3.8 × 1030 making uncontrolled confounding unlikely.Conclusions. These results suggest that population level CA’s react more strongly to small rises in cannabis use than tobacco or alcohol; cardiovascular, chromosomal, body wall and gastrointestinal CA’s rise significantly with small increases in cannabis use; that cannabis is a bivariate correlate of AVTPCDSGDH and ACT anomalies, is robust to adjustment for other substances; and is causal.

The breeding behaviour of the endangered regent honeyeater, Xanthomyza phrygia, near Armidale, New South Wales

1998 ◽  
Vol 46 (2) ◽  
pp. 153 ◽  
Author(s):  
Damon L. Oliver
Keyword(s):  
New South ◽  
New South Wales ◽  
Population Level ◽  
Similar Rate ◽  
Nest Construction ◽  
Aggressive Interactions ◽  
Breeding Behaviour ◽  
South Wales ◽  
The Mean ◽  
Breeding Seasons

The regent honeyea ter, Xanthomyza phrygia, is an endangered woodland bird whose range and population size have decreased in the last thirty years. Suggested reasons for this decline include abnormal breeding behaviour, poor reproductive output, and excessive inter- and intra-specific aggression. This study investigated the breeding behaviour and aggressive interactions of regent honeyeaters during the nest construction, incubation, nestling, and fledgling stages in two consecutive breeding seasons in the Bundarra–Barraba region near Armidale, New South Wales. The female was entirely responsible for nest construction and incubation, which is typical of many honeyeaters. Both parents fed the nestlings, and at a similar rate, although only the female brooded chicks on the nest. Both parents fed the fledglings. The mean frequency at which nestlings (23 times per hour) and fledglings (29 times per hour) were fed is the highest published rate of any non-cooperative honeyeater. Breeding males were involved in significantly more aggressive interactions with conspecifics and other nectarivores than were females, although the overall percentage of day-time spent in aggression for both sexes was low (2.5%). It appears that abnormal breeding behaviour, poor reproductive effort, or excessive aggression are not experienced by this species in northern New South Wales, and that other factors are likely to be responsible for its current low population level.

scholarly journals SMART precision cancer medicine: a FHIR-based app to provide genomic information at the point of care

2016 ◽  
Vol 23 (4) ◽  
pp. 701-710 ◽  
Author(s):  
Jeremy L Warner ◽  
Matthew J Rioth ◽  
Kenneth D Mandl ◽  
Joshua C Mandel ◽  
David A Kreda ◽  
...  
Keyword(s):  
Point Of Care ◽  
Gene Mutations ◽  
Population Level ◽  
Knowledge Bases ◽  
Mobile App ◽  
Genomic Information ◽  
Clinical Workflow ◽  
External Knowledge ◽  
Cancer Medicine ◽  
The Individual

Abstract Background Precision cancer medicine (PCM) will require ready access to genomic data within the clinical workflow and tools to assist clinical interpretation and enable decisions. Since most electronic health record (EHR) systems do not yet provide such functionality, we developed an EHR-agnostic, clinico-genomic mobile app to demonstrate several features that will be needed for point-of-care conversations. Methods Our prototype, called Substitutable Medical Applications and Reusable Technology (SMART)® PCM, visualizes genomic information in real time, comparing a patient’s diagnosis-specific somatic gene mutations detected by PCR-based hotspot testing to a population-level set of comparable data. The initial prototype works for patient specimens with 0 or 1 detected mutation. Genomics extensions were created for the Health Level Seven® Fast Healthcare Interoperability Resources (FHIR)® standard; otherwise, the prototype is a normal SMART on FHIR app. Results The PCM prototype can rapidly present a visualization that compares a patient’s somatic genomic alterations against a distribution built from more than 3000 patients, along with context-specific links to external knowledge bases. Initial evaluation by oncologists provided important feedback about the prototype’s strengths and weaknesses. We added several requested enhancements and successfully demonstrated the app at the inaugural American Society of Clinical Oncology Interoperability Demonstration; we have also begun to expand visualization capabilities to include cancer specimens with multiple mutations. Discussion PCM is open-source software for clinicians to present the individual patient within the population-level spectrum of cancer somatic mutations. The app can be implemented on any SMART on FHIR-enabled EHRs, and future versions of PCM should be able to evolve in parallel with external knowledge bases.

scholarly journals Adjusting for non-response in the Finnish Drinking Habits Survey

2019 ◽  
Vol 47 (4) ◽  
pp. 469-473 ◽  
Author(s):  
Hanna Tolonen ◽  
Miika Honkala ◽  
Jaakko Reinikainen ◽  
Tommi Härkänen ◽  
Pia Mäkelä
Keyword(s):  
Logistic Regression ◽  
Random Forest ◽  
Alcohol Use ◽  
Population Level ◽  
Added Value ◽  
Drinking Habits ◽  
Wide Range ◽  
Random Forest Models ◽  
Survey Estimates ◽  
Design Weights

Aim: We aim to compare four different weighting methods to adjust for non-response in a survey on drinking habits and to examine whether the problem of under-coverage of survey estimates of alcohol use could be remedied by these methods in comparison to sales statistics. Method: The data from a general population survey of Finns aged 15–79 years in 2016 ( n=2285, response rate 60%) were used. Outcome measures were the annual volume of drinking and prevalence of hazardous drinking. A wide range of sociodemographic and regional variables from registers were available to model the non-response. Response propensities were modelled using logistic regression and random forest models to derive two sets of refined weights in addition to design weights and basic post-stratification weights. Results: Estimated annual consumption changed from 2.43 litres of 100% alcohol using design weights to 2.36–2.44 when using the other three weights and the estimated prevalence of hazardous drinkers changed from 11.4% to 11.4–11.8%, correspondingly. The use of weights derived by the random forest method generally provided smaller estimates than use of the logistic regression-based weights. Conclusions: The use of complex non-response weights derived from the logistic regression model or random forest are not likely to provide much added value over more simple weights in surveys on alcohol use. Surveys may not catch heavy drinkers and therefore are prone for under-reporting of alcohol use at the population level. Also, factors other than sociodemographic characteristics are likely to influence participation decisions.

scholarly journals Understanding diagnosis through ACTion: evaluation of a point-of-care checklist for junior emergency medical residents

Diagnosis ◽  
2019 ◽  
Vol 6 (2) ◽  
pp. 151-156 ◽  
Author(s):  
Michael Kilian ◽  
Jonathan Sherbino ◽  
Christopher Hicks ◽  
Sandra D. Monteiro
Keyword(s):  
Logistic Regression ◽  
Point Of Care ◽  
Binary Logistic Regression ◽  
Diagnostic Error ◽  
Binary Logistic Regression Analysis ◽  
Provisional Diagnosis ◽  
Percent Correct ◽  
University Of Toronto ◽  
Severity Rating ◽  
Diagnostic Checklist

Abstract Background Avoiding or correcting a diagnostic error first requires identification of an error and perhaps deciding to revise a diagnosis, but little is known about the factors that lead to revision. Three aspects of reflective practice, seeking Alternative explanations, exploring the Consequences of missing these alternative diagnoses, identifying Traits that may contradict the provisional diagnosis, were incorporated into a three-point diagnostic checklist (abbreviated to ACT). Methods Seventeen first and second year emergency medicine residents from the University of Toronto participated. Participants read up to eight case vignettes and completed the ACT diagnostic checklist. Provisional and final diagnoses and all responses for alternatives, consequences, and traits were individually scored as correct or incorrect. Additionally, each consequence was scored on a severity scale from 0 (not severe) to 3 (very severe). Average scores for alternatives, consequences, and traits and the severity rating for each consequence were entered into a binary logistic regression analysis with the outcome of revised or retained provisional diagnosis. Results Only 13% of diagnoses were revised. The binary logistic regression revealed that three scores derived from the ACT tool responses were associated with the decision to revise: severity rating of the consequence for missing the provisional diagnosis, the percent correct for identifying consequences, and the percent correct for identifying traits (χ2 = 23.5, df = 6, p < 0.001). The other three factors were not significant predictors. Conclusions Decisions to revise diagnoses may be cued by the detection of contradictory evidence. Education interventions may be more effective at reducing diagnostic error by targeting the ability to detect contradictory information within patient cases.

Sign in / Sign up

Export Citation Format

Share Document