RT-LAMP has high accuracy for detecting SARS-CoV-2 in saliva and naso/oropharyngeal swabs from asymptomatic and symptomatic individuals

Previous studies have described RT-LAMP methodology for the rapid detection of SARS-CoV-2 in nasopharyngeal/oropharyngeal swab and saliva samples. Here we describe the validation of an improved simple sample preparation method for Direct SARS-CoV-2 RT-LAMP, removing the need for RNA extraction, using 559 swabs and 86,760 saliva samples from asymptomatic and symptomatic individuals across multiple healthcare settings. Using this improved method we report a diagnostic sensitivity (DSe) of 70.35% (95% CI 63.48-76.60%) on swabs and 84.62% (79.50-88.88%) on saliva, with diagnostic specificity (DSp) 100% (98.98-100.00%) on swabs and 100% (99.72-100.00%) on saliva when compared to RT-qPCR. Analysing samples with RT-qPCR ORF1ab CT values of <25 and <33 (high and medium-high viral loads, respectively), we found DSe of 100% (96.34-100%) and 77.78% (70.99-83.62%) for swabs, and 99.01% (94.61-99.97%) and 87.32% (80.71-92.31%) for saliva. We also describe RNA RT-LAMP (on extracted RNA) performed on 12,619 swabs and 12,521 saliva samples to provide updated performance data with DSe and DSp of 95.98% (92.74-98.06%) and 99.99% (99.95-100%) for swabs, and 80.65% (73.54-86.54%) and 99.99% (99.95-100%) for saliva, respectively. We also report on daily samples collected from one individual from symptom onset where both Direct and RNA RT-LAMP detected SARS-CoV-2 in saliva collected on all six days where symptoms were recorded, with RNA RT-LAMP detecting SARS-CoV-2 for an additional further day. The findings from these studies demonstrate that RT-LAMP testing of swabs and saliva is potentially applicable to a variety of use-cases, including frequent, interval-based testing of saliva from asymptomatic individuals via Direct RT-LAMP that may be missed using symptomatic testing alone.

Reconstructing Boulder Deposition Histories: Extreme Wave Signatures on a Complex Rocky Shoreline of Malta

The Żonqor coastline, southeast Malta, displays an exceptional range of geomorphic signatures of extreme coastal events. This paper brings together evidence acquired from a field survey, analysis of time-sequential imagery, and hydrodynamic modelling to investigate the histories of boulder groups identified by their intrinsic and contextual characteristics. Clear differences are revealed between the distribution of boulders recently moved and those of considerable age. Tracking the movement of boulders since 1957 confirms that storms of surprisingly frequent interval are capable of complex boulder movements, including lifting of megaclasts. Scrutiny of the ancient boulders, including weathering features and fascinating landward-facing (reverse) imbrication, cautiously suggests tsunami as the agent for their emplacement. A novel method is developed for depicting the velocity decay profiles of hypothetical waves, which overcomes some of the limitations of the Nott approach. Applied here, the wave run-up context further sets the ancient movers apart from their recent mover companions. The combined evidence implies a palimpsestic landscape where storm waves are regular geomorphic agents that add to and rework the distribution of boulders close to the shoreline, but over long time periods the landscape becomes reset by tsunami—a concept that is of value to agencies in Malta responsible for coastal safety, planning and management.

Estimating the public health impact of a national guideline on cervical cancer screening: an audit study of a program in Campinas, Brazil

Background A Brazilian guideline on cervical cancer screening was released in 2011. The objective was to verify changes in screening indicators around this period. Methods An audit study which sample was all screening tests performed by the public health system of Campinas city from 2010 to 2016. Variables were absolute tests numbers, excess tests, intervals and results, by age. For trend analysis was used Cochran-Armitage × 2 and linear regression. Results Were carried out 62,925 tests in 2010 and 43,523 tests in 2016, a tendency at a reduction (P = 0.001). Excess tests were higher than 50% over the years, with a tendency at a reduction (P < 0.001). Tests performed on women under 25 ranged from 20.2 to 15.4% in the period (P < 0.001), while in the 25–64 years age-group, it ranged from 75.1 to 80.2% (P < 0.001). In 2010 the most frequent interval was annual (47.5%) and in 2016 biennial (34.7%). There was a tendency at a reduction in the proportion of tests performed at the first time and those with an annual interval (P < 0.001), and also a tendency at an increase in tests with intervals equal to or greater than biannual (P < 0.001). We observed a tendency at a reduction in LSIL and HSIL-CIN2 results (P = 0.04 and P = 0.001, respectively), and a tendency at an increase in HSIL-CIN3 result (P = 0.02). Conclusion The proportion of cervical cancer screening tests performed out of the recommendation showed a significant reduction in the period. This indicates a tendency to align cervical cancer screening in Campinas with the standards recommended.

Recurrent papillary craniopharyngioma with BRAF V600E mutation treated with dabrafenib: case report

The authors present the case of a man with a papillary craniopharyngioma, first diagnosed at 47 years of age, who experienced multiple recurrences. Review of the pathologic specimen from his first resection demonstrated the BRAF V600E mutation. With his most recent recurrence following previous surgery and radiotherapy, at 52 years of age, the decision was made to initiate treatment with the BRAF V600E inhibitor dabrafenib. Imaging following initiation of dabrafenib demonstrated reduction in tumor size. He remained on dabrafenib therapy for approximately 1 year and continued to demonstrate a good clinical result. At that time the decision was made to discontinue dabrafenib therapy and follow up with serial imaging. After more than 1 year of follow-up since stopping dabrafenib, the patient has continued to do well with no radiographic evidence of tumor progression and continues to be monitored with frequent interval imaging.

The Distinctiveness Effect in the Recognition of Whole Melodies

Distinctive stimuli are better recognized than typical stimuli in many domains (e.g., faces, words). Distinctiveness predicts the point of recognition of a melody (Bailes, 2010), and the recognition of unique tones within a melody (Vuvan, Podolak, & Schmuckler, 2014), yet no studies have examined the role of distinctiveness in recognizing whole melodies. We composed a set of novel melodies according to rules that should result in these being perceived as more or less distinctive. Using computational analysis and human ratings by a group of 36 pilot testers, we established a final stimulus set of 96 novel melodies (48 eightnote, 48 sixteen-note), half of which were high and half low in distinctiveness. A separate group of 26 participants completed a recognition test using this stimulus set. Using linear mixed-effects modeling, we found that greater pitch and interval range, wider intervals, varied contour, and ambiguous tonality within a Western diatonic framework predicted human perception of distinctiveness. However, only a wider modal (most frequent) interval predicted correct recognition. Distinctiveness improved recognition performance in both stimulus lengths; however, a significant advantage was only shown for sixteen-note melodies. Thus, the distinctiveness effect as observed across domains generalizes to the recognition of longer, whole melodies.

Age-Related Differences in Time-Based Event Expectancies

The ability to form time-based event expectancies is one of the most important determinants of anticipative behavior. The aim of the present study was to determine whether healthy aging influences the formation of time-based event expectancies. Ten older adults with ages ranging between 60 and 73 years and ten younger adults with ages ranging between 20 and 32 years participated. We employed a binary choice response task mimicking a computer game, in which two target stimuli and two pre-target intervals appeared overall equally often. One of the targets was paired with the short interval and the other target with the long interval in 80% of the trials. Our results showed that younger adults responded more rapidly to frequent interval–target combinations than to infrequent combinations, suggesting that the young participants formed time-based event expectancies. In contrast, the ability to form time-based event expectancies was reduced for older participants. The formation of time-based event expectancies seems to change during healthy aging. We propose that this age-related difference is due to age-related expectation deficits or a reduction of attentional capacities, rather than to deficits in timing abilities.

Time-Based Expectancy for Task Relevant Stimulus Features

When a particular target stimulus appears more frequently after a certain interval than after another one, participants adapt to such regularity, as evidenced by faster responses to frequent interval-target combinations than to infrequent ones. This phenomenon is known as time-based expectancy. Previous research has suggested that time-based expectancy is primarily motor-based, in the sense that participants learn to prepare a particular response after a specific interval. Perceptual time-based expectancy — in the sense of learning to perceive a certain stimulus after specific interval — has previously not been observed. We conducted a Two-Alternative-Forced-Choice experiment with four stimuli differing in shape and orientation. A subset of the stimuli was frequently paired with a certain interval, while the other subset was uncorrelated with interval. We varied the response relevance of the interval-correlated stimuli, and investigated under which conditions time-based expectancy transfers from trials with interval-correlated stimuli to trials with interval-uncorrelated stimuli. Transfer was observed only where transfer of perceptual expectancy and transfer of response expectancy predicted the same behavioral pattern, not when they predicted opposite patterns. The results indicate that participants formed time-based expectancy for stimuli as well as for responses. However, alternative interpretations are also discussed.

Clinical and laboratory features of childhood systemic lupus erythematosus and its course in Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta

A descriptive, retrospective study has been performed among 33 children with SLE during the period of January 1986 to December 1999 in Department of Child Health, Cipto Mangunkusumo Hospital. The results of the present study show that SLE in childhood was more commonly found in girls than in boys, with a ratio of 4.5: 1. The mean age of onset was 10.5 years and the mean age of diagnosis was 10.9 years, most frequently observed in the age of > 10 years and rarely found in the age of < 5 years. The time interval between the time of onset and time of diagnosis ranged from 1 to 24 months and the most frequent interval was 1-3 months. The most common initial symptoms were prolonged fever, rash on the skin and face, and athralgia. In its natural history of the disease, kidneys, skin/mucous membrane and joints are the most frequent organs involved. Most of the SLE patients develop anemia. Positive anti ds-DNA, ANA and decreased levels of C3 and C4 respectively in 28 (28/31), in 29 (29/30), in 25 (25/33), and in 19 (19/27) cases. LE cells were encountered only in four (4/17) cases. Out of 11 cases upon which renal biopsies were done, the most common histological features were mesangeal glomerulonephritis (class II) and diffuse proliferative glomerulonephritis (class IV). The mean time interval between the onset and renal complication manifestations was 6.96 months, cardiac complication was 16.77 months, central nerve system was 22.71 months and lungs were 25.0 months. Duration of illness of patients with SLE ranged from 2 to 175 with the mean of 31.3 months. The causes of death were mostly due to gastrointestinal bleeding and renal failure.