Symptom-Based Predictive Model of COVID-19 Disease in Children

Background: Testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is neither always accessible nor easy to perform in children. We aimed to propose a machine learning model to assess the need for a SARS-CoV-2 test in children (<16 years old), depending on their clinical symptoms. Methods: Epidemiological and clinical data were obtained from the REDCap® registry. Overall, 4434 SARS-CoV-2 tests were performed in symptomatic children between 1 November 2020 and 31 March 2021, 784 were positive (17.68%). We pre-processed the data to be suitable for a machine learning (ML) algorithm, balancing the positive-negative rate and preparing subsets of data by age. We trained several models and chose those with the best performance for each subset. Results: The use of ML demonstrated an AUROC of 0.65 to predict a COVID-19 diagnosis in children. The absence of high-grade fever was the major predictor of COVID-19 in younger children, whereas loss of taste or smell was the most determinant symptom in older children. Conclusions: Although the accuracy of the models was lower than expected, they can be used to provide a diagnosis when epidemiological data on the risk of exposure to COVID-19 is unknown.

Predictors of COVID testing among Australian youth: Insights from the Longitudinal Study of Australian Children

Background Testing has played a crucial role in reducing the spread of COVID. Although COVID symptoms tend to be less severe in children and adolescents, a key concern is young peoples role in the transmission of the virus given their highly social lifestyles. In this study, we aimed to identify the predictors associated with COVID testing in Australian youth using data from the Longitudinal Study of Australian Children (LSAC). Methods We used the latest wave 9C1 of the LSAC, where data were collected from 16 to 21 year olds Australians via an online survey between October and December 2021. In total, 2291 Australian youths responded to the questions about COVID testing and COVID symptom severity. Data were stratified by living with/without parents, and bivariate and logistic regression analyses examined predictor variables (age, sex, country of birth, remoteness, education level, employment, relationship status, number of household members, living with parents, receiving the COVID financial supplement from government and index of relative socio-economic advantage and disadvantage) and their distributions over the outcome variable COVID testing. Results Youths aged between 16 to 17 years were more likely to live at home than youths aged between 20 and 21 years. The strongest predictor of COVID testing was living in major cities (regardless of living with or without parents). The changed household composition was significantly associated with COVID testing among the youths living in the parental home. While among the respondents living without their parents, living with multiple household members and low or no cohesion among household members was associated with higher rates of COVID testing. Conclusion Our study revealed young people have been very good at getting tested for COVID. To further incentivise testing in this age group, we should consider providing this age group with continued financial and social support while awaiting the outcome of the test and during any isolation.

The acceptability of testing contacts of confirmed COVID-19 cases using serial, self-administered lateral flow devices as an alternative to self-isolation

Background: Testing asymptomatic contacts of confirmed COVID-19 cases for the presence of SARS-CoV-2 could reduce onward transmission by improving case ascertainment and lessen the impact of self-isolation on un-infected individuals. This study investigated the feasibility and acceptability of implementing a test to enable approach as part of England's tracing strategy. Methods: Contacts of confirmed COVID-19 cases were offered serial testing as an alternative to self-isolation using daily self-performed lateral flow device (LFD) tests for the first 7 days post exposure. Asymptomatic participants with a negative LFD result were given 24 hours of freedom from self-isolation between each test. A self-collected confirmatory PCR test was performed on testing positive or at the end of the LFD testing period. Results: Of 1,760 contacts, 882 consented to daily testing, with 812 within 48 hours of exposure sent testing packs. Of those who declined to participate, 39.1% stated they had already accessed PCR testing. Of the 812 who were sent packs, 570 (70.2%) reported one or more LFD results; 102 (17.9%) tested positive. Concordance between reported LFD result and a supplied LFD image was 97.1%. 82.8% of PCR positive samples and 99.6% of PCR negative samples were correctly detected by LFD. The proportion of secondary cases from contacts of those who participated in the study and tested positive (6.3%; 95% CI: 3.4-11.1%) were comparable to a comparator group who self-isolated (7.6%; 95% CI: 7.3-7.8%). Conclusion: This study shows a high acceptability, compliance and positivity rates when using self-administered LFDs among contacts of confirmed COVID-19 cases. Offering routine testing as a structured part of the contact tracing process is likely to be an effective method of case ascertainment.

PERBANDINGAN KADAR FLAVONOID TOTAL EKSTRAK ETANOLIK DAUN BELUNTAS (Pluchea indica L.) BERDASARKAN VARIASI KONSENTRASI PELARUT SECARA SPEKTROFOTOMETER UV–VIS

Background: Testing or analysis of total flavonoid levels of herbal ethanolic extract of beluntas (Pluchea indica L.) leaves has been carried out. Beluntas leaf (Pluchea indica L.) is a traditional medicinal plant that is not widely known by the public about its benefits for various diseases.Objective: to determine an overview of total flavonoid levels between different of variation concentration.Method:Extraction of the compound of beluntas (Pluchea indica L.) leaves was carried out by maceration method using 100 mL of aquadest and 100 mL of ethanol - aquades mixture withethanol96% (v / v) concentrations, ethanol 70% (v / v), ethanol 50% (v / v), and ethanol 30% (v / v) for 24 hoursrespectively. Phytochemical screening continued with Thin Layer Chromatography (TLC). While the measurement of the levels of flavonoid compounds in the sample was conducted out by the UV-Vis spectrophotometer methodResult:Phytochemical screening using TLC on beluntas (Pluchea indica L.) leaves is known to contain flavonoidsrespectively. The measurement results of total flavonoids in aquadest extract amounted to 1.94% (b / b), whereas in ethanol extract 96% -aquadest was 16.62% (b / b), ethanol extract - aquadest 70% by 33.80% (b / b), 50% ethanol - aquades was 30.29% (b / b) and 30% ethanol - aquades was 15.27% (b / b). The results of measurements of total flavonoid levels in beluntas (Pluchea indica L.) leaves stated that the highest total flavonoid content obtained in 70% ethanol extract was 33.80% (b / b), followed by 50% ethanol was 30.29% (b / b), 96% ethanol 16.62% (b / b), 30% ethanol was 15.27% (b / b), and 30% distilled water was 1, 94% (b / b).

Universal Screening for G6PD Deficiency Detects More Cases Than Selective Testing

Background: Testing for glucose-6-phosphate dehydrogenase (G6PD) deficiency is traditionally restricted to jaundiced neonates, as well as to those whose risk factors provide sufficient grounds to suspect the deficiency. We assumed that in a multi-ethnic, multicultural society, routine neonatal screening for G6PD deficiency would detect more affected neonates. Methods: An observational, population-based, cohort study was designed to compare the incidence of G6PD deficiency between two groups of neonates using a validated qualitative enzyme test. Incidence of G6PD deficiency was calculated retrospectively for one group of neonates born between January 2005 and July 2012 (i.e., epoch 1), when only "at-risk" newborns were tested for the deficiency (i.e., group 1). Incidence was also calculated for a second, prospective group of neonates, who were all to be born between August 2012 and April 2014 (i.e., epoch 2), and were all screened for the deficiency irrespective of risk factors. Results: A total of 39,268 live-born infants were included in our study. In epoch 1, 6.8% of all newborns were tested for the deficiency, compared to about 87% in epoch 2. The incidence of G6PD deficiency was 0.4% (119/29,332) and 1.6% (156/9,936) in epoch 1 and epoch 2, respectively (p<0.05). Among females, there was a 6.6-fold increase in incidence of G6PD deficiency between epoch 1 (0.08% [12/14,410]) and epoch 2 (0.53% [26/4,881]), while among males there was a 3.4-fold increase in incidence between epoch 1 and epoch 2 (0.72% [107/14,922] and 2.47% [125/5055], respectively). Conclusions: As universal screening for G6PD deficiency detects more affected newborns than the selective, risk-factor-based testing does, we suggest that validation of our study and cost-effectiveness analyses may further the aim of introducing universal screening for G6PD deficiency for neonates born in multi-ethnic, multicultural society setting. Disclosures No relevant conflicts of interest to declare.

Assuring organisational resilience with lean scenario-driven exercises

Purpose – The purpose of this paper is to draw on the author’s background testing resilience in “no fail” organisations at the heart of UK government. The paper outlines a lean approach to high-impact training for strategic leaders, achieved in the form of low-cost exercises and harnessed to build resilience by surfacing risks, engaging with options and modelling decision outcomes. Repeated rehearsal of crisis and risk management responses grows organisational resilience and human capacity and reduces reputational, legal, operational and other costs. Design/methodology/approach – The methodology employed scenario-driven exercises (SDEs) is described for the first time in the open literature. Findings – Approaches such as SDEs build strategic resilience through effective training and learning, focusing on the fundamental priorities of strategic delivery, reputation and crisis management through avoiding and reacting to challenging circumstances. Practical implications – By being targeted at probing and gaming participants’ taking of decisions and logic of analysing available information, the use of frugal SDEs can provide substantial value in organisations where robust testing is welcomed and its findings implemented. Originality/value – SDEs are described for the first time in the open literature.