Performance of Abbott Architect, Ortho Vitros, and Euroimmun Assays in Detecting Prior SARS-CoV-2 Infection [preprint]

Background: Several serological assays have been developed to detect anti-SARS-CoV-2 IgG antibodies, but evidence about their comparative performance is limited. We sought to assess the sensitivity of four anti-SARS-CoV-2 IgG enzyme-linked immunosorbent assays (ELISA) in individuals with evidence of prior SARS-CoV-2 infection. Methods: We obtained sera from 36 individuals with PCR-confirmed SARS-CoV-2 infection between March and May 2020. We evaluated samples collected at around 21 days (±14 days) after their initial PCR test using 3 commercially available ELISA assays, two anti-spike (Ortho-Clinical Diagnostics Vitros, and Euroimmun) and one anti-nucleocapsid (Abbott Architect), and a Yale-developed anti-spike ELISA test. We determined the sensitivity of the tests and compared their results. The Euroimmun and Yale ELISA had an equivocal and indeterminate category, which were considered as both negative and positive. Results: Among the 36 individuals with SARS-CoV-2 infection, mean age was 43 (±13) years and 19 (53%) were female. The sensitivities of the tests were not significantly different (Abbott Architect, Ortho Vitros, Euroimmmun, and Yale assays: 86% (95% confidence interval [CI], 71-95), 94% (95% CI, 81-99), 86% (95% CI, 71-95), and 94% (95% CI, 81-99), respectively; p-value=0.464). The sensitivities of the Euroimmun and Yale ELISA tests increased when the equivocal/indeterminate results were considered positive (97% [95% CI, 85-100] and 100% [95% CI, 90-100], respectively), but were not significantly different from other tests (p=0.082). The cross-correlation coefficient ranged from 0.85-0.98 between three anti-spike protein assays (Ortho Vitros, Euroimmun, Yale) and was 0.58-0.71 between the three anti-spike protein assays and the anti-nucleocapsid assay (Abbott). Conclusion: The sensitivities of four anti-SARS-CoV-2 protein assays did not significantly differ, although the sample size was small. Sensitivity also depended on the interpretation of equivocal and indeterminate results. The strongest correlations were present for the three anti-spike proteins assays. These findings suggest that individual test characteristics and the correlation between different tests should be considered when comparing or aggregating data across different populations studies for serologic surveillance of past SARS-CoV-2 infection

Obstructive sleep apnea in Treacher Collins syndrome

The aim of the present study was to investigate the prevalence of obstructive sleep apnea syndrome (OSAS) among the Norwegian population with Treacher Collins syndrome (TCS). A secondary aim was to establish whether TCS phenotype severity is associated with OSAS severity. A prospective case study design was used. Individuals who were 5 years old and above with a known diagnosis of TCS in Norway were invited to participate in a study. The study included genetic testing, medical and dental examinations and polysomnography. All participants demonstrated disturbed respiration during sleep; 18/19 met the diagnostic criteria for OSAS. Subjectively evaluated snoring was not a reliable predictor of OSAS. We found no significant association between TCS phenotype severity and the severity of OSAS. OSAS is common in TCS, but there is no association with the phenotype severity. Individuals diagnosed with TCS must undergo sleep studies to identify the presence of OSAS

Neglected diseases of neglected populations: Thinking to reshape the determinants of health in Latin America and the Caribbean

BACKGROUND: People living in poverty throughout the developing world are heavily burdened with neglected communicable diseases and often marginalized by the health sector. These diseases are currently referred to as Neglected Diseases of Neglected Populations. The neglected diseases create social and financial burdens to the individual, the family, the community, and the nation. DISCUSSION: Numerous studies of successful individual interventions to manage communicable disease determinants in various types of communities have been published, but few have applied multiple interventions in an integrated, coordinated manner. We have identified a series of successful interventions and developed three hypothetical scenarios where such interventions could be applied in an integrated, multi-disease, inter-programmatic, and/or inter-sectoral approach for prevention and control of neglected diseases in three different populations: a slum, an indigenous community, and a city with a mix of populations. SUMMARY: The objective of this paper is to identify new opportunities to address neglected diseases, improve community health and promote sustainable development in neglected populations by highlighting examples of key risk and protective factors for neglected diseases which can be managed and implemented through multi-disease-based, integrated, inter-programmatic, and/or inter-sectoral approaches. Based on a literature review, analysis and development of scenarios we visualize how multiple interventions could manage multiple disease problems and propose these as possible strategies to be tested. We seek to stimulate intra- and inter-sectoral dialogue which will help in the construction of new strategies for neglected diseases (particularly for the parasitic diseases) which could benefit the poor and marginalized based on the principle of sustainability and understanding of key determinants of health, and lead to the establishment of pilot projects and activities which can contribute to the achievement of the Millennium Development Goals

Qualitative Analysis Of Mobile Clinical Decision Support For Community Health Workers In Kosirai

In an effort to assess the effect of mobile clinical decision support (CDS) algorithms on the delivery of antenatal and postnatal care by community health workers (CHWs) in Kosirai, Kenya, we conducted mixed methods that included a cluster- randomized controlled trial, in-depth interviews, and focus group discussions. In the qualitative research of focus group discussions (FGDs), we sought to gain a more comprehensive understanding of how CHWs worked in Kosirai, how the residents understood and utilized community health services, and how the phone hardware and software facilitated or constrained the workflows of CHWs delivering antenatal and postnatal care in Kosirai. A total of eight focus group discussions with women who were pregnant or who had recently delivered in Kosirai (n=44), and six focus groups with CHWs (n=24) were conducted over a two year period. FGD participants were selected by purposeful sampling, and comparison with a concurrent survey conducted by the Academic Model for Providing Access to Healthcare (AMPATH) Primary Health Care demonstrated that FGD participants covered a wide range of population demographics. The initial focus groups were held approximately 18 months after the initiation of the CHW program, when the CHWs were using paper forms and job aids. The subsequent FGDs occurred 6 months after the CHWs had received phones, and 6 after the implementation of the clinical decision support, at the conclusion of the randomized-controlled trial. In this thesis, we discuss two emergent themes identified from the FGDs, and the relevance of the mobile health intervention on each theme. `We are people of their village\u27 covers the relationship between CHWs and the women they served, focusing on the accessibility, availability and acceptability of community-based care as well as the impact of phones on promoting access to health care. `Collective responsibility\u27 examines the familial and sociocultural networks in which the CHWs and their clients seek health care, and the relevance of the phone in this sphere. Through these themes, we explain how the mobile clinical decision support system enabled greater autonomy, flexibility, responsiveness, and quality of service delivery among CHWs, but emphasize how these benefits were limited to a subset of highly committed CHWs

New polymerization and substitution reactions of monomeric and polymeric boron-nitrogen species

Boron nitride ceramics posses unique thermal, electronic, and optical properties. New technologies require boron nitride in forms not accessible by conventional powder techniques. In order to exploit these properties there is a need to develop new high yield, processable precursors to boron nitride. The overall goal of this research was to develop new high yield synthetic routes to boron-nitrogen molecular and polymeric species. An emphasis was placed on those species which could be used in the development of polymeric precursors to boron nitride ceramics. The major accomplishments of this work are summarized below. The synthesis and ceramic conversion reactions of polyborazylene, (B{\rm \sb3N\sb3H\sb{\sim4})\sb{x}}, were investigated. The polymer was produced in high yields by simply heating borazine at relatively low temperatures (70-110\sp\circ{\rm C}) for 48h. The polymer was found to be soluble in polar ethers such as glyme and THF. Spectroscopic and molecular weight data indicate that the polymer appears to have a complex structure, having linear, branched-chain, and fused-cyclic segments, related to those of the organic polyphenylenes. The isolation and structural characterization of small amounts of the polycyclic boron-nitrogen compounds diborazine, 1:2\sp\prime-(B\sb3N\sb3H\sb5)\sb2, and borazanaphthalene, {\rm B\sb5N\sb5H\sb8}, supports this conclusion. Pyrolysis studies show that the polymer converts to boron nitride in excellent chemical, 89 to 99%, and ceramic yields, 84 to 93%. The quality of the resulting boron nitride was determined by elemental analysis, DRIFT spectra, powder XRD, density measurements, and TGA oxidation studies. Studies of the polymer/ceramic conversion process, as followed by TGA, TGA/MS, DRIFT, XRD, and micro analysis of materials produced at intermediate temperatures, suggest that the polymer has a layered structure in the solid state and that the conversion to boron nitride occurs by means of a two-dimensional cross-linking reaction. The polymer was also useful for producing boron nitride coatings on ceramic and carbon fiber yarn bundles. A new method was also developed that allows the systematic controlled alkylation of borazine, as well as polyborazylene. Borazine was found to react with a wide variety of olefins, including ethylene, propene, 1-butene, cis- and trans-2-butene, 3,3,3-trifluoropropene, styrene, $\alpha$-methylstyrene, and 4-allylanisole, in the presence of catalytic amounts of RhH(CO)(PPh\sb3)\sb3 to selectively produce the mono-, di- and tri-B-alkylborazines in excellent yields. The degree of substitution was controlled by altering the reactant ratios. Unsymmetrically substituted tri-B-alkylborazines are produced by the catalyzed reaction of mono- or di-B-substituted borazines with a different olefin. RhH(CO)(PPh\sb3)\sb3 is also used to catalyze direct alkylation of borazine-based polymers. Thus, the catalyzed addition of either ethylene or propene with polyborazylene, ({\rm B\sb3N\sb3H\sb{\sim4})\sb{x}}, yielded the B-alkylated polymers ({\rm C\sb2H\sb5)\sb{y}(B\sb3N\sb3H\sb{\sim4-y}}) and ({\rm C\sb3H\sb7)\sb{y}(B\sb3N\sb3H\sb{\sim4-y}}), respectively