Test, trace, isolate:Evidence for declining SARS-CoV-2 PCR sensitivity in a clinical cohort

Real-time reverse transcription-polymerase chain reaction (RT-PCR) on upper respiratory tract (URT) samples is the primary method to diagnose SARS-CoV-2 infections and guide public health measures, with a supportive role for serology. We reinforce previous findings on limited sensitivity of PCR testing, and solidify this fact by statistically utilizing a firm basis of multiple tests per individual. We integrate stratifications with respect to several patient characteristics such as severity of disease and time since onset of symptoms. Bayesian statistical modelling was used to retrospectively determine the sensitivity of RT-PCR using SARS-CoV-2 serology in 644 COVID-19-suspected patients with varying degrees of disease severity and duration. The sensitivity of RT-PCR ranged between 80% − 95%; increasing with disease severity, it decreased rapidly over time in mild COVID-19 cases. Negative URT RT-PCR results should be interpreted in the context of clinical characteristics, especially with regard to containment of viral transmission based on ‘test, trace and isolate’

Personality, psychological stress, and self-reported influenza symptomatology

<p>Abstract</p> <p>Background</p> <p>Psychological stress and negative mood have been related to increased vulnerability to influenza-like illness (ILI). This prospective study re-evaluated the predictive value of perceived stress for self-reported ILI. We additionally explored the role of the negative affectivity and social inhibition traits.</p> <p>Methods</p> <p>In this study, 5,404 respondents from the general population were assessed in terms of perceived stress, personality, and control variables (vaccination, vitamin use, exercise, etc.). ILI were registered weekly using self-report measures during a follow-up period of four weeks.</p> <p>Results</p> <p>Multivariable logistic regression analysis on ILI was performed to test the predictive power of stress and personality. In this model, negative affectivity (OR = 1.05, p = 0.009), social inhibition (OR = 0.97, p = 0.011), and perceived stress (OR = 1.03, p = 0.048) predicted ILI reporting. Having a history of asthma (OR = 2.33, p = < 0.0001) was also associated with ILI reporting. Older age was associated with less self-reported ILI (OR = 0.98, P = 0.017).</p> <p>Conclusion</p> <p>Elderly and socially inhibited persons tend to report less ILI as compared to their younger and less socially inhibited counterparts. In contrast, asthma, trait negative affectivity, and perceived stress were associated with higher self-report of ILI. Our results demonstrate the importance of including trait markers in future studies examining the relation between stress and self-report symptom measures.</p

Disrupting the rhythm of depression: design and protocol of a randomized controlled trial on preventing relapse using brief cognitive therapy with or without antidepressants

Background: Maintenance treatment with antidepressants is the leading strategy to prevent relapse and recurrence in patients with recurrent major depressive disorder (MDD) who have responded to acute treatment with antidepressants (AD). However, in clinical practice most patients (up to 70-80%) are not willing to take this medication after remission or take too low dosages. Moreover, as patients need to take medication for several years, it may not be the most cost-effective strategy. The best established effective and available alternative is brief cognitive therapy (CT). However, it is unclear whether brief CT while tapering antidepressants (AD) is an effective alternative for long term use of AD in recurrent depression. In addition, it is unclear whether the combination of AD to brief CT is beneficial.Methods/design: Therefore, we will compare the effectiveness and cost-effectiveness of brief CT while tapering AD to maintenance AD and the combination of CT with maintenance AD. In addition, we examine whether the prophylactic effect of CT was due to CT tackling illness related risk factors for recurrence such as residual symptoms or to its efficacy to modify presumed vulnerability factors of recurrence (e.g. rigid explicit and/or implicit dysfunctional attitudes). This is a multicenter RCT comparing the above treatment scenarios. Remitted patients on AD with at least two previous depressive episodes in the past five years (n = 276) will be recruited. The primary outcome is time related proportion of depression relapse/recurrence during minimal 15 months using DSM-IV-R criteria as assessed by the Structural Clinical Interview for Depression. Secondary outcome: economic evaluation (using a societal perspective) and number, duration and severity of relapses/recurrences.Discussion: This will be the first trial to investigate whether CT is effective in preventing relapse to depression in recurrent depression while tapering antidepressant treatment compared to antidepressant treatment alone and the combination of both. In addition, we explore explicit and implicit mediators of CT.Trial registration: Netherlands Trial Register (NTR): NTR1907

LV distribution network voltage control mechanism: Analysis of large-scale field-test

This work presents the results of an extensive large-scale field test of a local voltage control mechanism in Low Voltage (LV) distribution grids. The main goal of the voltage control system is to mitigate over- and under voltages in the feeder, and for that the readily available flexibility of residential smart appliances is used. The advantage of the control system is that there is no need for a communication network between the different households within the LV network. The control system merely requires communication between the smart appliances within one household, and uses locally available measurements, such as the household supply voltage provided by e.g. a smart meter. The control system was rolled out in the LINEAR residential demand response pilot in 85 families, and was tested from December 2013 to September 2014.status: publishe

Phase switching and phase balancing to cope with a massive photovoltaic penetration

This paper compares two methods that result in a more balanced operation of the electricity grid. A balanced distribution grid results in improved voltage profiles, a lower voltage unbalance and lower losses. The first method discusses the changing of the phase connection of single-phase customers. Optimization techniques with a constrained maximum number of changes show that this passive solution may be suitable for unbalanced grids. Secondly the effect of balancing three-phase PV-inverters is investigated. The proposed control consists of injecting the majority of the produced power in the phase with the highest power consumption, based only on local voltage information. Both methods are evaluated with extensive load flow simulations with real data.status: accepte

Satisfaction with Relationship Status: Development of a New Scale and the Role in Predicting Well-Being

To develop a generic instrument assessing satisfaction with relationship status, and to examine the role of status satisfaction in explaining life satisfaction and distress beyond marital status. In two studies, we first examined the psychometric properties of the Satisfaction with Relationship Status Scale (ReSta). Subsequently, regression analyses were used to test the predictive value of ReSta for life satisfaction and distress after controlling for sociodemographic variables and a perceived lack of social support. An economic five-item scale was constructed, cross-validated, and showed very high reliability. In both studies, higher ReSta-scores predicted higher satisfaction with life and lower distress, explaining considerable amounts of additional variance (18–29 %) after controlling for sociodemographic variables (i.e. gender, age, and education), marital status, and also after taking a perceived lack of social support into account. Hence, being satisfied with one’s current relationship status (either having a partner or not) seems to be more important in explaining broader well-being constructs (such as life satisfaction and distress), as compared to considering marital status alone. ReSta is the first analog scale enabling comparisons between partnered and single individuals and adds explanatory value beyond marital status and other factors in predicting life satisfaction and distress

LV Distribution Network Feeders in Belgium and Power Quality Issues due to Increasing PV Penetration Levels

In this paper, the impact of residential distributed energy resources (DER) on the power quality is investigated in four feeder types of the electrical LV distribution network in Flanders, Belgium. The investigated power quality issues are over-voltage, under-voltage and unbalance. The results of the simulations are discussed in detail. The paper leads to an estimation of the compliance to the power quality standard EN 50160, and a summary of issues in the distribution grids when increasing the amount of DER.status: publishe

Virological response with fully active etravirine: Pooled results from the DUET-1 and DUET-2 trials

The objective of this subanalysis of the Phase III DUET trials was to examine virological response to an etravirine-containing regimen in patients harbouring virus fully sensitive to etravirine. Full etravirine sensitivity was defined as fold change in 50% effective concentration (FC) ≤3 or weighted genotypic score ≤2. At Week 48 in the etravirine group, 74% of patients with etravirine FC ≤3 and 77% with etravirine genotypic score ≤2 had viral load <50 HIV-1 RNA copies/mL, versus 48% and 46%, respectively, in the placebo group (P < 0.0001). Response rates increased with baseline phenotypic sensitivity score, but were consistently higher with etravirine (56-82%) than placebo (2-72%). Similar observations were made in patients harbouring virus with full etravirine and darunavir sensitivity. Our findings support current recommendations to include three active agents in treatment-experienced patients' regimens.SCOPUS: ar.jinfo:eu-repo/semantics/publishe