COVID-19: Rapid antigen detection for SARS-CoV-2 by lateral flow assay: A national systematic evaluation of sensitivity and specificity for mass-testing

Background Lateral flow device (LFD) viral antigen immunoassays have been developed around the world as diagnostic tests for SARS-CoV-2 infection. They have been proposed to deliver an infrastructure-light, cost-economical solution giving results within half an hour. Methods LFDs were initially reviewed by a Department of Health and Social Care team, part of the UK government, from which 64 were selected for further evaluation from 1st August to 15th December 2020. Standardised laboratory evaluations, and for those that met the published criteria, field testing in the Falcon-C19 research study and UK pilots were performed (UK COVID-19 testing centres, hospital, schools, armed forces). Findings 4/64 LFDs so far have desirable performance characteristics (orient Gene, Deepblue, Abbott and Innova SARS-CoV-2 Antigen Rapid Qualitative Test). All these LFDs have a viral antigen detection of >90% at 100,000 RNA copies/ml. 8951 Innova LFD tests were performed with a kit failure rate of 5.6% (502/8951, 95% CI: 5.1–6.1), false positive rate of 0.32% (22/6954, 95% CI: 0.20–0.48). Viral antigen detection/sensitivity across the sampling cohort when performed by laboratory scientists was 78.8% (156/198, 95% CI 72.4–84.3). Interpretation Our results suggest LFDs have promising performance characteristics for mass population testing and can be used to identify infectious positive individuals. The Innova LFD shows good viral antigen detection/sensitivity with excellent specificity, although kit failure rates and the impact of training are potential issues. These results support the expanded evaluation of LFDs, and assessment of greater access to testing on COVID-19 transmission. Funding Department of Health and Social Care. University of Oxford. Public Health England Porton Down, Manchester University NHS Foundation Trust, National Institute of Health Research

DETECTION OF SUBCLINICAL AUTONOMIC NEUROPATHY IN CONSTIPATED PATIENTS USING A SWEAT TEST

Erythromycin has been shown to be a powerful prokinetic of the gastrointestinal tract. Little is known about its value to improve motility and transit in gastrectomized patients. METHODS: Thirteen disease-free patients subjected to subtotal gastrectomy and 11 subjected to total gastrectomy for gastric cancer entered the study. Gastrointestinal transit of a standard 99mTc-labelled meal and fasting motility were studied before and after oral erythromycin. RESULTS: In patients who had subtotal gastrectomy mean(s.d.) gastric half-emptying time was 42(14) min before and 26(11) min after erythromycin (P = 0.011). Before erythromycin prolonged rhythmical contractions (3 per min) were recorded in eight patients, sporadic non-organized contractions in two and prolonged bursts of waves in one. After erythromycin, clustered waves resembling a migrating motor complex (MMC) appeared in eight patients, while rhythmic motor activity was unchanged in three. In patients who had total gastrectomy jejunal half-emptying time was 39(18) min before and 45(12) min after erythromycin. In eight patients, frequent MMCs were recorded, peristaltic in four, synchronous in one, antiperistaltic in two, with clusters of non-propagated waves in one. After erythromycin, longer peristaltic MMCs were recorded in three, antiperistaltic MMCs persisted in two, synchronous in one and clusters of non-propagated waves in two. CONCLUSION: Oral erythromycin improves gastrointestinal transit and motility after subtotal gastrectomy. The findings after total gastrectomy are controversial

Efeito da covariância genética aditivo-materna sobre estimativas de parâmetros genéticos e em avaliações genéticas de características de crescimento de animais Tabapuã Effect of additive genetic-maternal covariance on genetic parameter estimates and on genetic evaluation of growth traits of Tabapuã Zebu breed

Avaliou-se o efeito da covariância genética aditiva direto-materna sobre estimativas de parâmetros genéticos e sobre a predição e a ordenação de valores genéticos de animais da raça Tabapuã. Os parâmetros genéticos foram estimados com base em 19646, 14276, 10663 e 6172 registros de pesos ao nascimento e ajustados para 205, 365 e 550 dias de idade em análises unicaracterística, utilizando o programa computacional MTDREML, pelo método da máxima verossimilhança restrita livre de derivadas por modelos animal com ou sem a inclusão da covariância. As estimativas da covariância genética aditiva direto-materna foram, respectivamente, -0,08; -0,22; -0,10 e 0,34, para os pesos ao nascer e ajustados para 205, 365 e 550 dias de idade. As herdabilidades diretas e maternas obtidas sob modelo com a inclusão da covariância genética direto-materna foram, respectivamente, 0,31 e 0,10; 0,20 e 0,17; 0,20 e 0,06 e 0,17 e 0,01, para os mesmos pesos, enquanto sem a inclusão foram, respectivamente, 0,31 e 0,09; 0,18 e 0,14; 0,20 e 0,05 e 0,18 e 0,02. Os valores de correlação de posto entre os valores genéticos preditos pelos modelos com e sem a inclusão foram 0,999; 0,992; 0,999 e 0,998. As correlações de posto entre os valores genéticos maternos foram 0,999; 0,985; 0,992 e 0,771. A inclusão da covariância genética aditiva direto-materna não influenciou as estimativas dos parâmetros genéticos e teve efeito inexpressivo na ordenação dos valores genéticos dos pesos de animais da raça Tabapuã.<br>This study was carried out to evaluate the effect of additive genetic-maternal covariance on estimates of genetic parameters and on the prediction and ranking of breeding values of Tabapuã animals. Records of 19,646, 14,276, 10,663, and 6,176 birth weights and weights at 205, 365, and 550 days of age were used in univariate animal model analysis using MTDFREML software, including or not the additive genetic-maternal covariance in the models. The additive genetic-maternal covariance estimates were, respectively, -0.08, -0.22, -0.10, and 0.34 for birth weight and weights at 205, 365, and 550 days of age. The direct and maternal heritability estimates including the additive direct-maternal covariance were, respectively, 0.31, and 0.10; 0.31 and 0.20, and 0.17; and 0.20 and 0.06; and 0.17 and 0.01 for birth weight and weights at 205, 365, and 550 days of age, while without the additive direct-maternal covariance those values were, respectively, 0.31 and 0.09; 0.18 and 0.14; 0.20 and 0.05; .18 and 0.02. Rank correlation between predicted breeding values from two models for birth weight and weights at 205 and 550 days of age were, respectively, 0.999, 0.992, 0.999, and 0.998. For maternal genetic values, these estimated rank correlations were, respectively, 0.995, 0.985, 0.992, and 0.771. The inclusion of additive genetic-maternal covariance in the analysis did not affect genetic parameter estimates and had a very small effect on breeding values ranking of Tabapuã animals

Cigarette smoking gives more respiratory symptoms among women than among men The Nord-Trøndelag Health Study (HUNT)

STUDY OBJECTIVE—Studies have indicated that women are more vulnerable to the effect of tobacco smoking compared with men. The aim of this study was to explore the prevalence of reported respiratory symptoms and diseases according to smoking burden, age and sex.
DESIGN—Questionnaire in a cross sectional population based study.
SETTING—The BONT (Bronchial obstruction in Nord-Trøndelag) study is part of a comprehensive health survey of all inhabitants aged above 19 years in the county of Nord-Trøndelag, Norway, which was carried out from 1995 to 1997.
PARTICIPANTS—A total of 65 717 subjects, 71.3% of the total population aged 20-100, answered the main questionnaire.
MAIN RESULTS—In all, 12.7% men and 12.1% women reported episodes of wheezing or breathlessness during the past 12 months, 8.8% men and 8.4% women reported that they had or had had asthma, 7.5% men and 8.2% women had ever used asthma medication, and 4.0% men and 3.0% women reported chronic bronchitis. Thirty per cent of men and 31% of women were smokers, and average pack years of smoking were 15.9 and 10.3, respectively. Among previous and current smokers, significant more women reported episodes of wheezing or breathlessness, current asthma and persistent coughing compared with men with the same smoke burden (pack years) and daily number of cigarettes.
CONCLUSION—The prevalence of reported asthma and use of asthma medication was higher than reported in previous Scandinavian studies. Respiratory symptoms increased by smoking burden. Comparing the prevalence of symptoms and current asthma among women and men with the same smoke burden or daily cigarette consumption, women seemed to be more susceptible to the effect of tobacco smoking than men.


Keywords: asthma; chronic bronchitis; coughing; tobacco smokin