Rapid antigen testing in COVID-19 management for school-aged children: an observational study in Cheshire and Merseyside, UK.

BACKGROUND: Twice weekly lateral flow tests (LFTs) for secondary school children was UK Government policy from 8 March 2021. We evaluate use of LFTs (both supervised at test centres, and home test kits) in school-aged children in Cheshire and Merseyside. METHODS: We report (i) number of LFT positives (ii) proportion of LFT positive with confirmatory reverse transcription polymerase chain reaction (PCR) test within 2 days, and (iii) agreement between LFT-positive and confirmatory PCR, and dependence of (i-iii) on COVID-19 prevalence. FINDINGS: 1 248 468 LFTs were taken by 211 255 12-18 years old, and 163 914 by 52 116 5-11 years old between 6 November 2020 and 31 July 2021. Five thousand three hundred and fourteen (2.5%) 12-18 years old and 1996 (3.8%) 5-11 years old returned LFT positives, with 3829 (72.1%) and 1535 (76.9%) confirmatory PCRs, and 3357 (87.7%) and 1383 (90.1%) confirmatory PCR-positives, respectively.Monthly proportions of LFT positive with PCR negative varied between 4.7% and 35.3% in 12-18 years old (corresponding proportion of all tests positive: 9.7% and 0.3%).Deprivation and non-White ethnicity were associated with reduced uptake of confirmatory PCR. INTERPRETATION: Substantial inequalities in confirmatory testing need more attention to avoid further disadvantage through education loss. When prevalence is low additional measures, including confirmatory testing, are needed. Local Directors of Public Health taking more control over schools testing may be needed. FUNDING: DHSC, MRC, NIHR, EPSRC.

Association of SARS-CoV-2 viral load distributions with individual demographics and suspected variant type: results from the Liverpool community testing pilot, England, 6 November 2020 to 8 September 2021.

BackgroundThe PCR quantification cycle (Cq) is a proxy measure of the viral load of a SARS-CoV-2-infected individual.AimTo investigate if Cq values vary according to different population characteristics, in particular demographic ones, and within the COVID-19 pandemic context, notably the SARS-CoV-2 type/variant individuals get infected with.MethodsWe considered all positive PCR results from Cheshire and Merseyside, England, between 6 November 2020 and 8 September 2021. Cq distributions were inspected with Kernel density estimates. Multivariable quantile regression models assessed associations between people's features and Cq.ResultsWe report Cq values for 188,821 SARS-CoV-2 positive individuals. Median Cqs increased with decreasing age for suspected wild-type virus and Alpha variant infections, but less so, if not, for Delta. For example, compared to 30-39-year-olds (median age group), 5-11-year-olds exhibited 1.8 (95% CI: 1.5 to 2.1), 2.2 (95% CI: 1.8 to 2.6) and 0.8 (95% CI: 0.6 to 0.9) higher median Cqs for suspected wild-type, Alpha and Delta positives, respectively, in multivariable analysis. 12-18-year-olds also had higher Cqs for wild-type and Alpha positives, however, not for Delta. Overall, in univariable analysis, suspected Delta positives reported 2.8 lower median Cqs than wild-type positives (95% CI: 2.7 to 2.8; p < 0.001). Suspected Alpha positives had 1.5 (95% CI: 1.4 to 1.5; p < 0.001) lower median Cqs than wild type.ConclusionsWild-type- or Alpha-infected school-aged children (5-11-year-olds) might transmit less than adults (> 18 years old), but have greater mixing exposures. Smaller differences in viral loads with age occurred in suspected Delta infections. Suspected-Alpha- or Delta-infections involved higher viral loads than wild type, suggesting increased transmission risk. COVID-19 control strategies should consider age and dominant variant.

Changing patterns of SARS-CoV-2 infection through Delta and Omicron waves by vaccination status, previous infection and neighbourhood deprivation: a cohort analysis of 2.7 M people.

BACKGROUND: Our study examines if SARS-CoV-2 infections varied by vaccination status, if an individual had previously tested positive and by neighbourhood socioeconomic deprivation across the Delta and Omicron epidemic waves of SARS-CoV-2. METHODS: Population cohort study using electronic health records for 2.7 M residents in Cheshire and Merseyside, England (3rd June 2021 to 1st March 2022). Our outcome variable was registered positive test for SARS-CoV-2. Explanatory variables were vaccination status, previous registered positive test and neighbourhood socioeconomic deprivation. Cox regression models were used to analyse associations. RESULTS: Originally higher SARS-CoV-2 rates in the most socioeconomically deprived neighbourhoods changed to being higher in the least deprived neighbourhoods from the 1st September 2021, and were inconsistent during the Omicron wave. Individuals who were fully vaccinated (two doses) were associated with fewer registered positive tests (e.g., individuals engaged in testing between 1st September and 27th November 2021-Hazards Ratio (HR) = 0.48, 95% Confidence Intervals (CIs) = 0.47-0.50. Individuals with a previous registered positive test were also less likely to have a registered positive test (e.g., individuals engaged in testing between 1st September and 27th November 2021-HR = 0.16, 95% CIs = 0.15-0.18. However, the Omicron period saw smaller effect sizes for both vaccination status and previous registered positive test. CONCLUSIONS: Changing patterns of SARS-CoV-2 infections during the Delta and Omicron waves reveals a dynamic pandemic that continues to affect diverse communities in sometimes unexpected ways.

Enhanced lateral flow testing strategies in care homes are associated with poor adherence and were insufficient to prevent COVID-19 outbreaks: results from a mixed methods implementation study.

INTRODUCTION: Care homes have been severely affected by the SARS-CoV-2 pandemic. Rapid antigen testing could identify most SARS-CoV-2 infected staff and visitors before they enter homes. We explored implementation of staff and visitor testing protocols using lateral flow devices (LFDs). METHODS: An evaluation of a SARS-CoV-2 LFD-based testing protocol in 11 care homes in Liverpool, UK, including staff and visitor testing, plus a qualitative exploratory study in nine of these homes. The proportion of pilot homes with outbreaks, and outbreak size, were compared to non-pilot homes in Liverpool. Adherence to testing protocols was evaluated. Fifteen staff were interviewed, and transcript data were thematically coded using an iterative analysis to identify and categorize factors influencing testing implementation. RESULTS: In total, 1,638 LFD rapid tests were performed on 407 staff. Protocol adherence was poor with 8.6% of staff achieving >75% protocol adherence, and 25.3% achieving $\ge$50%. Six care homes had outbreaks during the study. Compared to non-pilot care homes, there was no evidence of significant difference in the proportion of homes with outbreaks, or the size of outbreaks. Qualitative data showed difficulty implementing testing strategies due to excessive work burden. Factors influencing adherence related to test integration and procedural factors, socio-economic factors, cognitive overload and the emotional value of testing. CONCLUSION: Implementation of staff and visitor care home LFD testing protocols was poorly adhered to and consequently did not reduce the number or scale of COVID-19 outbreaks. More focus is needed on the contextual and behavioural factors that influence protocol adherence.

Saturated and trans-fatty acids in UK takeaway food.

The aim of the study was to analyze the saturated fatty acid (SFA) and trans-fatty acid (TFA) contents of popular takeaway foods in the UK (including English, pizza, Chinese, Indian and kebab cuisine). Samples of meals were analyzed by an accredited public analyst laboratory for SFA and TFA. The meals were highly variable for SFA and TFA. English and Pizza meals had the highest median amount of SFA with 35.7 g/meal; Kebab meals were high in TFA with up to 5.2 g/meal. When compared to UK dietary reference values, some meals exceeded SFA and TFA recommendations from just one meal. Takeaway food would be an obvious target to reduce SFA and TFA contents and increase the potential of meeting UK recommendations. Strategies such as reformulation and smaller takeaway portion sizes warrant investigation.

Assessing measurement invariance of the Personal Growth Initiative Scale-II among Hispanics, African Americans, and European Americans.

This study tested the cross-cultural validity of scores on the Personal Growth Initiative Scale-II (PGIS-II; Robitschek et al., 2012) with Hispanic, African American, and European American community samples. Multigroup confirmatory factor analyses were performed on data from 218 Hispanics, 129 African Americans, and 552 European Americans to examine measurement equivalence among these groups. Measurement invariance of the PGIS-II was established with the original 4 factors of readiness for change, planfulness, using resources, and intentional behavior. These findings suggest the PGIS-II can be administered across these groups and provide meaningful comparisons and interpretations. All samples yielded good internal consistency estimates. The African American sample reported higher means than Hispanic and European American samples for all subscale and total mean scores, and Hispanics scored higher in planfulness, readiness for change, and total score than European Americans, indicating potential cultural factors influencing the scores. Implications for research and clinical practice are discussed.

Relations between macroinvertebrates, nutrients, and water quality criteria in wadeable streams of Maryland, USA.

In an ongoing effort to propose biologically protective nutrient criteria, we examined how total nitrogen (TN) and its forms were associated with macroinvertebrate communities in wadeable streams of Maryland. Taxonomic and functional metrics of an index of biological integrity (IBI) were significantly associated with multiple nutrient measures; however, the highest correlations with nutrients were for ammonia-N and nitrite-N and among macroinvertebrate measures were for Beck's Biotic Index and its metrics. Since IBI metrics showed comparatively less association, we evaluated how macroinvertebrate taxa related to proposed nutrient criteria previously derived for those same streams instead of developing nutrient-biology thresholds. We identified one tolerant and three intolerant taxa whose occurrence appeared related to a TN benchmark. Individually, these taxa poorly indicated whether streams exceeded the benchmark, but combining taxa notably improved classification rates. We then extracted major physiochemical gradients using principal components analysis to develop models that assessed their influence on nutrient indicator taxa. The response of intolerant taxa was predominantly influenced by a nutrient-forest cover gradient. In contrast, habitat quality had a greater effect on tolerant taxa. When taxa were aggregated into a nutrient sensitive index, the response was primarily influenced by the nutrient-forest gradient. Multiple lines of evidence highlight the effects of excessive nutrients in streams on macroinvertebrate communities and taxa in Maryland, whose loss may not be reflected in metrics that form the basis of biological criteria. Refinement of indicator taxa and a nutrient-sensitive index is warranted before thresholds in aquatic life to water quality are quantified.

COVID-19 vaccine hesitancy in care home staff: A survey of Liverpool care homes.

Uptake of COVID-19 vaccine first doses in UK care homes has been higher among residents compared to staff. We aimed to identify causes of lower COVID-19 vaccine uptake amongst care home staff within Liverpool. An anonymised online survey was distributed to all care home managers, between the 21st and the 29th January 2021. 53 % of 87 care homes responded. The overall COVID-19 vaccination rate was 52.6 % (n = 1119). Reasons, identified by care home managers for staff being unvaccinated included: concerns about lack of vaccine research (37.0 %), staff being off-site during vaccination sessions (36.5 %), pregnancy and fertility concerns (5.6 %), and allergic reactions concerns (3.2 %). Care home managers wanted to tackle vaccine hesitancy through conversations with health professionals, and provision of evidence dispelling vaccine misinformation. Vaccine hesitancy and logistical issues were the main causes for reduced vaccine uptake among care home staff. The former could be addressed by targeted training, and public health communication campaigns to build confidence and acceptance of COVID-19 vaccines.

'McDonalds and KFC, it's never going to happen': the challenges of working with food outlets to tackle the obesogenic environment.

BACKGROUND: Food outlets may make an important contribution to an obesogenic environment. This study investigated barriers and facilitators to public health work with food outlets in disadvantaged areas. METHODS: In-depth qualitative interviews with 36 directors, managers and public health service delivery staff in a coterminous primary care trust and local authority in northwest England. Data were analysed using the constant comparative method. RESULTS: Three interventions were available to engage with businesses; awards for premises that welcomed breastfeeding mothers or offered healthy menu options and local authority planning powers. Sensitivity to the potential conflict between activities that generate profit and those that promote health, led to compromises, such as awards for cafés that offer only one healthy option on an otherwise unhealthy menu. An absence of existing relationships with businesses and limited time were powerful disincentives to action, leading to greater engagement with public rather than private sector organizations. Hiring staff with commercial experience and incentives for businesses were identified as useful strategies, but seldom used. CONCLUSIONS: Encouraging food outlets to contribute to tackling the obesogenic environment is a major challenge for local public health teams that requires supportive national policies. Commitment to engage with the local public health service should be part of any national voluntary agreements with industry.

Development and psychometric evaluation of the Personal Growth Initiative Scale-II.

The original Personal Growth Initiative Scale (PGIS; Robitschek, 1998) was unidimensional, despite theory identifying multiple components (e.g., cognition and behavior) of personal growth initiative (PGI). The present research developed a multidimensional measure of the complex process of PGI, while retaining the brief and psychometrically sound properties of the original scale. Study 1 focused on scale development, including theoretical derivation of items, assessing factor structure, reducing number of items, and refining the scale length using samples of college students. Study 2 consisted of confirmatory factor analysis with 3 independent samples of college students and community members. Lastly, Study 3 assessed test-retest reliability over 1-, 2-, 4-, and 6-week periods and tests of concurrent and discriminant validity using samples of college students. The final measure, the Personal Growth Initiative Scale-II (PGIS-II), includes 4 subscales: Readiness for Change, Planfulness, Using Resources, and Intentional Behavior. These studies provide exploratory and confirmatory evidence for the 4-factor structure, strong internal consistency for the subscales and overall score across samples, acceptable temporal stability at all assessed intervals, and concurrent and discriminant validity of the PGIS-II. Future directions for research and clinical practice are discussed.

Impact of community asymptomatic rapid antigen testing on covid-19 related hospital admissions: synthetic control study.

OBJECTIVE: To analyse the impact of voluntary rapid testing for SARS-CoV-2 antigen in Liverpool city on covid-19 related hospital admissions. DESIGN: Synthetic control analysis comparing hospital admissions for small areas in the intervention population with a group of control areas weighted to be similar for past covid-19 related hospital admission rates and sociodemographic factors. SETTING: Liverpool city, UK, 6 November 2020 to 2 January 2021, under the intervention of Covid-SMART (systematic meaningful asymptomatic repeated testing) voluntary, open access supervised self-testing with lateral flow devices, compared with control areas selected from the rest of England. POPULATION: General population of Liverpool (n=498 042) and a synthetic control population from the rest of England. MAIN OUTCOME MEASURE: Weekly covid-19 related hospital admissions for neighbourhoods in England. RESULTS: The introduction of community testing was associated with a 43% (95% confidence interval 29% to 57%) reduction (146 (96 to 192) in total) in covid-19 related hospital admissions in Liverpool compared with the synthetic control population (non-adjacent set of neighbourhoods with aggregate trends in covid-19 hospital admissions similar to Liverpool) for the initial period of intensive testing with military assistance in national lockdown from 6 November to 3 December 2020. A 25% (11% to 35%) reduction (239 (104 to 333) in total) was estimated across the overall intervention period (6 November 2020 to 2 January 2021), involving fewer testing centres, before England's national roll-out of community testing, after adjusting for regional differences in tiers of covid-19 restrictions from 3 December 2020 to 2 January 2021. CONCLUSIONS: The city-wide pilot of community based asymptomatic testing for SARS-CoV-2 was associated with substantially reduced covid-19 related hospital admissions. Large scale asymptomatic rapid testing for SARS-CoV-2 could help reduce transmission and prevent hospital admissions.

The Orthopaedic Sports Medicine Fellowship Application Process: An Analysis of the Applicant Experience.

PURPOSE: To evaluate the process of applying to orthopaedic sports medicine fellowships from the applicant's perspective, with a focus on number of program applications, interviews, interview day importance, and financial burden. METHODS: An anonymous electronic survey was distributed to all orthopaedic surgery residents who applied to orthopaedic sports medicine fellowships in the United States in 2016 and 2017. The survey contained 26 questions, with 10 pertaining to applicant demographics, accolades, and examination scores. A follow up e-mail was distributed at 2 and 4 weeks to increase participation. RESULTS: The survey was distributed to 453 sports medicine fellowship applicants; 148 (34.1%) completed the survey. Of the respondents, 130 (87.8%) were male and 18 (12.2%) were female. When analyzing United States Medical Licensing Examination scores, respondents who scored above a 251 on Step 2 CK were more likely to receive more than 20 interviews compared with those who scored lower (P = .013). Previous collegiate or professional athlete status did not influence the number of interviews received. In total, 94 of 147 (64.0%) respondents applied to more than 20 programs, and 73 respondents (49.7%) attended between 11 and 15 interviews. The majority of respondents spent between $4001 and $6000 (49; 33.1%) throughout the application process. Interaction with faculty and case volume/complexity were the most important factors in ranking programs. CONCLUSIONS: The majority of orthopaedic surgery residents pursue at least 1 year of fellowship training following residency, with sports medicine being one of the most popular specialties. The application process for sports medicine fellowships is complex, competitive, and a financial burden for applicants. Most applicants apply to more than 20 programs, spend between $4000 and $6,000 over the course of the application process, and value faculty interaction and case volume/complexity over other factors associated with a program. CLINICAL RELEVANCE: As other surgical fellowships have detailed their application process from the applicant's perspective, there remains a need for increased transparency of the sports medicine fellowship application in order to offer additional insight and guidance for future applicants.

Evaluating social and spatial inequalities of large scale rapid lateral flow SARS-CoV-2 antigen testing in COVID-19 management: An observational study of Liverpool, UK (November 2020 to January 2021).

BACKGROUND: Large-scale asymptomatic testing of communities in Liverpool (UK) for SARS-CoV-2 was used as a public health tool for containing COVID-19. The aim of the study is to explore social and spatial inequalities in uptake and case-detection of rapid lateral flow SARS-CoV-2 antigen tests (LFTs) offered to people without symptoms of COVID-19. METHODS: Linked pseudonymised records for asymptomatic residents in Liverpool who received a LFT for COVID-19 between 6th November 2020 to 31st January 2021 were accessed using the Combined Intelligence for Population Health Action resource. Bayesian Hierarchical Poisson Besag, York, and Mollié models were used to estimate ecological associations for uptake and positivity of testing. FINDINGS: 214 525 residents (43%) received a LFT identifying 5192 individuals as positive cases of COVID-19 (1.3% of tests were positive). Uptake was highest in November when there was military assistance. High uptake was observed again in the week preceding Christmas and was sustained into a national lockdown. Overall uptake were lower among males (e.g. 40% uptake over the whole period), Black Asian and other Minority Ethnic groups (e.g. 27% uptake for 'Mixed' ethnicity) and in the most deprived areas (e.g. 32% uptake in most deprived areas). These population groups were also more likely to have received positive tests for COVID-19. Models demonstrated that uptake and repeat testing were lower in areas of higher deprivation, areas located further from test sites and areas containing populations less confident in the using Internet technologies. Positive tests were spatially clustered in deprived areas. INTERPRETATION: Large-scale voluntary asymptomatic community testing saw social, ethnic, digital and spatial inequalities in uptake. COVID-19 testing and support to isolate need to be more accessible to the vulnerable communities most impacted by the pandemic, including non-digital means of access. FUNDING: Department of Health and Social Care (UK) and Economic and Social Research Council.

Time marches on, but do the causal pathways driving instream habitat and biology remain consistent?

Stream ecosystems are complex networks of interacting terrestrial and aquatic drivers. To untangle these ecological networks, efforts evaluating the direct and indirect effects of landscape, climate, and instream predictors on biological condition through time are needed. We used structural equation modeling and leveraged a stream survey program to identify and compare important predictors driving condition of benthic macroinvertebrate and fish assemblages. We used data resampled 14 years apart at 252 locations across Maryland, USA. Sample locations covered a wide range of conditions that varied spatiotemporally. Overall, the relationship directions were consistent between sample periods, but their relative strength varied temporally. For benthic macroinvertebrates, we found that the total effect of natural landscape (e.g., elevation, longitude, latitude, geology) and land use (i.e., forest, development, agriculture) predictors was 1.4 and 1.5 times greater in the late 2010s compared to the 2000s. Moreover, the total effect of water quality (e.g., total nitrogen and conductivity) and habitat (e.g., embeddedness, riffle quality) was 1.2 and 4.8 times lower in the 2010s, respectively. For fish assemblage condition, the total effect of land use-land cover predictors was 2.3 times greater in the 2010s compared to the 2000s, while the total effect of local habitat was 1.4 times lower in the 2010s, respectively. As expected, we found biological assemblages in catchments with more agriculture and urban development were generally comprised of tolerant, generalist species, while assemblages in catchments with greater forest cover had more-specialized, less-tolerant species (e.g., Ephemeroptera, Plecoptera, and Trichoptera taxa, clingers, benthic and lithophilic spawning fishes). Changes in the relative importance of landscape and land-use predictors suggest other correlated, yet unmeasured, proximal factors became more important over time. By untangling these ecological networks, stakeholders can gain a better understanding of the spatiotemporal relationships driving biological condition to implement management practices aimed at improving stream condition.

Novel point-of-care test for simultaneous detection of nontreponemal and treponemal antibodies in patients with syphilis.

We describe a point-of-care immunochromatographic test for the simultaneous detection of both nontreponemal and treponemal antibodies in the sera of patients with syphilis that acts as both a screening and a confirmatory test. A total of 1,601 banked serum samples were examined by the dual test, and the results were compared to those obtained using a quantitative rapid plasma reagin (RPR) test and the Treponema pallidum passive particle agglutination (TP-PA) assay. Compared to the RPR test, the reactive concordance of the dual test nontreponemal line was 98.4% when the RPR titers of sera were ≥1:2 and the nonreactive concordance was 98.6%. Compared to the TP-PA assay, the reactive and nonreactive concordances of the treponemal line were 96.5% and 95.5%, respectively. These results indicate that the dual test could be used for the serological diagnosis of syphilis in primary health care clinics or resource-poor settings and therefore improve rates of treatment where patients may fail to return for their laboratory results.

What Are We Measuring? A Systematic Review of Outcome Measurements Used in Shoulder Surgery.

PURPOSE: The purpose of this study was to identify the most commonly used outcome measurements following shoulder surgery and to investigate demographic variables related to their use. METHODS: PubMed and Embase were searched to identify studies in which at least 1 shoulder-specific outcome measurement was used. Exclusion criteria included duplicate studies, review articles, lack of surgical arm, written in a language other than English, or not adult-specific. Additionally, surgeries were subcategorized based on the type of pathology leading to surgery. RESULTS: Of the 589 articles identified in the search, 180 met the inclusion criteria. A total of 35 shoulder-specific outcome measurements were reported. The Constant-Murley score (CMS), American Shoulder and Elbow Surgeons Shoulder Score (ASES), Subjective Shoulder Value (SSV), Simple Shoulder Test (SST), and University of California Los Angeles Score (UCLA) were used in more than 10% of the articles. The CMS and SSV were used more commonly together than individually (P = .0074). Additionally, the ASES (P < .00001) and CMS (P = .0109) were associated with the country of origin of the article. The SST was used more frequently in randomized control trials (P = .0287). The ASES and DASH were associated with surgeries categorized under the degenerative indication (P = .001 and P = .0146). Finally, the SSV, ASES and DASH were all found to be significantly paired with surgeries that indicated traumatic pathology (P = .0061, P = .0077 and P = .0069, respectively). CONCLUSIONS: There is great variability among the outcome measurements currently being used for assessing function following orthopaedic shoulder surgery; however, 5 scoring systems are used more frequently than others. There remains a large discrepancy between the ideal reporting, as noted in the recent literature review, and the current state of outcomes reported at this time. CLINICAL RELEVANCE: By identifying and evaluating the heterogeneity of the reporting and the usage of the performance indicators, these results can guide the standardization of outcome measurements in shoulder surgery and allow for better comparability when assessing outcomes between patients and studies.

Psychological Readiness to Return to Sport Following Anterior Cruciate Ligament Reconstruction.

Anterior cruciate ligament (ACL) tears are among the most common athletic injuries in the United States, and reconstruction is often necessary for athletes to be able to return to their pre-injury level of sport. Following ACL reconstruction, many athletes are not able to return to sport. A number of factors have been identified that could account for the return-to-sport discrepancy; however, psychological readiness can have an important influence on an athlete's ability to return to sport. Various interventions aimed at improving psychological factors have shown mixed results, although overall they seem promising. Sociodemographic factors (e.g., age, sex, and race) appear to have an influence on psychological readiness to return to sport; however, little research has been conducted on this topic.

Debranchase-resistant labeling of RNA using the 10DM24 deoxyribozyme and fluorescent modified nucleotides.

The 10DM24 deoxyribozyme can site-specifically label RNAs with fluorophore-GTP conjugates; however, the 2',5'-branched RNA linkage is readily cleaved by debranchase. To prevent loss of labels upon cleavage, we synthesized phosphorothioate-modified, fluorescent GTP derivatives and elaborated conditions for their incorporation by 10DM24. RNAs labeled with fluorescent derivatives of Sp-GTPS were found to be resistant to debranchase.

Development of a Dual Path Platform (DPP®) immunoassay for rapid detection of Candida albicans in human whole blood and serum.

Candida albicans is an opportunistic pathogen which can lead to Candidiasis and blood-stream infections, resulting in a mortality rate near 40%. Given its high fatality and emerging pathogenicity, there is a strong need for the development of a rapid C. albicans diagnostic assay. Point-of-care devices, specifically lateral flow assays, are an attractive and often employed diagnostic modality for C. albicans detection. However, they lack the required performance characteristics needed for accurate pathogen detection and subsequent treatment options. Thus, we describe herein the utility of the Dual Path Platform (DPP®) device as an immunochromatographic Point-of-care assay for C. albicans. The limit of detection for hyphal and budding C. albicans in DPP® tests are reported to be as low as 7.94 × 10(5) whole cells/mL in human serum. C. albicans cells were detected with up to a 3.9 fold increase in sensitivity on DPP® when compared to conventional lateral flow modalities.

The cultural lens approach to evaluating cultural validity of psychological theory.

In this article, we introduce the cultural lens approach (CLA), a novel approach to evaluating the extent to which a psychological theory applies across cultural groups. The CLA requires scholars to apply their accumulated knowledge about cultural influences and differences (e.g., independent and interdependent self-construals; Markus & Kitayama, 1991) to the ways in which theoretical propositions are interpreted and operationalized. First we highlight three limitations in existing approaches to cultural validity and the ways in which the CLA addresses these limitations. Next, we articulate the five steps involved in the CLA and apply it to three different theories from social, vocational, and positive psychology to demonstrate its broad utility. In all cases, we highlight how applying the CLA can generate multiple novel testable hypotheses to stimulate future research and to advance knowledge that is culturally sensitive.