If you build it, will they use it? Use of a Digital Assistant for Self-Reporting of COVID-19 Rapid Antigen Test Results during Large Nationwide Community Testing Initiative

ImportanceWide-spread distribution of rapid-antigen tests is integral to the United States strategy to address COVID-19; however, it is estimated that few rapid-antigen test results are reported to local departments of health. ObjectiveTo characterize how often individuals in six communities throughout the United States used a digital assistant to log rapid-antigen test results and report them to their local Department of Health. DesignThis prospective cohort study is based on anonymously collected data from the beneficiaries of The Say Yes! Covid Test program, which distributed 3,000,000 rapid antigen tests at no cost to residents of six communities between April and October 2021. We provide a descriptive evaluation of beneficiaries use of digital assistant for logging and reporting their rapid antigen test results. Main Outcome and MeasuresNumber and proportion of tests logged and reported to the Department of Health through the digital assistant ResultsA total of 178,785 test kits were ordered by the digital assistant, and 14,398 households used the digital assistant to log 41,465 test results. Overall, a small proportion of beneficiaries used the digital assistant (8%), but over 75% of those who used it reported their rapid antigen test results to their state public health department. The reporting behavior varied between communities and was significantly different for communities that were incentivized for reporting test results (p < 0.001). In all communities, positive tests were less reported than negative tests (60.4% vs 75.5%; p<0.001). Conclusions and RelevanceThese results indicate that app-based reporting with incentives may be an effective way to increase reporting of rapid tests for COVID-19; however, increasing the adoption of the digital assistant is a critical first step.

Mini-XT, a miniaturized tagmentation-based protocol for efficient sequencing of SARS-CoV-2

IntroductionThe COVID-19 pandemic has highlighted the importance of whole genome sequencing (WGS) of SARS-CoV-2 to inform public health policy. By enabling definition of lineages it facilitates tracking of the global spread of the virus. The evolution of new variants can be monitored and knowledge of specific mutations provides insights into the mechanisms through which the virus increases transmissibility or evades immunity. To date almost one million SARS-CoV-2 genomes have been sequenced by members of the COVID-19 Genomics UK (COG-UK) Consortium. To achieve similar feats in a more cost-effective and sustainable manner in future, improved high throughput virus sequencing protocols are required. We have therefore developed a miniaturized library preparation protocol with drastically reduced consumable use and costs. MethodsSARS-CoV-2 RNA was amplified using the ARTIC nCov-2019 multiplex RT-PCR protocol and purified using a conventional liquid handling system. Acoustic liquid transfer (Echo 525) was employed to reduce reaction volumes and the number of tips required for a Nextera XT library preparation. Sequencing was performed on an Illumina MiSeq. ResultsWe present the Mini-XT miniaturized tagmentation-based library preparation protocol available on protocols.io (https://dx.doi.org/10.17504/protocols.io.bvntn5en). The final version of Mini-XT has been used to sequence 4,384 SARS-CoV-2 samples from N. Ireland with a COG-UK QC pass rate of 97.4%. Sequencing quality was comparable and lineage calling consistent for replicate samples processed with full volume Nextera DNA Flex (333 samples) or using nanopore technology (20 samples). SNP calling between Mini-XT and these technologies was consistent and sequences from replicate samples paired together in maximum likelihood phylogenetic trees. ConclusionThe Mini-XT protocol maintains sequence quality while reducing library preparation reagent volumes 8-fold and halving overall tip usage from sample to sequence to provide concomitant cost savings relative to standard protocols. This will enable more efficient high-throughput sequencing of SARS-CoV-2 isolates and future pathogen WGS.

Prevalence of vitamin D inadequacy and bone turnover markers concerning bone mineral density in older persons.

Owing to the early tooth loss in a large population, the need for removable prosthodontic therapy has widely increased. Loss of teeth can occur due to trauma, periodontal disease, dental caries, and/or oral health negligence. The removable prosthesis is preferred over other teeth replacement methods owing to its cost-effectiveness. However, due to continuous alveolar bone resorption, relining of the removable prosthesis is needed regularly. We aimed to assess the prevalence of vitamin D deficiency and bone turnover marker concerning bone mineral density. Eighty complete denture wearers either in the maxilla or in the mandible or both constituted the study sample. Before the study, all subjects were explained the procedures of the study, and informed consent was obtained before proceeding with the study. Subjects were instructed to provide an early morning sample in a fasting state as serum osteocalcin (OCN) and C-terminal telopeptide (C-Tx) have diurnal variations. Blood samples were collected, and samples were ruled out for 25-OH vitamin D, serum OCN, and C-TX. To determine the association between frequency of relining and bone turnover marker, the collected data were subjected to statistical evaluation. Significant correlations were seen between bone C-Tx, turnover markers (p<0.001), and frequency of denture relining and osteocalcin (p<0.001). No statistically significant effect of gender, vitamin D levels, age, calcium levels, vitamin D supplements, and diabetes was seen on denture relining frequency. The present study concludes that an elevated level of the bone turnover markers such as OCN and C-Tx increases the frequency of relining.

Awareness, perception and practice regarding orthodontic practice and principles among non orthodontic specialists- An exploratory research.

BACKGROUND: Non-orthodontics specialist should have the responsibility of taking care of the smiles of the patients. This also has the implications on the oral health of the patient. The present study was done to determine awareness, perception, and practice regarding orthodontic practice and principles among non-orthodontic specialists. MATERIALS AND METHODS: The present study is a cross-sectional descriptive questionnaire study conducted among non-orthodontic specialists working in private clinics. The survey was conducted in among 212 non-orthodontic specialists. In the present study a close ended interview schedule was prepared to perception and practice of Dental specialists. After entry of data in Microsoft excel 2007. SPSS version 19.0 is used to analyze the data. RESULTS: Dental specialists have moderate awareness, positive perception and poor practice regarding Orthodontic practice and principles. Awareness regarding, Orthodontic was significantly (P = 0.02*) associated with practice while Perception was significantly associated (P = 0.00*) with Awareness. Age group was significantly (P = 0.01**) associated with awareness of study participants. Specialty and year of practice of dental professional was significantly (P = 0.05*), (P = 0.00***) associated with perception regarding Orthodontic practice and principles. Number of Orthodontic patients treating per months was significantly associated (P = 0.00***) with Practice of study participants of Orthodontic practice and principles. CONCLUSION: From above it has been concluded that dental specialists has moderate awareness, positive perception and poor practice regarding Orthodontic practice and principles. Age group, type of Specialty, Year of practice and number of Orthodontic cases treated per month significantly associated with awareness, perception, and practice of dental professionals regarding Orthodontic practice and principles.

Perception of dental professionals regarding integration of dental auxiliary into dental health delivery system.

BACKGROUND: The practical solution to handle increasing awareness toward dental treatment and cost of the dental treatment is integration of dental auxiliary into dental healthcare delivery system, and hence the objective of this study was to assess the perception of dental professionals regarding integration of dental auxiliaries into dental health delivery system in India. MATERIALS AND METHODS: This cross-sectional study of Indian dentists was conducted using self-administered closed-ended questionnaire. Questions were asked to assess the opinions of the dentists on expanding the roles of dental auxiliaries and its consequences on dental services. The data were analyzed using Statistical Package for the Social Sciences version 22.0. The level of significance was kept at P < 0.05. RESULTS: Of 230 dentists who participated in the study, 155 (67.39%) reported unfavorable opinion toward expanded duty dental auxiliaries. Among the studied consequences of expanding the functions of dental auxiliaries, cost-effectiveness of treatment had the highest mean score, followed by redundancy of dentists. Undergraduates reported that expanded function dental auxiliaries would lead to redundancy of dentists. CONCLUSION: It is recommended to train the auxiliaries to meet the expectations of patients, but this should be considered keeping in mind the existing situation of dental professionals in the country. Nonetheless, this study gives us information necessary to tailor health policies and improve the standards of the existing oral healthcare delivery in India.

Effect of plasticizer on drug crystallinity of hydroxypropyl methylcellulose matrix film.

Effect of different hydrophilic plasticizers on drug crystallinity of hydroxypropyl methylcellulose (HPMC) matrix film was studied. HPMC films containing telmisartan using different plasticizers were prepared by casting method. Drug crystallinity in the films was examined using polarized light microscopy (PLM), scanning electron microscopy (SEM), and x-ray diffractometry (XRD) to describe their phase behavior/solid state miscibility/crystal growth and drug-polymer-plasticizer interaction. HPMC and plasticizer were compatible with the drug and no phase separation was observed upon solvent evaporation. Plasticized-HPMC contributed a major role in the significant inhibition of crystal growth of the drug in the film. The triethanolamine film produced a relatively smooth surface in comparison to the other films in the submicron level. The films have not shown any significant changes even after exposure to stress (40°C/75% RH, 6 w). Triethanolamine as plasticizer brought about amorphization of telmisartan to the maximum extent in the film which is technologically more advantageous than the others owing to its anticipated better bioavailability.