Measuring the clustering effect of the SARS-CoV-2 transmission in a school population: a cross-sectional study in a high incidence region.

Since the beginning of the pandemic, there has been a great deal of controversy regarding the role of schools in the spread of SARS-CoV-2 infection, and the relative contribution of students, teachers, and others. To quantify the clustering effect of SARS-CoV-2 infection within classes and schools considering the seroprevalence of specific antibodies among students and school staff (teachers and non-teachers) evaluated in schools located in the Northern region of Portugal. 1517 individuals (1307 students and 210 school staff) from 4 public and 2 private schools, comprising daycare to secondary levels, were evaluated. A rapid point-of-care test for SARS-CoV-2 specific IgM and IgG antibodies was performed and a questionnaire was completed providing sociodemographic and clinical information. We calculated the seroprevalence of IgM and IgG antibodies and estimated the Median Odds Ratio (OR) and 95% confidence interval (CI) to assess the clustering effect, using a multilevel (school and class) logistic regression. SARS-CoV-2 seroprevalence (IgM or IgG) was 21.8% and 23.8% (p = 0.575) in students and school staff, respectively. A total of 84 (8.6%) students and 35 (16.7%) school staff reported a previous molecular diagnosis. Among students, those who reported high-risk contacts only at school (OR = 1.13; 95% CI 0.72-1.78) had a seroprevalence similar to those without high-risk contacts; however, seroprevalence was significantly higher among those who only reported a high-risk contact outside the school (OR = 6.56; 95% CI 3.68-11.72), or in both places (OR = 7.83; 95% CI 5.14-11.93). Similar associations were found for school staff. The median OR was 1.00 (95% CI 1.00, 1.38) at the school-level and 1.78 (95% CI 1.40, 2.06) at the class-level. SARS-CoV-2 seroprevalence was similar between students and staff, without a clustering effect observed at the school level, and only a moderate clustering effect documented within classes. These results indicate that the mitigation measures in the school environment can prevent the spread of class outbreaks to the remaining school community.

Tomographic Study of Femoral Positioning in Anterior Cruciate Ligament Reconstruction Using the Transtibial Technique.

Purpose: To analyze the location of the femoral tunnel by three-dimensional computed tomography (3D CT) of the lateral condyle in patients who underwent arthroscopic single-bundle anterior cruciate ligament (ACL) reconstruction, performed using a modified transtibial technique, and to compare the results with data from the literature. Materials and Methods: Seventeen patients with ACL lesions underwent modified transtibial ACL reconstruction. Postoperatively, 3D CT examinations were performed and the images were analyzed by the quadrant system described by Bernard and Hertel to define the femoral tunnel coordinates. Results: The mean value of femoral tunnel location coordinates was 37.1±5.9 in the horizontal plane and 23.9±7.5 in the vertical plane. Compared with other studies using the transtibial or transportal technique, femoral positioning was improved in the vertical plane. The outside-in technique provided the best results both in the vertical and horizontal planes. Conclusions: The modified transtibial technique was not effective for systematically anatomic femoral tunnel positioning; however, it was relatively better than the conventional transtibial technique.

Medical record review to recover missing data in a Portuguese birth cohort: agreement with self-reported data collected by questionnaire and inter-ratervariability

Objectives: To assess the yield of medical record review to recover missing data originally collected by questionnaire, to analyze the agreement between these two data sources and to determine interobservervariability in clinical record review.Methods: We analyzed data from a birth cohort of 8,127 women who were consecutively recruited aftergiving birth from 2005-2006. Recruitment was conducted at all public maternity units of Porto, Portugal.We reviewed the medical records of 3,657 women with missing data in the baseline questionnaire and assessed agreement between these two sources by using information from participants with data from both sources. Interobserver variability was assessed by using 400 randomly selected clinical records.Results: Data on pregnancy complications and maternal anthropometric parameters were successfully recovered. Agreement between the questionnaire and records in family history data was fair, particularlyfor cardiovascular disease [k = 0.27; 95% confidence interval (95%CI): 0.23-0.32]. The highest agreement was observed for personal history of diabetes (k = 0.82; 95%CI 0.70-0.93), while agreement for hypertension was moderate (k = 0.60; 95%CI 0.50-0.69). Discrepancies in prepregnancy body mass index classes were observed in 10.3% women. Data were highly consistent between the two reviewers, with the highestagreement found for gestational diabetes (k = 1.00) and birth weight (99.5% concordance).Conclusion: Data from the medical records and questionnaire were concordant with regard to pregnancyand well-known risk factors. The low interobserver variability did not threaten the precision of our data

Objetivo: Evaluar el rendimiento de la revisión de registros médicos para completar datos originalmente recogidos por cuestionario, y analizar la concordancia entre ambas fuentes de datos y la variabilidad interobservador en la revisión de registros médicos. Métodos: Cohorte de nacimiento con 8.127 mujeres reclutadas de forma consecutiva después del parto en todas las maternidades públicas de Porto, Portugal (2005-2006). Se revisaron los registros médicos de3.657 mujeres con datos incompletos en el cuestionario inicial, y se evaluó la concordancia entre ambas fuentes. La variabilidad interobservador se evaluó en 400 historias clínicas seleccionadas aleatoriamente. Resultados: La información sobre complicaciones patológicas del embarazo y la antropometría de las madres se recuperó con éxito. La concordancia entre el cuestionario y los registros con respecto a los antecedentes familiares era débil, especialmente para las enfermedades cardiovasculares (k = 0,27, intervalo de confianza del 95% [IC95%]: 0,23-0,32). La concordancia máxima se observó en los antecedentes personales de diabetes (k = 0,82, IC95%: 0,70-0,93), mientras que para la hipertensión fue moderada(k = 0,60, IC95%: 0,50-0,69). Se observaron discrepancias en las categorías de índice de masa corporalantes del embarazo en el 10,3% de las mujeres. Los datos fueron muy concordantes entre los revisores,con el máximo nivel de concordancia para la diabetes gestacional (k = 1,00), seguida del peso al nacer(99,5% concordantes).Conclusión: Los registros médicos y la información del cuestionario fueron concordantes para los datos relacionados con el embarazo y los factores de riesgo conocidos. La baja variabilidad interobservador no pone en peligro la precisión de los datos. (AU)

Medical record review to recover missing data in a Portuguese birth cohort: agreement with self-reported data collected by questionnaire and inter-rater variability.

OBJECTIVES: To assess the yield of medical record review to recover missing data originally collected by questionnaire, to analyze the agreement between these two data sources and to determine interobserver variability in clinical record review. METHODS: We analyzed data from a birth cohort of 8,127 women who were consecutively recruited after giving birth from 2005-2006. Recruitment was conducted at all public maternity units of Porto, Portugal. We reviewed the medical records of 3,657 women with missing data in the baseline questionnaire and assessed agreement between these two sources by using information from participants with data from both sources. Interobserver variability was assessed by using 400 randomly selected clinical records. RESULTS: Data on pregnancy complications and maternal anthropometric parameters were successfully recovered. Agreement between the questionnaire and records in family history data was fair, particularly for cardiovascular disease [k=0.27; 95% confidence interval (95%CI): 0.23-0.32]. The highest agreement was observed for personal history of diabetes (k=0.82; 95%CI 0.70-0.93), while agreement for hypertension was moderate (k=0.60; 95%CI 0.50-0.69). Discrepancies in prepregnancy body mass index classes were observed in 10.3% women. Data were highly consistent between the two reviewers, with the highest agreement found for gestational diabetes (k=1.00) and birth weight (99.5% concordance). CONCLUSION: Data from the medical records and questionnaire were concordant with regard to pregnancy and well-known risk factors. The low interobserver variability did not threaten the precision of our data.