Home-based Test Research Articles

Screening and risk assessment for sleep-related breathing disorders in individuals living with spinal cord injury

ObjectivesThis research work was performed: (1) To assess the accessibility of in-laboratory polysomnography for individuals with spinal cord injury (SCI); (2) to evaluate the validity of four screening questionnaires for sleep-related breathing disorders (SRBDs); and (3) to assess the association between anthropometric features and apnea-hypopnea index (AHI). MethodsAn Environmental scan (E-scan) was performed in the province of Ontario, where all sleep clinics were invited to complete the E-scan survey. Furthermore, a cross-sectional study was performed at a rehabilitation hospital (Canada), where consecutive adults with subacute/chronic (>1 month) SCI were recruited. Using a home-based screening sleep test (HBSST), the validity of the Berlin, STOP, Medical Outcomes Study Sleep Scale [MOS-SS], and STOP-Bang screening questionnaires was assessed. The association between AHI and three features (i.e., neck circumference, body mass index [BMI] and oropharynx opening as assessed using the Modified Mallampati classification [MMC]) was evaluated. ResultsAccording to the E-scan, access to polysomnography is limited for the SCI population in Ontario. Of the 28 participants with SCI (11 females, 17 males; mean age: 54.9 years) included in the cross-sectional study, 32.1 % were diagnosed with moderate-to-severe SRBD. The performance of the questionnaires was considered insufficient for screening of individuals living with SCI. AHI was not associated with neck circumference, BMI, or MMC. ConclusionsThose results suggest that the use of a HBSST could overcome the barriers for individuals with SCI to access diagnostic testing of SRBDs. The use of screening questionnaires and risk assessment for SRBDs in the SCI population is unreliable.

Test-retest reliability of remote home-based audiometry in differing ambient noise conditions

BackgroundHome-based remote audiometry has been emerging due to the increasing accessibility of mobile technology and the need for healthcare solutions that are available worldwide. However, the challenges presented by uncontrolled conditions, such as noisy environments, could compromise the reliability of the hearing assessment.MethodIn this study, we evaluate the reliability of the Jacoti Hearing Center (JHC) smartphone application in differing ambient noise environments. Hearing test data were synchronized from the JHC application to the Jacoti earCloud database (JEC). We collected, de-identified, and analyzed real-world, home-based audiometric test data spanning from 2015 to 2023, extracted from the JEC database. A set of exclusion criteria was defined to perform data cleaning, ensuring the removal of incomplete and unreliable data, as well as, data from users who had completed a large number of tests. The final dataset comprised 9,421 test and retest threshold pairs from 1,115 users. Hearing tests conducted under relatively quiet and noisy conditions were categorized based on threshold-to-noise ratio.ResultsThe test-retest reliability of the JHC application demonstrated an average absolute difference of 4.7 dB within the range from 20 to 75 dB, ranging from 3.7 dB to 6.2 dB across frequencies. A strong positive correlation of 0.85 was found between test and retest thresholds. Moreover, the pure tone average differences were within 5 dB for 84.6% of the audiograms. No clinically significant effects of ambient noise were observed on thresholds determined between 20 and 75 dB HL.ConclusionsOur results demonstrate that the JHC application can provide reliable audiometric data for hearing loss, even in non-ideal acoustic conditions. This highlights the potential of home-based audiometric assessment, reinforcing the idea that, with continuous noise monitoring and noise-aware control of the testing procedure, remote audiometry can be reliable.

Feasibility and usefulness of cognitive monitoring using a new home-based cognitive test in mild cognitive impairment: a prospective single arm study

BackgroundThe risk of dementia is increased in subjects with mild cognitive impairment (MCI). Despite the plethora of in-person cognitive tests, those that can be administered over the phone are lacking. We hypothesized that a home-based cognitive test (HCT) using phone calls would be feasible and useful in non-demented elderly. We aimed to assess feasibility and validity of a new HCT as an optional cognitive monitoring tool without visiting hospitals.MethodsOur study was conducted in a prospective design during 24 weeks. We developed a new HCT consisting of 20 questions (score range 0–30). Participants with MCI (n = 38) were consecutively enrolled and underwent regular HCTs during 24 weeks. Associations between HCT scores and in-person cognitive scores and Alzheimer’s disease (AD) biomarkers were evaluated. In addition, HCT scores in MCI participants were cross-sectionally compared with age-matched cognitively normal (n = 30) and mild AD dementia (n = 17) participants for discriminative ability of the HCT.ResultsHCT had good intra-class reliability (test-retest Cronbach’s alpha 0.839). HCT scores were correlated with the Mini-Mental State Examination (MMSE), verbal memory delayed recall, and Stroop test scores but not associated with AD biomarkers. HCT scores significantly differed among cognitively normal, MCI, and mild dementia participants, indicating its discriminative ability. Finally, 32 MCI participants completed follow-up evaluations, and 8 progressed to dementia. Baseline HCT scores in dementia progressors were lower than those in non-progressors (p = 0.001).ConclusionThe feasibility and usefulness of the HCT were demonstrated in elderly subjects with MCI. HCT could be an alternative option to monitor cognitive decline in early stages without dementia.

S294 Measurement of Fecal Volatile Organic Compounds Using a Passive Electronic Nose: Home-Based Test

S294 Measurement of Fecal Volatile Organic Compounds Using a Passive Electronic Nose: Home-Based Test

Poster (Health Services, Economics and Policy Change) ID 1969166

Background We studied the feasibility of a home-based screening sleep test (HBSST), the validity of four questionnaires used to screen for sleep-related breathing disorders (SRBDs), and the potential association between SRBD and clinical features in individuals with spinal cord injury (SCI). Methods Adults with subacute/chronic (>1 month post-injury) SCI were recruited for the cross-sectional study and qualitative analysis. Feasibility of the HBSST was objectively evaluated and participants shared their experience. We also examined the validity of the Berlin, STOP, Medical Outcomes Study Sleep Scale [MOS-SS], and STOP-Bang screening questionnaires. We investigated the association between the degree of SRBD and three features (i.e., neck circumference, body mass index [BMI] and oropharynx opening as assessed using the Modified Mallampati classification [MMC]). Results There were 13 females and 18 males with ages varying from 20 to 86 years (mean age: 54.7 years) with motor complete (n=8) or incomplete SCI at cervical (n=21) or thoraco-lumbar levels. Time since SCI varied from 1.5 to 474 months. Overall, 28 individuals completed the HBSST and endorsed its feasibility. Mean apnea-hypopnea index (AHI) was 17.3 events/hour (range: 0.5-83.7). AHI was significantly correlated with Berlin (p=0.036) and STOP-Bang scores (p=0.009). There was no significant correlation between AHI and MOS-SS (p=0.348) or STOP (p=0.165). AHI was not associated with neck circumference (p=0.614), BMI (p=0.958), or MMC (p=0.335). Conclusions Our results suggest that HBSST is a feasible screening method, and Berlin and STOP-Bang are valid screening questionnaires for the SCI population. AHI was not correlated with BMI, neck circumference, or MMC.

Participation rate and yield of two home-based screening methods to detect increased albuminuria in the general population in the Netherlands (THOMAS): a prospective, randomised, open-label implementation study

Chronic kidney disease (CKD) has a rising global prevalence and is expected to become the fifth leading cause of death by 2030. Increased albuminuria defines the early stages of CKD and is among the strongest risk factors for progressive CKD and cardiovascular disease. The value of population screening for albuminuria to detect CKD in an early phase has yet to be studied. We aimed to evaluate the effectiveness of two home-based albuminuria population screening methods. Towards Home-based Albuminuria Screening (THOMAS) was a prospective, randomised, open-label implementation study that invited Dutch adults aged 45-80 years for albuminuria screening. Individuals were randomly assigned (1:1) to screening by applying either a urine collection device (UCD) that was sent by post to a central laboratory for measurement of the albumin-to-creatinine ratio (ACR) by immunoturbidimetry or to screening via a smartphone application that measures the ACR with a dipstick method at home. Randomisation was done with a four-block method via a web-based system and was stratified by age, sex, and socioeconomic status. If two or more individuals per household were invited to participate, these individuals were randomly assigned to the same group. In case of confirmed increased albuminuria at home, participants were invited for an elaborate screening in a regional hospital (Amphia Hospital, Breda, Netherlands) for CKD and cardiovascular risk factors. When abnormalities were found, participants were referred to their general practitioner for treatment. The primary outcomes were the participation rate and yield of the home-based screening and elaborate screening. Participation rate was assessed in the intention-to-screen population (ie, all participants who were invited for the home-based screening or elaborate screening). Yield was assessed in the per-protocol population (ie, all individuals who participated in the home-based screening or elaborate screening). An exploratory analysis assessed the sensitivity and specificity of both home-based screening methods. To this end, an additional quantitative ACR test was performed among people participating in the elaborate screening, and a substudy was performed among participants with a first negative home-based screening test, who were invited for an additional test. The study is registered with ClinicalTrials.gov, NCT04295889. 15 074 participants were enrolled between Nov 14, 2019, and March 19, 2021. 7552 (50·1%) were randomly assigned to home-based albuminuria screening by the UCD method and 7522 (49·9%) were assigned to albuminuria screening by the smartphone application method. The participation rate of the home-based screening was 4484 (59·4% [95% CI 58·3-60·5]) of the 7552 invited individuals for the UCD method and 3336 (44·3% [43·2-45·5]) of 7522 invited individuals for the smartphone application method (p<0·0001). Increased ACR was confirmed by home-based testing in 150 (3·3% [95% CI 2·9-3·9]) of 4484 individuals for the UCD method and 171 (5·1% [4·4-5·9]) of 3336 indivduals for the smartphone application method. 124 (82·7% [95% CI 75·8-87·9]) of 150 individuals assigned to the UCD method and 142 (83·0% [76·7-87·9]) of 171 participants assigned to the smartphone application method attended the elaborate screening. Sensitivity to detect increased ACR was 96·6% (95% CI 91·5-99·1) for the UCD method and 98·1% (89·9-99·9) for the smartphone application method, and specificity was 97·3% (94·7-98·8) for the UCD method and 67·9% (62·0-73·3) for the smartphone application method, indicating that the test characteristics of only the UCD method were sufficient for screening. Albuminuria, hypertension, hypercholesterolaemia, and decreased kidney function were newly diagnosed in 77 (62·1%), 44 (35·5%), 30 (24·2%), and 27 (21·8%) of 124 participants for the UCD method, respectively. Of the 124 participants assigned to the UCD method who completed elaborate screening, 111 (89·5%) were referred to their general practitioner for treatment because of newly diagnosed CKD or cardiovascular disease risk factors or known risk factors outside the target range. Home-based screening of the general population for increased ACR using a UCD had a high participation rate and correctly identified individuals with increased albuminuria and yet unknown or known but outside target range CKD and cardiovascular risk factors. By contrast, the smartphone application method had a lower at-home participation rate than the UCD method and the test specificity was too low to accurately assess individuals for risk factors during the elaborate screening. The UCD screening strategy could allow for an early start of treatment to prevent progressive kidney function loss and cardiovascular disease in patients with CKD. Dutch Kidney Foundation, Top Sector Life Sciences & Health of the Dutch Ministry of Economic Affairs.

Smartphone-based Sickle Cell Disease Detection and Monitoring for Point-of-Care Settings

Abstract: Sickle cell disease (SCD), a haematological illness that affects people all over the world, can lead to painful episodes, anaemia, organ damage, stroke, and even death. Sub-Saharan Africa and other nations with scarce resources are where it is more prevalent. Traditional laboratory-based diagnostic techniques for SCD are laborious, complicated, and unable to be completed at the point-of-care (POC) and at home. To distinguish between sickled and normal red blood cells (RBCs), optical microscope-based classification and counting requires a large amount of time, expensive setup, and experienced human labour. The need for a POC and home-based test to detect and track SCD and lower mortality in areas with limited resources exists. The effective therapy of SCD can benefit from an early and prompt diagnosis. This article discusses For the purpose of taking RBC photos from the SCD patients under normoxia and hypoxia, we used a smartphone-based image capture technique. To distinguish RBCs from the patient's blood before and after cell sickling, a computer algorithm is created. We acquired the same percentage of sickle cells in blood samples using the developed smartphone-based technology as those obtained using the traditional method (standard microscope). The created testing technique demonstrates the Potential savings from using a smartphone to administer the test could lower the entire cost of diagnosing and treating SCD, making the procedure more useful in environments with limited resources. Our system is very helpful in determining the seriousness of the SCD and does not call for any specific storage requirements. This is the distinguishing benefit of our method over previous hemoglobin-based POC diagnostic methods

Factors affecting post-vasectomy semen analysis compliance in home- and lab-based testing.

We used a home-based (HB) post-vasectomy semen analysis (PVSA) between 2014 and 2017, but we have since reverted to local lab-based (LB) testing. In this study, we compared PVSA compliance rates in HB and LB test settings and describe factors that may influence completion rates. We retrospectively identified patients who underwent vasectomy at our institution. Surgeons X and Y performed vasectomies from 2014-2017 using a HB immunochromatographic PVSA kit. From 2017-2020, surgeon X used a local LB PVSA. We collected data on PVSA completion status and patient demographics to perform two analyses. HB testing was examined by assessing all patients who had a vasectomy from 2014-2017. Another compared HB and LB testing by looking at surgeon X vasectomies from 2014-2017 and 2017-2020. We identified 285 patients who underwent vasectomy from 2014-2017 and were assessed with HB testing. Compliance with PVSA was 35% with HB PVSA. Age at vasectomy, number of children, and surgeon influenced PVSA completion in the 2014-2017 cohort. Surgeon X PVSA completion was 29% for the HB (n=136) testing cohort and 46% for the LB (n=201) cohort (odds ratio 0.47, 95% confidence interval 0.29-0.74). Again, more children decreased PVSA completion. Compliance with PVSA testing was inadequate in both test settings, although it was significantly higher in local LB setting. Based on these findings, the convenience of HB testing appears to decrease compliance with PVSA, although surgeon factors may be influential. These findings may help surgeons identify factors that improve PVSA compliance rates.

Evaluating interventions to reduce behaviour associated with HCV reinfection in men who have sex with men: study protocol for a non-blinded, phase 2, randomised trial

BackgroundAs highly effective therapy against hepatitis C virus (HCV) infection is available with rapid uptake, there is newfound optimism for HCV elimination. Nevertheless, certain key populations have a high risk of HCV reinfection, in particular men who have sex with men (MSM) in Western European countries. Modelling data indicate that HCV elimination will not be feasible without reduction in risk behaviour, thus supporting the need for effective interventions aimed at reducing risk behaviour and preventing reinfections in MSM.MethodsThe ICECREAM study is an international, multi-centred, phase 2, 3-arm randomised trial comparing run-in and intervention periods enrolling MSM with a history of a cured or spontaneously cleared HCV infection. Individuals are followed in routine care for 6 months (i.e. run-in period) and then randomly allocated (1:1:1) to one of the following: a tailored, interactive online risk-reduction behavioural intervention, a validated home-based HCV-RNA self-sampling test service using dried blood spots, or a combination of both. After randomisation, individuals are followed every 6 months until 18 months (i.e. intervention period). Interventions are delivered in addition to standard of care. Online questionnaire measuring risk behaviour over the past 6 months is administered at every visit. The primary outcome is the proportion at risk of HCV infection during run-in versus intervention periods assessed by using the HCV-MOSAIC risk score. The risk score consists of six self-reported HCV-related risk behaviours. Secondary outcomes include incidence of HCV reinfection, changes in the individual risk behaviour items and changes in sexual well-being since changes in sexual behaviour may have an impact on sexual experience. Two hundred forty-six MSM aged 18 years or older will be invited to participate.DiscussionThe ICECREAM study is a trial aimed at establishing interventions that could effectively decrease the incidence of HCV re-infection in MSM with a previous HCV infection. By offering an online behavioural risk-reduction intervention and HCV-RNA self-sampling, both of which are aimed to influence risk behaviour, we are able to provide products to at-risk MSM that could further reduce population-level HCV incidence and ultimately help reach HCV micro-elimination.Trial registrationClinicalTrials.gov NCT04156945. Registered on November 8, 2019

Development of a home-based cognitive test for cognitive monitoring in subjective cognitive decline with high risk of Alzheimer's disease.

Subjective cognitive decline (SCD) indicates a self-perceived persistent cognitive worsening despite of normal performance in standard neuropsychological tests. Owing to its heterogeneity and potential risk of Alzheimer's disease, baseline biomarkers to predict cognitive decline are important. In the present study, we developed a home-based cognitive test (HCT) to monitor cognitive changes regularly without visiting hospitals. This study aims to compare cognitive and biomarker trajectories during a 48-month period between amyloid positive SCD and amyloid negative SCD subjects. Data will be collected from a prospective observational cohort study conducted in South Korea. Eighty participants with SCD aged ≥ 60 years are eligible for the study. All participants undergo annual neuropsychological tests and neurological examinations, bi-annual brain MRI scans and plasma amyloid markers, and baseline florbetaben Positron Emission Tomography scans. The amyloid burden and regional volumes will be measured. Cognitive and biomarker changes will be compared between the amyloid-positive SCD and amyloid negative SCD groups. Validation would be performed to assess reliability and feasibility of HCT. This study would suggest a perspective on SCD in terms of cognitive and biomarker trajectories. Baseline characteristics and biomarker status might affect faster cognitive decline and future biomarker trajectories. In addition, HCT could be an alternative option of in-person neuropsychological tests to track cognitive changes without visiting hospitals.

Knowledge on Chlamydia trachomatis and Acceptance to Testing for It Among Young Students in China.

Actively screening for Chlamydia trachomatis (CT) is important for young people because of a high prevalence of asymptomatic infection in this population. This study aimed to investigate knowledge on CT and preference to the screening services for CT among young students in China. From June to July 2022, a web-based questionnaire survey was conducted to collect information on sociodemographic characteristics, sexual behaviors, knowledge of CT, previous testing for CT, and preference to platform of testing for CT among Chinese young students. An online home-based self-sampling test (HBSST) service was offered free of charge if the participant was willing to be tested for CT. Statistical analyses included descriptive analysis, χ 2 test, and multivariable logistic regression. Of 520 participants, 419 (80.6%) were aged between 16 and 24 years, 235 (45.2%) reported having sexual experience in the past, and 27 (5.2%) being tested before for CT. Slightly higher than 10% (57/520) of students were knowledgeable about CT. About one-third (36.9%) expressed their willingness to have a testing for CT but majority of them (63.1%) preferred to a free testing. Having sexual experience was significantly associated with the willingness to take the HBSST service (adjusted odds ratio, 2.96; 95% confidence interval, 1.92-4.58). A total of 139 (26.7%) participants requested the HBSST service online and 43.2% (60/139) returned the specimen for testing, in which 2 positives (3.3%) were found. The knowledge on CT and the previous uptake or current willingness to have a testing for CT was low among Chinese young students.

Can a conditional financial incentive (CFI) reduce socio-demographic inequalities in home-based HIV testing uptake? A secondary analysis of the HITS clinical trial intervention in rural South Africa

In sub-Saharan Africa, home-based HIV testing interventions are designed to reach sub-populations with low access to HIV testing such as men, younger or less educated people. Combining these interventions with conditional financial incentives (CFI) has been shown to be effective to increase testing uptake. CFI are effective for one-off health behaviour change but whether they operate differentially on different socio-demographic groups is less clear. Using data from the HITS trial in South Africa, we investigated whether a CFI was able to reduce existing home-based HIV testing uptake inequalities observed by socio-demographic groups. Residents aged ≥15 years in the study area were assigned to an intervention arm (16 clusters) or a control arm (29 clusters). In the intervention arm, individuals received a food voucher (∼3.5 US dollars) if they accepted to take a home-based HIV test. Testing uptake differences were considered for socio-demographic (sex, age, education, employment status, marital status, household asset index) and geographical (urban/rural living area, distance from clinic) characteristics. Among the 37,028 residents, 24,793 (9290 men, 15,503 women) were included in the analysis. CFI increased significantly testing uptake among men (39.2% vs 25.2%, p < 0.001) and women (45.9% vs 32.0%, p < 0.001) with similar absolute increase between men and women. Uptake was higher amongst the youngest or least educated individuals, and amongst single (vs in union) or unemployed men. Absolute uptake increase was also significantly higher amongst these groups resulting in increasing socio-demographic differentials for home-based HIV testing uptake. However, because these groups are known to have less access to other public HIV testing services, CFI could reduce inequalities for HIV testing access in our specific context. Although CFI significantly increased home-based HIV testing uptake, it did not do so differentially by socio-demographic group. Future interventions using CFI should make sure that the intervention alone does not increase existing health inequities.

The adapted Autonomic Profile (aAP) home-based test for the evaluation of neuro-cardiovascular autonomic dysfunction

Autonomic dysfunction is an increasingly recognised complication in chronic neurological conditions such as Parkinson’s disease, and other medical conditions, including diabetes mellitus, chronic fatigue syndrome, postural tachycardia syndrome (PoTS) with and without Ehlers-Danlos syndrome, fibromyalgia and recently Long COVID. Despite laboratory-based tests to evaluate normal and abnormal autonomic function, there are no home-based tests to record neuro-cardiovascular autonomic responses to common stimuli in daily life that are dependent on normal functioning of the autonomic nervous system. We have developed an adapted blood pressure/heart rate Autonomic Profile (aAP) that can be used by an individual independently and repeatedly in a domiciliary setting to determine the physiological and symptomatic response to standing, food, and physical or mental (cognitive, emotional) activities. The aAP aids separating autonomic failure (often irreversible) from autonomic dysfunction. This helps the individual and attending healthcare professional understand the relationship between symptoms and common triggers in daily life and informs on self-management in debilitating conditions such as the postural tachycardia syndrome (PoTS) and Long Covid.

Ectopic Pregnancy in A 28-year-old Woman with CuT IUCD in Situ – A Case Report

Background: There is a 3–4 percent chance of all pregnancies being ectopic in location. The risk of ectopic pregnancy to a woman using an Intrauterine Contraceptive Device (IUCD) is lower than that in a woman using no form of birth control. However if awoman gets pregnant whiles using the IUCD, the chances of having ectopic is more than 4 percent. Data on the occurrence of ectopic gestation with IUCD in situ is scanty, with no report of any such case in Ghana or West Africa. The objective of this report is therefore to contribute to knowledge on the subject with the view to bring it to attention among clinicians.Case: A 28year old woman (G3P1A+1) who has had copper IUCD in situ for over two years, reported to a health facility in Accra after missing her period for two weeks. She had performed a home-based urine pregnancy test on three separate occasions, and theywere all positive. A trans-vaginal ultrasound scan showed a small cystic lesion in the right adnexa with moderate fluid in the pouch of Douglas. A right tubal abortion was found at laparotomy.Conclusion: Ectopic pregnancy in women with an IUCD is an important major potential complication that can be life-threatening.Adequate counselling by clinicians would create awareness among clients for early reporting of amenorhoea and prompt intervention for desirable outcome.

Implementation of the Hanyu Shuiping Kaoshi and its Home Edition During the Covid-19 Pandemic: A Survey of European Test Centres

The Hanyu Shuiping Kaoshi (HSK) test is a standardized Chinese language proficiency test targeting non-native speakers. Compared with other Chinese proficiency tests, the HSK has the largest test population in the world and has attracted the most academic research. This article examines how the HSK was carried out during the Covid-19 pandemic and the issues facing home-based HSK test, the so-called HSK Home Edition. The results of a primary survey showed that the majority of test centres in Europe opted to implement the traditional paper-based format of the HSK during the Covid-19 pandemic, despite the availability of the HSK Home Edition. Concerns related to technical and security issues were among the major factors that hindered successful implementation of the Home Edition. Of the test centres that utilised the Home Edition, they rated their overall experience as satisfactory. This finding suggests that concerns relating to technical and security issues associated with the adoption of the Home Edition may be less daunting than anticipated. Additional training for test centre staff could improve the implementation of the Home Edition.

Risk Factors for Post-Vasectomy Semen Analysis Non-Adherence in Home-based and Local Lab-based Testing

ABSTRACT Introduction Post-vasectomy semen analysis (PVSA) is the recommended method for confirming sterility after vasectomy. Current literature reports poor PVSA adherence rates. Our institution utilized a home-based PVSA test between 2014 and 2017 to address this issue, but we have since reverted back to lab-based testing. Objective In this study, we compare PVSA adherence rates in home- and lab-based test settings and describe factors that may influence completion rates in each cohort. Methods We retrospectively identified adult patients who underwent a vasectomy at our institution. Surgeon X and Surgeon Y performed vasectomies from December 2014 to January 2017, while only Surgeon X performed them from July 2017 to August 2020. From 2014-2017, each patient was offered purchase of a home immunochromatographic PVSA kit (SpermCheck®). From 2017-2020, each patient was offered local lab-based testing. We collected data on PVSA completion status and patient demographics to perform two analyses. One compared patients of Surgeon X from 2014-2017 to patients of Surgeon Y from 2014-2017. Another compared patients of Surgeon X from 2014-2017 to patients of Surgeon X from 2017-2020. Results We identified 285 patients who underwent a vasectomy from 2014-2017 (Surgeon Y, 149; Surgeon X, 136). Adherence with PVSA was 36%. The completion of PVSA increased by a factor of 1.04 per year of patient age at which vasectomy was performed (95% CI 1.01-1.08). The completion of PVSA decreased by a factor of 0.70 with each child (95% CI 0.56-0.87). Patients treated by Surgeon X were less likely to complete PVSA than Surgeon Y (OR 0.56, 95% CI 0.34-0.92). No significant difference in completion was found between insurance type, body mass index (BMI), or if a post-operative call or unplanned visit occurred. We identified 629 patients who underwent a vasectomy by Surgeon X (home-based PVSA, 136; lab-based PVSA, 472). Adherence with PVSA was 29% for the home cohort and 52% for the lab cohort. Patients in the home-based cohort were less likely to complete PVSA than the lab-based cohort (OR 0.37, 95% CI 0.24-0.56). The completion of PVSA decreased by a factor of 0.95 as BMI increased (95% CI 0.92-0.98). The completion of PVSA decreased by a factor of 0.74 with each child (95% CI 0.64-0.85). Patients with self-pay or private insurance were more likely to complete PVSA than those with public insurance (OR 2.37, 95% CI 1.22-4.60). Black patients were less likely to complete PVSA than white patients (OR 0.24, 95% CI 0.08-0.72). No significant difference in completion was found between age at vasectomy, distance between patient home and office, or if a post-operative call or unplanned visit occurred. Conclusions Adherence with PVSA testing was low in both test settings, though it was significantly higher in local lab setting. Age at vasectomy, number of children, and surgeon influenced PVSA completion rate in the 2014-2017 cohort. Sperm analysis test setting, BMI, number of children, insurance type, and race influenced PVSA completion rate for Surgeon X's patients in both time periods. These findings may help surgeons identify groups to focus on in future initiatives to improve PVSA adherence rates. Disclosure No

“We are looking at the future right now”: community acceptability of a home-based viral load test device in the context of HIV cure-related research with analytical treatment interruptions in the United States

Background People with HIV (PWH) and community members have advocated for the development of a home-based viral load test device that could make analytical treatment interruptions (ATIs) less burdensome. Objective We assessed community acceptability of a novel home-based viral load test device. Methods In 2021, we conducted 15 interviews and 3 virtual focus groups with PWH involved in HIV cure research. We used conventional thematic analysis to analyze the data. Results PWH viewed the home-based viral load test device as a critical adjunct in ongoing HIV cure trials with ATIs. The ability to test for viral load at home on demand would alleviate anxiety around being off ART. Participants drew parallels with glucometers used for diabetes. A preference was expressed for the home-based test to clearly indicate whether one was detectable or undetectable for HIV to mitigate risk of HIV transmission to partners. Perceived advantages of the device included convenience, sense of control, and no puncturing of veins. Perceived concerns were possible physical marks, user errors and navigating the logistics of mailing samples to a laboratory and receiving test results. Participants expressed mixed effects on stigma, such as helping normalize HIV, but increased potential for inadvertent disclosure of HIV status or ATI participation. Increasing pluri-potency of the device beyond viral load testing (e.g., CD4+ count test) would increase its utility. Participants suggested pairing the device with telemedicine and mobile health technologies. Conclusions If proven effective, the home-based viral load test device will become a critical adjunct in HIV cure research and HIV care.

The Avon Longitudinal Study of Parents and Children - A resource for COVID-19 research: Antibody testing results, April - June 2021.

The Avon Longitudinal Study of Parents and Children (ALSPAC) is a prospective population-based cohort which recruited pregnant women in 1990-1992 and has followed these women, their partners (Generation 0; G0) and their offspring (Generation 1; G1) ever since. The study reacted rapidly and repeatedly to the coronavirus disease 2019 (COVID-19) pandemic, deploying multiple online questionnaires and a previous home-based antibody test in October 2020. A second antibody test, in collaboration with ten other longitudinal population studies, was completed by 4,622 ALSPAC participants between April and June 2021. Of 4,241 participants with a valid spike protein antibody test result (8.2% were void), indicating antibody response to either COVID-19 vaccination or natural infection, 3,172 were positive (74.8%). Generational differences were substantial, with 2,463/2,555 G0 participants classified positive (96.4%) compared to 709/1,686 G1 participants (42.1%). Of 4,199 participants with a valid nucleocapsid antibody test result (9.2% were void), suggesting potential and recent natural infection, 493 were positive (11.7%); 248/2,526 G0 participants (9.8%) and 245/1,673 G1 participants (14.6%) tested positive, respectively. We also compare results for this round of testing to that undertaken in October 2020. Future work will combine these test results with additional sources of data to identify participants' COVID-19 infection and vaccination status. These ALSPAC COVID-19 serology data are being complemented with linkage to health records and Public Health England pillar testing results as they become available, in addition to four previous questionnaire waves and a prior antibody test. Data have been released as an update to the previous COVID-19 datasets. These comprise: 1) a standard dataset containing all participant responses to all four previous questionnaires with key sociodemographic factors; and 2) individual participant-specific release files enabling bespoke research across all areas supported by the study. This data note describes the second ALSPAC antibody test and the data obtained from it.

Effectiveness of a photoscreener in identifying undiagnosed unilateral amblyopia at vision screening of 3-year-old children in Japan.

In Japan a basic preparatory ophthalmic examination is routinely performed for 3-year-old children. This study aimed to determine the value of incorporating a photoscreener into the examination and evaluate parents' satisfaction with the photoscreener examination. Prospective study. Children aged 42-47months in Nagasaki City, Japan, underwent a visual acuity test by a parent at home and by automated vision screening using a photoscreener at their local municipal health center between October 2018 and March 2019. Subjects were children referred to Nagasaki University Hospital for examination after failing either test. Children previously diagnosed with strabismus and/or amblyopia were excluded. A questionnaire survey evaluated the level of satisfaction with the photoscreener-based screening by parents who attended these examinations at the local municipal health center. Of children who completed the two tests, 52 (failed visual acuity test, 3; failed photoscreener examination, 49) were referred for examination. Of the 49 photoscreener failures, 12 were diagnosed with amblyopia: unilateral amblyopia with anisometropic hyperopia in 10 (83.3%), and bilateral amblyopia with astigmatism and hyperopia in 2 (16.7%). The photoscreener detected all 12 cases of amblyopia, whereas the home-based visual acuity test detected only two cases. More than 80% of 1035 parents were satisfied with the photoscreener examination. Unilateral amblyopia with anisometropic hyperopia was easily overlooked with the home-based test but was detectable by photoscreener examination. The photoscreener proved to be an effective screening tool for amblyopia in children and was considered a satisfactory examination by a high proportion of parents.

Wearables, Respiratory Rehabilitation, Acute Myocardial Infarction and Frailty, and High-Intensity Respiratory Muscle Training

Wearables, Respiratory Rehabilitation, Acute Myocardial Infarction and Frailty, and High-Intensity Respiratory Muscle Training