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Can the combined use of two screening instruments improve the predictive power of dependency in (instrumental) activities of daily living, mortality and hospitalization in old age?

Background: Due to differences in the definition of frailty, many different screening instruments have been developed. However, the predictive validity of these instruments among community-dwelling older people remains uncertain. Objective: To investigate whether combined (i.e. sequential or parallel) use of available frailty instruments improves the predictive power of dependency in (instrumental) activities of daily living ((I)ADL), mortality and hospitalization. Design, setting and participants: A prospective cohort study with two-year followup was conducted among pre-frail and frail community-dwelling older people in the Netherlands. Measurements: Four combinations of two highly specific frailty instruments (Frailty Phenotype, Frailty Index) and two highly sensitive instruments (Tilburg Frailty Indicator, Groningen Frailty Indicator) were investigated. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for all single instruments as well as for the four combinations, sequential and parallel. Results: 2,420 individuals participated (mean age 76.3 ± 6.6 years, 60.5% female) in our study. Sequential use increased the levels of specificity, as expected, whereas the PPV hardly increased. Parallel use increased the levels of sensitivity, although the NPV hardly increased. Conclusions: Applying two frailty instruments sequential or parallel might not be a solution for achieving better predictions of frailty in community-dwelling older people. Our results show that the combination of different screening instruments does not improve predictive validity. However, as this is one of the first studies to investigate the combined use of screening instruments, we recommend further exploration of other combinations of instruments among other study populations.

Diversity through specificity design lessons learned from the games [4Diversity] jams

Comparison of Six Commercial ELISA Kits for Their Specificity and Sensitivity in Detecting Different Major Peanut Allergens

Author supplied: "Six commercial peanut enzyme-linked immunosorbent assay kits were assessed for their ability to recover peanut from the standard reference material 2387 peanut butter and also for their specificity in detecting four major peanut allergens, Ara h 1, Ara h 2, Ara h 3, and Ara h 6. The percentage recovery of peanut from peanut butter differed across different kits as well as at different sample concentrations. The highest recovery was observed with the Romer and R-Biopharm kits, while four other kits were found to underestimate the protein content of the reference peanut butter samples. Five of the kits were most sensitive in detecting Ara h 3 followed by Ara h 1, while hardly recognizing Ara h 2 and Ara h 6. The other kit showed the highest sensitivity to Ara h 2 and Ara h 6, while Ara h 1 and Ara h 3 were poorly recognized. Although Ara h 2 and Ara h 6 are known to be heat stable and more potent allergens, antisera specific to any of these four peanut proteins/allergens may serve as good markers for the detection of peanut residues."

Comprehensive analytical and clinical evaluation of a RNA extraction-free saliva-based molecular assay for SARS-CoV-2

Standard SARS-CoV-2 testing protocols using nasopharyngeal/throat (NP/T) swabs are invasive and require trained medical staff for reliable sampling. In addition, it has been shown that PCR is more sensitive as compared to antigen-based tests. Here we describe the analytical and clinical evaluation of our in-house RNA extraction-free saliva-based molecular assay for the detection of SARS-CoV-2. Analytical sensitivity of the test was equal to the sensitivity obtained in other Dutch diagnostic laboratories that process NP/T swabs. In this study, 955 individuals participated and provided NP/T swabs for routine molecular analysis (with RNA extraction) and saliva for comparison. Our RT-qPCR resulted in a sensitivity of 82,86% and a specificity of 98,94% compared to the gold standard. A false-negative ratio of 1,9% was found. The SARS-CoV-2 detection workflow described here enables easy, economical, and reliable saliva processing, useful for repeated testing of individuals.

Diversity through specificity design lessons learned from the games [4Diversity] jams

The study used a research-through-design approach and organized game jams as a method to examine game design processes, with the aim to investigate how the diverse identities of designers affect and inspire their game designs. During the Game [4Diversity] Jams we hypothesised that homogeneity in groups may lead to a single-minded message in their games, and diversity in groups may result in games that allow more freedom for players to create their own personal interpretation(s) of the game's content and mechanics. The results of this study suggest that a narrow theme and diverse team composition may assist designers in creating novel games. As such, designers can find diverse gameplay and content from additional specificity in the game jam's organisation.

Introducing a Method to Quantify the Specificity of Training for Races in Speed Skating

The specificity of training for races is believed to be important for performance development. However, measuring specificity is challenging. This study aimed to develop a method to quantify the specificity of speed skating training for sprint races (i.e., 500 and 1,000 m), and explore the amount of training specificity with a pilot study. On-ice training and races of 10 subelite-to-elite speed skaters were analyzed during 1 season (i.e., 26 weeks). Intensity was mapped using 5 equal zones, between 4 m·s-1 to peak velocity and 50% to peak heart rate. Training specificity was defined as skating in the intensity zone most representative for the race for a similar period as during the race. During the season, eight 500 m races, seven 1,000 m races, and 509 training sessions were analyzed, of which 414 contained heart rate and 375 sessions contained velocity measures. Within-subject analyses were performed. During races, most time was spent in the highest intensity zone (Vz5 and HRz5). In training, the highest velocity zone Vz5 was reached 107 ± 28 times, with 9 ± 3 efforts (0.3 ± 0.1% training) long enough to be considered 500 m specific, 6 ± 5 efforts (0.3 ± 0.3% training) were considered 1,000 m specific. For heart rate, HRz5 was reached 151 ± 89 times in training, 43 ± 33 efforts (1.3 ± 0.9% training) were considered 500 m specific, and 36 ± 23 efforts (3.2 ± 1.7% training) were considered 1,000 m specific. This newly developed method enables the examination of training specificity so that coaches can control whether their intended specificity was reached. It also opens doors to further explore the impact of training specificity on performance development.