Nevin Manimala

J Clin Virol Plus. 2023 Jan 11:100135. doi: 10.1016/j.jcvp.2023.100135. Online ahead of print.

ABSTRACT

OBJECTIVE: Lateral flow assays (LFA) are sensitive for detecting antibodies to SARS-CoV-2 proteins within weeks after infection. This study tested samples from immunocompetent adults, and those receiving treatments for chronic inflammatory diseases (CID), before and after mRNA SARS-CoV-2 vaccination.

METHODS: We compared results obtained with the COVIBLOCK Covid-19 LFA to those obtained by anti-spike (S) ELISA.

RESULTS: The LFA detected anti-S antibodies in 29 of 29 (100%) of the immunocompetent and 110 of 126 (87.3%) of the CID participants after vaccination. Semiquantitative LFA scores were statistically significantly lower in samples from immunosuppressed participants, and were significantly correlated with anti-S antibody levels measured by ELISA.

CONCLUSIONS: This simple LFA test is a practical alternative to laboratory-based assays for detecting anti-S antibodies after infection or vaccination. This type of test may be most useful for testing people in outpatient or resource-limited settings.

PMID:36644774 | PMC:PMC9831968 | DOI:10.1016/j.jcvp.2023.100135

J Obstet Gynaecol India. 2023 Jan 7:1-6. doi: 10.1007/s13224-022-01719-7. Online ahead of print.

ABSTRACT

BACKGROUND: COVID-19 pandemic led to an alarming rise in sickness absenteeism among the radiologists. Anticipating a continued shortage of experienced radiologists in future COVID waves, it is essential to train the medical professionals in basic skills related to ultrasonography to enable them to perform basic Obstetrics and Gynecology (OG) scans safely in emergencies. Virtual reality simulation training is an alternative to conventional ultrasound training.

METHODS: A cross-sectional study was conducted during 8-day-long workshop to identify the trainees’ basic, after training knowledge and skills in OG ultrasound and to document their perceptions of the training. Statistical analysis was done using descriptive statistics (percentages and mean standard deviations) and paired t test for comparisons.

RESULTS: A total of 80 health care professionals underwent ultrasound simulation training. It was found that the post-test score in the knowledge domain, instrument handling, basic gynecological skills, and first-trimester antenatal ultrasound skills in the practical domain was significantly higher than the pre-test score (P-value < 0.0001). Out of 80 participants, 45 (56.25%) agreed that ultrasound simulation is an ideal method of teaching and training basic OG skills to the novice. Sixty-six out of 80 (82.5%) felt that the principles of handling a human mannequin are the same as those of real patients. Forty-eight participants out of 80 (60.0%) felt that ultrasound simulation can be used as an ideal tool for self-assessment of health care professionals.

CONCLUSION: The study showed that ultrasound-based simulation can provide a realistic setting for training and assessment of novices in learning basic skills.

PMID:36644767 | PMC:PMC9822808 | DOI:10.1007/s13224-022-01719-7

Adv Med Educ Pract. 2023 Jan 7;14:21-30. doi: 10.2147/AMEP.S381760. eCollection 2023.

ABSTRACT

INTRODUCTION: Nursing knowledge, critical thinking ability, and self-perceived confidence are imperative to nursing skills in professional nursing practice. Therefore, nurse educators are required to use teaching strategies that will help promote their knowledge, critical thinking, and self-confidence in complex contents such as the nursing of acute upper gastrointestinal bleeding (AUGIB).

PURPOSE: This study compares the effect of student-led and instructor-led ward-round training methods on knowledge acquisition, critical thinking ability, and self-perceived confidence during AUGIB sessions.

METHODS: Forty nursing students in the first year of the Emergency Nursing Residency Program were randomly divided into a student-led ward round training group (SG) and an instructor-led ward round training group (IG) with a ratio of 1:1. A knowledge quiz, critical thinking ability test, and self-perceived confidence questionnaire were performed before and after the ward round training to assess both groups of students for their knowledge acquisition, critical thinking ability, and self-perceived confidence improvement. Feedback questionnaires were conducted after the training to evaluate students’ perspectives and interests concerning the teaching module.

RESULTS: The scores of the post-training quiz were significantly higher than that of the pre-training quiz in both the SG (44.10±2.92 vs 31.10±4.27, p<0.001) and IG (32.35±2.21 vs 30.55±2.24, p=0.01). In the post-training quiz, scores achieved by the students from the SG (44.10±2.92) were significantly higher than those achieved by the students from the IG (32.35±2.21, p< 0.001). The level of self-perceived confidence improved significantly after ward round training in the SG (p< 0.001). However, there was no statistically significant difference in the IG with respect to the change from pre- to post-training (p=0.43).The students’ critical thinking ability improved significantly in the SG (14.95±2.58 vs 7.10±1.79, p<0.001), while no significant improvement was found in the IG (7.91±2.28 vs 6.52±2.21, p=0.07) after ward round training.

CONCLUSION: The teaching method of SWRT improves nursing students’ knowledge acquisition, critical thinking ability, and self-perceived confidence in AUGIB.

PMID:36644766 | PMC:PMC9832928 | DOI:10.2147/AMEP.S381760

Cybern Syst Anal. 2022;58(6):983-990. doi: 10.1007/s10559-023-00533-x. Epub 2023 Jan 7.

ABSTRACT

This article discusses the current problem of cheating students of higher educational institutions during the exam. The subject area is investigated, and the results of theoretical and empirical research on cheating as one of the forms of academic fraud are presented. Statistical data of violations during the exam are shown, and the main patterns of violations during distance learning are revealed. The results of the study will help to determine during what period of the final certification students violate the rules of academic honesty more often.

PMID:36644756 | PMC:PMC9825068 | DOI:10.1007/s10559-023-00533-x

Hosp Pharm. 2023 Feb;58(1):84-91. doi: 10.1177/00185787221122656. Epub 2022 Sep 4.

ABSTRACT

OBJECTIVE: To describe the current prescribing practices of direct oral anticoagulants (DOACs) in intensive care unit (ICU) patients and the associated clinical outcomes, including the incidence of major bleeding episodes and the need for intervention (endoscopic, surgical, or interventional radiology guided).

DESIGN: Observational, retrospective chart review.

SETTING AND PARTICIPANTS: Single large academic center study. Participants included patients with critical illness who were admitted to the intensive care units (ICU) at Mayo Clinic from January 1st, 2012, until May 4th, 2018. Adult ICU patients with a DOAC (apixaban, rivaroxaban, dabigatran, or edoxaban) listed as one of the active medications at the time of hospital admission were included.

RESULTS: 37 249 patients in medical and surgical intensive care units were screened for the study period. After excluding patients who did not qualify, 558 unique encounters were included. The median age was 69 (IQR 59-78) years; most patients were male, white Caucasians, and had a median SOFA score of 4. After excluding the patients who had major bleeding episodes in the first 24 hours, 188 (39%) were continued on the same DOAC therapy, 204 (42%) were discontinued without transitioning to another agent, and 95 (20%) were transitioned to another agent. Finally, 410 (84%) were dismissed on DOAC therapy at the end of hospitalization. The difference in the continuation rate of the same DOAC agent beyond 24 hours, discontinuation without transition to an alternate agent, or discontinuation of DOAC with a transition to an alternate anticoagulation agent was not statistically significant (P = .60). A total of 52 major bleeding events were identified. Gastrointestinal bleeding was the most common bleeding complication [n (%): 34 (65)], followed by intra-abdominal and peri-procedural bleeding [7 (13.5) and 7 (13.5)]. Thirty-three (65%) patients had a major bleeding complication requiring intervention.

CONCLUSIONS: Our single-center retrospective study describes the current prescribing practices and preliminary outcomes in ICU patients with prehospital use of DOACs. Up to 20% of the patients were transitioned to a different agent within 24 hours of ICU admission, whereas a significant proportion of patients (42%) had anticoagulation discontinued altogether. Most patients who suffered a major bleeding episode required either endoscopic or surgical intervention to control bleeding.

PMID:36644754 | PMC:PMC9837329 | DOI:10.1177/00185787221122656

Biom J. 2023 Jan 15:e2200095. doi: 10.1002/bimj.202200095. Online ahead of print.

ABSTRACT

Statistical simulation studies are becoming increasingly popular to demonstrate the performance or superiority of new computational procedures and algorithms. Despite this status quo, previous surveys of the literature have shown that the reporting of statistical simulation studies often lacks relevant information and structure. The latter applies in particular to Bayesian simulation studies, and in this paper the Bayesian simulation study framework (BASIS) is presented as a step towards improving the situation. The BASIS framework provides a structured skeleton for planning, coding, executing, analyzing, and reporting Bayesian simulation studies in biometrical research and computational statistics. It encompasses various features of previous proposals and recommendations in the methodological literature and aims to promote neutral comparison studies in statistical research. Computational aspects covered in the BASIS include algorithmic choices, Markov-chain-Monte-Carlo convergence diagnostics, sensitivity analyses, and Monte Carlo standard error calculations for Bayesian simulation studies. Although the BASIS framework focuses primarily on methodological research, it also provides useful guidance for researchers who rely on the results of Bayesian simulation studies or analyses, as current state-of-the-art guidelines for Bayesian analyses are incorporated into the BASIS.

PMID:36642811 | DOI:10.1002/bimj.202200095

Biom J. 2023 Jan 15:e2100386. doi: 10.1002/bimj.202100386. Online ahead of print.

ABSTRACT

Model-based geostatistical design involves the selection of locations to collect data to minimize an expected loss function over a set of all possible locations. The loss function is specified to reflect the aim of data collection, which, for geostatistical studies, could be to minimize the prediction uncertainty at unobserved locations. In this paper, we propose a new approach to design such studies via a loss function derived through considering the entropy about the model predictions and the parameters of the model. The approach includes a multivariate extension to generalized linear spatial models, and thus can be used to design experiments with more than one response. Unfortunately, evaluating our proposed loss function is computationally expensive so we provide an approximation such that our approach can be adopted to design realistically sized geostatistical studies. This is demonstrated through a simulated study and through designing an air quality monitoring program in Queensland, Australia. The results show that our designs remain highly efficient in achieving each experimental objective individually, providing an ideal compromise between the two objectives. Accordingly, we advocate that our approach could be adopted more generally in model-based geostatistical design.

PMID:36642810 | DOI:10.1002/bimj.202100386

Biom J. 2023 Jan 15:e2200021. doi: 10.1002/bimj.202200021. Online ahead of print.

ABSTRACT

In practice, a disease process might involve three ordinal diagnostic stages: the normal healthy stage, the early stage of the disease, and the stage of full development of the disease. Early detection is critical for some diseases since it often means an optimal time window for therapeutic treatments of the diseases. In this study, we propose a new influence function-based empirical likelihood method and Bayesian empirical likelihood methods to construct confidence/credible intervals for the sensitivity of a test to patients in the early diseased stage given a specificity and a sensitivity of the test to patients in the fully diseased stage. Numerical studies are performed to compare the finite sample performances of the proposed approaches with existing methods. The proposed methods are shown to outperform existing methods in terms of coverage probability. A real dataset from the Alzheimer’s Disease Neuroimaging Initiative (ANDI) is used to illustrate the proposed methods.

PMID:36642803 | DOI:10.1002/bimj.202200021

Biom J. 2023 Jan 15:e2200102. doi: 10.1002/bimj.202200102. Online ahead of print.

ABSTRACT

When comparing the performance of two or more competing tests, simulation studies commonly focus on statistical power. However, if the size of the tests being compared are either different from one another or from the nominal size, comparing tests based on power alone may be misleading. By analogy with diagnostic accuracy studies, we introduce relative positive and negative likelihood ratios to factor in both power and size in the comparison of multiple tests. We derive sample size formulas for a comparative simulation study. As an example, we compared the performance of six statistical tests for small-study effects in meta-analyses of randomized controlled trials: Begg’s rank correlation, Egger’s regression, Schwarzer’s method for sparse data, the trim-and-fill method, the arcsine-Thompson test, and Lin and Chu’s combined test. We illustrate that comparing power alone, or power adjusted or penalized for size, can be misleading, and how the proposed likelihood ratio approach enables accurate comparison of the trade-off between power and size between competing tests.

PMID:36642800 | DOI:10.1002/bimj.202200102

J Genet Couns. 2023 Jan 15. doi: 10.1002/jgc4.1670. Online ahead of print.

ABSTRACT

A growing percentage of genetic counselors are employed in roles that do not involve direct patient care, commonly in commercial diagnostic laboratories. This study aimed to assess characteristics of laboratory and industry (LI) roles and perceptions of the genetic counseling community’s views towards such roles. Members of NSGC and ABGC were invited to participate in this study. Data analysis included descriptive and inferential statistics and select participant quotes are included to highlight key points identified by statistical analyses. Three hundred twenty-six genetic counselors who self-identified as currently or previously working within an LI role responded to the survey. Over 40% of participants reported feeling that they were not perceived positively by colleagues outside of LI settings, and 54% felt that GC colleagues in non-LI roles provided mostly negative commentary about LI GC roles. Over 90% of individuals felt that their employer was a factor in the way they were perceived by others and that this factor carried a bigger weight than job title, work setting, or even professional responsibilities. Qualitative responses from open-ended text questions suggest that while perceptions toward LI roles have improved over time, commentary regarding the “dark side” of genetic counseling persists. To promote the continued, unified growth of the genetic counseling profession and other healthcare professions, it is necessary to address this source of intra-professional conflict.

PMID:36642782 | DOI:10.1002/jgc4.1670