scholarly journals Improving Competence in Diagnosis, Referral and Initial Management of Acquired Hemophilia a through Online Interactive Case-Based Education

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2990-2990
Author(s):  
Christy Rohani-Montez ◽  
Deborah Middleton ◽  
Karen Reid ◽  
Alice Ma
Keyword(s):  
Correct Response ◽  
Response Rate ◽  
Initial Management ◽  
Paired Samples ◽  
Cohen’S D ◽  
Increased Risk ◽  
Cohen's D ◽  
Post Assessment ◽  
Correct Response Rate ◽  
Case Based

Abstract INTRODUCTION Diagnosing acquired haemophilia A (AHA) can be challenging due to a) it's rarity (~1.5 cases per million), and b) the range of nonspecific bleeding patterns that may present. Therefore, there is a substantial diagnostic delay and rate of misdiagnosis, leading to an increased risk of morbidity and mortality. This study was conducted to determine whether online interactive case-based independent medical education could improve clinicians' competence in identifying possible AHA, in appropriate referral to specialist centers and in initial management. METHODS Hematologists and emergency medicine (EM) physicians participated in a text, case-based activity and completed pre- and post-questions (Ma A. Active Bleeding in the ER and a Prolonged aPTT: What's Your Next Step? www.medscape.org/viewarticle/944112). Educational effect was assessed using a 3-question repeated-pair design with pre-/post-assessment. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and a McNemar's test was conducted at the learning objective level (5% significance level, P <.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (<.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 03/15/2021 to 06/14/2021. RESULTS Overall significant improvements at the aggregate level were seen after participation for hematologists (33% average correct response rate at pre-assessment vs 94% at post-assessment; P<.001, Cohen's d= 2.27, N=86), and EM physicians (24% average correct response rate at pre-assessment vs 80% at post-assessment; P<.001, Cohen's d= 1.30, N=102). Highly significant improvements were achieved with regards to recognizing symptoms of AHA, appropriate referral, and initial therapeutic management (figure). After participating, 37% of hematologists and 40% of pulmonologists had measurable improved confidence (both P<.001), resulting in 63% of hematologists and 46% of EM physicians who were mostly or very confident in identifying features consistent with a possible AHA diagnosis post-CME (vs 44% and 26% pre-CME respectively). CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving clinicians' competence in identifying patients with possible AHA, appropriate referral and initial treatment. Both improvement and reinforcement in the context of a linked learning assessment have been shown to positively correlate with increases in confidence as well as intention to make clinical practice changes (Lucero KS, Chen P. J Eur CME. 2020 Oct 12;9(1):1834759), suggesting that most clinicians who participated in this activity are likely to make improvements in their practice. This could lead to earlier appropriate treatment and improved overall outcomes for these patients. Figure 1 Figure 1. Disclosures Ma: Takeda: Honoraria, Research Funding; Accordant: Consultancy.

scholarly journals Effectiveness of Interactive Case-Based Online Education in Improving Attp Diagnosis and Treatment Selection

Blood ◽  
2020 ◽  
Vol 136 (Supplement 1) ◽  
pp. 36-37
Author(s):  
Christy Rohani-Montez ◽  
Dayan Gunesekera ◽  
Paul Coppo
Keyword(s):  
Emergency Medicine ◽  
Medical Education ◽  
Correct Response ◽  
Research Funding ◽  
Response Rate ◽  
Diagnostic Features ◽  
Design For All ◽  
Post Assessment ◽  
Correct Response Rate ◽  
Case Based

INTRODUCTION The prompt recognition and treatment of acquired thrombotic thrombocytopenic purpura (aTTP) is critical to prevent life-threatening consequences; however, this condition continues to be under-diagnosed and associated with significant mortality. Reducing mortality rates and improving outcomes is dependent on clinician awareness of aTTP diagnostic features, and on prompt implementation of evidence-based treatment approaches. OBJECTIVES This study was conducted to determine whether online case-based independent medical education could improve hematologists' and emergency medicine specialists' competence in identifying key diagnostic features of aTTP and selecting an initial treatment approach; and knowledge regarding recent clinical data on aTTP treatment. METHODS Hematologists and emergency medicine physicians electively participated in a 15-minute, case-based interactive online independent medical education activity on aTTP (Coppo P. Fatigue, Bruises, and Thrombocytopenia: What's Your Next Step? Launched: 1/30/2020. Data as of 4/22/2020. Available at www.medscape.org/viewarticle/923316). The effects of the education on knowledge and competence were assessed using a 3-question, repeated pairs, pre-assessment/post-assessment study design. For all questions combined, the chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. The activity launched on January 30, 2020 and data were collected through April 22, 2020. RESULTS Overall significant improvements were seen after participation for both hematologists (average correct response rate of 33% at pre-assessment vs 82% at post-assessment; P<.001, N=124), and emergency medicine physicians (average correct response rate of 18% at pre-assessment vs 73% at post-assessment; P<.001, N=45). Specifically, there were significant improvements in recognizing laboratory findings indicative of a TTP diagnosis; selecting a triplet regimen as initial therapy for aTTP, based on current data; and understanding possible treatment-related adverse event expectations (Figure). After participating in the activity, 44% of hematologists and 84% of emergency medicine physicians had measurable improved confidence related to their ability to manage patients presenting with signs and symptoms of aTTP. Despite the increases in knowledge and confidence observed, the baseline rates of correct responses were low; therefore, ongoing education will be needed to reinforce knowledge and competence. Reinforcement is an important outcome from education that keeps clinicians' practices up-to-date (Lucero KS, Dunn S. Available at: http://almanac.acehp.org/p/bl/et/blogid=2&blogaid=599. Accessed June 11, 2020). CONCLUSIONS This study demonstrates the success of online, interactive case-based education in improving hematologists' and emergency medicine specialists' knowledge and competence in diagnosing and managing aTTP. This could lead to earlier diagnosis and a more widespread adoption of a new standard of aTTP treatment to improve overall outcomes for these patients. Figure Disclosures Coppo: Octapharma: Consultancy; Roche: Consultancy, Research Funding, Speakers Bureau; Sanofi: Consultancy, Speakers Bureau; Takeda: Consultancy, Speakers Bureau; Alexion Pharmaceuticals, Inc.: Consultancy, Research Funding, Speakers Bureau.

THU0584 CASE-BASED ONLINE EDUCATION SIGNIFICANTLY INCREASES CLINICIAN COMPETENCE IN ASSESSING SSC-ILD DISEASE PROGRESSION AND IMPLEMENTING APPROPRIATE THERAPY

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 534.1-534
Author(s):  
C. Rohani-Montez ◽  
M. Calle ◽  
C. Allen ◽  
C. Denton
Keyword(s):  
Online Education ◽  
Disease Progression ◽  
Correct Response ◽  
Response Rate ◽  
Response To Therapy ◽  
Chi Square ◽  
Design For All ◽  
Post Assessment ◽  
Correct Response Rate ◽  
Case Based

Background:Due to the heterogeneity in both the initial manifestations of systemic sclerosis (SSc) and progression with SSc-associated interstitial lung disease (SSc-ILD), diagnosis and prognosis can be challenging in clinical practice. Clinicians need expert case-based guidance on how best to monitor patients with SSc and the treatment implications.Objectives:This study was conducted to determine whether online case-based independent medical education could improve rheumatologists’ and pulmonologists’ competence in evaluating and monitoring SSc-ILD progression and initiating the right treatments when progression is identified.Methods:Rheumatologists and pulmonologists participated in two comprehensive online case studies, using a ‘test then teach’ approach and completed all pre- and post-questions.1The effects of the education on knowledge and competence were assessed using a 3-question, repeated pairs, pre-assessment/post-assessment study design. For all questions combined, the chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. The activity launched on September 24, 2019, and data were collected through December 9, 2019.Results:Overall significant improvements were seen after participation for both rheumatologists (average correct response rate of 65% at pre-assessment vs 97% at post-assessment; P<.001, N=89), and pulmonologists (average correct response rate of 64% at pre-assessment vs 95% at post-assessment; P<.001, N=71). Specifically, significant improvements were observed in clinicians’ competence in assessing response to therapy and monitoring for disease progression; and managing evidence of disease worsening (figure).Figure.After participating in the activity, 54% of rheumatologists and 51% of pulmonologists had measurable improved confidence related to communicating with patients with SSc-ILD about the possibility of disease progression.Given that only around half of clinicians provided correct responses at baseline, it will be important to continue to reinforce these learnings in ongoing education.Conclusion:This study demonstrates the success of online, case-based education in improving rheumatologists’ and pulmonologists’ competence in managing patients with SSc-ILD. This could lead to earlier changes in therapeutic approach for those with signs of progression and result in improved overall outcomes for these patients.References:[1]Denton C. When SSc-ILD Starts Progressing: Monitoring and Managing Those at Risk for Poor Prognosis. Launched: 9/24/2019. Data as of 12/9/2019. Available atwww.medscape.org/viewarticle/918465Disclosure of Interests:Christy Rohani-Montez: None declared, Marinella Calle: None declared, Chris Allen: None declared, Christopher Denton Grant/research support from: GlaxoSmithKline, CSL Behring, and Inventiva, Consultant of: Medscape, Roche-Genentech, Actelion, GlaxoSmithKline, Sanofi Aventis, Inventiva, CSL Behring, Boehringer Ingelheim, Corbus Pharmaceuticals, Acceleron, Curzion and Bayer

scholarly journals POS1449 SEGMENTED SHORT-FORMAT ONLINE EDUCATION SIGNIFICANTLY INCREASES PREDICTION, PROGNOSIS, AND MANAGEMENT OF FIBROSING INTERSTITIAL LUNG DISEASE ASSOCIATED WITH CONNECTIVE TISSUE DISEASE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1008.1-1009
Author(s):  
C. Rohani-Montez ◽  
M. Calle ◽  
C. Allen ◽  
T. Maher ◽  
V. Smith ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Connective Tissue ◽  
Online Education ◽  
Lung Disease ◽  
Disease Progression ◽  
Correct Response ◽  
Response Rate ◽  
Research Support ◽  
Post Assessment ◽  
Correct Response Rate

Background:Identifying fibrosing interstitial lung disease (ILD) at the earliest opportunity remains one of the most urgent challenges for the effective management of this potentially rapidly progressive and burdensome condition, which is frequently associated with several connective tissue diseases (CTDs). However, knowledge on how to identify early hallmarks and predictors of fibrosing ILD, as well as knowing which steps to take next is frequently lacking in clinical practice.Objectives:This study was conducted to determine whether online independent medical education could improve rheumatologists’ and pulmonologists’ knowledge and competence in identifying and managing progressive fibrosing ILDs earlier in the disease course.Methods:Rheumatologists and pulmonologists participated in five ~10-min presentations about the early identification of fibrosing ILD in patients with or without CTDs and completed all pre- and post-questions.1 The effects of the education on knowledge and competence were assessed using a 3-question, repeated pairs, pre-assessment/post-assessment study design. For all questions combined, the chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. The activity launched on October 9, 2020, and data were collected through December 18, 2020.Results:Overall significant improvements were seen after participation for both rheumatologists (average correct response rate of 28% at pre-assessment vs 74% at post-assessment; P<.001, representing a 165% relative percentage change [RPC]; N=39), and pulmonologists (average correct response rate of 39% at pre-assessment vs 67% at post-assessment; P<.001, representing a 72% RPC; N=102). Specifically, significant improvements were observed in clinicians’ knowledge of predictors of fibrosing ILD in patients with CTD, as well as competence in selecting the right HRCT parameters to assess prognosis and select a treatment approach to reduce the risk of disease progression (Figure 1).Figure 1.After participating in the activity, 59% of rheumatologists and 50% of pulmonologists had measurable improved confidence related to identifying early disease progression in patients with progressive fibrosing ILDs.Given the very low rates of correct responses at baseline regarding predictors of fibrosing ILD and assessing prognosis, it will be important to continue to reinforce these learnings in ongoing educational programs.Conclusion:This study demonstrates the success of segmented online education in improving rheumatologists’ and pulmonologists’ knowledge and competence in evaluating risk and prognosis of fibrosing ILD and managing patients with CTD-ILDs. This could lead to earlier changes in therapeutic approach for those with signs of progression and result in improved overall outcomes for these patients.References:[1]Kolb M, Maher T, Smith V, Jacob J, Rimekasten G. Catching and Managing Progressive Fibrosing Interstitial Lung Disease Progression Earlier. Launched: Oct 9, 2020. Data as of Dec 18, 2020. Available at www.medscape.org/viewarticle/938826Disclosure of Interests:Christy Rohani-Montez: None declared, Marinella Calle: None declared, Chris Allen: None declared, Toby Maher Speakers bureau: Astra Zeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos, Galecto, GlaxoSmithKline R&D, Indalo, IQVIA, Pliant, Respivant, Roche and Theravance, Consultant of: Astra Zeneca, Bayer, Blade Therapeutics, Boehringer Ingelheim, Bristol-Myers Squibb, Galapagos, Galecto, GlaxoSmithKline R&D, Indalo, IQVIA, Pliant, Respivant, Roche and Theravance, Grant/research support from: Astra Zeneca and GlaxoSmithKline R&D, Vanessa Smith Speakers bureau: Boehringer-Ingelheim Pharma GmbH&Co and Janssen-Cilag NV, Consultant of: Boehringer-Ingelheim Pharma GmbH&Co, Grant/research support from: Research Foundation - Flanders (FWO), Belgian Fund for Scientific Research in Rheumatic diseases (FWRO), Boehringer-Ingelheim, Pharma GmbH&Co, and Janssen-Cilag NV, Joseph Jacob Speakers bureau: Boehringer-Ingelheim; Roche, Consultant of: Boehringer-Ingelheim, Grant/research support from: GlaxoSmithKline, Gabriela Riemekasten Speakers bureau: AbbVie; Actelion; Boehringer-Ingelheim, Consultant of: Actelion; CellTrend; Janssen, Grant/research support from: AbbVie; Actelion, Martin Kolb Speakers bureau: AstraZeneca; Boehringer-Ingelheim; Novartis; Roche, Consultant of: AbbVie Inc.; Algernon Pharma; AstraZeneca;, Boehringer-Ingelheim; Cipla; Covance; EPG Health; Galapagos NV; Gilead; GlaxoSmithKline; Indalo; MitoImmune Therapeutics Inc; Novartis; Pieris; Prometic (now Liminal Biosciences); Roche; Third Pole Inc.; TwoXAR Inc., Grant/research support from: Boehringer-Ingelheim; GlaxoSmithKline; Novartis; Prometic; Roche; Avalyn

scholarly journals Online CME As a Tool to Increase Clinicians' Ability to Identify and Diagnose Paroxysmal Nocturnal Hemoglobinuria

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 2988-2988
Author(s):  
Michelle Arielle Worst ◽  
Emily S. Van Laar ◽  
Lisa A Cockrell ◽  
Ilene C. Weitz
Keyword(s):  
Primary Care Physicians ◽  
Paroxysmal Nocturnal Hemoglobinuria ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Healthcare Team ◽  
Hematopoietic Stem ◽  
Paired Samples ◽  
Cohen’S D ◽  
Cohen's D ◽  
Post Assessment

Abstract Background: Paroxysmal nocturnal hemoglobinuria (PNH) is an extremely rare clonal hematopoietic stem cell disorder characterized by episodes of hemolysis and a high risk of thrombosis [Hill A, et al. Nat Rev Dis Primers. 2017;3:17028.]. PNH has diverse clinical manifestations, which contribute to its particularly challenging diagnosis. As a result, diagnostic delays are common, and patients often experience complications of untreated PNH [Mancuso S, et al. Hematol Rep. 2018;10:7523.]. Due to the rarity and confounding presentation of PNH, many members of the healthcare team are challenged to accurately recognize signs and symptoms of the disease and implement appropriate diagnostic methods. The objective of this study was to determine if an online continuing medical education (CME) intervention could improve hematologists' and primary care physicians' (PCPs) ability in identifying and diagnosing patients with PNH. Methods: The activity consisted of an approximately 2,000-word text-based interview between a moderator and a single expert faculty [Weitz I. https://www.medscape.org/viewarticle/943900. 2021.]. Educational effect was assessed with a repeated pairs pre-/post-assessment study including a 3-item, multiple choice, knowledge/competence questionnaire and 1 confidence assessment question, with each participant serving as his/her own control. Pre- and post-assessment scores were compared to determine relative changes in the proportion of correct responses to knowledge/competence questions. A paired samples t-test was conducted for significance testing on overall average number of correct responses and for confidence rating, and McNemar's test was conducted at the learning objective level (5% significance level, P &lt;.05). Cohen's d with correction for paired samples estimated the effect size of the education on number of correct responses (&lt;.20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). The activity launched 15 January 2021; data were collected until 3 May 2021. Results: Overall, statistically significant improvements in knowledge/competence were seen after education consumption for hematologists (N=55, P &lt;.001, Cohen's d=.59) and PCPs (N=332, P &lt;.001, Cohen's d=.47). 5% of hematologists and 17% of PCPs improved (P &lt;.317 and P &lt;.001, respectively) and 78% and 57%, respectively, reinforced their knowledge regarding the clinical manifestations of PNH. 29% of hematologists and 40% of PCPs improved (P&lt;.001) and 69% and 36%, respectively, reinforced their competence related to establishing a diagnosis of PNH. Following the activity, 38% of hematologists and 52% of PCPs had a measurable increase in confidence regarding their ability to evaluate patients with suspected PNH. Conclusions: Participation in a text-based CME-certified activity resulted in statistically significant improvements in knowledge/competence and measurable increases in confidence of hematologists and PCPs regarding the diagnosis of PNH. These results have the ability to translate to improvements in clinical care. The need for additional educational activities was also identified to address residual gaps and further increase clinicians' ability in this rare clinical setting. Disclosures Weitz: Apellis Pharmaceuticals: Consultancy, Honoraria; Alexion: Consultancy, Honoraria, Speakers Bureau; Biocryst: Consultancy, Honoraria; Novartis Corporation: Consultancy, Honoraria; Sanofi Genxyme: Consultancy, Honoraria.

scholarly journals AB1272 ONLINE EDUCATION BOOSTS CLINICIAN KNOWLEDGE ABOUT EMERGING THERAPIES FOR PATIENTS WITH SYSTEMIC SCLEROSIS-ASSOCIATED INTERSTITIAL LUNG DISEASE

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1927.2-1927
Author(s):  
C. Rohani-Montez ◽  
M. Calle ◽  
C. Allen ◽  
A. M. Hoffmann-Vold ◽  
O. Distler
Keyword(s):  
Systemic Sclerosis ◽  
Interstitial Lung Disease ◽  
Lung Disease ◽  
Correct Response ◽  
Response Rate ◽  
Treatment Needs ◽  
Research Support ◽  
Emerging Therapies ◽  
Post Assessment ◽  
Correct Response Rate

Background:Systemic sclerosis-associated interstitial lung disease (SSc-ILD) has traditionally been treated with therapies such as cyclophosphamide, mycophenolate mofetil, and hematopoietic stem cell transplantation. However, these therapies are limited by potential toxicity, as well as duration and magnitude of effect. Clinicians need awareness of emerging therapies in late-stage clinical trials that may address these limitations.Objectives:This study was conducted to determine whether online independent medical education could improve rheumatologists’ and pulmonologists’ knowledge of emerging therapies for the management of SSc-ILD.Methods:Physicians (N = 2,076) participated in a 30-minute, 2-faculty, video-based, online CME with synchronized slides.1The majority of participants were rheumatologists (n = 522) or pulmonologists (n = 557), but the cohort also included clinical immunologists (n = 132) and other physicians with an interest in the topic (n = 865). This study focuses on the 120 rheumatologists and 111 pulmonologists who completed all pre- and post-questions. The effects of the education on knowledge was assessed using a 3-question, repeated pairs, pre-assessment/post-assessment study design. For all questions combined, the chi-square test assessed differences from pre- to post-assessment. P values <.05 are statistically significant. The activity launched on September 17, 2019, and data were collected through November 5, 2019.Results:Overall significant improvements were seen after participation for both rheumatologists (average correct response rate of 55% at pre-assessment vs 75% at post-assessment; P<.001, N=120), and pulmonologists (average correct response rate of 60% at pre-assessment vs 77% at post-assessment; P<.001, N=111). Specifically, significant improvements were observed in clinicians’ knowledge of clinical trial data for emerging SSc-ILD therapies (figure).Figure.Clinicians from APAC (n = 67) and Europe (n = 79) made up the majority of the cohort, and had similar rates of correct responses without significant differences, indicating consistent effects, independent of the region of origin. After participating in the activity, 48% of pulmonologists and rheumatologists had measurable improved confidence related to their knowledge of emerging therapies for patients with SSc-ILD.Despite the increases in knowledge and confidence observed, the rates of correct responses suggest there is still room for improvement; therefore, ongoing education will be needed to reinforce knowledge of the latest data evaluating new therapies for SSc-ILD and what they will mean for future practice.Conclusion:This study demonstrates the success of online, video-based education in improving rheumatologists’ and pulmonologists’ knowledge of the latest clinical data on emerging therapies for SSc-ILD. This could lead to earlier adoption of new, efficacious therapies that may slow disease progression and improve overall outcomes for these patients.References:[1]Distler O, Hoffmann-Vold A-M. How Can We Meet the Treatment Needs of Patients With Systemic Sclerosis-Interstitial Lung Disease? Launched: 9/17/2019. Data as of 11/5/2019. Available atwww.medscape.org/viewarticle/917034Disclosure of Interests:Christy Rohani-Montez: None declared, Marinella Calle: None declared, Chris Allen: None declared, Anna-Maria Hoffmann-Vold Grant/research support from: Boehringer Ingelheim, Consultant of: Boehringer Ingelheim, Actelion, Bayer, GlaxoSmithKline, Speakers bureau: Boehringer Ingelheim, Actelion, Roche, Oliver Distler Grant/research support from: Grants/Research support from Actelion, Bayer, Boehringer Ingelheim, Competitive Drug Development International Ltd. and Mitsubishi Tanabe; he also holds the issued Patent on mir-29 for the treatment of systemic sclerosis (US8247389, EP2331143)., Consultant of: Consultancy fees from Actelion, Acceleron Pharma, AnaMar, Bayer, Baecon Discovery, Blade Therapeutics, Boehringer, CSL Behring, Catenion, ChemomAb, Curzion Pharmaceuticals, Ergonex, Galapagos NV, GSK, Glenmark Pharmaceuticals, Inventiva, Italfarmaco, iQvia, medac, Medscape, Mitsubishi Tanabe Pharma, MSD, Roche, Sanofi and UCB, Speakers bureau: Speaker fees from Actelion, Bayer, Boehringer Ingelheim, Medscape, Pfizer and Roche

Understanding Language Features in Loneliness Forum Posts that Elicit Comments (Preprint)

2021 ◽  
Author(s):  
Anietie Andy
Keyword(s):  
Language Processing ◽  
Latent Dirichlet Allocation ◽  
Well Being ◽  
Time Of Day ◽  
Online Forums ◽  
Cohen’S D ◽  
Increased Risk ◽  
Social Media Platforms ◽  
Cohen's D ◽  
To Receive

BACKGROUND Loneliness is a threat to the well-being of individuals and in older adults is associated with increased risk of early mortality. Studies have shown that some individuals seek support around loneliness on online forums/social media platforms. A common challenge in online forums is that some posts do not receive comments. In some non-health related forums, posts not receiving comments may not be a serious concern, however, in an online health forum such as those focused on discussions around loneliness, posts not receiving comments could translate to individuals seeking support around loneliness not receiving adequate support. OBJECTIVE The aim of this work is to analyze posts published on an active online forum focused on discussions around loneliness (loneliness forum) to determine the language features associated with posts that elicit comments from members of the forum. METHODS For the analysis in this work, 15,012 posts published on an online loneliness forum by 9,956 users were analyzed. Of these posts, 6,450 received five or more comments, 13,221 received one or more comments, and 1,791 received no comments. Using the natural language processing method, latent dirichlet allocation (LDA) and a psycholinguistic dictionary, Linguistics Inquiry and Word Count (LIWC), the language features expressed in posts that elicit comments from members of the forum were determined. RESULTS The findings from this work show that posts related to topics themes on relationships (Cohen’s D = 0.319) and the use of negation words (Cohen’s D = 0.149) tend to receive one or more comments. Also, posts associated with LIWC categories on first person singular pronouns (Cohen’s D = 0.264) tend to elicit one or more comments. Posts on topic themes related to spending time around holidays/birthdays/year/time of day or week (Cohen’s D = 0.79) and affection relative to relationships (Cohen’s D = 0.102) tend to receive five or more comments. CONCLUSIONS This work identifies language features expressed in loneliness forum posts that elicit comments. The findings from this work can provide members of online loneliness forums tips on how to write posts that potentially elicit comments from members of the forum.

Education on reactive oxygen species to lay the foundation for understanding therapeutic advances in anticancer therapy.

2021 ◽  
Vol 39 (3_suppl) ◽  
pp. 478-478
Author(s):  
Kinjal Parikh ◽  
Charlotte Warren ◽  
Richard Caracio
Keyword(s):  
Reactive Oxygen Species ◽  
Cell Death ◽  
Cancer Cell ◽  
Reactive Oxygen ◽  
Educational Activity ◽  
Oxygen Species ◽  
Ongoing Research ◽  
Cohen’S D ◽  
Cohen's D ◽  
Post Assessment

478 Background: The disruption of redox balance is increasingly thought to be one of the most important underlying factors contributing to the development, progression, and metastasis of cancers in human cells. This imbalance in redox homeostasis has been shown to be induced by the generation of free radicals, predominantly reactive oxygen species (ROS). Emerging data have established ROS as a new potential therapeutic target. Understanding the mechanisms associated with tumorigenesis is important to integrate novel potential therapeutic targets and understand which tumors or patient populations may benefit from ongoing research. Shortcomings in oncologists’ knowledge and confidence can hamper the integration of new treatments into the care of patients with cancer. Methods: An online continuing education (CME) activity consisted of a multi-media 30-minute video panel of two panelists discussing the mechanism, pathophysiology, and the premises for novel anti-cancer therapies. Educational effect was assessed using a repeated paired pre-/post-assessment study design. A McNemar’s test was used to identify differences between pre- and post-assessment responses. Effect size was calculated using Cohen’s d test by determining the strength of the association between the activity and the outcomes (d < .20 is modest and d ≥ .80 is large). P values were calculated and those < .05 were considered statistically significant. The activity launched 5/14/2020 and data are represented through 8/6/2020. Results: A total of 1,033 learners, of which there are 656 physicians, participated in the activity. Participating in education resulted in statistically significant improvements and noticeable educational effect and data for oncologists that answered all pre- and post-assessment questions are represented below (n = 45, p < .001, Cohen’s d = .454). Percentages represent relative rates of improvement The role of ROS on cancer cell proliferation, cancer cell toxicity, and the tumor microenvironment (67%, p < .05) The interplay of antioxidants to aid in the development of therapies to induce DNA-damaged cell death (100%; p < .001) The potential biomarkers to aid in the development of therapies to induce DNA-damaged cell death (34%; p < .05). Conclusions: This online, interactive, expert-led, CME-certified educational activity resulted in significant gains in oncologist knowledge and confidence regarding the ROS pathway and associated clinical pipeline developments Upon completion of the initiative, only 11% of oncologists were able to answer all 3 matched pre/post questions correctly, signifying the need for further education The novelty of the information to many learners demonstrate the need to continue highlighting clinical advances and molecular pathways that may have potential implications in cancer therapy progress.

scholarly journals Awareness of the Basic Knowledge of Hand Hygiene in Chinese Medical Facilities: A Questionnaire-Based Survey

2020 ◽  
Author(s):  
Jing YANG ◽  
Li LONG ◽  
Shu FENG ◽  
Wei SUN ◽  
Lifang GAO ◽  
...  
Keyword(s):  
Hand Hygiene ◽  
Correct Response ◽  
Response Rate ◽  
Basic Knowledge ◽  
Healthcare Staff ◽  
Healthcare Associated Infection ◽  
Care Facilities ◽  
Healthcare Associated ◽  
Clinical Departments ◽  
Correct Response Rate

Abstract Background: Hand hygiene is a key measure for the prevention and control of healthcare-associated infection. We investigated the level of awareness of the basic concepts surrounding hand hygiene among healthcare staff in China in order to inform the development of future targeted hand hygiene promotion activities. Methods: A pre-tested questionnaire was used to obtain data from April to June 2018 in 30 provinces and municipalities in three regions of China. Ten single/multiple-choice questions investigated the level of awareness of the role of hands in germ transmission, the concept of hand hygiene, and the indications when it should be performed. Logistic analysis was performed to identify differences between regions, types of hospitals, healthcare staff categories, clinical departments and gender.Results: A total of 52,286 responses were received. Among these, 45,455 (86.94%) complete surveys were eligible to be included in the final analysis. The two highest correct response rates concerned the relationship between hand hygiene and healthcare-associated infection and the characteristics of microbiota and resident flora on hands (97.71% and 96.35%, respectively). These were followed by awareness of the World Health Organization’s “My 5 moments for hand hygiene” concept (91.61%), glove use (90.53%), hand hygiene materials (89.28%), characteristics of microbiota and transient flora on hands (84.60%), indications for hand hygiene and other aspects (71.00%), the basic concept of hand hygiene (65.20%), and the effectiveness of alcohol-based handrub on the hand microbiome (48.04%). The overall correct response rate was 26.53%. Eastern China demonstrated a better knowledge than other regions (adjusted odds ratio [aOR] 4.08; 95% CI 3.84–4.32). Respondents in primary care facilities had a higher correct response rate than other types of hospitals (aOR 2.33; 95% CI 2.05–2.66) and logistics staff had the highest correct response rate than other professional groups (aOR1.84; 95% CI 1.53–2.29). Among clinical departments, staff in the outpatient/emergency room had the highest rate of correct responses (aOR1.51; 95% 1.34-1.71).Conclusions: Large differences exist in the basic knowledge of hand hygiene across different regions in China. Knowledge levels need to be specifically strengthened among secondary care facilities, nurse professionals, gynaecology/obstetrics/paediatric departments and infection control units.

scholarly journals Real-Time Extraction of Important Surgical Phases in Cataract Surgery Videos

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Shoji Morita ◽  
Hitoshi Tabuchi ◽  
Hiroki Masumoto ◽  
Tomofusa Yamauchi ◽  
Naotake Kamiura
Keyword(s):  
Neural Network ◽  
Cataract Surgery ◽  
Real Time ◽  
Network Model ◽  
Neural Network Model ◽  
Correct Response ◽  
Response Rate ◽  
The Neural Network ◽  
End Times ◽  
Correct Response Rate

Abstract The present study aimed to conduct a real-time automatic analysis of two important surgical phases, which are continuous curvilinear capsulorrhexis (CCC), nuclear extraction, and three other surgical phases of cataract surgery using artificial intelligence technology. A total of 303 cases of cataract surgery registered in the clinical database of the Ophthalmology Department of Tsukazaki Hospital were used as a dataset. Surgical videos were downsampled to a resolution of 299 × 168 at 1 FPS to image each frame. Next, based on the start and end times of each surgical phase recorded by an ophthalmologist, the obtained images were labeled correctly. Using the data, a neural network model, known as InceptionV3, was developed to identify the given surgical phase for each image. Then, the obtained images were processed in chronological order using the neural network model, where the moving average of the output result of five consecutive images was derived. The class with the maximum output value was defined as the surgical phase. For each surgical phase, the time at which a phase was first identified was defined as the start time, and the time at which a phase was last identified was defined as the end time. The performance was evaluated by finding the mean absolute error between the start and end times of each important phase recorded by the ophthalmologist as well as the start and end times determined by the model. The correct response rate of the cataract surgical phase classification was 90.7% for CCC, 94.5% for nuclear extraction, and 97.9% for other phases, with a mean correct response rate of 96.5%. The errors between each phase’s start and end times recorded by the ophthalmologist and those determined by the neural network model were as follows: CCC’s start and end times, 3.34 seconds and 4.43 seconds, respectively and nuclear extraction’s start and end times, 7.21 seconds and 6.04 seconds, respectively, with a mean of 5.25 seconds. The neural network model used in this study was able to perform the classification of the surgical phase by only referring to the last 5 seconds of video images. Therefore, our method has performed like a real-time classification.

Sign in / Sign up

Export Citation Format

Share Document