145 Improving Management of Mood Disorders Through an Online Interactive Patient Case Challenge

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 90-91
Author(s):  
Jovana Lubarda ◽  
Piyali Chatterjee-Shin ◽  
Joseph F. Goldberg
Keyword(s):  
Mood Disorders ◽  
Bipolar Depression ◽  
Accurate Diagnosis ◽  
Educational Activity ◽  
List Type ◽  
Type Number ◽  
Data Set ◽  
P Values ◽  
Mixed Features ◽  
Post Assessment

AbstractBackgroundTo determine if online continuing medical education (CME) could improve knowledge, competence, and confidence of psychiatrists and primary care physicians (PCPs) in managing patients with major depressive disorder (MDD) and co-occurring hypomanic/manic features.Methods∙Physicians participated in a 1-hour text-based, online CME activity composed of 2 patient cases with interactive questions related to diagnosis, assessment, and management of various presentations of MDD∙Evidence-based educational feedback was provided following each answer∙Effects of CME were assessed using a repeated-question pairs pre- to post-assessment study design where individual participants served as his/her own control∙The assessment included 3 multiple-choice knowledge/competence questions and 1 self-efficacy question that rated confidence in managing MDD with mixed features on a 5-point Likert Scale∙For all questions combined, McNemar’s chi-square test assessed the differences from pre- to post-assessment∙P values measured significance; P values <.05 were considered statistically significant∙Effect size was calculated using Cramer’s V by determining the change in proportion of participants who answered questions correctly from pre- to post- assessment∙Survey data were collected from December 8th, 2016, to January 24th, 2017.Results∙Data set included responses from 1454 psychiatrists and 488 PCPs who completed all assessment questions during the study period∙Psychiatrists: Knowledge/competence improved (P<.001; V=0.54; large educational effect) following participation in the CME activity:°While 5% answered all 3 questions correctly on pre-assessment, 70% answered them all correctly on post- assessment, with the largest increases on accurate differentiation between possible signs of mania and depression, accurate diagnosis of bipolar depression, and ability to select treatments for MDD with mixed features°20% reported being more confident in their ability to select treatments for various presentations of mood disorders∙PCPs: Knowledge/competence improved (P<.001; V=0.49; large educational effect) following participation in the CME activity:°While 2% answered all 3 questions correctly on pre-assessment, 48% answered them all correctly on post-assessment, with the largest increases on accurate differentiation between possible signs of mania and depression, accurate diagnosis of bipolar depression, and ability to select treatments for MDD with mixed features°24% reported being more confident in their ability to select treatments for various presentations of mood disordersConclusionsOnline CME in a clinically relevant interactive case-based format can improve knowledge, competence, and confidence in management of various presentations of mooddisorders and better equip physicians to recognize key features, accurately diagnose, and treat the complex spectrum of this patient population.Funding AcknowledgementsThe educational activity and outcomes measurement were funded through an independent educational grant from Sunovion Pharmaceuticals Inc.

Abstract 250: Antiplatelet Therapy in Post-Acute Coronary Syndrome: Effect of Education on Physician Knowledge and Competence

2018 ◽  
Vol 11 (suppl_1) ◽  
Author(s):  
Thomas O’Neil ◽  
Philippe Guedj ◽  
Suzanne Hughes
Keyword(s):  
Acute Coronary Syndrome ◽  
Antiplatelet Therapy ◽  
Educational Activity ◽  
Medium Effect ◽  
Online Video ◽  
P Values ◽  
Coronary Syndrome ◽  
Physician Knowledge ◽  
Platelet Receptor ◽  
Post Assessment

Background: Decreasing hospital readmission rates resulting from suboptimal antiplatelet therapy requires education to diminish an gap in physician knowledge/competence. We sought to determine if online medical education could improve clinical knowledge/competence regarding dual antiplatelet therapy (DAPT) in post-acute coronary syndrome (ACS) patients among non-United States (US) cardiologists. Methods: The educational activity was a 30-minute online video discussion between 4 experts with synchronized slides. Educational effect was assessed using a 4-question repeated pairs pre-/post-assessment and McNemar’s chi-squared test. P values are shown as a measure of significance; P values <.05 are statistically significant. Cramer’s V statistic indicated the effect size (<0.05 no effect; 0.06-0.15 small effect, 0.16-0.30 medium effect, >0.30 large effect). The activity launched August 23, 2016; data were collected through December 20, 2016. Results: 117 non-US cardiologists completed the study. The change in correct responses from pre- to post-assessment achieved statistical significance (P<.05) for 2 of 3 questions. An average of 26% of cardiologists selected the best response at pre-assessment (range, 9% to 38%); this figure improved to an average of 35% at post-assessment (range, 22% to 55%). Specific improvements were observed in the following areas: The relationship between platelet reactivity and stent thrombosis with DAPT post-drug eluting stent implantation (90% improvement, 29%pre vs 55%post, P = <.001) Optimal treatment strategy with adenosine diphosphate platelet receptor (P2Y12) inhibition in patients with unstable angina or non-ST segment myocardial infarction (144% improvement, 9%pre vs 22%post, P =.007) Conclusion: Participation in a 30-minute online video discussion with synchronized slides resulted in statistically significant improvement in non-US cardiologists’ knowledge and competence regarding DAPT in patients with post-ACS.

New Three-Dimensional Algebraic Reconstruction Techniques (Art)

1971 ◽  
Vol 29 ◽  
pp. 82-83 ◽  
Author(s):  
Richard Gordon ◽  
Robert Bender
Keyword(s):  
Three Dimensional ◽  
Fourier Method ◽  
List Type ◽  
Type Number ◽  
Data Set ◽  
3 Dimensional ◽  
Dimensional Reconstruction ◽  
Algebraic Reconstruction Techniques ◽  
Electron Microscope Data ◽  
Algebraic Reconstruction

Algebraic reconstruction techniques (ART) for 3-dimensional reconstruction from electron microscope data have been developed and implemented in this laboratory. These methods are an alternitive to the Fourier method of de Rosier and Klug and have several advantages over it, such as:relatively few views are required (about 6-12)limited angular ranges give useful reconstructions (+/-30°)no presumption of symmetry is necessary for facile implementingcomputation is fasterthe computation is stable in the presence of noiseThe dimensionality of the problem may be reduced from three to two by tilts about a single axis, so that planes perpendicular to the axis of tilt are independent of each other. This is not absolutely necessary, but is by far the most tractable mode computationally. A typical input data set, then, consists of m≥6 photos of the same region of the specimen at several known angles of tilt about the same axis. In general the direction of the tilt axis is not known.

scholarly journals 488 The impact of education on novel concepts in metastatic melanoma: triplet therapy

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A524-A524
Author(s):  
Kinjal Parikh ◽  
Sara Fagerlie ◽  
Patrick Kugel ◽  
Richard Caracio ◽  
Ryan Sullivan
Keyword(s):  
Clinical Trial ◽  
Checkpoint Inhibitors ◽  
Panel Discussion ◽  
Clinical Trial Data ◽  
Advanced Melanoma ◽  
Trial Data ◽  
Educational Activity ◽  
List Type ◽  
The Impact ◽  
Post Assessment

BackgroundAdvanced melanoma treatment selection is guided by BRAF-mutation status and patient and disease-specific factors. Historically, oncologists decided between targeted therapy or immune checkpoint inhibitors (ICI). However, given the differences in onset of activity, response durability, and adverse events combination BRAF/MEK inhibitors and ICI (triplet therapy) are being evaluated to optimize outcomes. With several trials due to report, oncologists need education to stay up-to-date on the available data and contextualize this potential treatment option.MethodsAn online continuing education (CME) activity consisting of a multi-media 30-minute video panel discussion explored the rationale, available clinical trial data, and future directions of triplet therapy for the treatment of advanced BRAF-mutated melanoma. Educational effect was assessed using a repeated pairs pre-assessment/post-assessment study design and compared the pre- and post-assessment responses. A chi-square test was used to identify differences between pre- and post-assessment responses. Effect size was calculated using Cramer’s V test by determining the strength of the association between the activity and the outcomes (V = 0.16–0.26 is considerable and V > 0.26 is extensive). P values were calculated and those < 0.05 were considered statistically significant. Data from oncologist participants were collected between 12/23/2019 through 2/26/20.ResultsParticipation in education resulted in statistically significant improvements and noticeable educational effect for oncologists (n=49; p < 0.05, V =0.136). • 39% of pre-assessment questions were correctly answered increasing to 52% post-assessment • 15% of oncologists had a measurable improvement in confidence regarding the rationale for use of triplet therapy in advanced melanoma• Significant improvement in knowledge regarding clinical trial data in triplet therapy was observed (35% vs. 55%; p < 0.05, V = 0.205)ConclusionsThis online, interactive, expert-led, CME-certified educational activity resulted in significant gains in oncologist knowledge and confidence regarding triplet therapy in the management of melanoma. These results demonstrate the effectiveness of on-demand education but also highlight an ongoing need for education on this topic as further data becomes available.AcknowledgementsThis educational initiative was supported through educational grants from Novartis Pharmaceuticals Corporation and GenentechReferenceSullivan RJ, Salama AKS. Managing Melanoma: Emerging Concepts of Triplet Therapy. https://www.medscape.org/viewarticle/923003

489 The impact of education on novel concepts in adjuvant melanoma: a closer look at high risk stage II disease

2020 ◽  
Vol 8 (Suppl 3) ◽  
pp. A525-A525
Author(s):  
Kinjal Parikh ◽  
Charlotte Warren ◽  
Emily Van Laar ◽  
Jason Luke
Keyword(s):  
High Risk ◽  
Adjuvant Therapy ◽  
Adjuvant Treatment ◽  
Stage Ii ◽  
Educational Activity ◽  
List Type ◽  
Optimal Care ◽  
Multi Media ◽  
The Impact ◽  
Post Assessment

BackgroundAdjuvant therapy for patients with melanoma is currently recommended for patients with stage III disease with either immune checkpint inhibitors or combination dabrafenib/trametinib based on BRAF-status. Adjuvant treatment demonstrates improvement in recurence-free survival and overall survival. However, risk models suggesting that patients with stage IIB/IIC disease may have a higher risk of recurrence than patients with stage IIIA disease have prompted exploration into the use of adjuvant therapy in this patient subgroup as well. With several ongoing trials due to report, oncologists need education to stay up-to-date on the available data and contextualize this potential treatment option to implement therapy at the earliest point of clinical benefit to patients while also collaborating with surgical teams for optimal care planning.MethodsAn online continuing education (CME) activity consisted of a multi-media 30-minute video panel of a medical oncologist and surgical oncologist discussing the rationale, available clinical trial data, and future directions of adjuvant therapy for the treatment of patients with stage II melanoma. Educational effect was assessed using a repeated paired pre-assessment/post-assessment study design and compared the pre- and post-assessment responses. A chi-square test was used to identify differences between pre- and post-assessment responses. Effect size was calculated using Cramer’s V test by determining the strength of the association between the activity and the outcomes (V = 0.16–0.26 is considerable and V > 0.26 is extensive). P values were calculated and those < 0.05 were considered statistically significant. Data from 65 oncologists and 138 surgeons are represented here through 8/12/2020.ResultsParticipation in education resulted noticeable educational effects for both oncologists (p < 0.01, V=0.143) and surgeons (p = 0.001, V=0.114): Statistically significant improvements in knowledge and competence were also seen regarding: -Knowledge regarding the rationale for adjuvant therapy in stage II diseaseo Oncologists: 46% pre; 69% post, p < 0.01o Surgeons: 24% pre; 36% post, p < 0.05 -Competence utilizing patient and tumor characteristics to identify potential candidates for adjuvant therapy in stage II diseaseo Oncologists: 52% pre; 77% post, p < 0.01o Surgeons: 29% pre; 43% post, p < 0.05-Increase in confidence was also observed for coordinating with the multidisciplinary team to augment surgical care with potential systemic adjuvant treatment for eligible patientso 22% improvement for oncologists o 19% improvement for surgeonsConclusionsThis online, interactive, multi-media, expert-led, CME-certified educational activity resulted in significant gains in oncologist and surgeon knowledge and competence with improvements in confidence regarding the role of adjuvant therapy in the management of high risk stage II melanoma and recommending clinical trials for eligible patients. These results demonstrate the effectiveness of education, especially in online and on-demand formats and those requiring cross-discipline collaboration, and also highlights an ongoing need to further educate on this topic.AcknowledgementsThis educational initiative was supported through independent educational grants from Bristol Myers Squibb.ReferenceLuke J, Yoon C. Adjuvant Melanoma Treatment: Can We Improve Outcomes for More Patients: https://www.medscape.org/viewarticle/932047.

Solar Corona Investigation by the Coronal Line Photometer at Lomnický Peak

1994 ◽  
Vol 144 ◽  
pp. 431-434
Author(s):  
M. Minarovjech ◽  
M. Rybanský
Keyword(s):  
Solar Corona ◽  
Time Resolution ◽  
Active Regions ◽  
High Time ◽  
High Time Resolution ◽  
List Type ◽  
Type Number ◽  
Coronal Line ◽  
Global Cycle

AbstractThis paper deals with a possibility to use the ground-based method of observation in order to solve basic problems connected with the solar corona research. Namely:1.heating of the solar corona2.course of the global cycle in the corona3.rotation of the solar corona and development of active regions.There is stressed a possibility of high-time resolution of the coronal line photometer at Lomnický Peak coronal station, and use of the latter to obtain crucial observations.

The LDE-Type Flare Occurrence (1969-1993)

1994 ◽  
Vol 144 ◽  
pp. 279-282
Author(s):  
A. Antalová
Keyword(s):  
Time Series ◽  
Fourier Analysis ◽  
Sunspot Cycle ◽  
List Type ◽  
Type Number ◽  
Solar Cycles ◽  
Type Iv ◽  
Long Duration ◽  
Cycle Maximum ◽  
Flare Index

AbstractThe occurrence of LDE-type flares in the last three cycles has been investigated. The Fourier analysis spectrum was calculated for the time series of the LDE-type flare occurrence during the 20-th, the 21-st and the rising part of the 22-nd cycle. LDE-type flares (Long Duration Events in SXR) are associated with the interplanetary protons (SEP and STIP as well), energized coronal archs and radio type IV emission. Generally, in all the cycles considered, LDE-type flares mainly originated during a 6-year interval of the respective cycle (2 years before and 4 years after the sunspot cycle maximum). The following significant periodicities were found:• in the 20-th cycle: 1.4, 2.1, 2.9, 4.0, 10.7 and 54.2 of month,• in the 21-st cycle: 1.2, 1.6, 2.8, 4.9, 7.8 and 44.5 of month,• in the 22-nd cycle, till March 1992: 1.4, 1.8, 2.4, 7.2, 8.7, 11.8 and 29.1 of month,• in all interval (1969-1992):a)the longer periodicities: 232.1, 121.1 (the dominant at 10.1 of year), 80.7, 61.9 and 25.6 of month,b)the shorter periodicities: 4.7, 5.0, 6.8, 7.9, 9.1, 15.8 and 20.4 of month.Fourier analysis of the LDE-type flare index (FI) yields significant peaks at 2.3 - 2.9 months and 4.2 - 4.9 months. These short periodicities correspond remarkably in the all three last solar cycles. The larger periodicities are different in respective cycles.

Discussion following the presentation by F. Deubner

1977 ◽  
Vol 36 ◽  
pp. 69-74
Keyword(s):  
List Type ◽  
The Sun ◽  
Type Number ◽  
Harmonic Motion ◽  
Locally Excited ◽  
Long Period ◽  
Coherent Wave ◽  
Short Period ◽  
Global Modes

The discussion was separated into 3 different topics according to the separation made by the reviewer between the different periods of waves observed in the sun :1) global modes (long period oscillations) with predominantly radial harmonic motion.2) modes with large coherent - wave systems but not necessarily global excitation (300 s oscillation).3) locally excited - short period waves.

Prominences and Solar Activity

1979 ◽  
Vol 44 ◽  
pp. 357-372
Author(s):  
Z. Švestka
Keyword(s):  
Solar Activity ◽  
Solar Cycle ◽  
List Type ◽  
Type Number ◽  
Flare Loops ◽  
Filament Activation

The following subjects were discussed:(1)Filament activation(2)Post-flare loops.(3)Surges and sprays.(4)Coronal transients.(5)Disk vs. limb observations.(6)Solar cycle variations of prominence occurrence.(7)Active prominences patrol service.Of all these items, (1) and (2) were discussed in most detail and we also pay most attention to them in this report. Items (3) and (4) did not bring anything new when compared with the earlier invited presentations given by RUST and ZIRIN and therefore, we omit them.

A New System For Optomanual Semiautomatic Quantitative Image Analysis

1977 ◽  
Vol 35 ◽  
pp. 210-211
Author(s):  
H.P. Rohr
Keyword(s):  
Image Analysis ◽  
Volume Density ◽  
List Type ◽  
Distribution Analysis ◽  
Type Number ◽  
Point Counting ◽  
Human Eye ◽  
Quantitative Image ◽  
Point Density ◽  
Electronic Counting

Today, in image analysis the broadest possible rationalization and economization have become desirable. Basically, there are two approaches for image analysis: The image analysis through the so-called scanning methods which are usually performed without the human eye and the systems of optical semiautomatic analysis completely relying on the human eye.The new MOP AM 01 opto-manual system (fig.) represents one of the very promising approaches in this field. The instrument consists of an electronic counting and storing unit, which incorporates a microprocessor and a keyboard for choice of measuring parameters, well designed for easy use.Using the MOP AM 01 there are three possibilities of image analysis:the manual point counting,the opto-manual point counting andthe measurement of absolute areas and/or length (size distribution analysis included).To determine a point density for the calculation of the corresponding volume density the intercepts lying within the structure are scanned with the light pen.

Hydration Chamber for Jeolco 200 Kv Microscope

1970 ◽  
Vol 28 ◽  
pp. 542-543
Author(s):  
V. R. Matricardi ◽  
G. G. Hausner ◽  
D. F. Parsons
Keyword(s):  
Electron Microscope ◽  
Water Vapor ◽  
Vapor Pressure ◽  
Pressure Gradient ◽  
Room Temperature ◽  
List Type ◽  
Type Number ◽  
Equilibrium Vapor Pressure

In order to observe room temperature hydrated specimens in an electron microscope, the following conditions should be satisfied: The specimen should be surrounded by water vapor as close as possible to the equilibrium vapor pressure corresponding to the temperature of the specimen.The specimen grid should be inserted, focused and photo graphed in the shortest possible time in order to minimize dehydration.The full area of the specimen grid should be visible in order to minimize the number of changes of specimen required.There should be no pressure gradient across the grid so that specimens can be straddled across holes.Leakage of water vapor to the column should be minimized.

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