AI for Doctors—A Course to Educate Medical Professionals in Artificial Intelligence for Medical Imaging

Successful adoption of artificial intelligence (AI) in medical imaging requires medical professionals to understand underlying principles and techniques. However, educational offerings tailored to the need of medical professionals are scarce. To fill this gap, we created the course “AI for Doctors: Medical Imaging”. An analysis of participants’ opinions on AI and self-perceived skills rated on a five-point Likert scale was conducted before and after the course. The participants’ attitude towards AI in medical imaging was very optimistic before and after the course. However, deeper knowledge of AI and the process for validating and deploying it resulted in significantly less overoptimism with respect to perceivable patient benefits through AI (p = 0.020). Self-assessed skill ratings significantly improved after the course, and the appreciation of the course content was very positive. However, we observed a substantial drop-out rate, mostly attributed to the lack of time of medical professionals. There is a high demand for educational offerings regarding AI in medical imaging among medical professionals, and better education may lead to a more realistic appreciation of clinical adoption. However, time constraints imposed by a busy clinical schedule need to be taken into account for successful education of medical professionals.

Impact evaluation of immunisation service integration to nutrition programmes and paediatric outpatient departments of primary healthcare centres in Rumbek East and Rumbek Centre counties of South Sudan

ObjectiveTo evaluate the impact of immunisation service integration to nutrition programmes and under 5-year-old paediatric outpatient departments of primary healthcare centres in Rumbek East and Rumbek Centre counties of South Sudan.DesignRetrospective intervention study.SettingThree primary healthcare centres in Rumbek East county and three primary healthcare centres in Rumbek Centre county of Lakes state in South Sudan.ParticipantWe extracted the data for the uptake of pentavalent vaccine (first, second and third dose) given to children aged between 6 weeks and 23 months from immunisation records for January–June 2019 before immunisation service integration and July–December 2019 after immunisation service integration from the District Health Information System 2 website to estimate the immunisation uptake ratios and drop-out rates.ResultsThe uptake of the first dose of the pentavalent vaccine improved from 61% to 96% (p<0.001) after immunisation service integration into the nutrition programmes of the primary healthcare centres in Rumbek Centre county. The uptake of the second pentavalent dose improved from 37% to 69% (p<0.001) and for the third pentavalent dose from 36% to 62% (p<0.001), while the drop-out rate reduced from 57% to 40% (p<0.001). While in Rumbek East county, the uptake of the first dose of the pentavalent vaccine improved from 55% to 77% (p<0.001) after immunisation service integration into the under 5-year-old paediatric outpatient departments. The uptake of the second dose improved from 36% to 62% (p<0.001) and for the third dose from 44% to 63% (p<0.001), while the drop-out rate reduced from 40% to 28% (p<0.001). Children were 23% more likely (RR 1.23, 95% CI 1.12 to 1.36, p<0.001) to be immunised with the first dose of the pentavalent vaccine on immunisation service integration into the nutrition programmes of primary healthcare centres of Rumbek Centre county in comparison to integration into under 5-year-old outpatient departments of Rumbek East county.ConclusionIntegration of immunisation service delivery to nutrition sites and children’s outpatient departments improved the immunisation coverage and decreased drop-out rates in the Rumbek East and Rumbek Centre counties of South Sudan. This evidence of positive impact should encourage the stakeholders of the Expanded Programme on Immunisation to focus on the sustainability and scale-up of this intervention to other counties in South Sudan, as logistically as possible.

Open-label placebo treatment to improve relaxation training effects in healthy psychology students: a randomized controlled trial

Placebos, that are administered with deception, can reduce stress and increase relaxation. The present study investigated an open-label placebo (OLP) to improve the effects of Progressive Muscle Relaxation (PMR) training. A total of 160 psychology students were randomly assigned to a 14-day PMR course with or without daily OLP treatment. The placebo was administered along with an explanation of placebo effects and the verbal suggestion that the OLP activates the body’s natural relaxation response. The relaxation instructions for home practice were delivered via a smartphone app, which was also used for the evaluation of the exercises. The participants of the OLP group completed more PMR exercises (M = 9.75) than the group without a placebo (M = 8.15). The two groups did not differ in reported exercise-related changes in relaxation level. On average, the OLP group rated the effects of the placebo as very low and was characterized by a higher drop-out rate compared to the group without OLP. Some participants experienced the OLP as negative. In conclusion, factors that influence the acceptance of OLP treatment require further investigation.

Potential Virus Involvement in Alzheimer’s Disease: Results from a Phase IIa Trial Evaluating Apovir, an Antiviral Drug Combination

Background: Accumulating data suggest infectious agents are involved in Alzheimer’s disease (AD). The two primary aims of this trial were to assess safety and efficacy of an antiviral drug combination on AD progression. Objective: The trial evaluated whether Apovir, a combination of two antiviral agents, pleconaril (active on enteroviruses) and ribavirin (active on several viruses), could slow AD progression. Methods: Sixty-nine patients 60–85 years were treated with Apovir or placebo for 9 months and followed until 12 months after end of treatment. Cognitive tests, safety, biomarkers, drug plasma, and cerebrospinal fluid concentrations were assessed. Results: The tolerability of Apovir was compromised as demonstrated by the large drop-out rate and increased frequency and severity of adverse events. The primary endpoint, demonstrating a difference in change from baseline to 9 months between groups in ADAS-cog total score, was not met (p = 0.1809). However, there were observations indicating potential effects on both ADAS-cog and CDR-SB but these effects need to be verified. Also, there was a decrease in cerebrospinal fluid amyloid-β in Apovir at 9 months (p = 0.0330) but no change in placebo. Conclusion: This was the first randomized, placebo controlled clinical trial exploring antiviral treatment on AD progression. The trial is considered inconclusive due to the large drop-out rate. New trials are needed to verify if the indications of effect observed can be confirmed and which component(s) in Apovir contributed to such effects. Pleconaril alone may be studied to improve the tolerability and to verify if enterovirus is involved in the disease process.

Impact evaluation of immunisation service integration to nutrition programmes and pediatric outpatient departments of primary health care centers in Rumbek East and Rumbek Centre counties of South Sudan

Objective:To evaluate the impact of immunisation service integration to nutrition programmes and under 5-year-old outpatient departments of primary health care centres in Rumbek East and Rumbek Centre counties of South Sudan.Design:A retrospective intervention study was conducted in selected primary health care centers (PHCCs).Setting:The study was conducted in 3 primary healthcare centres in Rumbek East county and 3 primary healthcare centres in Rumbek Centre county in Lakes state of South Sudan.Participant:We extracted the data for the uptake of pentavalent vaccine (1st, 2nd and 3rd dose) given to children between 6 weeks old to 23 months old from immunisation records for January to June 2019 before immunisation service integration and July 2019 to December 2019 after immunisation service integration on the District Health Information System 2 (DHIS2) website to estimate the immunisation uptake ratio and drop-out rate.Results:The uptake of the first dose of the pentavalent vaccine improved from 61–96% (p < 0.001) after immunisation service integration into the nutrition programmes of the primary health care centers in Rumbek Centre county. The uptake of the second pentavalent dose improved from 37–69% (p = 0.102) and for the third pentavalent dose from 36–62% (p < 0.001), while the drop-out rate reduced from 57–40% (p < 0.001). While in Rumbek East county, the uptake of the first dose of the pentavalent vaccine improved from 55–77% (p < 0.001) after immunisation service integration into the under 5-year-old pediatric outpatient departments. The uptake of the second dose improved from 36–62% (p < 0.001) and for the third dose from 44–63% (p < 0.001), while the drop-out rate reduced from 40–28% (p < 0.001). Children were 23% more likely (RR: 1.23 [95% CI: 1.01–1.50]) to have been immunised with the first dose of the pentavalent vaccine upon immunisation service integration into the nutrition programmes of primary health care centers of Rumbek Centre county in comparison to integration into under 5-year-old outpatient departments of Rumbek East county.Conclusion:Integration of immunisation service delivery to nutrition sites and children’s outpatient departments improved the immunisation coverage and decreased drop-out rate. Stakeholders of the extended programme on immunisation should focus on the sustainability and scale-up of this intervention as it has high potential to improve childhood immunisation coverage and lower the high rates of vaccine preventable deaths among the children in South Sudan.

Internet-based treatment of anxiety and depression in patients with ischemic heart disease attending cardiac rehabilitation: a feasibility study (eMindYourHeart)

Introduction Anxiety and depression are prevalent in 20% of patients with ischemic heart disease (IHD), however, treatment of psychological conditions is not commonly integrated in cardiac rehabilitation. Internet-based psychological treatment holds the potential to bridge this gap. Purpose To examine the feasibility of an eHealth intervention targeting anxiety and depression in patients with IHD attending cardiac rehabilitation. Methods We used a mixed-methods design, including quantitative methods to examine drop-out and change in anxiety and depression scores, and qualitative methods (thematic analysis) to evaluate patients’ and nurses’ experiences with the intervention. The therapist-guided intervention consisted of 12 modules provided via a web-based platform. The primary outcome was drop-out, with a drop-out rate &lt;25% considered acceptable. Patients were considered as non-drop-out if they completed ≥5 modules. Results Out of 60 patients screened positive for anxiety and/or depression, 29 patients were included. The drop-out rate was 24% (7/29). Patients had a mean improvement in anxiety and depression scores of 5.5 and 4.6, respectively. On average, patients had 8.0 phone calls with their therapist and 19.7 written messages. The qualitative analysis of patients’ experiences identified four themes: treatment platform, intervention, communication with therapist, and personal experience. Patients were positive towards the intervention, although some found the assignments burdensome. From the nurses we identified three themes: intervention, inclusion procedure and collaboration with study team. The nurses were positive, however, due to limited time some struggled with the inclusion procedure. Conclusion Integrating an eHealth intervention in cardiac rehabilitation is feasible and the drop-out rate acceptable.

Promoting Engagement in a CS1 Course with Assessment for Learning

This practice report discusses the evolution of a CS1 Course taught at the University of Liège, Belgium. Over the last seven years several teaching activities have been thought to complement traditional theoretical courses and exercise sessions in order to promote students’ engagement. The result is aligned with (i) the principles of assessment for learning, which consists in leveraging the assessment to improve the students learning, and (ii) the concept of blended learning. This report describes the difficulties the students faced and what we implemented to assist our course evolution. We also present and discuss results showing that, despite a high drop-out rate, we managed to engage students to work on a regular basis and, in some cases, raise their performance levels.