Conception and Feasibility of a Digital Tele-Guided Abdomen, Thorax, and Thyroid Gland Ultrasound Course for Medical Students (TELUS study)

Purpose Medical education has been transformed during the COVID-19 pandemic, creating challenges regarding adequate training in ultrasound (US). Due to the discontinuation of traditional classroom teaching, the need to expand digital learning opportunities is undeniable. The aim of our study is to develop a tele-guided US course for undergraduate medical students and test the feasibility and efficacy of this digital US teaching method. Materials and Methods A tele-guided US course was established for medical students. Students underwent seven US organ modules. Each module took place in a flipped classroom concept via the Amboss platform, providing supplementary e-learning material that was optional and included information on each of the US modules. An objective structured assessment of US skills (OSAUS) was implemented as the final exam. US images of the course and exam were rated by the Brightness Mode Quality Ultrasound Imaging Examination Technique (B-QUIET). Achieved points in image rating were compared to the OSAUS exam. Results A total of 15 medical students were enrolled. Students achieved an average score of 154.5 (SD ± 11.72) out of 175 points (88.29 %) in OSAUS, which corresponded to the image rating using B-QUIET. Interrater analysis of US images showed a favorable agreement with an ICC (2.1) of 0.895 (95 % confidence interval 0.858 < ICC < 0.924). Conclusion US training via teleguidance should be considered in medical education. Our pilot study demonstrates the feasibility of a concept that can be used in the future to improve US training of medical students even during a pandemic.

The Value of Convolutional-Neural-Network-Algorithm-Based Magnetic Resonance Imaging in the Diagnosis of Sports Knee Osteoarthropathy

The application value of the convolutional neural network (CNN) algorithm in the diagnosis of sports knee osteoarthropathy was investigated in this study. A network model was constructed in this experiment for image analysis of magnetic resonance imaging (MRI) technology. Then, 100 cases of sports knee osteoarthropathy patients and 50 healthy volunteers were selected. Digital radiography (DR) images and MRI images of all the research objects were collected after the inclusion of the two groups. Besides, the important physiological representations were extracted from their image data graphs, and the hidden complex relationships were learned. The state without input results was judged through convolutional network calculation, and the result prediction was given. On this basis, there was an analysis of the diagnostic efficiency of traditional DR images and MRI images based on CNN for patients with sports knee osteoarthropathy. The results showed that the MRI images analyzed by the CNN model showed a more obvious display rate than DR images for some nonbone changes of osteoarthritis. The correlation coefficient between MRI image rating and visual analog scale (VAS) was 0.865, which was higher than 0.713 of DR image rating, with a statistical meaning ( P < 0.01 ). For cases with mild lesions, the number of cases detected by MRI based on CNN algorithm in 0–4 image rating was 15, 18, 10, 6, and 7, respectively, which was markedly better than that of DR images. In short, the MRI examination based on the CNN image analysis model could extract important physiological representations from the image data and learn the hidden complex relationships. The convolutional network was calculated to determine the state of the uninput results and give the result predictions. Moreover, MRI examination based on the CNN image analysis model had high overall diagnostic efficiency and grading diagnostic efficiency for patients with motor knee osteoarthropathy, which was of great significance in clinical practice.

AB0846 CONCEPTION AND FEASIBILITY OF A DIGITAL TELE-GUIDED ABDOMEN, THORAX AND THYROID GLAND ULTRASOUND COURSE FOR MEDICAL STUDENTS

Background:Over the past few decades, technological advances in both ultrasound (US) and the application of telemedicine have been made [1]. Medical education has shifted to online classes during the COVID-19 pandemic, creating challenges in adequate training of US.Objectives:In the context of the current COVID-19 pandemic and the discontinuation of traditional classroom teaching, a tele-didactic US course for undergraduate medical students was developed. This study is examining the educational outcome of a new digital US course of the abdomen, thorax and the thyroid gland with the implementation of a modern portable US system.Methods:A tele-guided US course was established between April 1st and June 20th, 2020, at the University Hospital in Bonn, Germany. Students completed pre-and post-course surveys and underwent six US organ modules. Each module took place in a flipped-classroom concept including a digital learning platform. An objective structured assessment of US skills (OSAUS) [2] was implemented as final exam. Further, US images of the course and exam were rated by the Brightness Mode Quality Ultrasound Imaging Examination Technique (B-QUIET) [3]. Achieved points in image rating were compared to the OSAUS exam and survey results.Results:A total of 15 medical students were enrolled. There was a significant increase in self-assessed theoretical and practical ability (p < 0.001). Students achieved an average score of 154.5 (SD ± 11.72) out of 175 points (88.29%) in OSAUS, which corresponded to the image rating using B-QUIET and self-assessment data obtained in surveys. Interrater analysis of US images showed a favorable agreement with an ICC (2,1) of 0.895 (95% confidence interval 0.858 < ICC < 0.924).Conclusion:US training via teleguidance should be considered in medical education. Our pilot study demonstrates the feasibility of this concept that can be used in the future to improve US training of medical students even during a pandemic. The digital implementation with an affordable, portable point-of-care-US device could be an incredible opportunity to expedite US training worldwide.References:[1]Law J, Macbeth PB. Ultrasound: from Earth to space. Mcgill J Med 2011; 13(2): 59 [PMID: 22399873][2]Tolsgaard MG, Todsen T, Sorensen JL, et al. International multispecialty consensus on how to evaluate ultrasound competence: a Delphi consensus survey. PLoS One 2013; 8(2): e57687[https://doi.org/10.1371/journal.pone.0057687][PMID: 23469051][3]Bahner DP, Adkins EJ, Nagel R, Way D, Werman HA, Royall NA. Brightness mode quality ultrasound imaging examination technique (B-QUIET): quantifying quality in ultrasound imaging. J Ultrasound Med 2011; 30(12): 1649–55[4][https://doi.org/10.7863/jum.2011.30.12.1649][PMID: 22124000]Figure 1.Implementation of the digital ultrasound course conceptClassroom setting is displayed, demonstrating simultaneous screen transmission of ultrasound (US) and camera images. A: The peer tutor’s camera image is shared with the students while demonstrating the US examination, B: At the same time the tutor’s mobile phone screen is shared with the students in order to visualize the US image acquisition, C: Students performing the US examination on their own, D: Example of a worksheet, which had to be completed within the app and was stored along with the US images in the cloudDisclosure of Interests:None declared

Methodologies in Identification, Analysis, and Measurement of Visual Pollution: The Case Study of Intramuros

The problem of visual pollution in the Philippines has been increasingly evident, and people are becoming aware of it. But to create effective solutions, a deep understanding of the problem should first be established. This paper was aimed to identify, analyze, and measure the visual pollution present in Intramuros, a heritage city in the Philippines that encapsulates the Philippine colonial architecture in the 1890s. The site is known for its preservation of its city image but also modern landscape changes. To achieve the goal, the application of the Indirect and Direct Method of Landscape Evaluation was executed. These methods led to two results: (1) the identification of components— which are landscape attributes and indicators, that make up a visual landscape; and (2) the understanding of how it is perceived by the observer through a survey and interviews, which are quantified by ratings. To further understand the relationship of indicators and ratings with each other, a series of correlational studies was done. This resulted to the establishment of Disturbance, Stewardship, and Image Rating as the primary descriptors of visual pollution. A weighted average formula was then established, which quantified the visual pollution of Intramuros through indicator values and response ratings. It was concluded that visual pollution in Intramuros, through research-based methodology, can be identified, analyzed, and measured. Specific viewpoints in the district were identified as unacceptably visually-polluted. Magallanes St. cor. Victoria St. in Intramuros had the highest VP Score at -4.886. Elements that contributed to visual pollution were also identified.

Examining the Effects of Facial Expression and Image Presentation on Mood

Existing research shows that “pleasant” or “unpleasant” moods can be primed by presenting participants with “pleasant” or “unpleasant” images (Avero &amp; Calvo, 2006), and that stronger priming effects are induced by images as opposed to text (Powell et al., 2015). However, no previous research shows whether or not mood induction effects may differ based on image presentation format. Therefore, the present work aimed to test this hypothesis, by presenting participants (N = 145) with either standalone or grouped images, displaying either positive or negative facial expressions. We found that both facial expression and image presentation had a significant effect on participants’ average ratings of the emotional valence of the images, including a significant interaction effect. However, only facial expression had a significant effect on mood change. We found a slight correlation (r = .298) between image rating and mood change, suggesting that image presentation may have a slight effect on mood change that was unable to be observed in this small-scale study.

Implementation and evaluation of a community-based treatment for late-life hoarding

Objectives: The objective of this paper was to examine the implementation and effectiveness of a community-based intervention for hoarding disorder (HD) using Cognitive Rehabilitation and Exposure/Sorting Therapy (CREST). Design: This was a mixed-method, pre-post quasi-experimental study informed by the Practical, Robust Implementation and Sustainability Model for implementation science. Setting: Program activities took place in San Diego County, mainly within clients’ homes or community, with some activities in-office. Participants: Participants were aged 60 years or older, met eligibility for Medi-Cal or were uninsured, and met criteria for HD. Intervention: A manualized, mobile protocol that incorporated CREST was utilized. Measurements: The Clutter Image Rating and Hoarding Rating Scale were used as effectiveness outcomes. An investigator-created staff questionnaire was used to evaluate implementation. Results: Thirty-seven clients were reached and enrolled in treatment and 15 completed treatment during the initial 2 years of the program. There were significant changes in hoarding severity and clutter volume. Based on the initial 2 years of the program, funding was provided for expansion to cover additional San Diego County regions and hire more staff clinicians in year three. Conclusion: Preliminary data suggest that the CREST intervention can be successfully implemented in a community setting with positive results for older adults with HD.

Social Evaluation of Faces Across Gender and Familiarity

Models of social evaluation aim to capture the information people use to form first impressions of unfamiliar others. However, little is currently known about the relationship between perceived traits across gender. In Study 1, we asked viewers to provide ratings of key social dimensions (dominance, trustworthiness, etc.) for multiple images of 40 unfamiliar identities. We observed clear sex differences in the perception of dominance—with negative evaluations of high dominance in unfamiliar females but not males. In Study 2, we used the social evaluation context to investigate the key predictions about the importance of pictorial information in familiar and unfamiliar face processing. We compared the consistency of ratings attributed to different images of the same identities and demonstrated that ratings of images depicting the same familiar identity are more tightly clustered than those of unfamiliar identities. Such results imply a shift from image rating to person rating with increased familiarity, a finding which generalises results previously observed in studies of identification.

Validation of the clutter image rating in older adults with hoarding disorder

ABSTRACTBackground:The Clutter Image Rating (CIR) was created to meet a gap in the research on compulsive hoarding: how to ascertain clutter level in an individual's home without a home visit, as not all clinicians have the ability to conduct a home visit. The CIR has proven itself to be both reliable and valid for use in adults with compulsive hoarding symptoms. However, there is currently a dearth of information on performance of the CIR in older adults diagnosed with hoarding disorder (HD). Because older adults have increased medical issues, including fall risks, evaluating the level of clutter in the house is especially critical in geriatric populations.Method:The current study was an investigation of the reliability and validity of the CIR in assessing late life HD. The internal consistency, convergent and divergent validity, and norms of the CIR were investigated in a large geriatric HD sample and compared with a midlife sample of individuals with HD. Criterion validity of the CIR was investigated through the comparison of participant ratings conducted in the clinic and clinician ratings conducted in the home.Results:The current study found similar levels of reliability and validity in a late life sample as in previous studies conducted in mid-life adults.Conclusions:Unlike previous studies, the current study did not find a significant relationship between the CIR and the non-clutter related subscales of the Savings Inventory-Revised. The CIR appears to be both reliable and valid for assessing clutter levels in older adults diagnosed with HD.