Technology – Enhanced Pathology Education: Nigerian Medical Students Perspectives

Background: The delivery of pathology education traditionally through instructor centred didactic lectures, small group tutorials, and practical demonstrations using microscope glass slides, gross pot specimens and autopsy sessions, is paving way for electronic learner-centred methods. Successful adoption and implementation of rapidly advancing educational technologies in the resource-constrained environment obtainable in most of sub-Sahara Africa requires a comprehensive analysis of the learners’ reflections on their use and effectiveness.Aims: This study aimed to evaluate the perspectives of medical students towards the ever-advancing ways of teaching and learning pathology in Nigeria.Materials and methods: Fifty-five fourth year medical students randomly selected from two universities were given survey questionnaire. The questionnaires enquired into opinions of the students on the various aspects of the use of ICT in pathology education.Results: Studying with microscope mounted glass slides was considered by the majority (33, 60%) of the 55 respondents to be the most effective method of learning pathology and 24 (43.6%) favoured the projection of the glass slide on a large screen using a camera-mounted microscope. Twenty-seven (49.1%) preferred projected computer based digital microscope images. Twenty students (36.4%) disagreed with the use of internet-based images during practical classes. Prior distribution of digital images to students’ hand – held devices days before classes was agreed to by 19 (34.5%) and strongly agreed to by 15 (27.3%) students. Annotated digital images, instead of glass slides, were favoured by 50, (91%) students.  Self-study with webinars was not supported by 26, (47.2%) students. Eleven (20%) students strongly agree, 25 (45.5%) agree, eight (14.5) are undecided, and 10 (18.2%) disagree that the use of digital microscope images reduces microscope handling proficiency. The use of digital images instead of mounted glass slides during objective structured practical examination was supported by 20, (36.4%) students. Forty-seven (85.5%) reported interrupted classes due to faulty equipment.Conclusion: The challenge of developing ways for better delivery of pathology curriculum content to future doctors compels medical educators to explore easier ways of teaching and learning. This study has demonstrated that medical students in Nigeria favour technology enhanced learning and the integration of new teaching methods into already existing frameworks. Keywords: technology-enhanced learning, pathology, pathology education, student perspective

A standardised Phase III clinical trial framework to assess therapeutic interventions for Lassa fever

BACKGROUND: Only one recommendation currently exists for the treatment of Lassa fever (LF), which is ribavirin administered in conjunction with supportive care. This recommendation is primarily based on evidence generated from a single clinical trial that was conducted more than 30 years ago-the methodology and results of which have recently come under scrutiny. The requirement for novel therapeutics and reassessment of ribavirin is therefore urgent. However, a significant amount of work now needs to be undertaken to ensure that future trials for LF can be conducted consistently and reliably to facilitate the efficient generation of evidence. METHODOLOGY: We convened a consultation group to establish the position of clinicians and researchers on the core components of future trials. A Core Eligibility Criteria (CEC), Core Case Definition (CCD), Core Outcome Set (COS) and Core Data Variables (CDV) were developed through the process of a multi-stakeholder consultation that took place using a modified-Delphi methodology. RESULTS: A consensus position was achieved for each aspect of the framework, which accounts for the inclusion of pregnant women and children in future LF clinical trials. The framework consists of 8 core criteria, as well as additional considerations for trial protocols. CONCLUSIONS: This project represents the first step towards delineating the clinical development pathway for new Lassa fever therapeutics, following a period of 40 years without advancement. Future planned projects will bolster the work initiated here to continue the advancement of LF clinical research through a regionally-centred, collaborative methodology, with the aim of delineating a clear pathway through which LF clinical trials can progress efficiently and ensure sustainable investments are made in research capacity at a regional level

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Effects of a Twelve-Week Weight Reduction Exercise Programme on Selected Spatiotemporal Gait Parameters of Obese Individuals

Objectives. This study was carried out to investigate the effects of twelve-week weight reduction exercises on selected spatiotemporal gait parameters of obese individuals and compare with their normal weight counterparts. Methods. Sixty participants (30 obese and 30 of normal weight) started but only 58 participants (obese = 30, normal weight = 28) completed the quasi-experimental study. Only obese group had 12 weeks of weight reduction exercise training but both groups had their walking speed (WS), cadence (CD), step length (SL), step width (SW), and stride length (SDL) measured at baseline and at the end of weeks 4, 8, and 12 of the study. Data were analysed using appropriate descriptive and inferential statistics. Results. There was significantly lower WS, SL, and SDL but higher CD and SW in obese group than the normal weight group at baseline and week 12. However, the obese group had significantly higher percentage changes in all selected spatiotemporal parameters than the normal weight group. Conclusion. The 12-week weight reduction exercise programme produced significantly higher percentage changes in all selected spatiotemporal gait parameters in the obese than normal weight individuals and is recommended for improvement of these parameters among the obese individuals with gait related problems

Predictive evaluation of pediatric patients based on their typhoid fever status using linear discriminant model

Epidemiologic studies have established a relationship between pediatric patients and typhoid fever infection. This study was carried out to ascertain if specific hematological measurements of the pediatric patients dis- criminate between their positive and negative status to typhoid infection and to produce a rule for classifying other pediatric patients. Discriminant analysis was applied to predict the probability of a specific categorical outcome based on several explanatory variables (predictors). This study analyzed the differentiation between two hundred pediatric patients attending Landmark University Medical Centre based on their typhoid fever status. The hematological parameters considered were Packed Cell Volume, White Blood Cell count; Neutrophil, Erythrocyte level, Hemoglobin and Platelet count, Assay of samples were performed using standard procedures. Fisher’s Linear Discriminant Method was used for classification of variables in this study. With the use of the Fisher’s Linear Discrimination method for classification of the obtained data, a minimum value of −0.0067 was obtained implying that any new pediatric patient with a discriminant score above −0.0067 would be diagnosed to be typhoid negative; otherwise, they would be classified as typhoid positive pediatric patients. The efficiency of this method of classification was tested using two approaches; Retribution estimate approach and leaving-one out approach which showed a prevalence rate of typhoid positive patients at 75.8% and 74.7% respectively. This data analysis hypotheses that typhoid fever is highly endemic amongst our study subjects. A point-of-care di- agnosis with a strong positive predictive value, which improves pediatric enteric fever diagnosis, is strongly advocated

Investigating the association between multiple substance Use and dating violence involvement among U.S adolescents

Adolescent dating violence and substance use are clinical and public health concerns. Prior meta-analytic studies indicate that about 20% of adolescents reported having experienced physical dating violence (PDV) and 10% reported sexual dating violence (SDV). This study aims to assess the prevalence of dating violence, and the association between substance use and dating violence among adolescents. Our study population is derived from the 2019 Youth Risk Behavior Surveillance System (YRBSS)a cross-sectional, nationally representative survey of United States (U.S) adolescents. The sample comprised 13,677 adolescents between the ages of 13–19 years currently enrolled in school. Descriptive analysis estimated the prevalence of dating violence and substance use. Multiple logistic regression adjusted for confounders of the association between substance use and dating violence. The confounders adjusted for include sex, school grade, race, academic grade, and duration of night sleep. The prevalence of PDV and SDV was each 8.2%. Only 2.6% of this nationally representative sample had experienced both PDV and SDV. Adolescents who used three or more substances had 2.1 times higher odds of PDV (OR = 2.10, 95% CI = 1.27–3.47, p < 0.0001), and SDV (OR = 2.11, 95% CI = 1.34–3.34, p < 0.0001) respectively, and 2.8 (OR = 2.75, 95% CI = 1.34–5.61, p < 0.0001) times higher odds of both PDV and SDV in the past month. Multiple substance use increases the odds of dating violence. Policy and interventions should be focused on preventing substance use initiation among substance-naïve adolescents and to advocate abstinence and gradual reduction of substances used to mitigate the prevalence of dating violence