Augmented Reality in the LINDSAY Virtual Human: Adding a new Dimension in Tablet-based Medical Education

Imagine you are a medical student at the University of Calgary. As part of your training in anatomy, you are looking at a cadaver. However you are not able to understand the physiological aspects that take place within the body. The problem is the cadaver is essentially dead human tissue. Is there a way to expand your view, to bring this body back to life—in a virtual world? You take out your iPad and run the LINDSAY Atlas. The Atlas’ augmented reality (AR) feature merges the virtual world and the physical world, caught in real time by the built-in camera! You now begin to see the inner workings of a live human, superimposed on a cadaver; the beating heart inside a dead chest cavity, a cut on a lifeless arm being clotted, a diseased organ being healed by the body in front of your eyes. But you want more! You lift a finger and use gestures to interact with and explore different anatomical parts in 3D space. This increases your understanding of integrative physiology. Thus LINDSAY’s combination of AR and mobile touch technology enhances your medical training and prepares you for the practical new world of medicine

Automated Paper Screening for Clinical Reviews Using Large Language Models

Objective: To assess the performance of the OpenAI GPT API in accurately and efficiently identifying relevant titles and abstracts from real-world clinical review datasets and compare its performance against ground truth labelling by two independent human reviewers. Methods: We introduce a novel workflow using the OpenAI GPT API for screening titles and abstracts in clinical reviews. A Python script was created to make calls to the GPT API with the screening criteria in natural language and a corpus of title and abstract datasets that have been filtered by a minimum of two human reviewers. We compared the performance of our model against human-reviewed papers across six review papers, screening over 24,000 titles and abstracts. Results: Our results show an accuracy of 0.91, a sensitivity of excluded papers of 0.91, and a sensitivity of included papers of 0.76. On a randomly selected subset of papers, the GPT API demonstrated the ability to provide reasoning for its decisions and corrected its initial decision upon being asked to explain its reasoning for a subset of incorrect classifications. Conclusion: The GPT API has the potential to streamline the clinical review process, save valuable time and effort for researchers, and contribute to the overall quality of clinical reviews. By prioritizing the workflow and acting as an aid rather than a replacement for researchers and reviewers, the GPT API can enhance efficiency and lead to more accurate and reliable conclusions in medical research.Comment: 15 pages, 2 figures, 4 table

Explorer l'impact de la pandémie de la COVID-19 sur le bien-être des étudiants en médecine : une évaluation des besoins en vue de la du développement d'interventions en faveur du bien-être de l’apprenant

Background: On March 11, 2020 the World Health Organization declared the novel coronavirus SARS-CoV-2 disease (COVID-19) a global pandemic. We sought to understand impact of COVID-19 on learner wellness at a large tertiary care academic institution to inform the future development of learner wellness interventions during the COVID-19 pandemic. Methods: A cross-sectional, internet-based survey collected quantitative and qualitative data from learners April-June 2020. Descriptive statistics and univariate analyses were reported for quantitative data. Open-ended, qualitative responses were analyzed deductively using thematic analysis. Results: Twenty percent of enrolled learners in that faculty of medicine (540/2741) participated including undergraduate [Bachelor’s] students (25.7%), graduate [science] students (27.5%), undergraduate medical students (22.8%), and postgraduate resident physicians (23.5%). We found that learner wellness across all stages of training was negatively impacted and the ways in which learners were impacted varied as a result of their program's response to the COVID-19 pandemic. Conclusions: Learners in health sciences and medical education report worsening well-being because of the programs and the systems in which they function with the added burden of the COVID-19 pandemic. Future interventions would benefit from a holistic framework of learner wellness while engaging in systems thinking to understand how individuals, programs and respective systems intersect. The importance of acknowledging equity, diversity and inclusion, fostering psychological safety and engaging learners as active participants in their journey during a pandemic and beyond are key elements in developing wellness interventions.Contexte : Le 11 mars 2020, l’Organisation mondiale de la santé a déclaré que le nouveau coronavirus SRAS-CoV-2 (COVID-19) était pandémique. Nous avons tenté de cerner l’impact de la COVID-19 sur le bien-être des apprenants dans un grand centre universitaire de soins tertiaires afin d’étayer le développement futur d’interventions en faveur du bien-être des apprenants en contexte de pandémie. Méthodes : Une enquête transversale par sondage en ligne, menée entre les mois d’avril et juin 2020, a permis de recueillir des données quantitatives et qualitatives auprès des apprenants. Des statistiques descriptives et des analyses univariées ont été présentées comme données quantitatives. Les réponses ouvertes, qualitatives, ont été analysées de manière déductive par le biais d’une analyse thématique. Résultats : Vingt pour cent des étudiants de la faculté de médecine (540/2741) ont participé, dont 25,7 % étaient inscrits au premier cycle (baccalauréat), 27,5 % au deuxième cycle (sciences), 22,8 % au premier cycle en médecine et 23,5 % étaient résidents. Nous avons constaté que la pandémie a négativement affecté le bien-être des apprenants à tous les niveaux de formation et que les effets précis sur les étudiants pouvaient varier en fonction de la réponse de leur programme à la situation sanitaire. Conclusions : Les étudiants en médecine et en sciences de la santé signalent une détérioration de leur bien-être liée aux programmes et aux systèmes dans lesquels ils évoluent, auxquels s’ajoute le fardeau supplémentaire de la pandémie de la COVID-19. Il conviendrait de définir les interventions futures sur la base d’un cadre holistique du bien-être des apprenants tout en adoptant une réflexion systémique pour appréhender l’entrecroisement entre individus, programmes et systèmes.  Reconnaître l’importance de l’équité, de la diversité et de l’inclusion, favoriser la sécurité psychologique et assurer la participation active des apprenants dans leur parcours pendant la pandémie et au-delà, constituent des éléments clés dans l’élaboration d’interventions au profit de leur bien-être

A Statistically Rigorous Method for Determining Antigenic Switching Networks

Many vector-borne pathogens rely on antigenic variation to prolong infections and increase their likelihood of onward transmission. This immune evasion strategy often involves mutually exclusive switching between members of gene families that encode functionally similar but antigenically different variants during the course of a single infection. Studies of different pathogens have suggested that switching between variant genes is non-random and that genes have intrinsic probabilities of being activated or silenced. These factors could create a hierarchy of gene expression with important implications for both infection dynamics and the acquisition of protective immunity. Inferring complete switching networks from gene transcription data is problematic, however, because of the high dimensionality of the system and uncertainty in the data. Here we present a statistically rigorous method for analysing temporal gene transcription data to reconstruct an underlying switching network. Using artificially generated transcription profiles together with in vitro var gene transcript data from two Plasmodium falciparum laboratory strains, we show that instead of relying on data from long-term parasite cultures, accuracy can be greatly improved by using transcription time courses of several parasite populations from the same isolate, each starting with different variant distributions. The method further provides explicit indications about the reliability of the resulting networks and can thus be used to test competing hypotheses with regards to the underlying switching pathways. Our results demonstrate that antigenic switch pathways can be determined reliably from short gene transcription profiles assessing multiple time points, even when subject to moderate levels of experimental error. This should yield important new information about switching patterns in antigenically variable organisms and might help to shed light on the molecular basis of antigenic variation

The appropriateness of prescribing antibiotics in the community in Europe: study design

Contains fulltext : 97417.pdf (publisher's version ) (Open Access)ABSTRACT: BACKGROUND: Over 90% of all antibiotics in Europe are prescribed in primary care. It is important that antibiotics are prescribed that are likely to be effective; however, information about antibiotic resistance in the community is incomplete. The aim of our study is to investigate the appropriateness of antibiotic prescribing in primary care in Europe by collecting and combining patterns of antibiotic resistance patterns and antibiotic prescription patterns in primary care. We will also evaluate the appropriateness of national antibiotic prescription guidelines in relation to resistance patterns. METHODS/DESIGN: Antibiotic resistance will be studied in an opportunistic sample from the community in nine European countries. Resistance data will be collected by taking a nose swab of persons (N = 4,000 per country) visiting a primary care practice for a non-infectious disease. Staphylococcus aureus and Streptococcus pneumoniae will be isolated and tested for resistance to a range of antibiotics in one central laboratory. Data on antibiotic prescriptions over the past 5 years will be extracted from the electronic medical records of General Practitioners (GPs). The results of the study will include the prevalence and resistance data of the two species and 5 years of antibiotic prescription data in nine European countries.The odds of receiving an effective antibiotic in each country will be calculated as a measure for the appropriateness of prescribing. Multilevel analysis will be used to assess the appropriateness of prescribing. Relevant treatment guidelines of the nine participating countries will be evaluated using a standardized instrument and related to the resistance patterns in that country. DISCUSSION: This study will provide valuable and unique data concerning resistance patterns and prescription behaviour in primary care in nine European countries. It will provide evidence-based recommendations for antibiotic treatment guidelines that take resistance patterns into account which will be useful for both clinicians and policy makers. By improving antibiotic use we can move towards controlling the resistance problem globally

L’impact de la pandémie de la COVID-19 sur l’éducation médicale : une étude internationale transversale sur les étudiants en médecine

Background: The evidence surrounding the impact of COVID-19 on medical learners remains anecdotal and highly speculative despite the anticipated impact and potential consequences of the current pandemic on medical training. The purpose of this study was to explore the extent that COVID-19 initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training. Methods: A cross-sectional survey of medical learners was conducted between March 25–June 14, 2020, shortly after the World Health Organization declared COVID-19 a pandemic. Results: 6492 learners completed the survey from 140 countries. Most medical schools removed learners from the clinical environment and adopted online learning, but students reported concerns about the quality of their learning, training progression, and milestone fulfillment. Residents reported they could be better utilized and expressed concerns about their career timeline. Trainees generally felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some felt that contributing to healthcare during a pandemic was beyond the scope of a learner. Significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses as well as the impact of COVID-19 learner wellness and state-trait anxiety. Conclusions: The disruption to the status quo of medical education is perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial empirical insights into the areas that warrant future research as well as consideration for current and future policy planning.Contexte : On s’attendait à ce que la pandémie de la COVID-19 ait des conséquences sur la formation médicale, mais les constats relatifs à son impact sur les étudiants en médecine demeurent anecdotiques et plutôt spéculatifs. L’objectif de cette étude était d’explorer l’étendue des premiers effets de la COVID-19 sur les étudiants en médecine dans le monde et d’examiner les tendances et les schémas qui se dégagent, quels que soient la région géographique ou le niveau d’études. Méthodes : Une enquête transversale sur les étudiants en médecine a été menée entre le 25 mars et le 14 juin 2020, peu après que l’Organisation mondiale de la santé ait déclaré que la COVID-19 était une pandémie. Résultats : Le sondage a été réalisé auprès de 6492 étudiants de 140 pays. La plupart des facultés de médecine ont retiré les apprenants de l’environnement clinique et adopté l’apprentissage en ligne, mais les étudiants ont exprimé des préoccupations quant à sa qualité, à la progression de la formation et à l’atteinte de divers jalons. Les résidents jugent qu’ils pourraient être plus utiles et s’inquiètent de l’avancement de leur carrière. Les apprenants se sentent généralement sous-utilisés et souhaitent s’engager cliniquement de manière plus significative; cependant, certains estiment qu’il n’est pas à propos de demander aux étudiants de contribuer aux soins de santé pendant une pandémie. Des écarts importants ont été relevés entre les différents niveaux de formation et les différentes régions géographiques en ce qui concerne la satisfaction face aux réponses organisationnelles, l’impact de la COVID-19 sur leur bien-être et l’anxiété chronique et réactionnelle. Conclusions : La perturbation du statu quo dans l’éducation médicale est perçue par les étudiants de tous les niveaux et de toutes les régions géographiques, mais davantage encore par les résidents, comme ayant affecté négativement et leur formation et leur bien-être. Ces résultats fournissent des aperçus empiriques préliminaires sur les domaines qui méritent des recherches futures et qui devraient être pris en compte dans la formulation des politiques actuelles et à venir

Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners

Background: The evidence surrounding the impact of COVID-19 on medical learners remains anecdotal and highly speculative despite the anticipated impact and potential consequences of the current pandemic on medical training. The purpose of this study was to explore the extent that COVID-19 initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training.Methods: A cross-sectional survey of medical learners was conducted between March 25–June 14, 2020, shortly after the World Health Organization declared COVID-19 a pandemic.Results: 6492 learners completed the survey from 140 countries. Most medical schools removed learners from the clinical environment and adopted online learning, but students reported concerns about the quality of their learning, training progression, and milestone fulfillment. Residents reported they could be better utilized and expressed concerns about their career timeline. Trainees generally felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some felt that contributing to healthcare during a pandemic was beyond the scope of a learner. Significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses as well as the impact of COVID-19 learner wellness and state-trait anxiety.Conclusions: The disruption to the status quo of medical education is perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial empirical insights into the areas that warrant future research as well as consideration for current and future policy planning.Contexte : On s’attendait à ce que la pandémie de la COVID-19 ait des conséquences sur la formation médicale, mais les constats relatifs à son impact sur les étudiants en médecine demeurent anecdotiques et plutôt spéculatifs. L’objectif de cette étude était d’explorer l’étendue des premiers effets de la COVID-19 sur les étudiants en médecine dans le monde et d’examiner les tendances et les schémas qui se dégagent, quels que soient la région géographique ou le niveau d’études.Méthodes : Une enquête transversale sur les étudiants en médecine a été menée entre le 25 mars et le 14 juin 2020, peu après que l’Organisation mondiale de la santé ait déclaré que la COVID-19 était une pandémie.Résultats : Le sondage a été réalisé auprès de 6492 étudiants de 140 pays. La plupart des facultés de médecine ont retiré les apprenants de l’environnement clinique et adopté l’apprentissage en ligne, mais les étudiants ont exprimé des préoccupations quant à sa qualité, à la progression de la formation et à l’atteinte de divers jalons. Les résidents jugent qu’ils pourraient être plus utiles et s’inquiètent de l’avancement de leur carrière. Les apprenants se sentent généralement sous-utilisés et souhaitent s’engager cliniquement de manière plus significative; cependant, certains estiment qu’il n’est pas à propos de demander aux étudiants de contribuer aux soins de santé pendant une pandémie. Des écarts importants ont été relevés entre les différents niveaux de formation et les différentes régions géographiques en ce qui concerne la satisfaction face aux réponses organisationnelles, l’impact de la COVID-19 sur leur bien-être et l’anxiété chronique et réactionnelle.Conclusions : La perturbation du statu quo dans l’éducation médicale est perçue par les étudiants de tous les niveaux et de toutes les régions géographiques, mais davantage encore par les résidents, comme ayant affecté négativement et leur formation et leur bien-être. Ces résultats fournissent des aperçus empiriques préliminaires sur les domaines qui méritent des recherches futures et qui devraient être pris en compte dans la formulation des politiques actuelles et à venir

Exploring the impact of the COVID-19 pandemic on medical learner wellness: a needs assessment for the development of learner wellness interventions

Background: On March 11, 2020 the World Health Organization declared the novel coronavirus SARS-CoV-2 disease (COVID-19) a global pandemic. We sought to understand impact of COVID-19 on learner wellness at a large tertiary care academic institution to inform the future development of learner wellness interventions during the COVID-19 pandemic.Methods: A cross-sectional, internet-based survey collected quantitative and qualitative data from learners April-June 2020. Descriptive statistics and univariate analyses were reported for quantitative data. Open-ended, qualitative responses were analyzed deductively using thematic analysis.Results: Twenty percent of enrolled learners in that faculty of medicine (540/2741) participated including undergraduate [Bachelor’s] students (25.7%), graduate [science] students (27.5%), undergraduate medical students (22.8%), and postgraduate resident physicians (23.5%). We found that learner wellness across all stages of training was negatively impacted and the ways in which learners were impacted varied as a result of their program's response to the COVID-19 pandemic.Conclusions: Learners in health sciences and medical education report worsening well-being because of the programs and the systems in which they function with the added burden of the COVID-19 pandemic. Future interventions would benefit from a holistic framework of learner wellness while engaging in systems thinking to understand how individuals, programs and respective systems intersect. The importance of acknowledging equity, diversity and inclusion, fostering psychological safety and engaging learners as active participants in their journey during a pandemic and beyond are key elements in developing wellness interventions.Contexte : Le 11 mars 2020, l’Organisation mondiale de la santé a déclaré que le nouveau coronavirus SRAS-CoV-2 (COVID-19) était pandémique. Nous avons tenté de cerner l’impact de la COVID-19 sur le bien-être des apprenants dans un grand centre universitaire de soins tertiaires afin d’étayer le développement futur d’interventions en faveur du bien-être des apprenants en contexte de pandémie.Méthodes : Une enquête transversale par sondage en ligne, menée entre les mois d’avril et juin 2020, a permis de recueillir des données quantitatives et qualitatives auprès des apprenants. Des statistiques descriptives et des analyses univariées ont été présentées comme données quantitatives. Les réponses ouvertes, qualitatives, ont été analysées de manière déductive par le biais d’une analyse thématique.Résultats : Vingt pour cent des étudiants de la faculté de médecine (540/2741) ont participé, dont 25,7 % étaient inscrits au premier cycle (baccalauréat), 27,5 % au deuxième cycle (sciences), 22,8 % au premier cycle en médecine et 23,5 % étaient résidents. Nous avons constaté que la pandémie a négativement affecté le bien-être des apprenants à tous les niveaux de formation et que les effets précis sur les étudiants pouvaient varier en fonction de la réponse de leur programme à la situation sanitaire.Conclusions : Les étudiants en médecine et en sciences de la santé signalent une détérioration de leur bien-être liée aux programmes et aux systèmes dans lesquels ils évoluent, auxquels s’ajoute le fardeau supplémentaire de la pandémie de la COVID-19. Il conviendrait de définir les interventions futures sur la base d’un cadre holistique du bien-être des apprenants tout en adoptant une réflexion systémique pour appréhender l’entrecroisement entre individus, programmes et systèmes.  Reconnaître l’importance de l’équité, de la diversité et de l’inclusion, favoriser la sécurité psychologique et assurer la participation active des apprenants dans leur parcours pendant la pandémie et au-delà, constituent des éléments clés dans l’élaboration d’interventions au profit de leur bien-être

Wellbeing and mental health amongst medical students in Canada

RESEARCH: There is abundant data revealing that there is significant rate of rates of Psychiatric morbidity, psychological stress, and burnout in the medical student population. A core study group in the UK collaborated with 12 countries around the world to review medical student wellness. In this context we surveyed 101 medical students at the Cummings medical school, Calgary, Canada during the height of the COVID pandemic regarding their wellbeing and mental health. RESULTS/MAIN FINDINGS: Prior to medical school 27% reported a diagnosis with a mental disorder. Whilst at medical school 21% reported a mental health condition, most commonly an anxiety disorder and or depressive disorder. The most commonly reported source of stress was study at 81%, the second being relationships at 62%, money stress was a significant source of stress for 35%, and finally 10% reported accommodation or housing as stressful. Interestingly only 14% tested CAGE positive but 20% of students reported having taken a non-prescription substance to feel better or regulate their mood. Seventy-five percent of medical students met specific case criteria for exhaustion on the Oldenburg Burnout inventory 74% met criteria for the GHQ questionnaire. CONCLUSIONS: These findings confirm that medical students are facing significant stressors during their training. These stressors include, in order of frequency, study, relational, financial, and accommodation issues. Nonprescription Substance use was a common finding as well as exhaustion and psychiatric morbidity. Future interventions pursued will have to address cultural issues as well as the organizational and individual determinates of stress