ResearchPad - Education https://www.researchpad.co Default RSS Feed en-us © 2020 Newgen KnowledgeWorks <![CDATA[How students choose E‐learning resources: The importance of ease, familiarity, and convenience]]> https://www.researchpad.co/product?articleinfo=Ncda92ffc-35a5-48ca-ba42-2d99c401eced <![CDATA[MON-137 Evaluation of the Timeliness of Serial Denosumab Administrations at the University of Colorado Hospital]]> https://www.researchpad.co/product?articleinfo=Nebc5db97-67e3-4098-a8f0-47019a068095

Abstract

BACKGROUND:

Denosumab is an antiresorptive medication commonly used in the treatment of osteoporosis that works by slowing bone loss. This medication should not be delayed or interrupted without initiation of an alternative treatment (i.e. bisphosphonates) as studies have shown that this can lead to rapid bone loss, very high markers of bone turnover, and increased vertebral fracture (VF) risk. It is unknown how frequently dosing is delayed in practice settings and how best practices can ensure timely dosing. Our study aimed to (1) evaluate the frequency and causes of delayed denosumab doses at our institution and (2) compare the incidence of delayed doses before and after implementation of a new electronic ordering process.

METHODS:

We performed a retrospective chart audit for all patients receiving two or more denosumab doses at our institution between 1/1/16-8/11/18 and categorized those whose doses were >/=214 days (7 months) as delayed. We reviewed notes, imaging, and labs in a subset of this population to assess reasons for the delay. On 8/11/18, a new outpatient infusion center (OIC) therapy plan went into place. This plan bundled a one-year denosumab order (2 doses) with an automatic referral to the OIC along with physician reminders for renewal. We compared rates of delayed denosumab dosing before and after implementation of this new order process.

RESULTS:

Between 1/1/16-8/11/18, 385 patients received 1295 doses of denosumab, with 160 (41.6%) receiving 193 instances of delayed doses. We reviewed the charts of 98 individuals who received 111 instances of late doses between 7/6/16-8/11/18. The most prevalent reasons for delays were: delays in follow-up by the patient (27.9%), delays in the provider placing an order for the drug and OIC referral simultaneously (27.9%), and delays in OIC scheduling (18%). During the 14 months after implementation of the new ordering process, 347 patients received 614 instances of denosumab, of which 123 (35.4%) received 128 instances of delayed dosing. This is a relative decrease of 17.5% (p=0.09) for the proportion of patients with a late dose.

CONCLUSIONS AND FUTURE DIRECTIONS:

Nearly half of the patients on denosumab in our hospital received delayed denosumab dosing. Delays were often due to a lack of coordination between subsequent dose order placement and referral to the OIC. Our institution successfully implemented a bundled therapy plan to improve timely dosing. By March 2020, we expect to reassess the post-intervention group to further describe reasons for dosing delays. We also will compare rates of VFs associated with delayed denosumab dosing pre- and post-intervention periods.

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<![CDATA[Independent effects of 15 commonly prescribed drugs on all-cause mortality among US elderly patients with type 2 diabetes mellitus]]> https://www.researchpad.co/product?articleinfo=Nfa705d74-826b-4fba-999b-ad24afe57e08

Objective

Most patients with type 2 diabetes mellitus (T2DM) also have hypertension and hyperlipidemia. Consequently, they are taking medications for all three conditions concurrently and the effect of one drug could be confounded with that of another. This study aimed to determine the independent effects of 15 commonly prescribed medications for three conditions on the risk of all-cause mortality among elderly patients with T2DM.

Research design and methods

A cohort of 360 437 elderly patients with T2DM from 2007 to 2016 US Medicare data was traced along with cumulative uses of 8 diabetes, 6 hypertension and 1 hyperlipidemia drugs. The relative risk of all-cause mortality for each study drug was estimated using an extended Cox regression analysis adjusting for the concurrent use of other study drugs.

Results

Compared with the no use of each study medication, mortality risk declined with use of 3 diabetes drugs, sodium-glucose cotransporter-2 inhibitors (HR=0.73; 95% CI 0.64 to 0.84), glucagon-like peptide-1 receptor agonists (HR=0.75; 95% CI 0.70 to 0.80) and dipeptidyl peptidase-4 inhibitors (HR=0.94; 95% CI 0.91 to 0.98), the use of 3 blood pressure medications, diuretics (HR=0.89; 95% CI 0.87 to 0.92), angiotensin receptor blockers (HR=0.86; 95% CI 0.84 to 0.89), ACE inhibitors (HR=0.98; 95% CI 0.95 to 1.01) as well as statins (HR=0.83; 95% CI 0.80 to 0.85). It increased moderately with insulin (HR=1.55; 95% CI 1.51 to 1.59), sulfonylureas (HR=1.16; 95% CI 1.13 to 1.20), a small inconsistent amount with metformin (HR=1.05), beta-blockers (HR=1.07), dihydropyridine calcium-channel blockers (HR=0.99) and non-dihydropyridine calcium-channel blockers (HR=1.05). The use of thiazolidinedione had no effect.

Conclusion

Among older patients with diabetes, mortality risk decreased importantly with three new diabetes drugs, 3 blood pressure drugs and statins. It increased moderately with sulfonylurea and insulin. Studies of aggressive use of new T2DM drugs instead of sulfonylureas and insulin are needed. Our statin results empirically validate two national guidelines for using statins in older patients with diabetes. However, 23% of study patients never took a statin, suggesting missed opportunities for prevention.

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<![CDATA[Assessing the growth in clinical skills using a progress clinical skills examination]]> https://www.researchpad.co/product?articleinfo=N22edf03e-1df8-490d-b170-d8364e3b4da2

Background

This study evaluates the generalizability of an eight-station progress clinical skills examination and assesses the growth in performance for six clinical skills domains among first- and second-year medical students over four time points during the academic year.

Methods

We conducted a generalizability study for longitudinal and cross-sectional comparisons and assessed growth in six clinical skill domains via repeated measures ANOVA over the first and second year of medical school.

Results

The generalizability of the examination domain scores was low but consistent with previous studies of data gathering and communication skills. Variations in case difficulty across administrations of the examination made it difficult to assess longitudinal growth. It was possible to compare students at different training levels and the interaction of training level and growth. Second-year students outperformed first-year students, but first-year students’ clinical skills performance grew faster than second-year students narrowing the gap in clinical skills over the students’ first year of medical school.

Conclusions

Case specificity limits the ability to assess longitudinal growth in clinical skills through progress testing. Providing students with early clinical skills training and authentic clinical experiences appears to result in the rapid growth of clinical skills during the first year of medical school.

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<![CDATA[A Rare ST-Elevation Myocardial Infarction Mimic or a True Event?]]> https://www.researchpad.co/product?articleinfo=N46c3e4c8-4729-4ea7-aee9-281547783666

The etiology of ST-elevation myocardial infarction (STEMI) is either rupture or erosion of unstable plaque with subsequent thrombosis. With the widespread use of plaque-stabilizing lipid-lowering therapies (statins), plaque erosion, rather than rupture, now accounts for most cases of acute coronary syndromes (ACS). In the spectrum of ACS, STEMI usually results from the total occlusion of the culprit epicardial coronary artery, leading to the occlusion of blood flow to the affected myocardium. The differential diagnosis of ST-elevations on electrocardiograms are broad. However, an elevated cardiac marker, evidence of wall motion abnormality on echocardiogram or positive stress testing makes an alternate diagnosis less likely. This prompts emergent coronary angiography with an intent to fix the underlying cause. In some cases like ours, when the clinical suspicion of STEMI is high, the coronary angiography may be unrevealing of the diagnosis.

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<![CDATA[Competency-based medical curriculum: Psychiatry, training of faculty, and Indian Psychiatric Society]]> https://www.researchpad.co/product?articleinfo=N9305a720-7500-442f-b8b3-59db828ddead ]]> <![CDATA[A Post-operative Masquerade: Simulation-based Scenario Challenging Clinical Clerks to Recognize an Atypical Presentation of Myocardial Infarction]]> https://www.researchpad.co/product?articleinfo=Nc3ce8615-483b-47ec-8ec0-99acf94eb142

Post-operative myocardial infarctions (MI) are a challenging diagnosis due to the alterations in the presenting complaint compared to an acute MI. Patients may be asymptomatic due to their anesthetics and sedatives from their operation which may create clinical confusion. As such, there is an increased risk for delayed administration of reperfusion therapies in this patient population which has shown to increase morbidity and mortality. It is anticipated that the difficulty of recognizing a post-operative MI would be exacerbated for clinical clerks due to their lack of clinical experience and overstimulation. Fortunately, the use of simulation-based learning has been proven to be a useful teaching tool to help clinical clerks manage medical problems in a controlled environment. This technical report describes a simulation case designed to enhance the recognition and response to a post-operative MI by a third-year clinical clerk. In this scenario, a 56-year-old male accountant presents with shortness of breath while recovering in the orthopaedic ward 12 hours following a total knee replacement (TKR). The clinical clerks are expected to conduct an independent follow-up prior to finishing their shift during which the patient begins complaining of shortness of breath. The clerk is required to order an electrocardiogram (ECG) for further analysis which reveals an anterior ST-segment elevation. Once recognized, a request for the crash cart and patient handover to the senior physician are expected.

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<![CDATA[Eye care providers’ emerging roles in early detection of diabetes and management of diabetic changes to the ocular surface: a review]]> https://www.researchpad.co/product?articleinfo=N5a4f6065-3bce-4af3-80f2-19c49f62004d

US adults visit eye care providers more often than primary healthcare providers, placing these doctors in a prime position to help identify and manage patients with prediabetes and diabetes. Currently, diabetes is identified in eye clinics in an advanced stage, only after visible signs of diabetic retinopathy. Recent ophthalmic research has identified multiple subclinical and clinical changes that occur in the anterior segment of the eye with metabolic disease. The corneal epithelium exhibits increased defects and poor healing, including an increased risk of neurotrophic keratitis. Increased thickness and stiffness of the cornea artificially alters intraocular pressure. There is damage to the endothelial cells and changes to the bacterial species on the ocular surface, both of which can increase risk of complications with surgery. Decreased corneal sensitivity due to a loss of nerve density predispose patients with metabolic disease to further neurotrophic complications. Patients with diabetes have increased Meibomian gland dysfunction, blepharitis and reduced tear production, resulting in increased rates of dry eye disease and discomfort. Early detection of metabolic disease may allow eye care providers to be more proactive in recommending referral and intervention in order to reduce the risk of blindness and other diabetes-related morbidity. Continued research is needed to better understand the time course of changes to the anterior segment and what can be done to better detect and diagnose patients with prediabetes or undiagnosed diabetes and provide improved care for these patients.

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<![CDATA[Correlation of Medical College Admission Test Scores and Self-assessment Materials with the United States Medical Licensing Examination Step 1 Performance]]> https://www.researchpad.co/product?articleinfo=Ndfa78704-8a5e-4c47-9d9a-0489deac1e03

Purpose

Candidates' performance on the United States Medical Licensing Examination (USMLE) Step 1 examination had been correlated with the Medical College Admission Test (MCAT). However, in 2015, a new MCAT format was released and its correlation with Step 1 remains to be fully analyzed. Preparation for Step 1 typically involves purchasing and perusing practice tests from the National Board of Medical Examiners (NBME) and UWorld; however, their predictive value to performance on Step 1 remains to be ascertained, especially with the release of five new NBME practice tests. Additionally, there is a need for accurately predicting Step 1 scores to self-evaluate study progress and reduce student anxiety.

Rationale

Program directors rank USMLE Step 1 scores as the number one criterion in selecting interviewees for residency. Step 1 scores are more important than Step 2 scores, Dean’s letter, or other letters of recommendation in determining the overall ranking of a candidate after interviews.

Hypotheses

The authors hypothesized that the new MCAT scores correlated positively with Step 1 scores and that the new NBME practice tests were more predictive of performance on Step 1 as compared to old NBME tests. 

Methods

Linear regression analysis followed by either analysis of variance (ANOVA) or Student's t-tests were used to analyze 399 responses. Data obtained was used to update an existing Step 1 score predictor, which was then validated.

Results

A positive correlation between the MCAT (average score: 510.1 ± 6.3) and Step 1 scores (average score: 246.1 ± 14.2) was observed. While new NBME practice tests were more predictive of Step 1 scores than old NBME tests, UWorld test scores were the most predictive. Students who practiced with the new NBME practice tests scored significantly higher than students who did not use them. However, students using any of the UWorld practice tests did significantly better than students who practiced using only NBME practice tests but not UWorld practice tests. Ironically, NBME16,the second-most correlativetest to Step 1 performance, is no longer available for purchase. Overall, taking six or more practice tests significantly enhanced Step 1 scores; the optimal number of tests was found to be between six and nine. The predicted score by an updated Step 1 score predictor was within 3.8 points or 1.6% of the actual Step 1 score.

Conclusions

We believe this study will aid in the selection and purchase of appropriate self-assessment tests as preparatory material for the USMLE Step 1 examination. It will also introduce them to an existing Step 1 score predictor that will help determine their readiness for Step 1.

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<![CDATA[Orthopaedic Trainee Opinion on the Current Procedure-based Assessment Compared to its Predecessor: A UK Trauma Centre Perspective]]> https://www.researchpad.co/product?articleinfo=N6b87b54f-1326-4404-9628-9c3b5d816b7a

Background

Procedure-based assessments (PBAs) were introduced as a formative assessment of surgical performance. UK trainees are currently expected to complete at least 20 PBAs each training year. A new PBA tool was introduced in August 2016 in order to address several criticisms with its predecessor. These included mandatory written feedback and increasing the number of global levels of assessment.

Objectives

Our study sought to identify the impact of these modifications to the PBA tool on its perceived utility as a formative assessment of surgical skill.

Study design & methods

Orthopaedic trainee registrars (ST3-ST8) holding a UK National Training Number (NTN) at a major UK trauma centre were invited to take part in the study. Each trainee completed an anonymous questionnaire that was designed to elicit the view of trainees towards the old and new PBA.

Results

Twelve trainees took part in the study. Most of them admitted receiving good quality feedback from their trainer using both tools (75% old PBA; 83% ew PBA). Most trainees (58%) felt that written feedback did not encourage verbal feedback from their trainer. Overall, trainees felt the new PBA global rating scale levels had made it a more accurate measure of surgical performance and allowed them to better appreciate the gradual improvement in their surgical skills throughout their training.

Conclusions

Fifty per cent of the trainees believed that the new PBA overall was a better formative assessment of surgical skill than its predecessor. A significant factor has been the introduction of a new global rating score rather than efforts to improve feedback. Further work should look to identify whether these views match those of other UK-based trainees on a larger scale.

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<![CDATA[Constructing a Multidisciplinary Network That Relies on Disruptive Technologies to Design, Test, and Implement Simulation Training]]> https://www.researchpad.co/product?articleinfo=N45a2bbaf-94a5-45b5-adef-7e00fbb80c44

MaxSIMhealth is a multidisciplinary network of manufacturing, design, and simulation labs at Ontario Tech University combining expertise in health sciences, business and information technology (IT), and engineering while building community partnerships to advance simulation training. It discovers existing simulation gaps, provides innovative solutions that change systems, and leads to improved healthcare outcomes. Specifically, it utilizes disruptive technologies, including 3D printing, gaming, and extended reality, as innovative solutions that deliver cost-effective, portable, and realistic simulation, which is currently lacking. MaxSIMhealth is a novel collaborative innovation with aims to develop future cohorts of scholars with strong competencies ranging from technology application, to collaborating in new environments, communicating professionally, and problem-solving. Its work will transform current health professional education landscapes by providing novel, flexible, and inexpensive simulation environments. This editorial aims to showcase maxSIMhealth's innovative strategy focusing on collaborations of expertise in order to develop new simulation solutions that advance the health industry.

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<![CDATA[Establishment of consensus on content and learning objectives for an interprofessional education in childhood cancer: a Delphi survey]]> https://www.researchpad.co/product?articleinfo=N806aeb3c-9e72-4dfd-9e30-85404c041304

Background

Complex treatment, care and rehabilitation require continuous healthcare professional development and maintenance of competencies in collaboration with other professionals. Interprofessional education in childhood cancer involves several groups of healthcare professionals with both general and specific knowledge and skills.

Objective

To establish consensus on content and interprofessional learning objectives for an interprofessional education in childhood cancer.

Design

A three-round Delphi survey in Scandinavian childhood cancer departments.

Participants

Healthcare professionals appointed by their head of departments and head nurses based on their profession and their involvement in continuing professional development.

Main outcome measures

A prioritised list of interprofessional learning objectives with a mean score of ≥3 on a five-point scale (1=not relevant, 5=extremely relevant).

Results

12 childhood cancer departments participated with 30 healthcare professionals: 11 nurses, 10 medical doctors, 5 social workers, 2 physiotherapists and 2 pedagogues. In total, 28 (93%), 25 (83%) and 22 (73%) completed the first, second and third round, respectively. In the first round, we asked open-ended questions and used directed content analysis to analyse 386 statements. We formulated 170 interprofessional learning objectives in six categories: (1) acute life-threatening situations, (2) gastrointestinal toxicities and side effects, (3) pain, (4) palliation, (5) play and activity, and (6) prescription and administration of medicine. The second round resulted in 168 interprofessional learning objectives receiving a mean score of ≥3 on a five-point scale. Final agreement in the third round resulted in a prioritised list of 168 learning objectives.

Conclusions

Consensus on content and interprofessional learning objectives for an interprofessional education in childhood cancer was established across five groups of healthcare professionals in three countries. Some learning objectives are generic and can be applied in settings other than childhood cancer, where healthcare professionals collaborate to provide patients and families optimal treatment and care.

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<![CDATA[Use of psychiatric drugs in Dermatology]]> https://www.researchpad.co/product?articleinfo=N7b44ad1b-b3d1-4c25-9558-4f8563a3da5f

Patients with psychocutaneous disorders often refuse psychiatric intervention in their first consultations, leaving initial management to the dermatologist. The use of psychotropic agents in dermatological practice, represented by antidepressants, antipsychotics, anxiolytics, and mood stabilizers, should be indicated so that patients receive the most suitable treatment rapidly. It is important for dermatologists to be familiar with the most commonly used drugs for the best management of psychiatric symptoms associated with dermatoses, as well as to manage dermatologic symptoms triggered by psychiatric disorders.

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<![CDATA[LoAdaBoost: Loss-based AdaBoost federated machine learning with reduced computational complexity on IID and non-IID intensive care data]]> https://www.researchpad.co/product?articleinfo=Na533cb35-b26a-447b-bd62-8e125a165db4

Intensive care data are valuable for improvement of health care, policy making and many other purposes. Vast amount of such data are stored in different locations, on many different devices and in different data silos. Sharing data among different sources is a big challenge due to regulatory, operational and security reasons. One potential solution is federated machine learning, which is a method that sends machine learning algorithms simultaneously to all data sources, trains models in each source and aggregates the learned models. This strategy allows utilization of valuable data without moving them. One challenge in applying federated machine learning is the possibly different distributions of data from diverse sources. To tackle this problem, we proposed an adaptive boosting method named LoAdaBoost that increases the efficiency of federated machine learning. Using intensive care unit data from hospitals, we investigated the performance of learning in IID and non-IID data distribution scenarios, and showed that the proposed LoAdaBoost method achieved higher predictive accuracy with lower computational complexity than the baseline method.

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<![CDATA[Assessment of availability, awareness and perception of stakeholders regarding preschool vision screening in Kumasi, Ghana: An exploratory study]]> https://www.researchpad.co/product?articleinfo=N637f6c02-dcec-48f9-ae4a-5e42bca666db

Background

Regardless of the importance of preschool vision screening (PSVS), there is limited data on the current state of these programs in Africa (particularly Ghana). This study sought to investigate the level of awareness and perception of stakeholders regarding PSVS, its availability and related policies/programmes in the Kumasi Metropolis, Ghana.

Methods

This descriptive cross-sectional study included 100 systematically sampled preschools in the metropolis (using probability proportional-to-size method); 72 private schools and 28 public schools. Convenience sampling was used to recruit stakeholders of preschools (teachers, head teachers, proprietors, administrators, directors, and educationists), and were interviewed using a well-structured questionnaire. Questionnaires were administered to all eligible respondents who were present at the time of data collection.

Results

A total of 344 respondents participated in the study; 123 (35.8%) males and 221 (64.2%) females. The overall mean age of respondents was 37.63 ±12.20 years (18–71 years). Of the respondents, 215 (62.5%), 94 (27.3%), and 35 (10.2%) were enrolled from private schools, public schools, and Metropolitan Education Directorate, respectively. 73.8% of respondents reported the absence of routine PSVS in schools whereas 90.1% reported no written policies for PSVS in schools. Only 63.6% of respondents were aware of PSVS whereas more than half (59.6%) of all respondents perceived PSVS to be very important for preschoolers. Private school ownership was significantly associated with availability of PSVS whereas age, teachers, private school ownership, and preschool experience > 10 years were significantly associated with awareness of PSVS (P < 0.05). However, there was no significant association between sociodemographic factors and perception of PSVS.

Conclusion

PSVS is largely unavailable in most Ghanaian schools. Majority of stakeholders were aware of PSVS and agreed to its implementation and incorporation into schools’ health programmes. There is the need to implement a national programme/policy on preschool vision screening in Ghana.

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<![CDATA[Prevalence of depressive symptoms among Italian medical students: The multicentre cross-sectional “PRIMES” study]]> https://www.researchpad.co/product?articleinfo=N89095419-220d-4d38-944c-d00bb778cf6f

Background

Four percent of the world’s population suffers from depression, which is a major public health issue. Medical students are at risk, as their depressive symptoms (DS) prevalence is reported to be approximately 27% worldwide. Since few data on Italian medical students exist, this study aimed to estimate their DS prevalence and assess risk and protective factors.

Methods

The PRIMES was a multicentre cross-sectional study performed in 12 Italian medical schools. Questionnaires were self-reported and included 30 sociodemographic items and the Beck Depression Inventory-II (BDI-II). The primary outcome was the presence of DS (BDI-II score≥14). The main analyses were chi-squared tests and multivariable logistic regressions with a p-value<0.05 considered significant.

Results

The number of collected questionnaires was 2,513 (117 BDI-II incomplete). Females accounted for 61.3% of the respondents, and the median age was 22 years (IQR = 4). The prevalence of DS was 29.5%. Specifically, 14.0% had mild depression, 11.1% had moderate depression, and 4.5% had severe depression. The main risk factors for DS were age, being female, bisexual/asexual orientation, living with partner/housemates, poor economic status (worsened by living far from home), less than 90 min of weekly exercise, relatives with psychiatric disorders, personal chronic disease, judging medical school choice negatively, unsatisfying friendships with classmates, competitive and hostile climate among classmates, thinking that medical school hinders specific activities and being worried about not measuring up to the profession. Protective factors included family cohesion, hobbies, intellectual curiosity as a career motivation and no worries about the future.

Conclusion

Italian medical students are at high risk of reporting DS, similar to the global population of medical students’. Medical schools must make efforts to implement preventive and treatment interventions by offering counselling and working on modifiable factors, such as lifestyle and learning climate.

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<![CDATA[Characterization of e-Government adoption in Europe]]> https://www.researchpad.co/product?articleinfo=N2f6308d0-16b2-46c8-b471-69fa510f181d

The digital divide in Europe has not yet been bridged and thus more contributions towards understanding the factors affecting the different dimensions involved are required. This research offers some insights into the topic by analyzing the e-Government adoption or practical use of e-Government across Europe (26 EU countries). Based on the data provided by the statistical office of the European Union (Eurostat), we defined two indexes, the E-Government Use Index (EGUI) and an extreme version of it taking into account only null or complete use (EGUI+), and characterized the use/non use of e-Government tools using supervised learning procedures in a selection of countries with different e-Government adoption levels. These procedures achieved an average accuracy of 73% and determined the main factors related to the practical use of e-Government in each of the countries, e.g. the frequency of buying goods over the Internet or the education level. In addition, we compared the proposed indexes to other indexes measuring the level of e-readiness of a country such as the E-Government Development Index (EGDI) its Online Service Index (OSI) component, the Networked Readiness Index (NRI) and its Government usage component (GU). The ranking comparison found that EGUI+ is correlated with the four indexes mentioned at 0.05 significance level, as the majority of countries were ranked in similar positions. The outcomes contribute to gaining understanding about the factors influencing the use of e-Government in Europe and the different adoption levels.

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<![CDATA[Clinical applicability of the Feline Grimace Scale: real-time versus image scoring and the influence of sedation and surgery]]> https://www.researchpad.co/product?articleinfo=N2856c4d5-d500-4a4f-95c9-9bc743f8a422

Background

The Feline Grimace Scale (FGS) is a facial expression-based scoring system for acute pain assessment in cats with reported validity using image assessment. The aims of this study were to investigate the clinical applicability of the FGS in real-time when compared with image assessment, and to evaluate the influence of sedation and surgery on FGS scores in cats.

Methods

Sixty-five female cats (age: 1.37 ± 0.9 years and body weight: 2.85 ± 0.76 kg) were included in a prospective, randomized, clinical trial. Cats were sedated with intramuscular acepromazine and buprenorphine. Following induction with propofol, anesthesia was maintained with isoflurane and cats underwent ovariohysterectomy (OVH). Pain was evaluated at baseline, 15 min after sedation, and at 0.5, 1, 2, 3, 4, 6, 8, 12 and 24 h after extubation using the FGS in real-time (FGS-RT). Cats were video-recorded simultaneously at baseline, 15 min after sedation, and at 2, 6, 12, and 24 h after extubation for subsequent image assessment (FGS-IMG), which was performed six months later by the same observer. The agreement between FGS-RT and FGS-IMG scores was calculated using the Bland & Altman method for repeated measures. The effects of sedation (baseline versus 15 min) and OVH (baseline versus 24 h) were assessed using linear mixed models. Responsiveness to the administration of rescue analgesia (FGS scores before versus one hour after) was assessed using paired t-tests.

Results

Minimal bias (−0.057) and narrow limits of agreement (−0.351 to 0.237) were observed between the FGS-IMG and FGS-RT. Scores at baseline (FGS-RT: 0.16 ± 0.13 and FGS-IMG: 0.14 ± 0.13) were not different after sedation (FGS-RT: 0.2 ± 0.15, p = 0.39 and FGS-IMG: 0.16 ± 0.15, p = 0.99) nor at 24 h after extubation (FGS-RT: 0.16 ± 0.12, p = 0.99 and FGS-IMG: 0.12 ± 0.12, p = 0.96). Thirteen cats required rescue analgesia; their FGS scores were lower one hour after analgesic administration (FGS-RT: 0.21 ± 0.18 and FGS-IMG: 0.18 ± 0.17) than before (FGS-RT: 0.47 ± 0.24, p = 0.0005 and FGS-IMG: 0.45 ± 0.19, p = 0.015).

Conclusions

Real-time assessment slightly overestimates image scoring; however, with minimal clinical impact. Sedation with acepromazine-buprenorphine and ovariohysterectomy using a balanced anesthetic protocol did not influence the FGS scores. Responsiveness to analgesic administration was observed with both the FGS-RT and FGS-IMG.

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<![CDATA[Partition dependence in financial aid distribution to income categories]]> https://www.researchpad.co/product?articleinfo=N0611b39b-d559-4542-a5d9-a69c54a62df4

When allocating resources, people often diversify across categories even when those categories are arbitrary, such that allocations differ when identical sets of options are partitioned differently (“partition dependence”). The first goal of the present work (Experiment 1) was to replicate an experiment by Fox and colleagues in which graduate students exhibited partition dependence when asked how university financial aid should be allocated across arbitrarily partitioned income brackets. Our sample consisted of community members at a liberal arts college where financial aid practices have been recent topics of debate. Because stronger intrinsic preferences can reduce partition dependence, these participants might display little partition dependence with financial aid allocations. Alternatively, a demonstration of strong partition dependence in this population would emphasize the robustness of the effect. The second goal was to extend a “high transparency” modification to the present task context (Experiment 2) in which participants were shown both possible income partitions and randomly assigned themselves to one, to determine whether partition dependence in this paradigm would be reduced by revealing the study design (and the arbitrariness of income categories). Participants demonstrated clear partition dependence in both experiments. Results demonstrate the robustness of partition dependence in this context.

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<![CDATA[Catalyzing rapid discovery of gold-precipitating bacterial lineages with university students]]> https://www.researchpad.co/product?articleinfo=N1a44b6bf-58da-4441-b695-6e6e3f9e006c

Intriguing and potentially commercially useful microorganisms are found in our surroundings and new tools allow us to learn about their genetic potential and evolutionary history. Engaging students from different disciplines and courses in the search for microbes requires an exciting project with innovative but straightforward procedures and goals. Here we describe an interdisciplinary program to engage students from different courses in the sampling, identification and analysis of the DNA sequences of a unique yet common microbe, Delftia spp. A campus-wide challenge was created to identify the prevalence of this genus, able to precipitate gold, involving introductory level environmental and life science courses, upper-level advanced laboratory modules taken by undergraduate students (juniors and seniors), graduate students and staff from the campus. The number of participants involved allowed for extensive sampling while undergraduate researchers and students in lab-based courses participated in the sample processing and analyses, helping contextualize and solidify their learning of the molecular biology techniques. The results were shared at each step through publicly accessible websites and workshops. This model allows for the rapid discovery of Delftia presence and prevalence and is adaptable to different campuses and experimental questions.

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