Anomaly Identification during Polymerase Chain Reaction for Detecting SARS-CoV-2 Using Artificial Intelligence Trained from Simulated Data.

Real-time reverse transcription (RT) PCR is the gold standard for detecting Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), owing to its sensitivity and specificity, thereby meeting the demand for the rising number of cases. The scarcity of trained molecular biologists for analyzing PCR results makes data verification a challenge. Artificial intelligence (AI) was designed to ease verification, by detecting atypical profiles in PCR curves caused by contamination or artifacts. Four classes of simulated real-time RT-PCR curves were generated, namely, positive, early, no, and abnormal amplifications. Machine learning (ML) models were generated and tested using small amounts of data from each class. The best model was used for classifying the big data obtained by the Virology Laboratory of Simon Bolivar University from real-time RT-PCR curves for SARS-CoV-2, and the model was retrained and implemented in a software that correlated patient data with test and AI diagnoses. The best strategy for AI included a binary classification model, which was generated from simulated data, where data analyzed by the first model were classified as either positive or negative and abnormal. To differentiate between negative and abnormal, the data were reevaluated using the second model. In the first model, the data required preanalysis through a combination of prepossessing. The early amplification class was eliminated from the models because the numbers of cases in big data was negligible. ML models can be created from simulated data using minimum available information. During analysis, changes or variations can be incorporated by generating simulated data, avoiding the incorporation of large amounts of experimental data encompassing all possible changes. For diagnosing SARS-CoV-2, this type of AI is critical for optimizing PCR tests because it enables rapid diagnosis and reduces false positives. Our method can also be used for other types of molecular analyses.

"Residents get no satisfaction" a problem to face during internal medicine rotations: development and psychometric properties of the IMPRINT-15.

Clinical rotations are an essential part of Internal Medicine (IM) residency programmes, where curricular objectives are carried out. To our knowledge, there are no validated instruments to assess IM clinical rotations. Our objective was to develop an instrument for residents to assess the quality of clinical rotations in an IM residency programme, and to test the psychometric properties of the instrument. A mixed methodology was used, including qualitative and quantitative phases. Items were proposed by a group of experts based on previously identified residency needs, followed by a quantitative phase to generate consensus among educators and residents to define which items would be included in the instrument (Delphi panel). After generating the instrument, psychometric tests were performed to assess construct validity (factor analysis) and reliability (Raykov's reliability coefficient). We obtained a 15-item instrument after two Delphi rounds: Internal Medicine Program Instrument 15-items (IMPRINT-15). Sixty-two residents answered 428 surveys using a Likert scale during 7 months (response rate 98.9%). The median score was 4.3 (IQR 3.9-4.7) (scale from 1 to 5). The factor analysis showed two domains in the clinical rotation assessment: (1) teaching and care activities; (2) evaluation and feedback. The instrument is reliable with Raykov's reliability coefficient of 0.86. Also, Raykov's reliability coefficient for the domains were 0.89 and 0.83, respectively. The IMPRINT-15 instrument is a bi-dimensional, valid and reliable questionnaire to evaluate the perceived quality by residents of the IM clinical rotations. Also, it constitutes the first validated instrument in this field worldwide.

Stevia rebaudiana Bertoni and Its Effects in Human Disease: Emphasizing Its Role in Inflammation, Atherosclerosis and Metabolic Syndrome.

PURPOSE OF REVIEW: Stevia rebaudiana Bertoni is a perennial shrub with zero calorie content that has been increasing in popularity for its potential use as an adjuvant in the treatment of obesity. The level of evidence supporting general benefits to human health is insufficient. We conducted a review of the literature summarizing the current knowledge and role in human disease. RECENT FINDINGS: Despite stevia's minimal systemic absorption, studies have been promising regarding its potential benefits against inflammation, carcinogenesis, atherosclerosis glucose control, and hypertension. On the other hand, the growing popularity of artificial sweeteners does not correlate with improved trends in obesity. An increased intake of artificial non-caloric sweeteners may not be associated with decreased intake of traditional sugar-sweetened beverages and foods. The effects of Stevia on weight change have been linked to bacteria in the intestinal microbiome, mainly by affecting Clostridium and Bacteroides sp. POPULATIONS: A growing body of evidence indicates that Stevia rebaudiana Bertoni is protective against malignant conversion by inhibition of DNA replication in human cancer cell growth in vitro. Consumption of Stevia has demonstrated to be generally safe in most reports. Further clinical studies are warranted to determine if regular consumption brings sustained benefits for human health.

Continuous infusion or bolus injection of loop diuretics for congestive heart failure? / ¿Diuréticos de asa en infusión continua o en bolo en la insuficiencia cardiaca congestiva?

Loop diuretics are widely used in acute heart failure. However, there is controversy about the superiority of continuous infusion over bolus administration. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified four systematic reviews including 11 pertinent randomized controlled trials overall. We combined the evidence using meta-analysis and generated a summary of findings following the GRADE approach. We concluded continuous administration of loop diuretics probably reduces mortality and length of stay compared to intermittent administration in patients with acute heart failure.

Los diuréticos de asa son ampliamente utilizados en insuficiencia cardiaca aguda. Sin embargo, existe controversia respecto a la superioridad de la administración en infusión continua por sobre la administración en bolo. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos cuatro revisiones sistemáticas que en conjunto incluyen 11 estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Concluimos que la administración continua de diuréticos en comparación con la administración intermitente probablemente disminuye la mortalidad y la estadía hospitalaria en pacientes con insuficiencia cardiaca aguda.

What are the effects of hypertonic saline plus furosemide in acute heart failure?

In search of new therapies to solve diuretic resistance in acute heart failure, the addition of hypertonic saline has been proposed. Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified two systematic reviews including nine pertinent randomized controlled trials. We combined the evidence and generated a summary of findings following the GRADE approach. We concluded hypertonic saline associated with furosemide probably decrease mortality, length of hospital stay and hospital readmission in patients with acute decompensated heart failure.

En la búsqueda de nuevas terapias para resolver la resistencia a los diuréticos en insuficiencia cardiaca aguda se ha planteado la adición de suero hipertónico. Utilizando la base de datos Epistemonikos, la cual es mantenida mediante búsquedas en 30 bases de datos, identificamos dos revisiones sistemáticas que en conjunto incluyen nueve estudios aleatorizados. Realizamos un metanálisis y tablas de resumen de los resultados utilizando el método GRADE. Se concluye que el suero hipertónico asociado a furosemida probablemente disminuye la mortalidad, estadía y reingreso hospitalario en pacientes con insuficiencia cardiaca descompensada.

Caracterización del uso de la plataforma MOODLE por estudiantes de ciencias de la salud / Characterization of the use of the MOODLE platform by the health sciences students

Fundamento: la tecnología diversifica la labor didáctica en los procesos pedagógicos mediados por las tecnologías de la información y las comunicaciones. Objetivo: caracterizar el uso de la plataforma MOODLE por alumnos de ciencias de la salud de la Universidad SEK de Santiago de Chile. Métodos: se realizó un estudio descriptivo transversal durante el año académico 2013. La población de estudio estuvo constituida por 1 328 estudiantes del área de la salud, y la muestra fue de 185 estudiantes seleccionados mediante un muestreo no probabilístico intencionado. Se utilizaron métodos teóricos: análisis-síntesis e inductivo-deductivo; y empíricos: revisión documental y encuesta (cuestionario) a los estudiantes. Resultados: la revisión de correo electrónico y la participación en redes sociales fueron los usos más frecuentes de internet en los estudiantes de ambos sexos. No existen diferencias significativas según el sexo en relación al uso de MOODLE. Ninguno de los sujetos informó participar en foros. Los formatos más utilizados en MOODLE son Power point, texto y videos. Según el nivel socioeconómico, solo existe diferencia en las acciones: descargar información y ver noticias. Conclusiones: el estudio realizado permitió constatar que es bajo el porcentaje de estudiantes que utilizan internet para la búsqueda de información, por lo que los autores consideran necesario incentivar a alumnos y docentes en el uso de los mecanismos de MOODLE para la interacción docente-alumno y alumno-alumno en aras de la calidad del proceso docente.

Background: technology diversifies the work of the pedagogical processes dominated by the communications and information technologies. Objective: to characterize the use of the MOODLE platform by the health sciences students in Santiago de Chile SEK University. Methods: a cross-sectional descriptive study was carried out in the academic year 2013. The study population comprised 1328 students of the health area and 185 students were included in a non-random purposive sampling. Theoretical methods were used: analysis-synthesis and induction-deduction. Empirical methods: review of documents and a survey was applied to the students. Results: the checking of e-mails and the participation in the social networks were the most frequent uses of internet by the students of both sexes. There are no meaningful differences about sex in relation to the use of MOODLE. None of them participated in forum. The most used formats of MOODLE were PowerPoint, texts, and videos. There are differences in the actions discharging information and viewing videos according to socio-economic standards. Conclusions: the study carried out allowed stating that a low percentage of students used internet to search information, so the author considers that it is necessary to incentivize teachers and students to use MOODLE for the teacher-student and student-student interaction so as to improve the quality of the teaching process.

Caracterización del uso de la plataforma MOODLE por estudiantes de ciencias de la salud / Characterization of the use of the MOODLE platform by the health sciences students

Fundamento: la tecnología diversifica la labor didáctica en los procesos pedagógicos mediados por las tecnologías de la información y la comunicación (TIC). Objetivo: caracterizar el uso de la plataforma MOODLE por alumnos de ciencias de la salud de la Universidad SEK de Santiago de Chile. Métodos: se realizó un estudio descriptivo transversal durante el año académico 2013. La población de estudio estuvo constituida por 1 328 estudiantes del área de la salud, y la muestra fue de 185 estudiantes seleccionados mediante un muestreo no probabilístico intencionado. Se utilizaron métodos teóricos: análisis-síntesis e inductivo-deductivo; y empíricos: revisión documental y encuesta (cuestionario) a los estudiantes. Resultados: la revisión de correo electrónico y la participación en redes sociales fueron los usos más frecuentes de internet en los estudiantes de ambos sexos. No existen diferencias significativas según el sexo en relación al uso de MOODLE. Ninguno de los sujetos informó participar en foros. Los formatos más utilizados en MOODLE son Power point, texto y videos. Según el nivel socioeconómico, solo existe diferencia en las acciones: descargar información y ver noticias. Conclusiones: el estudio realizado permitió constatar que es bajo el porcentaje de estudiantes que utilizan internet para la búsqueda de información, por lo que los autores consideran necesario incentivar a alumnos y docentes en el uso de los mecanismos de MOODLE para la interacción docente-alumno y alumno-alumno en aras de la calidad del proceso docente(AU)