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- Clinical cases illustrate the epidemiology, diagnosis, and treatment of infectious diseases, reinforcing a clinical approach to learning. Full-color clinical photographs, images, and illustrations help you visualize the clinical presentations of...
- Phone: Fax: E-mail: ude. All Rights Reserved. This article has been cited by other articles in PMC. Abstract The development of web-based technologies provides a new method for course delivery. As with any new technique, evaluation is a necessary...
- Yet, successfully transitioning from the traditional classroom presents challenges regarding how to properly deliver course information in a web-based format. Some students may perceive a diminished level of interaction with the instructor in an online course 6 , 10 or that online course modules require too great of a work load 6. Faculty may also be concerned with the time commitment associated with an online course 7. To address some of the challenges of online teaching, Graham et al. A separately-graded laboratory course Applied Microbiology Laboratory, 1 SCH accompanies the lecture and is offered in only a face-to-face format.
- Concurrent enrollment in both the lecture and laboratory is recommended, but not required. Development of the online course material began in March of , with the first offering of the online version of Applied Microbiology in the spring semester of The conversion of the course to online format began with the development of lesson outlines based on existing lecture note materials. Unlike the classroom schedule, where a particular topic must be presented in x number of to minute intervals, the online environment allows for flexible amounts of material to be presented in each lesson. During the conversion of this course, 27 traditional lectures that had been delivered in minute class periods were redistributed among 17 online lessons Table 1.
- Groups of four to five of these lessons were then placed into a total of four major topics: history and principles of microbiology; microbial metabolism, ecology, and diversity; biotechnology and food microbiology; and microorganisms and disease. The information covered in each of these topics corresponded to the material for one of the four lecture examinations.
Construction And Evaluation Of An Online Microbiology Course For Nonscience Majors
Test Question Formats Step 1 assesses whether you understand and can apply important concepts of the sciences basic to the practice of medicine, with special emphasis on principles and mechanisms underlying health, disease, and modes of therapy. Step 1 ensures mastery of not only the sciences that provide a foundation for the safe and competent practice of medicine in the present, but also the scientific principles required for maintenance of competence through lifelong learning. Step 1 is constructed according to an integrated content outline that organizes basic science material along two dimensions: system and process. Step 1 is a one-day examination. It is divided into seven minute blocks and administered in one 8-hour testing session.- The number of questions per block on a given examination form may vary, but will not exceed The total number of items on the overall examination form will not exceed You must run the web-based Tutorial and Practice Test Items to become familiar with the test software prior to your test date. Become familiar with how these types of test items function before your test date. Please visit the USMLE website often to view announcements, regarding changes in the test delivery software, and to access updated practice materials. Content Description Step 1 consists of multiple-choice questions MCQs , also known as items, created by USMLE committees composed of faculty members, investigators, and clinicians with recognized prominence in their respective fields.
- Committee members are selected to provide broad representation from the academic, practice, and licensing communities across the United States and Canada. Step 1 is designed to measure basic science knowledge. Some questions test the examinee's fund of information per se, but the majority of questions require the examinee to interpret graphic and tabular material, to identify gross and microscopic pathologic and normal specimens, and to solve problems through application of basic science principles. The content description is not intended as a curriculum development or study guide. It provides a flexible structure for test construction that can readily accommodate new topics, emerging content domains, and shifts in emphasis.
- The categorizations and content coverage are subject to change. Broad-based learning that establishes a strong general understanding of concepts and principles in the basic sciences is the best preparation for the examination. No new content was assessed in Step 1 exams administered after the exam was updated in October Examinees testing after the October update saw an increase in the number of items that assess knowledge of Communication and Interpersonal Skills; this content has been included on the Step 1 exam for many years. You can see a representative Step 1 item assessing knowledge of Communication and Interpersonal Skills here. Content Outline All USMLE examinations are constructed from an integrated content outline , which organizes content according to general principles and individual organ systems. Test questions are classified in one of 18 major areas, depending on whether they focus on concepts and principles that are important across organ systems or within individual organ systems.
- Step 1 content weighting for these topics is provided in Table 1 below. Sections focusing on individual organ systems are subdivided according to normal and abnormal processes, including mechanisms of pharmacotherapy. In most instances, knowledge of normal processes is evaluated in the context of a disease process or specific pathology. While not all topics listed in the content outline are included in each USMLE Step examination, overall content coverage is comparable among the various examination forms that will be taken by different examinees for each Step.
- The examination will be testing core knowledge in medical microbiology and, in particular, the scientific basis of microbiology and infection. UK trainees in single or joint training programmes for Microbiology should refer to the information available on the Infection specialty page for information regarding their Part 1 examination. Part 1 Medical Microbiology Part 1 Examination Medically qualified candidates are required to have trained in a recognised Regional Specialist Training Programme in microbiology or virology for a period of normally not less than 12 months.
- Non-medically qualified candidates are required to have trained in a recognised training programme in microbiology for a period of normally not less than 12 months. In addition, they must be state registered, or the equivalent of state registered in another country. Format Multiple-choice; single best answer questions, designed to test both knowledge and understanding. The medical microbiology and virology curriculum is available on the Training and Education section of the College website. Standards and marking Objective multiple-choice question MCQ examination single three-hour paper with computerised marking. One-best-answer and extended-matching question formats. Experienced group of examiners involved in standard setting and curriculum mapping. The pass mark is set by an objective procedure by the Panel of Examiners individual question review to create minimum standard. Examination review is biannual.
- Graduate Division won't be accepting the Duolingo English Test. If you don't have access to taking any of the approved English language proficiency exams, we recommend contacting your program of interest for another option. Scores submitted may not be borrowed, photocopied, returned to you or sent elsewhere. Before performing duties as a Teaching Assistant, any student whose native language is not English must pass an oral English language competency exam upon arrival at UCR.
- This includes not only international students but also any student whose first language is not English. This exam must be taken within two years of the time you intend to enroll at UCR. Scores reported to UCR will be evaluated based on an exam where all sections were scored from one exam date. Results from multiple exams cannot be combined to create a super score. We strongly advise you to be aware of the deadline for the program to which you are applying.
- Visit ETS for more information about this exam. UCR's school code is GRE department and major codes can be found here. If ETS has not assigned a major code to the graduate program you are interested in, select The minimum acceptable overall score is 7 with no score less than 6 on any individual component. Remember to order the TRF from the test center where you took the test and ask the administrator to send the electronic score to UCR. For more information about registering for this exam or to locate the office of any test center, visit IELTS. Applicants will be able to enter their recommenders' information directly into our online application. Recommenders will be notified electronically and provided instructions on how to submit a letter online. All letters of recommendation must be received electronically so they are attached to the applicant's file for review.
- Graduate programs require three 3 letters of recommendation. Submitting more than three letters does not improve your standing as an applicant. At least two of these letters should be requested from professors in your major subject. The most important aspect of letters of recommendation is that they be completed by individuals who are able to analyze your academic ability and potential for success in a rigorous graduate program. If you wish to submit a letter from an employer, please contact the graduate program advisor to determine if this will be acceptable. If you are applying to the M. All letters of recommendation must be in English. If you have been enrolled in a previous graduate program, it is required that one letter be from your research or program advisor in that graduate program. Applicants using Interfolio's online portfolio service can have their letters uploaded to our online application using Interfolio's "Web Delivery" Method.
- To do so, please follow the step-by-step instructions located within the Reference Information section of the online application. If you wish to waive your right to inspect the letters of recommendation, mark the appropriate box below the reference information. Only enrolled UCR students are permitted to inspect letters of recommendation for which they did not waive their right to access. Letters of recommendation cannot be released to the applicant and cannot be forwarded elsewhere. Applicants must submit these essays directly into their online application. Please note that each essay should not duplicate the other. We also do not accept a personal resume or curriculum vitae as a response to either essay.
- The Statement of Purpose is your opportunity to state your specific interests with respect to the program to which you are applying. Your intended area of specialization, career objectives and research interests and experience are of interest. The Personal History Statement is your opportunity to discuss how your personal background informs your decision to pursue a graduate degree. Please check with the graduate program for more information on what relevant experience they are looking for as well as any addition program requirements that must be provided to review the application like: Writing Samples Projects Course prerequisites A non-refundable application fee is required, and payment can be made using Visa, MasterCard or Discover prior to submitting your online application. As application fees vary, please review the below table to determine your required application fee. Domestic U. Waivers are not automatically granted and need to be approved prior to submission of your application.
- Only one fee waiver is allowed per student, per application period. We cannot issue refunds for any application fees already paid.
- Continuous global improvement in diagnostic test preparedness is essential for more rapid detection of patients, possibly at the point of care, and for optimized prevention and treatment, in both industrialized countries and low-resource settings. Download PDF Introduction During a pandemic there are multiple concurrent clinical priorities, including the need to understand the pathophysiology of the disease, optimized patient care and prevention of future infections 1. The detection and characterization of the etiological agent or its immunological consequences in the host are the necessary starting points 2.
- Being able to define the pathogen, biologically and genetically, and whether it is inducing protective immunity are key in the development of protective and curative protocols against future persisting disease. The current diagnostic procedures are twofold. First there is the direct detection of parts of the virus. This can be done by culture of the virus, detection of one or more of its proteins and, the method used most frequently during the present pandemic, direct detection of nucleic acids or detection via amplification of nucleic acids. Immunological tests detect the consequences of infection by the virus in the host. This is most frequently focused on the detection of virus-specific antibodies, whereas some specialized laboratories may also be capable of defining the cellular immune response.
- Here we will mostly focus on the nucleic amplification tests, with illustrations of how immune tests may complement molecular tests in several cases. Diagnostics can be used in various manners, the so-called use cases. These include triage of symptomatic individuals in an epidemic or endemic setting, triage of at-risk presymptomatic and symptomatic individuals in endemic settings, confirmatory testing, diagnosis of symptomatic individuals in endemic or epidemic settings, differential diagnosis in endemic or epidemic settings, testing of patients with previous exposure to severe acute respiratory syndrome coronavirus 2 SARS-CoV-2; the cause of the coronavirus disease COVID pandemic , surveillance at sites of previous or potential outbreaks and environmental monitoring Foundation for Innovative New Diagnostics FIND. The use case determines the way in which diagnostic tests are used optimally 3. The ongoing COVID pandemic has underpinned the central position of diagnostic testing in outbreak control 4.
- Ending the pandemic involves the accurate application of diagnostic testing in high volumes and the rapid use of the results to help implement the appropriate therapy and prevent further spread. The value of integrated diagnostics in the management of the current COVID wave and possible future COVID waves is high, especially for the molecular detection of the virus, and for the qualification and quantification of the immunological host response 5. Test design, validation and verification, emergency use approval and the manufacturing of test kits in very high numbers are just a few examples of such obstacles. From the perspective of a routine-diagnostic microbiology laboratory, the setting up of high-throughput diagnostic pipelines, the logistics involved and the optimization of pragmatic use of test results were encountered as important problems during the first wave of the ongoing COVID pandemic. Ultimately, optimized diagnostic tools will provide guidance in the development of therapeutics and vaccines Fig.
- Diagnostic lessons learnt during the first wave of the COVID pandemic should be used to help prepare for the next wave, which is anticipated by many. The boxes on the left identify some of the important medical, scientific and industrial deliverables where an interconnected approach covering each steps from fundamental research to commercialization is needed. Translational medicine relies on the interconnection of multidisciplinary teams of life scientists able to translate basic scientific discoveries into changes in clinical practice supported by expertise from engineering, law and financial sciences.
- The most important facilitators are indicated in each box. The column on the right lists the innovation drivers. Current innovation drivers combine the ability to process large amounts of data and to facilitate access to biological material through easy access to a biobank. The intense collaboration between academia and industry, with detailed sharing of research goals and directions during the coronavirus disease COVID pandemic, through the identification of an optimal collaborative approach capitalizing on the strengths of both made possible the rapid development of new diagnostic tests, drugs and possible vaccines against COVID Full size image In this Review we address early COVID test design and the design-, development-, production- and distribution-associated hurdles. We discuss the importance of quality control and options for mass production as well as the practical issues around broad and rapid implementation of entirely new tests that have not undergone classic evaluation and validation.
- We also estimate the effect of new-generation COVID tests on laboratory medicine practice, the need for new approaches towards biobanking and the economic consequences of the pandemic. Of note, we focus on molecular assays, with limited presentation and explanation of serological tests. For adaption towards the more frequently used diagnostic DNA detection formats, the viral genome needs to be transcribed into a DNA complement by reverse transcriptase. Moreover, monitoring the host response is important in identifying individuals who have already been infected with SARS-CoV-2 as well as for assessing future vaccine efficacy. Over the past months, all currently available technologies have been exploited to rapidly develop highly sensitive and highly specific detection and characterization assays for SARS-CoV In this section we briefly discuss these test formats, but we will not consider functional tests that assess virus inactivation or the therapeutic effect of cellular immune responses 1.
- Such assays are mostly limited to highly specialized laboratories and do not yet have a major impact on current global health-care practice. Diagnostic tests developed and their application Direct diagnostic testing to detect active SARS-CoV-2 infections mostly involves reverse transcriptase real-time PCR rtPCR , although different molecular technologies, such as CRISPR-mediated detection or loop-mediated isothermal amplification, have also been applied 8 , 9 , 10 , 11 , Operation and application of these molecular tests is in keeping with those for previously developed tests that detect infectious agents Moreover, rapid antigen detection tests have also been developed to detect active infection, although a limited number of such tests are available 14 , However, in comparison with rtPCR, rapid antigen detection tests lack sensitivity, and owing to the increased risk of false-negative results, they are considered as an adjunct to rtPCR tests 16 , Antibody testing can have a mostly complementary role to rtPCR tests in the diagnosis of COVID, at approximately 10 days or more after the onset of symptoms, in assessing past infections and defining the dynamics of the individual humoral responses in individual patients or in patient cohorts undergoing certain forms of treatment 20 , Targets for the tests have been identified by comparative screening for genomic regions that have a low mutation frequency to avoid primer and antibody mismatches, and enhance test quality and stability Hundreds of such diagnostic tests have now been developed Supplementary Table 1 , and technical reviews of their comparative performance assessment have been published recently 25 , 26 , 27 , 28 , 29 , 30 , 31 , FIND is or has been assessing more than diagnostic assays, more than of which are so-called rapid tests taking less than 30 minutes to generate a result.
- It is important to note that all novel tests urgently need useful clinical cut-off values to help enhance their medical value At present, negative results in either of these test types do not completely rule out current or past infections owing to possible false-negative results 36 , Quantitative test results may be a prerequisite for the choice of COVID treatment strategy, for treatment follow-up or for the support of vaccine trials. Another important aspect is surveillance: the rapid and continuous detection efforts aimed at early recognition, isolation and treatment of those infected with the virus For adequate surveillance and tracing, both regionally and globally epidemiological virus typing is important. Next-generation nucleotide sequencing is used to define polymorphisms and to define interrelatedness between virus strains 39 , Such approaches have been instrumental in defining the global spread of the virus and may also help to define virus variants with different biological capacities for example, ease of spread, pathogenicity and tissue tropism.
- Metagenomic next-generation nucleotide sequencing can also be used diagnostically for virus detection in patients 41 or in environmental samples such as wastewater Considerations for the development, production and distribution of diagnostic COVID tests The superficial sketch of test design provided in the previous subsection represents only the first steps in test development. Initial design, experimental small-scale laboratory validation and, if at all possible, clinical evaluation using high-quality and patient specimens are followed by industrial scale-up. The test format needs to be compatible with large-scale production, which in the case of COVID was possible for tests that were supported on pre-existing platforms Any test that was developed rapidly but was not applicable on an existing instrument had a substantial disadvantage to reach the market Possible exceptions are tests that are presented in a platform-agnostic layout and that can be combined with any type of instrument already available to laboratory-based diagnosticians Moreover, instruments and tests need to be abundantly available at a local and global scale to ensure scale-up of clinical testing.
- The preavailability of a platform also enables the broad geographical spread of the test. If an installed base of instruments already exists, then new tests in the already existing format can be rapidly and reliably added to the testing repertoire of a laboratory. In such cases, assay transport and storage are two remaining hurdles, and test distribution in itself may be an important obstacle. The shelf life of a test, the temperature tolerance of the test components and simple characteristics such as the size and weight of the package are all important parameters in the perceived ease of distribution.
- Once the instrument and assays are available to users, instrument availability and human expertise may still be limiting factors in high-throughput test application Finally, there needs to be a balance between the laboratory test capacity and the number of requests for tests, and the fluctuation in the number of tests requested and changes in priority test recommendations pose additional problems. It is clear that the entire global population cannot be tested repeatedly at the same time, and choices need to be made to prioritize patient groups or groups at increased risk of being infected for example, health-care workers When these groups have been identified, sampling processes and their logistics need to be designed and implemented. Simplicity of sampling and homogeneity of the sample itself are important parameters to consider, and other sources, such as saliva, have been considered as alternative specimens for COVID testing Testing of sample pools has been suggested as a solution to minimize test costs while maintaining test sensitivity and specificity, specifically in settings where the incidence of infection is low Pooling of samples may generally induce practical pretesting burden and may lower traceability, and thus sample pooling should perhaps be restricted to times of reagent shortage.
- The jury is still out on whether pooling is diagnostically robust and cost-effective, with conflicting reports having been published 50 , 51 , In addition, the current consensus is that individual laboratories should perform validation studies before embarking on large-scale pooling strategies Finally, there is a continuous need for means of rapid and reliable result dissemination, an issue that is covered in privacy loopholes but also the need to use test results beyond the privacy of an individual patient.
- Test results are key in surveillance and outbreak management and should be used to inform infection prevention measures. Diagnostic tests need careful consideration and validation before being launched. This is often underestimated and underappreciated by scientists and the community, and involves processes that are costly and time-consuming.
- In addition, the provision of positive control templates was effectively implemented by the European Virus Archive goes Global EVAg project, supplying specific products such as RNA transcripts for assays through its online catalogue by mid-January refs 54 , Technical qualification data, based on the use of cell culture materials and synthetic nucleic acid constructs, as well as results from exclusivity testing of 75 clinical samples, were included in the first diagnostic protocol provided to the WHO on 13 January Unfortunately, and despite this EUA registration, as described in a news article , there were problems with one of the reagents described in the CDC protocol, partially blocking rapid implementation of the test or leading to retraction of test results. On 29 February , new guidance was issued for laboratories to be able to develop and implement COVID molecular diagnostic tests before obtaining EUA 58 , 59 , 60 , 61 see also Supplementary Table 1.
- The relative technical ease with which such diagnostic tests could be designed and the stable nature of the target genetic material of the pathogen were contributing factors to test quality and reproducibility, which resulted in various tests being developed within a few months Box 1. Diagnostic testing without quality control at all levels from design up and until end use is without value and results in abuse of valuable and possibly scarce resources. Box 1 Defining the clinical validation of diagnostic tests Clinical validation of diagnostic tests, as considered in this Review, involves assessing the performance of the test in comparison with a reference test that is capable of assigning the sample status without error. The generic validation of a novel technology should be performed on a larger scale, ideally in multiple laboratories, and should include a much more comprehensive investigation of the critical parameters relevant to the specific technology to provide the highest chance of detecting sources of variation and interference.
- The competence of testing and calibration via new laboratory-developed methods or acquired methods adopted by the laboratory may also be appropriate if they are sufficiently validated. Laboratories have to validate all non-standard methods, and all standard methods used outside their intended scope. This covers both laboratory-based methods and predictive models using diagnostic data to predict the severity of disease, for instance For amplifications and modifications of standard methods, it has to be confirmed that the methods are fit for the intended use through the provision of a well-recorded, validation protocol and resulting outcomes. Test sensitivity and specificity The analytical specificity of a molecular COVID test is its ability to determine exclusively the analyte it intends to measure in the presence of off-target templates or interfering substances under well-controlled laboratory conditions.
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