Taylorella equigenitalis, the cause of contagious equine metritis (CEM), can be detected by culture but in recent years polymerase chain reaction (PCR) has also been used. In 2008, the World Organisation for Animal Health (OIE) Reference Laboratory for CEM in the United Kingdom set up a ring trial for laboratories to assess their ability to identify T. equigenitalis in laboratory-prepared samples because the identification of T. equigenitalis in the laboratory was recognised to be difficult. Freeze-dried culture suspensions in various combinations of any of T. equigenitalis, Taylorella asinigenitalis, other typical equine contaminant organisms, or no organism were used. All laboratories provided culture results and some also gave PCR results. The results reported here cover the ten years since inception and look at the ability to identify T. equigenitalis under ideal laboratory conditions, a necessity to be able to detect its presence in equine genital samples. The detection rate was very high by both methods. The accuracy was not significantly different between the culture and PCR methods for pure T. equigenitalis samples. For T. equigenitalis mixed with contaminants, culture missed about 2% (p = 0.02) compared with PCR, which was over 99% accurate. Difficulty in differentiating T. asinigenitalis from T. equigenitalis was apparent in a number of laboratories for both culture and PCR in 2008 but was less evident in 2016. It was also noted that culture results from laboratories that also tested by PCR had around 4% higher detection rates (p < 0.05) of T. equigenitalis than those that only used culture.
La détection de Taylorella equigenitalis, l\'agent causal de la métrite contagieuse équine, peut être réalisée par culture, mais aussi, depuis quelques années, par amplification en chaîne par polymérase (PCR). En 2008, le Laboratoire de référence de l\'Organisation mondiale de la santé animale (OIE) pour cette maladie au Royaume-Uni a conçu une série d\'essais comparatifs inter-laboratoires visant à évaluer la capacité des laboratoires à identifier des échantillons préparés de T. equigenitalis, compte tenu de la difficulté avérée de cette identification au laboratoire. Les essais ont porté sur des cultures lyophilisées en suspension contenant, dans diverses combinaisons, T. equigenitalis, Taylorella asinigenitalis, d\'autres micro-organismes pathogènes des équidés, ou aucun agent pathogène. Tous les laboratoires participants ont communiqué les résultats des mises en culture et certains ont également transmis les résultats obtenus par PCR. Les résultats rapportés par les auteurs couvrent les dix années écoulées depuis le lancement des essais et visent à déterminer la capacité à identifier T. equigenitalis dans des conditions de laboratoire idéales, exigence essentielle pour pouvoir détecter la présence de cette bactérie à partir de prélèvements génitaux d\'équidés. Le taux de détection s\'est révélé très élevé pour chacune des deux méthodes. Il n\'a pas été observé de variation significative entre l\'exactitude de la mise en culture et celle de la PCR lorsque les prélèvements ne contenaient que T. equigenitalis. S\'agissant de suspensions où T. equigenitalis était mélangée à d\'autres agents pathogènes, les résultats font état d\'environ 2 % (p = 0,02) d\'échecs de l\'identification par culture, tandis que l\'exactitude de la PCR était de 99 %. En 2008, plusieurs laboratoires ont manifestement eu des difficultés à différencier T. asinigenitalis de T. equigenitalis aussi bien en culture que par PCR, mais cette difficulté était moins perceptible en 2016. Il a également été constaté que les identifications après culture effectuées par les laboratoires qui testaient aussi par PCR se traduisaient par un taux de détection de T. equigenitalis supérieur d\'environ 4 % (p < 0,05) par rapport aux laboratoires qui ne pratiquaient que la mise en culture.
Taylorella equigenitalis, patógeno causante de la metritis contagiosa equina, puede ser detectado por cultivo, pero en los últimos años también se viene utilizando la técnica de reacción en cadena de la polimerasa (PCR). En 2008, ante la sabida dificultad que presenta la identificación en laboratorio de T. equigenitalis, el Laboratorio de Referencia de la Organización Mundial de Sanidad Animal (OIE), para esta enfermedad sito en el Reino Unido, puso en marcha una serie de pruebas de competencia para evaluar la aptitud de diferentes laboratorios para detectar la presencia de T. equigenitalis en muestras preparadas en laboratorio, empleando al efecto suspensiones de cultivo liofilizado con diversas combinaciones en las que estaban presentes T. equigenitalis, Taylorella asinigenitalis, otros patógenos equinos típicos o ningún microorganismo en absoluto. Todos los laboratorios comunicaron los resultados de las técnicas de cultivo y algunos de ellos también proporcionaron los resultados obtenidos por PCR. Los resultados aquí expuestos cubren los diez años transcurridos desde el inicio de las pruebas y dan cuenta de la capacidad para identificar a T. equigenitalis en condiciones de laboratorio idóneas, elemento imprescindible para poder detectar su presencia en muestras genitales equinas. Con ambos métodos se obtenía una tasa de detección muy elevada, sin que hubiera una diferencia de exactitud significativa entre el cultivo y la PCR en el caso de muestras puras de T. equigenitalis. Cuando este microorganismo estaba mezclado con contaminantes, «escapaban» al método de cultivo alrededor de un 2% (p = 0,02) de las muestras, frente a la exactitud del 99% que deparaban las técnicas de PCR. Los resultados obtenidos por una serie de laboratorios en 2008 ponían de manifiesto una evidente dificultad para distinguir entre T. asinigenitalis y T. equigenitalis, ya fuera por cultivo o por PCR, dificultad que resultaba menos obvia en 2016. También se observó que las tasas de detección en cultivo de T. equigenitalis obtenidas por laboratorios que también analizaban las muestras por PCR eran alrededor de un 4% superiores (p < 0,05) a las de laboratorios que empleaban únicamente el método de cultivo.

The objective of our study was to evaluate the sensitivity and specificity of rapid antigen detection tests versus those of reverse transcriptase PCR (RT-PCR) using oral, anterior nasal, and nasopharyngeal swabs. The underlying prospective, diagnostic case-control-type accuracy study included 87 hospitalized and nonhospitalized participants in a positive and a negative sample cohort between 16 March and 14 May 2021 in two hospitals in Vienna. SARS-CoV-2 infection status was confirmed by RT-PCR. Participants self-performed one oral and one anterior nasal swab for the rapid antigen test, immediately followed by two nasopharyngeal swabs for the rapid antigen test and RT-PCR by the investigator. Test results were read after 15 min, and participants completed a questionnaire in the meantime. Test parameters were calculated based on the evaluation of 87 participants. The overall sensitivity of rapid antigen detection tests versus that of RT-PCR with oral, anterior nasal, and nasopharyngeal samples was 18.18% (95% confidence interval [CI] 8.19% to 32.71%), 63.04% (95% CI 47.55% to 76.79%), and 73.33% (95% CI 58.06% to 85.4%), respectively. All sampling methods had a test specificity of 100% regardless of the cycle threshold (CT) value. Rapid antigen detection tests using self-collected anterior nasal swabs proved to be as sensitive as and more tolerable than professionally collected nasopharyngeal swabs for CT values up to 30 determined by RT-PCR. This finding illustrates the reliability of tests obtained by adequate self-collected anterior nasal specimen. Sensitivity was dependent upon the CT value for each sampling method. While the main advantage of rapid antigen detection tests is the immediate availability of results, PCR should be preferred in crucial settings wherever possible. IMPORTANCE Rapid antigen detection devices for SARS-CoV-2 represent a valuable tool for monitoring the spread of infection. However, the reliability of the tests depends largely on the test performance and the respective sampling method. Nasopharyngeal swabs mark the gold standard for sample collection in suspected respiratory tract infections but are unsuitable for widespread application, as they must be performed by medically trained personnel. With the underlying study, the head-to-head test performance and the usability of self-collected samples for SARS-CoV-2 detection using rapid antigen detection devices were evaluated. The results confirm similar sensitivity of self-collected anterior nasal swabs to that of professionally collected nasopharyngeal swabs for patients with a CT of < 30 determined by RT-PCR.

OBJECTIVE: To examine the factors that influence nursing students\' mathematics self-efficacy, the effect of numeracy instruction on self-efficacy, and the association between self-efficacy and numeracy test performance.
BACKGROUND: Medication administration errors, including administering incorrect dosages or infusion rates, can result in serious harm to patients. Hence, it is essential that nursing students are adequately prepared with the necessary numeracy skills during their nursing program.
METHODS: This quasi-experimental cohort study used a pre- and post-test survey design. The study complied with the STROBE checklist for cohort research.
METHODS: In total, n = 715 undergraduate first year nursing students participated in the study from June to October 2017 at a single multi-campus university in the Western Sydney region of Australia. Data were collected at three time-points: (a) baseline, including assessing pre-instruction mathematics self-efficacy (NSE-Math scale); (b) 6-week follow-up; including assessing post-instruction mathematics self-efficacy; and (c) numeracy test performance was collected at 7-week follow-up.
RESULTS: At baseline, those with high NSE-Math scale scores were more likely to be male and have at least high school advanced mathematics level education. Following structured numeracy instruction, NSE-Math scale scores increased significantly, and those who obtained a satisfactory grade in their numeracy assessment were more likely to have high NSE-Math scale scores and high academic performance in the previous semester.
CONCLUSIONS: The study shows that structured numeracy instruction improved mathematics self-efficacy, which in turn influenced numeracy test performance.
CONCLUSIONS: Using a structured medication numeracy pedagogical approach, to teach skills in nursing undergraduate programs, provides students with the foundations to improve mathematics self-efficacy and to be successful and safe with medication numeracy calculations and administration in clinical practice.

In patients with CKD, the risk of developing colorectal cancer is high and outcomes are poor. Screening using fecal immunochemical testing (FIT) is effective in reducing mortality from colorectal cancer, but performance characteristics of FIT in CKD are unknown.
To determine the detection rates and performance characteristics of FIT for advanced colorectal neoplasia (ACN) in patients with CKD, we used FIT to prospectively screen patients aged 35-74 years with CKD (stages 3-5 CKD, dialysis, and renal transplant) from 11 sites in Australia, New Zealand, Canada, and Spain. All participants received clinical follow-up at 2 years. We used a two-step reference standard approach to estimate disease status.
Overall, 369 out of 1706 patients who completed FIT (21.6%) tested positive; 323 (87.5%) underwent colonoscopies. A total of 1553 (91.0%) completed follow-up; 82 (4.8%) had died and 71 (4.2%) were lost. The detection rate of ACN using FIT was 6.0% (5.6%, 7.4%, and 5.6% for stages 3-5 CKD, dialysis, and transplant). Sensitivity, specificity, and positive and negative predictive values of FIT for ACN were 0.90, 0.83, 0.30, and 0.99, respectively. Of participants who underwent colonoscopy, five (1.5%) experienced major colonoscopy-related complications, including bowel perforation and major bleeding.
FIT appears to be an accurate screening test for patients with CKD, such that a negative test may rule out the diagnosis of colorectal cancer within 2 years. However, the risk of major complications from work-up colonoscopy are at least ten-fold higher than in the general population.

OBJECTIVE: To determine the effectiveness of didactic case-based instruction methodology to improve medical student comprehension of common neurological illnesses and neurological emergencies.
METHODS: Neurology department, academic university.
METHODS: 415 third and fourth year medical students performing a required four week neurology clerkship.
METHODS: Raw test scores on a 1 hour, 50-item clinical vignette based examination and open-ended questions in a post-clerkship feedback session.
RESULTS: There was a statistically significant improvement in overall test scores (p<0.001).
CONCLUSIONS: Didactic teaching sessions have a significant positive impact on neurology student clerkship test score performance and perception of their educational experience. Confirmation of these results across multiple specialties in a multi-center trial is warranted.