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1. Teaching Immunology in the 21st Century: A Scoping Review of Emerging Challenges and Strategies

Author

Merav Siani, Ilana Dubovi, Anna Borushko, and Michal Haskel-Ittah

Abstract

Immunology, a complex and rapidly evolving biological field, serves dual educational goals: training healthcare professionals and immunologists as well as promoting immune literacy among laypeople. This study conducted a scoping review of the literature to explore different aspects of immunology education, examining various contexts, levels, and content areas, including cognitive and motivational challenges. In addition, analysis covered different teaching strategies and research methodologies. Eight hundred and seventy-four articles were screened, and 20 articles proceeded to full-text analysis. Notably, the majority of the analysed studies concentrated on undergraduate education, emphasising strategies for teaching immunology, with a heavy reliance on quantitative research methods. Teaching strategies that were influential for improving the knowledge of the students were, for example, using games, using simulations and visualisations, using hands on experiments and self-directed learning. The content of the reviewed articles primarily revolved around topics related to innate and adaptive immunity, basic immunology, and immune system diseases. There was less emphasis on advanced immunology and on addressing the inherent complexity of the subject and even less on methods to motivate students to engage with immunology. Practical implications and suggestions for future research are described considering both healthcare practitioner training and immune literacy for laypeople.

Published
2024
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2. Diagnostic performance of serial serum total tryptase measurement to differentiate positive from negative allergy testing among patients with suspected perioperative hypersensitivity

Author

Jean-Marc Malinovsky, R. Stenger, Pascal Demoly, Yoann Ehrhard, Charles Tacquard, Anna Borushko, Anca-Mirela Chiriac, Simon Viville, Witchaya Srisuwatchari, P.M. Mertes, Département pneumologie et addictologie [Montpellier], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Arnaud de Villeneuve, Siriraj Hospital, Mahidol University, Mahidol University [Bangkok], CHU Strasbourg, Belarusian Medical Academy of Post-Graduate Education [Minsk] (BelMAPGE), Hôpital Maison Blanche, Centre Hospitalier Universitaire de Reims (CHU Reims), Médecine de précision par intégration de données et inférence causale (PREMEDICAL), Inria Sophia Antipolis - Méditerranée (CRISAM), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Institut Desbrest de santé publique (IDESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Institut Desbrest de santé publique (IDESP), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)

Subjects
MESH: Drug Hypersensitivity, medicine.medical_specialty, Allergy, MESH: Tryptases, Tryptase measurement, drug hypersensitivity reaction, Immunology, Drug allergy, tryptase, Tryptase, Allergy testing, perioperative hypersensitivity, Gastroenterology, Perioperative Care, Drug Hypersensitivity, diagnostic performance, Internal medicine, Immunology and Allergy, Medicine, Humans, MESH: Perioperative Care, [SDV.IMM.ALL]Life Sciences [q-bio]/Immunology/Allergology, Anaphylaxis, MESH: Humans, biology, business.industry, Perioperative, medicine.disease, Work-up, Hypersensitivity reaction, MESH: Anaphylaxis, MESH: France, biology.protein, Tryptases, France, business
Abstract

International audience; Background: Serum total tryptase has been shown to increase during acute allergic reactions (acute tryptase, TA ); however, few studies have investigated the values of TA or a combination of TA and baseline tryptase (TB ) to discriminate positive from negative testing in perioperative hypersensitivity reaction (POH) allergy work-up. The aim of this study was to determine the diagnostic performance of TA in order to differentiate positive from negative allergy testing suspected POH and analyse the diagnostic performance of serial tryptase levels using several formulas.Methods: All patients from the University hospital of Montpellier and Strasbourg, France, who presented with suspected POH and underwent complete drug allergy work-up between March 2011 and December 2019 with available TA and TB were included. Four formulas, including a change in TA > 11 (F1), or >2 + 1.2 × TB (F2), or >3 + TB (F3), or >120%TB (F4), were applied.Results: One hundred and sixty-two patients were included, and 131 of them (80.8%) had Grade III or IV reactions. Ninety patients had positive allergy testing. The optimal cut-off value of TA to distinguish positive from negative allergy testing patients was 9.8 μg/L with an AUC of 0.817 (95% CI: 0.752-0.882, p < .001). The 93% PPV threshold for TA was 33 μg/L (95.8% specificity). Paired tryptase levels according to formulas F2 and F3 yielded the highest Youden index (0.54 and 0.53, respectively).Conclusion: The optimal cut-off point for TA for distinguishing positive from negative allergy testing suspected POH was 9.8 μg/L. TA value of 33 μg/L was required to achieve >90% PPV.

Published
2021
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