Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Hea...Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.展开更多
With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge i...With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge is mainly taught by the teachers,and the students passively absorb it.This study examines a problem-oriented Socratic experiment in nongraded English teaching in senior high school.The teachers seek output from students,who respond by interpreting questions,fostering critical thinking,and enhancing problem-solving skills.This teaching experiment indicates that the Socratic method has a significant positive effect on cultivating nongraded senior high English students’critical thinking under the New National College Entrance Examination.展开更多
“Introduction to Language,”as the core course of the English major,mainly reveals the basic laws of language,enabling the students to have the ability to apply linguistic theories to explain language phenomena and s...“Introduction to Language,”as the core course of the English major,mainly reveals the basic laws of language,enabling the students to have the ability to apply linguistic theories to explain language phenomena and solve specific language problems.This course is highly theoretical and has a certain degree of difficulty.The evaluation of student grades has always been based on examination reform,but several problems have been encountered during the implementation process.This article analyzes the current situation of the reform and implementation of the“Introduction to Language”course examination in applied universities and puts forth suggestions and specific measures to improve the assessment of the course,aiming to enhance the teaching effectiveness of the course and scientifically and comprehensively evaluate students’abilities.展开更多
In the environment of smart examination rooms, it is important to quickly and accurately detect abnormal behavior(human standing) for the construction of a smart campus. Based on deep learning, we propose an intellige...In the environment of smart examination rooms, it is important to quickly and accurately detect abnormal behavior(human standing) for the construction of a smart campus. Based on deep learning, we propose an intelligentstanding human detection (ISHD) method based on an improved single shot multibox detector to detect thetarget of standing human posture in the scene frame of exam room video surveillance at a specific examinationstage. ISHD combines the MobileNet network in a single shot multibox detector network, improves the posturefeature extractor of a standing person, merges prior knowledge, and introduces transfer learning in the trainingstrategy, which greatly reduces the computation amount, improves the detection accuracy, and reduces the trainingdifficulty. The experiment proves that the model proposed in this paper has a better detection ability for the smalland medium-sized standing human body posture in video test scenes on the EMV-2 dataset.展开更多
Objective: To evaluate the interest of the simulation in the learning of the obstetric examination of parturient by medical students. Materials and methods: It was an analytical cross-sectional study that took place f...Objective: To evaluate the interest of the simulation in the learning of the obstetric examination of parturient by medical students. Materials and methods: It was an analytical cross-sectional study that took place from 1 to 28 February 2020 at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso. The study population was made up of medical students at the Doctorate II level. The previous experience of the students in the obstetric examination of the parturient, the contribution of the simulation on their feelings and on their skills towards this examination were studied. The Mc Nemar Chi<sup>2</sup> test was used to compare percentages on paired samples. Results: The level of difficulty in performing the obstetrical examination in the parturient evolved downwards after the practice of the simulation. The stress level to perform the obstetric exam has been significantly reduced. On the other hand, confidence has increased. The students’ ability to appreciate each of the elements of the obstetric examination studied had improved after the practice of simulation. Conclusion: The simulation in the skills laboratory was a great contribution and the acquisition of models of better fidelity would help to improve the contribution to the confidence building and the acquisition of skills by learners.展开更多
Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery exa...Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery examination pass rate. Methods: This was a cross-sequential study involving 148 surgical candidates (72 UK trainees, 75 non-UK trainees) who had attended our revision course (Phoenix FRCS Course) from June 2017 until 2023. Each course comprised a two-day weekend preparation with dedicated sections for clinical, viva, and academic reading, incorporating SBL as its key learning style. We maintained a prospective database of candidate and course details, examination results, and feedback since the course inception. Results: We found that 97% of candidates passed the FRCS examination after their first attempt. The course was attended once by 89% of candidates, and only 3 of the 148 candidates exhausted all four attempts at the examination. Candidate feedback for the course and its style of learning was positive, with simulation-based table viva sessions and virtual clinical sessions proving the most popular learning sessions (95% and 80% of candidates attending courses run in December 2017, April 2018, and May 2021 rated them “Excellent” respectively). Conclusions: The course is centered around shared adult learning and mindfulness tools to encourage candidates to learn from each other and develop confidence and mastery in all domains of surgical practice. These methods have been shown to be effective in achieving high success rates in the Intercollegiate and International FRCS examinations for UK and overseas surgeons.展开更多
Objective:To optimize the magnetic resonance imaging(MRI)detection process in view of the COVID-19 pandemic,standardize and strengthen the infection control and management MRI rooms.Methods:According to the Technical ...Objective:To optimize the magnetic resonance imaging(MRI)detection process in view of the COVID-19 pandemic,standardize and strengthen the infection control and management MRI rooms.Methods:According to the Technical Guide for COVID-19 Prevention and Control in Medical Institutions(3rd Edition),with reference to the current COVID-19 infection control plan,there are three aspects involved in the planning of MRI examination:MRI room management,medical staff management and protection,and patient management,especially the use of full plastic nose strip medical masks.Infection prevention measures are formulated,scientific prevention and control are made,and accurate policies are implemented.Results:MRI examination was carried out according to the infection control and management of MRI room plan during the epidemic,so as to ensure the safety of examination,the safety of patients and the safety of medical staff and no cross infection in hospital.Conclusion:The implementation of proper infection prevention measures during MRI examination in light of COVID-19 ensures that patients wear medical surgical masks with full plastic nose strips throughout the process to avoid cross-infection,ensure the safety of doctors and patients,and maintain the health of the population.展开更多
The lungs are the main fundamental part of the human respiratory system and are among the major organs of the human body.Lung disorders,including Coronavirus(Covid-19),are among the world’s deadliest and most life-th...The lungs are the main fundamental part of the human respiratory system and are among the major organs of the human body.Lung disorders,including Coronavirus(Covid-19),are among the world’s deadliest and most life-threatening diseases.Early and social distance-based detection and treatment can save lives as well as protect the rest of humanity.Even though X-rays or Computed Tomography(CT)scans are the imaging techniques to analyze lung-related disorders,medical practitioners still find it challenging to analyze and identify lung cancer from scanned images.unless COVID-19 reaches the lungs,it is unable to be diagnosed.through these modalities.So,the Internet of Medical Things(IoMT)and machine learning-based computer-assisted approaches have been developed and applied to automate these diagnostic procedures.This study also aims at investigating an automated approach for the detection of COVID-19 and lung disorders other than COVID-19 infection in a non-invasive manner at their early stages through the analysis of human breath.Human breath contains several volatile organic compounds,i.e.,water vapor(5.0%–6.3%),nitrogen(79%),oxygen(13.6%–16.0%),carbon dioxide(4.0%–5.3%),argon(1%),hydro-gen(1 ppm)(parts per million),carbon monoxide(1%),proteins(1%),isoprene(1%),acetone(1%),and ammonia(1%).Beyond these limits,the presence of a certain volatile organic compound(VOC)may indicate a disease.The proposed research not only aims to increase the accuracy of lung disorder detection from breath analysis but also to deploy the model in a real-time environment as a home appliance.Different sensors detect VOC;microcontrollers and machine learning models have been used to detect these lung disorders.Overall,the suggested methodology is accurate,efficient,and non-invasive.The proposed method obtained an accuracy of 93.59%,a sensitivity of 89.59%,a specificity of 94.87%,and an AUC-Value of 0.96.展开更多
Based on the deepening awareness of the risk of changing packaging materials of injections,the national regulatory authorities and the China National Pharmaceutical Packaging Association have issued the relevant guide...Based on the deepening awareness of the risk of changing packaging materials of injections,the national regulatory authorities and the China National Pharmaceutical Packaging Association have issued the relevant guidelines and group standards for changing packaging materials in recent years,greatly improving the research and development and technical requirements of packaging materials of injections.In 2021,Guangdong Province carried out the archival examination of the change of listed drugs,among which the proportion of the acceptance of changed injection packaging materials has increased year by year.On the basis of sorting out the archival examination work and combining with the cases of changing packaging materials of chemical injections accepted by Guangdong Province during 2021-2022,the requirements and problems of archival examination were analyzed and discussed to provide a reference and idea for applicants when studying the change in packaging materials.展开更多
Objective: Major international guidelines have not standardized the sequence of diagnostic examinations during the follow-up of a patient with a diagnosed breast cancer. The aim of this study is to investigate the acc...Objective: Major international guidelines have not standardized the sequence of diagnostic examinations during the follow-up of a patient with a diagnosed breast cancer. The aim of this study is to investigate the accuracy of sonography in the diagnosis of loco-regional lymphatic recurrences in comparison to the core needle biopsy results. Materials and Methods: Among 6455 patients who were followed up with clinical examination, mammography and ultrasound between January 2004 and November 2011, 125 (1.93%) patients had to be investigated with a core needle biopsy of a sonographically suspicious loco-regional lymph node. Results: Among the whole series, a total of 142 ultrasound-guided core needle biopsies were performed. Follow-up for the primary tumor lasted for a median time of 6.1 years (range 1 - 27 years). Ultrasound of suspicious loco-regional lymph nodes showed a sensitivity of 89.5%, a specificity of 87.1% and a positive predictive value of 89.5%. Conclusions: In our experience, ultrasound of suspicious loco-regional lymph nodes showed good accuracy and it should be a part of the standard examinations performed during follow-up for breast cancer.展开更多
AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a tota...AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.展开更多
Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a succ...Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.展开更多
BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study pre...BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.展开更多
The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data fro...The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.展开更多
Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest f...Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.展开更多
Background: Regular breast self-examination (BSE) has been known to effectively detect breast cancer occurrence early. Are Women who consider BSE effective in detecting breast cancer more likely to be aware of BSE, or...Background: Regular breast self-examination (BSE) has been known to effectively detect breast cancer occurrence early. Are Women who consider BSE effective in detecting breast cancer more likely to be aware of BSE, or vice versa? The present study was an attempt to answer this question. Methods: A cross-sectional study was performed for 259 female University students in Kampala, Uganda. Data were analyzed using SPSS. Univariate and bivariate analyses were carried out. Results: The majority (64.1%) were aware of the BSE technique. Women considering BSE to be effective for early cancer detection were significantly more likely to be aware of the BSE technique. Conclusions: University students who believed in the benefits of BSE were more likely to be aware of BSE than those who did not. More emphasis should be placed on health education for women of younger ages to increase the knowledge of the practice of BSE.展开更多
本文结合相关辞书,概述与examination相关的表达。1.用prepare/revise/studyfor等表示“为考试而准备”“复习迎考”“温习备考”。例如:We are preparing for the examination next week.我们正在为下周的考试做准备。I do not have mu...本文结合相关辞书,概述与examination相关的表达。1.用prepare/revise/studyfor等表示“为考试而准备”“复习迎考”“温习备考”。例如:We are preparing for the examination next week.我们正在为下周的考试做准备。I do not have much time to revise for examinations.我没有很多时间复习迎考。Ineed time to study for tomorrow's exami nation.我需要时间学习,准备明天的考试。展开更多
Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting ...Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE) status, % free PSA and transrectal ultrasound (TRUS) findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% (223/535). The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.展开更多
AIM: To take fundus examination in the preterm neonates to observe the common diseases and report the outcomes in a neonatal intensive care unit (NICU) in Guangzhou between May 2008 and May 2011. METHODS: Fundus exami...AIM: To take fundus examination in the preterm neonates to observe the common diseases and report the outcomes in a neonatal intensive care unit (NICU) in Guangzhou between May 2008 and May 2011. METHODS: Fundus examinations were performed with Retcam II in 957 prematures. RESULTS: There were 957 prematures in this study, including 666 males and 291 females, 2 triple births, 152 twins and 803 singletons. During the three years, 86 infants with any stage retinopathy of prematurity (ROP) (9.0%), 123 infants with retinal hemorrhage (12.9%), 10 infants with neonatal fundual jaundice (1.0%) and 3 babies with congenital choroidal coloboma (0.3%) were found. CONCLUSION: Early detection and prompt treatment of ocular disorders in neonates is important to avoid lifelong visual impairment. Examination of the eyes should be performed in the newborn period and at all well-child visits.展开更多
基金funded by the grants from the National Key Research and Development Program of China[2021YFC2301503,2022YFC2302900]the National Natural and Science Foundation of China[82171739,82171815,81873884]。
文摘Objective To evaluate the diagnostic value of histopathological examination of ultrasound-guided puncture biopsy samples in extrapulmonary tuberculosis(EPTB).Methods This study was conducted at the Shanghai Public Health Clinical Center.A total of 115patients underwent ultrasound-guided puncture biopsy,followed by MGIT 960 culture(culture),smear,Gene Xpert MTB/RIF(Xpert),and histopathological examination.These assays were performed to evaluate their effectiveness in diagnosing EPTB in comparison to two different diagnostic criteria:liquid culture and composite reference standard(CRS).Results When CRS was used as the reference standard,the sensitivity and specificity of culture,smear,Xpert,and histopathological examination were(44.83%,89.29%),(51.72%,89.29%),(70.11%,96.43%),and(85.06%,82.14%),respectively.Based on liquid culture tests,the sensitivity and specificity of smear,Xpert,and pathological examination were(66.67%,72.60%),(83.33%,63.01%),and(92.86%,45.21%),respectively.Histopathological examination showed the highest sensitivity but lowest specificity.Further,we found that the combination of Xpert and histopathological examination showed a sensitivity of 90.80%and a specificity of 89.29%.Conclusion Ultrasound-guided puncture sampling is safe and effective for the diagnosis of EPTB.Compared with culture,smear,and Xpert,histopathological examination showed higher sensitivity but lower specificity.The combination of histopathology with Xpert showed the best performance characteristics.
基金This research is funded by 2021 Postgraduate Scientific Research Innovation Project of Hunan Province Key Project—Diagnosis and Evaluation of High School Students’Critical Thinking Quality in English(Project approval No.QL20210120)the 2022 Hunan Province General Higher Education Teaching Reform Research Project—Research on the Cultivation Path of English Learners’Critical Thinking Ability From the Perspective of Curriculum Ideology and Politics(Project Approval No.HNJG-2022-1299).
文摘With the reform of the New National College Entrance Examination(Gaokao),the nongraded education will become an inevitable trend.In senior high school,the traditional test-oriented education is popular.The knowledge is mainly taught by the teachers,and the students passively absorb it.This study examines a problem-oriented Socratic experiment in nongraded English teaching in senior high school.The teachers seek output from students,who respond by interpreting questions,fostering critical thinking,and enhancing problem-solving skills.This teaching experiment indicates that the Socratic method has a significant positive effect on cultivating nongraded senior high English students’critical thinking under the New National College Entrance Examination.
基金Second batch of“opening bidding”Wuhan University of Bioengineering“Research on the Evaluation of the Implementation Effect of Curriculum Examination Reform:Taking the Course of Introduction to Language as an Example”(No.2023JGYB37)。
文摘“Introduction to Language,”as the core course of the English major,mainly reveals the basic laws of language,enabling the students to have the ability to apply linguistic theories to explain language phenomena and solve specific language problems.This course is highly theoretical and has a certain degree of difficulty.The evaluation of student grades has always been based on examination reform,but several problems have been encountered during the implementation process.This article analyzes the current situation of the reform and implementation of the“Introduction to Language”course examination in applied universities and puts forth suggestions and specific measures to improve the assessment of the course,aiming to enhance the teaching effectiveness of the course and scientifically and comprehensively evaluate students’abilities.
基金supported by the Natural Science Foundation of China 62102147National Science Foundation of Hunan Province 2022JJ30424,2022JJ50253,and 2022JJ30275+2 种基金Scientific Research Project of Hunan Provincial Department of Education 21B0616 and 21B0738Hunan University of Arts and Sciences Ph.D.Start-Up Project BSQD02,20BSQD13the Construct Program of Applied Characteristic Discipline in Hunan University of Science and Engineering.
文摘In the environment of smart examination rooms, it is important to quickly and accurately detect abnormal behavior(human standing) for the construction of a smart campus. Based on deep learning, we propose an intelligentstanding human detection (ISHD) method based on an improved single shot multibox detector to detect thetarget of standing human posture in the scene frame of exam room video surveillance at a specific examinationstage. ISHD combines the MobileNet network in a single shot multibox detector network, improves the posturefeature extractor of a standing person, merges prior knowledge, and introduces transfer learning in the trainingstrategy, which greatly reduces the computation amount, improves the detection accuracy, and reduces the trainingdifficulty. The experiment proves that the model proposed in this paper has a better detection ability for the smalland medium-sized standing human body posture in video test scenes on the EMV-2 dataset.
文摘Objective: To evaluate the interest of the simulation in the learning of the obstetric examination of parturient by medical students. Materials and methods: It was an analytical cross-sectional study that took place from 1 to 28 February 2020 at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso. The study population was made up of medical students at the Doctorate II level. The previous experience of the students in the obstetric examination of the parturient, the contribution of the simulation on their feelings and on their skills towards this examination were studied. The Mc Nemar Chi<sup>2</sup> test was used to compare percentages on paired samples. Results: The level of difficulty in performing the obstetrical examination in the parturient evolved downwards after the practice of the simulation. The stress level to perform the obstetric exam has been significantly reduced. On the other hand, confidence has increased. The students’ ability to appreciate each of the elements of the obstetric examination studied had improved after the practice of simulation. Conclusion: The simulation in the skills laboratory was a great contribution and the acquisition of models of better fidelity would help to improve the contribution to the confidence building and the acquisition of skills by learners.
文摘Objectives: To evaluate the impact of adult learning and simulation-based learning (SBL) on surgical trainees’ learning experiences and Fellowship of the Royal College of Surgeons (FRCS) Section 2 General Surgery examination pass rate. Methods: This was a cross-sequential study involving 148 surgical candidates (72 UK trainees, 75 non-UK trainees) who had attended our revision course (Phoenix FRCS Course) from June 2017 until 2023. Each course comprised a two-day weekend preparation with dedicated sections for clinical, viva, and academic reading, incorporating SBL as its key learning style. We maintained a prospective database of candidate and course details, examination results, and feedback since the course inception. Results: We found that 97% of candidates passed the FRCS examination after their first attempt. The course was attended once by 89% of candidates, and only 3 of the 148 candidates exhausted all four attempts at the examination. Candidate feedback for the course and its style of learning was positive, with simulation-based table viva sessions and virtual clinical sessions proving the most popular learning sessions (95% and 80% of candidates attending courses run in December 2017, April 2018, and May 2021 rated them “Excellent” respectively). Conclusions: The course is centered around shared adult learning and mindfulness tools to encourage candidates to learn from each other and develop confidence and mastery in all domains of surgical practice. These methods have been shown to be effective in achieving high success rates in the Intercollegiate and International FRCS examinations for UK and overseas surgeons.
基金Medical Science Research Program of Hebei Province:Analysis and Prevention and Control of Drug Resistance of Main Pathogenic Bacteria in Third-Class A Hospitals in the Recent 3 Years(No.20210845)Hebei University Affiliated Hospital:The Effect of Improving Hand Hygiene of Medical Staff on Nosocomial Infection During the Normalization Period of the Pandemic 2021(2021Z010)+1 种基金National Natural Science Foundation of China:Interaction of NEDD4L with eEF1A1 in VEC Autophagy and Tumor Angiogenesis Via Ubiquitination Activity(No.82103181)Natural Science Foundation of Hebei Province:Study on the Role of Sal-Mir-58 in Transspecies Regulation KLF3 in the Proliferation and Migration of Vascular Endothelial Cells(No.C2020201052)。
文摘Objective:To optimize the magnetic resonance imaging(MRI)detection process in view of the COVID-19 pandemic,standardize and strengthen the infection control and management MRI rooms.Methods:According to the Technical Guide for COVID-19 Prevention and Control in Medical Institutions(3rd Edition),with reference to the current COVID-19 infection control plan,there are three aspects involved in the planning of MRI examination:MRI room management,medical staff management and protection,and patient management,especially the use of full plastic nose strip medical masks.Infection prevention measures are formulated,scientific prevention and control are made,and accurate policies are implemented.Results:MRI examination was carried out according to the infection control and management of MRI room plan during the epidemic,so as to ensure the safety of examination,the safety of patients and the safety of medical staff and no cross infection in hospital.Conclusion:The implementation of proper infection prevention measures during MRI examination in light of COVID-19 ensures that patients wear medical surgical masks with full plastic nose strips throughout the process to avoid cross-infection,ensure the safety of doctors and patients,and maintain the health of the population.
文摘The lungs are the main fundamental part of the human respiratory system and are among the major organs of the human body.Lung disorders,including Coronavirus(Covid-19),are among the world’s deadliest and most life-threatening diseases.Early and social distance-based detection and treatment can save lives as well as protect the rest of humanity.Even though X-rays or Computed Tomography(CT)scans are the imaging techniques to analyze lung-related disorders,medical practitioners still find it challenging to analyze and identify lung cancer from scanned images.unless COVID-19 reaches the lungs,it is unable to be diagnosed.through these modalities.So,the Internet of Medical Things(IoMT)and machine learning-based computer-assisted approaches have been developed and applied to automate these diagnostic procedures.This study also aims at investigating an automated approach for the detection of COVID-19 and lung disorders other than COVID-19 infection in a non-invasive manner at their early stages through the analysis of human breath.Human breath contains several volatile organic compounds,i.e.,water vapor(5.0%–6.3%),nitrogen(79%),oxygen(13.6%–16.0%),carbon dioxide(4.0%–5.3%),argon(1%),hydro-gen(1 ppm)(parts per million),carbon monoxide(1%),proteins(1%),isoprene(1%),acetone(1%),and ammonia(1%).Beyond these limits,the presence of a certain volatile organic compound(VOC)may indicate a disease.The proposed research not only aims to increase the accuracy of lung disorder detection from breath analysis but also to deploy the model in a real-time environment as a home appliance.Different sensors detect VOC;microcontrollers and machine learning models have been used to detect these lung disorders.Overall,the suggested methodology is accurate,efficient,and non-invasive.The proposed method obtained an accuracy of 93.59%,a sensitivity of 89.59%,a specificity of 94.87%,and an AUC-Value of 0.96.
基金Supported by the Research on the Archival Examination Strategy of changes in Listed Drugs Based on Risk under the Guidance of Holders'Principal Responsibility(2023TDZ01)。
文摘Based on the deepening awareness of the risk of changing packaging materials of injections,the national regulatory authorities and the China National Pharmaceutical Packaging Association have issued the relevant guidelines and group standards for changing packaging materials in recent years,greatly improving the research and development and technical requirements of packaging materials of injections.In 2021,Guangdong Province carried out the archival examination of the change of listed drugs,among which the proportion of the acceptance of changed injection packaging materials has increased year by year.On the basis of sorting out the archival examination work and combining with the cases of changing packaging materials of chemical injections accepted by Guangdong Province during 2021-2022,the requirements and problems of archival examination were analyzed and discussed to provide a reference and idea for applicants when studying the change in packaging materials.
文摘Objective: Major international guidelines have not standardized the sequence of diagnostic examinations during the follow-up of a patient with a diagnosed breast cancer. The aim of this study is to investigate the accuracy of sonography in the diagnosis of loco-regional lymphatic recurrences in comparison to the core needle biopsy results. Materials and Methods: Among 6455 patients who were followed up with clinical examination, mammography and ultrasound between January 2004 and November 2011, 125 (1.93%) patients had to be investigated with a core needle biopsy of a sonographically suspicious loco-regional lymph node. Results: Among the whole series, a total of 142 ultrasound-guided core needle biopsies were performed. Follow-up for the primary tumor lasted for a median time of 6.1 years (range 1 - 27 years). Ultrasound of suspicious loco-regional lymph nodes showed a sensitivity of 89.5%, a specificity of 87.1% and a positive predictive value of 89.5%. Conclusions: In our experience, ultrasound of suspicious loco-regional lymph nodes showed good accuracy and it should be a part of the standard examinations performed during follow-up for breast cancer.
基金Supported by the Key Innovation and Guidance Program of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.YNZD2201903)the Scientific Research Foundation of the Eye Hospital,School of Ophthalmology&Optometry,Wenzhou Medical University(No.KYQD20180306)the Nursing Project of the Eye Hospital of Wenzhou Medical University(No.YNHL2201908).
文摘AIM:To assess glaucoma patient satisfaction and follow-up adherence in case management and identify associated predictors to improve healthcare quality and patient outcomes.METHODS:In this cross-sectional study,a total of 119 patients completed a Patient Satisfaction Questionnaire-18 and a sociodemographic questionnaire.Clinical data was obtained from the case management system.Follow-up adherence was defined as completing each follow-up within±30d of the scheduled time set by ophthalmologists during the study period.RESULTS:Average satisfaction scored 78.65±7,with an average of 4.39±0.58 across the seven dimensions.Age negatively correlated with satisfaction(P=0.008),whilst patients with follow-up duration of 2 or more years reported higher satisfaction(P=0.045).Multivariate logistics regression analysis revealed that longer follow-up durations were associated with lower follow-up adherence(OR=0.97,95%CI,0.95-1.00,P=0.044).Additionally,patients with suspected glaucoma(OR=2.72,95%CI,1.03-7.20,P=0.044)and those with an annual income over 100000 Chinese yuan demonstrated higher adherence(OR=5.57,95%CI,1.00-30.89,P=0.049).CONCLUSION:The case management model proves effective for glaucoma patients,with positive adherence rates.The implementation of this model can be optimized in the future based on the identified factors and extended to glaucoma patients in more hospitals.
文摘Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.
文摘BACKGROUND Enzymatic fasciotomy with collagenase clostridium histolyticum(CCH)has revolutionized the treatment for Dupuytren’s contracture(DC).Despite its benefits,the long-term outcomes remain unclear.This study presented a comprehensive 10-year follow-up assessment of the enduring effects of CCH on patients with DC.AIM To compare the short-term(12 wk)and long-term(10 years)outcomes on CCH treatment in patients with DC.METHODS A cohort of 45 patients was treated with CCH at the metacarpophalangeal(MCP)joint and the proximal interphalangeal(PIP)joint and underwent systematic reevaluation.The study adhered to multicenter trial protocols,and assessments were conducted at 12 wk,7 years,and 10 years post-surgery.RESULTS Thirty-seven patients completed the 10-year follow-up.At 10 years,patients treated at the PIP joint exhibited a 100%recurrence.However,patients treated at the MCP joint only showed a 50%recurrence.Patient satisfaction varied,with a lower satisfaction reported in PIP joint cases.Recurrence exceeding 20 degrees on the total passive extension deficit was observed,indicating a challenge for sustained efficacy.Significant differences were noted between outcomes at the 7-year and 10-year intervals.CONCLUSION CCH demonstrated sustained efficacy when applied to the MCP joint.However,caution is warranted for CCH treatment at the PIP joint due to a high level of recurrence and low patient satisfaction.Re-intervention is needed within a decade of treatment.
基金This study was supported by the Jungwon University Research Grant(2021-044).
文摘The association between heavy metals in the blood and obesity has been examined in many studies.However,inconsistencies have been observed in the results of these studies.The present study was conducted using data from 119,181 participants of the Korea National Health and Nutrition Examination Survey(KNHANES)for 11 years in 2005 and between 2008 and 2017.The subjects with missing heavy metal blood tests,health interview data,and health examination data were excluded from the study.The study population comprised 1,844 individuals(972 men,and 872 women)who were eligible for inclusion.It was found that obesity and abdominal obesity were associated with an increase in both blood mercury(P<0.001)and alanine aminotransferase(ALT)(P<0.001).After adjusting the confounding factors,those with concurrent high levels of ALT and the highest tertile of mercury showed an increased risk of obesity(odds ratio 4.46,95%confidence interval 2.23-8.90,P<0.001)as well as abdominal obesity(odds ratio 5.36,95%confidence interval 2.57-11.17,P<0.001).The interrelationship of mercury and ALT with the parameters of body mass index(P for interaction=0.009)and waist circumference(P for interaction=0.012),respectively,have been observed to be significant,suggesting that the reciprocal relationship could contribute to obesity and abdominal obesity.
文摘Follow-up of environmental impacts is an integral part of the Environmental Impact Assessment (EIA) process, closely related to the effectiveness of the instrument. EIA follow-up has been receiving a lot of interest from scientists and practitioners, though it is recognized as one of the weakest points of EIA systems globally. Also, EIA follow-up is influenced by the context, mainly in terms of the types of projects or activities and their related impacts on the environment. Therefore, the present paper is focused on the investigation of the follow-up stage applied to the activity of seismic survey coupled with offshore oil & gas exploitation in Brazil. Research was based on a qualitative approach that included document analysis and semi-structured interviews with analysts involved in EIA processes, and sought to generate evidence of effectiveness of the EIA follow-up as conducted by the Federal Environment Agency (Ibama) in order to situate the practice of follow-up in the broader context of international best practice principles. Based on the findings, it was concluded that, due to the peculiarities of offshore seismic survey, it is necessary to promote adaptations in the procedures for monitoring impacts in order to ensure proper alignment with the principles and conceptual foundations that guide EIA practice. Specifically, the timing of the execution of the activity imposes challenges for its integration into the “conventional” cycle that has guided the monitoring of the impacts in the EIA of projects.
文摘Background: Regular breast self-examination (BSE) has been known to effectively detect breast cancer occurrence early. Are Women who consider BSE effective in detecting breast cancer more likely to be aware of BSE, or vice versa? The present study was an attempt to answer this question. Methods: A cross-sectional study was performed for 259 female University students in Kampala, Uganda. Data were analyzed using SPSS. Univariate and bivariate analyses were carried out. Results: The majority (64.1%) were aware of the BSE technique. Women considering BSE to be effective for early cancer detection were significantly more likely to be aware of the BSE technique. Conclusions: University students who believed in the benefits of BSE were more likely to be aware of BSE than those who did not. More emphasis should be placed on health education for women of younger ages to increase the knowledge of the practice of BSE.
文摘本文结合相关辞书,概述与examination相关的表达。1.用prepare/revise/studyfor等表示“为考试而准备”“复习迎考”“温习备考”。例如:We are preparing for the examination next week.我们正在为下周的考试做准备。I do not have much time to revise for examinations.我没有很多时间复习迎考。Ineed time to study for tomorrow's exami nation.我需要时间学习,准备明天的考试。
文摘Nomograms for predicting the risk of prostate cancer developed using other populations may introduce sizable bias when applied to a Chinese cohort. In the present study, we sought to develop a nomogram for predicting the probability of a positive initial prostate biopsy in a Chinese population. A total of 535 Chinese men who underwent a prostatic biopsy for the detection of prostate cancer in the past decade with complete biopsy data were included. Stepwise logistic regression was used to determine the independent predictors of a positive initial biopsy. Age, prostate-specific antigen (PSA), prostate volume (PV), digital rectal examination (DRE) status, % free PSA and transrectal ultrasound (TRUS) findings were included in the analysis. A nomogram model was developed that was based on these independent predictors to calculate the probability of a positive initial prostate biopsy. A receiver-operating characteristic curve was used to assess the accuracy of using the nomogram and PSA levels alone for predicting positive prostate biopsy. The rate for positive initial prostate biopsy was 41.7% (223/535). The independent variables used to predict a positive initial prostate biopsy were age, PSA, PV and DRE status. The areas under the receiver-operating characteristic curve for a positive initial prostate biopsy for PSA alone and the nomogram were 79.7% and 84.8%, respectively. Our results indicate that the risk of a positive initial prostate biopsy can be predicted to a satisfactory level in a Chinese population using our nomogram. The nomogram can be used to identify and counsel patients who should consider a prostate biopsy, ultimately enhancing accuracy in diagnosing prostate cancer.
基金Guangdong Provincial Science and Technology Projects,China(No.2011B031800105)
文摘AIM: To take fundus examination in the preterm neonates to observe the common diseases and report the outcomes in a neonatal intensive care unit (NICU) in Guangzhou between May 2008 and May 2011. METHODS: Fundus examinations were performed with Retcam II in 957 prematures. RESULTS: There were 957 prematures in this study, including 666 males and 291 females, 2 triple births, 152 twins and 803 singletons. During the three years, 86 infants with any stage retinopathy of prematurity (ROP) (9.0%), 123 infants with retinal hemorrhage (12.9%), 10 infants with neonatal fundual jaundice (1.0%) and 3 babies with congenital choroidal coloboma (0.3%) were found. CONCLUSION: Early detection and prompt treatment of ocular disorders in neonates is important to avoid lifelong visual impairment. Examination of the eyes should be performed in the newborn period and at all well-child visits.