Scenario-Based, Single Best, Multiple-Choice Questions (SB-SB-MCQs) in Basic Medical Sciences: An Exploratory Study about the Staff Awareness, Knowledge and Difficulties Encountered

Background: Multiple Choice Questions (MCQs) are well known and widely used assessment tool. They can be used to measure the different levels of educational outcomes: knowledge, understanding, judgment and problem solving. Traditional MCQs (stand-alone MCQs) often are used as a tool for facts recall. Advantages of using Scenario-based questions (SBQs) include more focus on learning objectives and ability to assess higher levels of learning. Shifting to scenario-based questions can increase the level of difficulty and measure higher levels of cognition. Purpose: This study explores the current knowledge and overall awareness of the undergraduate teaching staff about the use and difficulties of scenario-based single-best answer, multiple-choice questions (SB-SBA-MCQs) in assessments of the basic medical sciences. Method: We used an e-Likert scale questionnaire to explore this issue. The questionnaire covered the current knowledge, experience of staff in writing (SB-SBA-MCQs), courses or postgraduate degrees they attended and difficulties they face or anticipate in writing (SB-SBA-MCQs). Results: The majority (86%) are familiar with courses or workshops related to MCQs writing and assessment in general, a small minority have not attended any. The majority (86%) had some experience in writing MCQs. Only, a small percentage have not tried writing this type of MCQs. Nearly 60% think it takes time to construct, the majority (96%) of those researched are in support of shifting to scenario-based MCQs in basic medical sciences. Conclusion: The study has shown most of the teachers of basic medical sciences are aware of and with good knowledge in (SB-SBA-MCQs). It also highlighted the importance and need for regular training courses and workshops on the same.

SOME PERSONAL VIEWS ON THE BASIC RESEARCH OF NATURAL SCIENCES IN CHINA

Mankind is going to stride across the threshold of the new century while world science advances by leaps and bounds. At the same time, China will enter a comparatively well-off state in terms of its economic development and its next step forward is to be a moderately developed country in the international community. At the 15th National Congress

New Perspective for the Philosophy of Science： Re-Construction and Definition of New Branches ＆ Hierarchy of Sciences

In this work, author evaluated past theories and perspectives behind the definitions of science and/or branches of science. Also some of the philosophers of science and their specific philosophical interests were expressed. Author considered some type of interactions between some disciplines to determine, to solve the philosophical/scientific problems and to define the possible solutions. The purposes of this article are： （i） to define new synthesis method, （ii） to define new perspective for the philosophy of science, （iii） to define relation between new philosophy perspective and philosophy of science, （iv） to define and organize name, number, relations, and correct structure between special science branches and philosophy of science, （v） to define necessary and sufficient number of branches for philosophy of science, （vi） to define and express the importance and place of new philosophy of science perspective in the new system, （vii） to extend the definition/limits of philosophy of science, （viii） to re-define meanings of some philosophical/scientific theories, （ix） to define systematic solution for the conflicts, problems, confusions about philosophy of science, sciences and branches of science, （x） to define new branches of science, （xi） to re-construct branches and hierarchy of science, （xii） to define new theories about science and branches of science. Author considered R-Synthesis as a method for the evaluation oftbe philosophy, philosophy of science, sciences and branches of science. This R-Synthesis includes evaluation of eight categories of general/specific perspective, 21-dimensions, and 12 general subjects （with related scope and contents） for the past 12,000 years. It is a kind of synthesis of science and non-science, physical science and non-physical science, religious science and non-religious science, and others. In this article, author defined 27 possible definitive/certain result cases for this new synthesis. Author defined the possible formation stages shortly to express new disciplines, new constructional and/or complementary theories. These theories are considered to define 21 major effective disciplines. New philosophy perspective is defined （R-Philosophy） shortly. New perspective and sub branches are defined for the philosophy of science. Major sciences are defined due to new basic philosophies. 42-basic components are defined for each science branch. New and/or re-constructed sciences, branches of science, basic sciences, and new hierarchy of science are defined with figure. Electromagnetic sciences, information sciences, and system sciences are defined specifically. Hybrid Sciences, New Era Science, and Ideal Scientific System are defined with general/specific figure. Relation between the some old branches and new branches of science was expressed generally due to new perspective of philosophy of science.

Flexner has fallen:Transitions in medical education system across time,a gradual return to pre-Flexnerian state(de-Flexnerization)

The modern medical education system has gradually evolved starting from 1910 incorporating the suggestions by Abraham Flexner,his public disclosure of the poor conditions at many medical schools provided a means to galvanize all the constituencies needed for reform to occur.He could say what other reformers could not,due to their links to the medical education community.But now we are again going back to a pre-Flexnerian state due to multiple reasons such as gradually diminishing importance of basic science subjects for the students,the decline in the number and quality of investigator initiated research among clinical researchers,lesser emphasis to bedside training by means of detailed clinical examination and making appropriate observation of signs to reach to a diagnosis rather than over reliance on the laboratory tests and radiological modalities for the diagnosis,poor exposure to basic clinical skills starting from college throughout residency and the trend of disrespect and absenteeism from both theoretical and clinical/practical classes.The attitude of students is just to complete their required attendance so that they are not barred from appearing in examinations.This de-Flexnerization trend and regression to pre-Flexnerian era standards,ideologies,structures,processes,and attitudes,are bound to beget pre-Flexnerian outcomes,for you get what you designed for.

Double-row repair of rotator cuff tears: Comparing tendon contact area between techniques

BACKGROUND In rotator cuff repair surgery,the double-row technique is widely performed.Studies have shown that with increased contact area and pressure between tendon and bone interface,better healing is promoted.AIM To assess the different suture configurations with the double-row technique and how this influences the contact area of the rotator cuff tendon to bone.METHODS This was a controlled laboratory study where identical tears were created in 24 fresh porcine shoulders over a 1.5 cm×2.5 cm infraspinatus insertion footprint.Double-row repair techniques,with 3 to 4-suture anchors in different configurations(2 medial,2 lateral vs 2 medial,1 lateral vs 1 medial,2 lateral),were employed for three control groups.Each group consisted of eight shoulders with identical repair configurations.Footprint contact areas of the repaired tendon against the tuberosity were determined using pressure sensitive Fujifilm placed between the tendon and tuberosity.RESULTS The mean contact area between tendon and insertion footprint from the imprinted Fujifilm was obtained using computer software.The contact area measured from a standard 4-suture anchor double row repair was 75.1±9.3 mm2,whereas areas obtained for the 2 lateral-1 medial and 2 medial-1 lateral anchor configurations were 72.9±5.2 mm2 and 75.0±4.9 mm2 respectively.No statistical significance was noted between the three groups.CONCLUSION In the technique of double-row repair,using a 3-suture anchor configuration may offer a non-inferior alternative to the standard 4-anchor construct in terms of efficacy.This may also result in overall cost reduction and shorter surgical time.

Opinion Spreading with Mobility on Scale-Free Networks

A continuum opinion dynamic model is presented based on two rules. The first one considers the mobilities of the individuals, the second one supposes that the individuals update their opinions independently. The results of the model indicate that the bounded confidence εc, separating consensus and incoherent states, of a scale-free network is much smaller than the one of a lattice. If the system can reach the consensus state, the sum of all individuals＇ opinion change Oc（t） quickly decreases in an exponential form, while if it reaches the incoherent state finally, Oc（t） decreases slowly and has the punctuated equilibrium characteristic.

Pushing the frontiers of military medical excellence:updates,progress and future needs

Since its establishment in 2014,Military Medical Research has come a long way in becoming a premier journal for scientific articles from various different specialties,with a special emphasis on topics with military relevance.The field of military medicine may be obscure,and may not be readily encountered by the typical clinician on a day-today basis.This journal aims not only to pursue excellence in military research,but also to keep current with the latest advancements on general medical topics from each and every specialty.This editorial serves to recap and synthesize the existing progress,updates and future needs of military medical excellence,discussing foremostly the unique traits of literature published in this journal,and subsequently presenting the discourse regarding wartime and peacetime medicine,the role of the military in a public health emergency,as well as wound healing and organ regeneration.Special attention has been devoted to military topics to shed light on the effects of Chemical,Biological,Radiological and Explosive warfare,environmental medicine and military psychiatry,topics which rarely have a chance to be discussed elsewhere.The interconnectedness between military combat and soldier physical and mental well-being is intricate,and has been distorted by pandemics such as coronavirus disease 2019(COVID-19).This journal has come a long way since its first article was published,steadily contributing to the existing knowledge pool on general medical topics with a military slant.Only with continuous research and sharing,can we build upon the work of the scientific community,with hopes for the betterment of patient care.

Precision Medicine: What Do We Expect in the Scope of Basic Biomedical Sciences?

The era of Precision Medicine （PM） has entered its execution phase where acquisition of human genome variation data is already leading the charge [1,2]. PM has come a long way to this phase from the Human Genome Project started some 25 years ago [3,4]; it marks the beginning of disease-centric research in the field of biomedical sciences. Other than deliver- ing high-coverage human genomes by millions--of course tai- lored to patients and common diseases--in the next decade or so, what else do we expect to have and what should we be doing to make the best out of PM projects beyond the current expectation of genetics？

Circadian fluctuations in three types of sensory modules in healthy subjects

This study was designed to observe and compare the circadian fluctuations in tactile sense, joint reposition sense and two-point discrimination in healthy subjects. Twenty-one healthy adult subjects received perceptual ability tests through these three different sensory modules at approximately 9：00, 13：00 and 18：00 in a day. The distribution of ranking for perceptual ability was significantly different among the three different time points in each individual, with highest perceptual ability in the evening compared with noon and morning, in terms of tactile sense and two-point discrimination. These findings suggest that the perceptual ability of healthy subjects fluctuates according to the time points in a day.

PROSPECT OF MEDICAL GENETICS IN CHINA FROM A HISTORICAL POINT OF VIEW

The history of medical genetics is briefly reviewed. It is evident that medical genetics with its inseparable part, clinical genetics, started out as a cfinical science from the very beginning. Its robust development in the developed countries is the result of a close interaction between the basic sciences and clinical genetics. In China, however, clinical genetics has not received due emphasis and medical genetics is still not recognized as one of the medical specialties. This is in marked contrast to the situation in the West. It is high time to acknowledge that medical genetics is a medical specialty and to promote clinical genetics service in qualified hospitals in our country.

Improvement of Synchronizability of Scale-Free Networks

We investigate the factors that affect synchronizability of coupled oscillators on scale-free networks. Using the memory Tabu search （MTS） algorithm, we improve the eigen-ratio Q of a coupling matrix by edge intercrossing. The numerical results show that the synchronizatlon-improved scale-free networks should have distinctive both small average distance and larger clustering coefficient, which are consistent with some real-world networks. Moreover, the synchronizability-improved networks demonstrate the disassortative coefficient.

Role of the posterior deep deltoid ligament in ankle fracture stability: A biomechanical cadaver study

BACKGROUND The deltoid ligament is a key component of ankle fracture stability.Clinical tests to assess deltoid ligament injury have low specificity.In supination externalrotation(SER)type-IV ankle fractures,there is either a medial malleolus fracture or deltoid ligament injury.These injuries are often considered unstable,requiring surgical stabilisation.We look to identify the anatomical basis for this instability.This study investigates the anatomical basis for such instability by re-creating SER type ankle fractures in a standardised cadaveric study model,investigating the anatomical basis for such instability.AIM To investigate the anatomical basis for fracture instability in SER type ankle fractures.METHODS Four matched pairs of cadaveric limbs were tested for stability both when axially loaded and under external rotation stress.Four matched pairs of cadaveric limbs(8 specimens)were tested for stability when axially loaded to 750 N with a custom rig.Specimens were tested through increasing stages of SER injury in a stepwise fashion before restoring the lateral side with open reduction and internal fixation(ORIF).Clinical photographs and radiographs were recorded at each step.We defined instability in accordance with well accepted radiological parameters:>4 mm medial clear space opening on a mortise-view radiograph or>7 degrees of talar tilt.RESULTS All specimens with an intact posterior deep deltoid ligament were stable.Once the posterior deep deltoid ligament was sectioned there was instability in all specimens.Stabilisation of the lateral side prevented talar shift,but not talar tilt.CONCLUSION If the posterior deep deltoid ligament is intact then SER fractures can be managed without surgery.If the posterior deep deltoid is incompetent,ORIF and cautious rehabilitation is recommended because the talus can still tilt in the mortise.

Several Problems in the Development of Basic Disciplines

In this paper, several problems related to the development of basic disciplines are expounded from macroscopic visual angle. First, four important concepts(basic science, basic discipline, basic research, fundamental research) are analyzed. Then, reserve strength for the development of basic disciplines in China is considered in accordance with funds that have been put into basic research. Finally, several theoretical cognition problems concerning the development of basic disciplines (such as social function of science, motive force for the development of basic disciplines, as well as soft environment and cultural atmosphere favourable to it) are discussed.

Japanese Science and Technology Basic Plan: A Perspective of Policy Process

The Japanese government formulates the Science and Technology Basic Plan every five years based on the Science and Technology Basic Law, and indicates the future direction of Japan’s science and technology. This paper describes its history, significance, and decision process of this Science and Technology Basic Plan. Then this paper describes the characteristics of the previous five plans, contributions to Japanese science and technological activities, and its challenges for the future. In the formulation of the Science and Technology Basic Plan, the role of the Council for Science and Technology Policy has been significant. However, after establishing Shinzo Abe administration, the inclination to global innovation has been emphasized in Japan as well, the Council for Science and Technology Policy was renamed the Council for Science, Technology and Innovation, and the midterm and annual strategies centered on innovation have also been prepared. This paper described these movements.Japan suffers from population decline and the increase in governmental deficits, and there is also a tendency towards weakness in science and technology innovation. To formulate more suitable science and technology basic plans will revitalize and strengthen Japan’s science and technology innovation.