The issue related to the risk of identity impersonation, where one person can be replaced by another in online exam surveillance systems, poses challenges. This study focuses on the effectiveness of detecting attempts...The issue related to the risk of identity impersonation, where one person can be replaced by another in online exam surveillance systems, poses challenges. This study focuses on the effectiveness of detecting attempts of identity impersonation through face substitution during online exams, with the aim of ensuring the integrity of assessments. The goal is to develop facial recognition algorithms capable of precisely detecting these impersonations, training them on a tailored database rather than biased generic data. An original database of student faces has been created. An algorithm leveraging advanced deep learning techniques such as depthwise separable convolution has been developed and evaluated on this database. We achieved very high levels of precision, reaching an accuracy rate of 98% in face detection and recognition.展开更多
This paper discusses the importance of a well-written college English final exam within a university at the end of each semester, the directive function of such an exam, the valuable informative feedback of the detail...This paper discusses the importance of a well-written college English final exam within a university at the end of each semester, the directive function of such an exam, the valuable informative feedback of the detailed scores, the necessity and importance of informing students of the general format of the exam and types of items as early as possible. It also deals with the importance of formative evaluation, the functions of regular scores, problems in retests that test-makers should pay attention to and the different organizations of test-makers.展开更多
Aims: This study aims at designing and implementing syllabus-oriented question-bank system that is capable of producing paper-based exams with multiple forms along with answer keys. The developed software tool is nam...Aims: This study aims at designing and implementing syllabus-oriented question-bank system that is capable of producing paper-based exams with multiple forms along with answer keys. The developed software tool is named Χ(Chi)-Pro Milestone and supports four types of questions, namely: Multiple-choice, True/False, Short-Answer and Free-Response Essay questions. The study is motivated by the fact that student number in schools and universities is continuously growing at high, non-linear, and uncontrolled rates. This growth, however, is not accompanied by an equivalent growth of educational resources (mainly: instructors, classrooms, and labs). A direct result of this situation is having relatively large number of students in each classroom. It is observed that providing and using online-examining systems could be intractable and expensive. As an alternative, paper-based exams can be used. One main issue is that manually produced paper-based exams are of low quality because of some human factors such as instability and relatively narrow range of topics [1]. Further, it is observed that instructors usually need to spend a lot of time and energy in composing paper-based exams with multiple forms. Therefore, the use of computers for automatic production of paper-based exams from question banks is becoming more and more important. Methodology: The design and evaluation of X-Pro Milestone are done by considering a basic set of design principles that are based on a list of identified Functional and Non-Functional Requirements. Deriving those requirements is made possible by developing X-Pro Milestone using the Iterative and Incremental model from software engineering domain. Results: We demonstrate that X-Pro Milestone has a number of excellent characteristics compared to the exam-preparation and question banks tools available in market. Some of these characteristics are: ease of use and operation, user-friendly interface and good usability, high security and protection of the question bank-items, high stability, and reliability. Further, X-Pro Milestone makes initiating, maintaining and archiving Question-Banks and produced exams possible. Putting X-Pro Milestone into real use has showed that X-Pro Milestone is easy to be learned and effectively used. We demonstrate that X-Pro Milestone is a cost-effective alternative to online examining systems with more and richer features and with low infrastructure requirements.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
Introduction: MRI is a rapidly growing technique with more and more indica-tions and requests in the Republic of Guinea. Its correct prescription is a guar-antee for the satisfaction of the actors, both prescribers, r...Introduction: MRI is a rapidly growing technique with more and more indica-tions and requests in the Republic of Guinea. Its correct prescription is a guar-antee for the satisfaction of the actors, both prescribers, radiologists and pa-tients. The main objective of this study was to evaluate the compliance of MRI examination requests at the Diagnostic Center of the National Social Se-curity Fund (CNSS) in Conakry. Material and Methods: This was a descriptive cross-sectional study of MRI prescription forms sent to the MRI unit of the CNSS Diagnostic Center from February 1 to May 1, 2021. The 8 compliance criteria established by the French High Authority for Health were used to evaluate the compliance of the examination requests. Results: A total of 7003 examination forms were sent to the facility, including 7% (n = 468) of MRIs. 56.2% of MRI requests were performed by specialists. We observed an overall compliance of 10%. Administrative and clinical compliance were missing in 24% and 38%, respectively. More specifically, the purpose of the examination was not mentioned in 60%, followed by the requesting department in 48.1% and the patient’s age in 35.1%. Conclusion: This study allowed us to highlight the gaps in establishing MRI requests. It would be important to organize an awareness campaign for prescribers on the usefulness of correctly filling an MRI request and to design templates to be filled out by prescribers.展开更多
Cheat sheets are so named because they may be used by students without the instructor's knowledge to cheat on a test.Student learning is greatly enhanced by studying prior to an exam.Allowing students to prepare a...Cheat sheets are so named because they may be used by students without the instructor's knowledge to cheat on a test.Student learning is greatly enhanced by studying prior to an exam.Allowing students to prepare a cheat sheet for the exam helps structure this study time and deepens learning.The crib sheet is well defined:one double-sided page of A4.An award for the best and most creative cheat sheet allows the instructor to appreciate the students' efforts.Using the cheat sheet can not only reduces student anxiety during testing but also incease student learning efficiency.展开更多
According to changed views on driver training and driverintroduced in the Netherlands. The exam consists of two parts: (l)instructor preparation, a competence-based instructor exam wasmultimedia theory tests; (2)...According to changed views on driver training and driverintroduced in the Netherlands. The exam consists of two parts: (l)instructor preparation, a competence-based instructor exam wasmultimedia theory tests; (2) a performance lesson for drivinginstruction and coaching. An implicit idea behind the innovated exam is that it can have a positive backwash effect on the quality ofdriver instructor preparation programs. This study aims to evaluate the reliability, validity and fairness of the theoretical tests, whichappear in different versions for successive groups of PDIs (prospective driving instructors). Data of 4,741 PDIs, enrolled during theperiod between January 2010 and October 2012, were used for analysis. The results of psychometric analyses show that the theory testsyielded reliable and fair decisions about instructor certification. The predictive validity of the theory tests for the final performanceassessment was low. Implications for the design and on-the-fly maintenance of exam item banks are discussed. Follow-up studies willfocus on the question, whether the improved instructor exam produces safer drivers in the end.展开更多
BACKGROUND The association between elevatedγ-glutamyltransferase(GGT)at a certain point and incident cancer has been suggested;however,no study has evaluated the association between repeatedly elevated GGT and cancer...BACKGROUND The association between elevatedγ-glutamyltransferase(GGT)at a certain point and incident cancer has been suggested;however,no study has evaluated the association between repeatedly elevated GGT and cancer incidence.AIM To investigate the effects of repeatedly elevated GGT on the incidence of digestive cancers.METHODS Participants who had undergone health screening from 2009 to 2012 and 4 consecutive previous examinations were enrolled.GGT points were calculated as the number of times participants met the criteria of quartile 4 of GGT in four serial measurements(0-4 points).Multivariable Cox proportional hazard regression models were applied.RESULTS In total,3559109 participants were included;among them,43574 digestive cancers developed during a median of 6.8 years of follow-up.The incidence of total digestive cancers increased in a dose-response manner in men[adjusted hazard ratio(aHR)compared with those with 0 GGT points=1.28 and 95%confidence interval(CI)=1.24-1.33 in those with 1 point;aHR=1.40 and 95%CI=1.35-1.46 in those with 2 points;aHR=1.52 and 95%CI=1.46-1.58 in those with 3 points;aHR=1.88 and 95%CI=1.83-1.94 in those with 4 points;P for trend<0.001].This trend was more prominent in men than in women and those with healthy habits(no smoking,no alcohol consumption,and a low body mass index)than in those with unhealthy habits.CONCLUSION Repeatedly elevated GGT levels were associated with an increased risk of incident digestive cancer in a dose-responsive manner,particularly in men and those with healthy habits.Repeated GGT measurements may be a good biomarker of incident digestive cancer and could help physicians identify high-risk populations.展开更多
BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficu...BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of SBP.AIM To develop a novel method for SBP milestone assessment of gastroenterology fellows using the OSCE.METHODS For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation survey.RESULTS Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encounters. All participating fellows stated that the immediate feedback was "very useful." One hundred percent of the fellows stated they would incorporate OSCE learning into their clinical practice.CONCLUSION OSCEs may be used for standardized evaluation of SBP milestones. Trainees scored lower on SBP milestones than other more concrete milestones. Training programs should consider OSCEs for assessment of SBP.展开更多
Aim It is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only "recommend" removing...Aim It is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only "recommend" removing jewelry, and only washing hands for 15 seconds with soap and warm water before donning gloves. This study examined several washing procedures and finger rings using simulated microbes. Methodology A gloved robber hand manikin was made and fitted with a flesh disposable vinyl glove. Four fingers were fitted with rings or no ring, dusted with simulated microbes, and washed with a scrub brush for 5, 15, and 25 seconds under 20℃ and 40℃ water alone, or with liquid hand soap. Light levels (in lux) of fluorescent powder before and after washing were measured and delta scores calculated for changes in light levels, equivalent to effectiveness of hand washing procedures. A full-factorial, 3-factor analysis of variance (ANOVA) was used to test for differences among levels of the three study factors-time, temperature, and soap use. Tukey's post hoc honestly significant difference (HSD) test was applied to significant factors to examine pair-wise differences between factor levels. Results It was found that the longer the hands with rings were washed with a scrub brush under flowing water, the more simulated microbes were removed. By 25 seconds, all methods were essentially the same. Simulated microbes were more difficult to remove from the palm compared to the back of the hand. The liquid hand soap used in this study was more effective with warm water than cold. When given a choice of washing with cold water up to 15 seconds, it would be preferable not to use soap to remove simulated microbes. Qualitatively, the outer surface of finger rings were more effectively cleaned than the crevice below the ring, and the ring with a stone setting appeared to accumulate and retain simulated microbes more than other rings. Conclusion The most effective treatment was washing with warm water and liquid soap. Longer times were more effective. Rings should not be worn under examination gloves due to difficulty cleaning in the crevice under the ring, and the well-known consequences of cross-contamination between the patient and the health care worker.展开更多
The main objective of this research is to provide a solution for online exam systems by using face recognition to authenticate learners for attending an online exam. More importantly, the system continuously (with sho...The main objective of this research is to provide a solution for online exam systems by using face recognition to authenticate learners for attending an online exam. More importantly, the system continuously (with short time intervals), checks for learner identity during the whole exam period to ensure that the learner who started the exam is the same one who continued until the end and prevent the possibility of cheating by looking at adjacent PC or reading from an external paper. The system will issue an early warning to the learners if suspicious behavior has been noticed by the system. The proposed system has been presented to eight e-learning instructors and experts in addition to 32 students to gather feedback and to study the impact and the benefit of such system in e-learning environment.展开更多
Telemedicine is a branch of healthcare that uses communication technology to deliver medical information and services between patients and healthcare providers. The applicability of telemedicine is vast and increasing...Telemedicine is a branch of healthcare that uses communication technology to deliver medical information and services between patients and healthcare providers. The applicability of telemedicine is vast and increasingly relevant. There is a lack of research on utilizing telemedicine for remote evaluation of the airway. The primary aim of this pilot study was to validate a telemedical airway exam as a viable alternative to an in-person evaluation. Three anesthesiologists evaluated 48 volunteers by telemedicine and live examination. The telemedical exam consisted of transmitting still images of four established, predictive parameters of difficult airways: Mallampati score;neck extension;ability to prognath;and thyromental distance. Each subject’s telemedical and face-to-face scores were compared to determine their degree of correlation. Still images were taken using standardized positioning with four pictures of mouth opening, neck extension, prognath, and thyromental distance. Data were analyzed using Wilcoxon signed-rank tests and free-marginal multirater kappa analysis. Average respective scores for live versus telemedicine examination were as follows: Mallampati scores were 1.73 versus 2.54;neck extension scores were 3.77 versus 3.60;thyromental distance (measured in finger breadths) was 2.95 versus 2.92;and prognath scores were 0.97 versus 0.94. There was no difference in grading of thyromental distance or prognathy ability between live and telemedical exams, and interrater reliability was very good for both parameters. This study supports telemedicine as a reliable tool for preoperative anesthesia airway exams to identify airway difficulties. This may be especially useful as an alternative in patients with COVID-19 undergoing urgent surgery.展开更多
This paper briefly discusses the causes which have led to the present situation ,most of the students study only for the exam itself,regard their grades in the exam as their lifeblood ,and the attitude towards study a...This paper briefly discusses the causes which have led to the present situation ,most of the students study only for the exam itself,regard their grades in the exam as their lifeblood ,and the attitude towards study and exam at all levels of education .展开更多
This paper is aimed at exploring the cultural reasons underlying the civil service examinations,which can be concludedas"Tri-Cs",namely the well-established agricultural civilization,cadre culture and family...This paper is aimed at exploring the cultural reasons underlying the civil service examinations,which can be concludedas"Tri-Cs",namely the well-established agricultural civilization,cadre culture and family-oriented concept.Through in-depthanalyses,the author strives to clarify the possible reasons for this exam fever and help delineate a clearer picture of the essentials ofChinese culture.展开更多
Solutions to the differential equation in Smith’s Prize Examination taken by Maxwell are discussed. It was a competitive examination using which skill full students were identified and James Clerk Maxwell was one of ...Solutions to the differential equation in Smith’s Prize Examination taken by Maxwell are discussed. It was a competitive examination using which skill full students were identified and James Clerk Maxwell was one of them. He later formulated the theory of Electromagnetism and predicted the light speed & its value was subsequently confirmed by experiments. Light travel in a direction perpendicular to oscillating electric and magnetic field through a vacuum from sun. In the same exam paper, Maxwell answered the question related to Stokes Theorem of vector calculus which was used in the formalism of Electromagnetic theory.展开更多
Using Seidman’s retention formula as a theoretical foundation, this study investigated historical data from a Bachelor of Science (BSN) nursing program to determine whether the admission variables of the preprogram g...Using Seidman’s retention formula as a theoretical foundation, this study investigated historical data from a Bachelor of Science (BSN) nursing program to determine whether the admission variables of the preprogram grade point averages (GPA), American College Testing (ACT) scores, anatomy and physiology course grades, and/or the Health Education System Inc. (HESI) Exit Exam scores could predict completing the nursing program, as well as passing the NCLEX-RN. A significant relationship (p < 0.01) was identified between the preprogram GPA, ACT scores, anatomy grades, and the HESI Exit Exam scores with the completion of the BSN program and passing the NCLEX-RN.展开更多
Enrollments in accounting programs and the demand for accounting graduates are increasing,but the number of candidates sitting for the CPA exam is decreasing.This study compares characteristics of students at a mid-si...Enrollments in accounting programs and the demand for accounting graduates are increasing,but the number of candidates sitting for the CPA exam is decreasing.This study compares characteristics of students at a mid-size regional university who plan to sit for the CPA exam with those who do not.In addition,reasons offered by students for their plans to take or not take the CPA exam are explored.The study finds that a student’s desired career path,as well as their mother’s educational level,is significantly related to their intention to sit for the exam.Career alignment or misalignments were the primary factors shaping a student’s plan to sit for the CPA exam.The proportion of students intending to sit for the CPA exam decreases with class level,and the majority of students intend to work outside of public accounting.This study will be of interest to the profession and public as the decline in CPA examination candidates coincides with a higher than average percentage of CPAs projected to retire in the next three years.展开更多
文摘The issue related to the risk of identity impersonation, where one person can be replaced by another in online exam surveillance systems, poses challenges. This study focuses on the effectiveness of detecting attempts of identity impersonation through face substitution during online exams, with the aim of ensuring the integrity of assessments. The goal is to develop facial recognition algorithms capable of precisely detecting these impersonations, training them on a tailored database rather than biased generic data. An original database of student faces has been created. An algorithm leveraging advanced deep learning techniques such as depthwise separable convolution has been developed and evaluated on this database. We achieved very high levels of precision, reaching an accuracy rate of 98% in face detection and recognition.
文摘This paper discusses the importance of a well-written college English final exam within a university at the end of each semester, the directive function of such an exam, the valuable informative feedback of the detailed scores, the necessity and importance of informing students of the general format of the exam and types of items as early as possible. It also deals with the importance of formative evaluation, the functions of regular scores, problems in retests that test-makers should pay attention to and the different organizations of test-makers.
文摘Aims: This study aims at designing and implementing syllabus-oriented question-bank system that is capable of producing paper-based exams with multiple forms along with answer keys. The developed software tool is named Χ(Chi)-Pro Milestone and supports four types of questions, namely: Multiple-choice, True/False, Short-Answer and Free-Response Essay questions. The study is motivated by the fact that student number in schools and universities is continuously growing at high, non-linear, and uncontrolled rates. This growth, however, is not accompanied by an equivalent growth of educational resources (mainly: instructors, classrooms, and labs). A direct result of this situation is having relatively large number of students in each classroom. It is observed that providing and using online-examining systems could be intractable and expensive. As an alternative, paper-based exams can be used. One main issue is that manually produced paper-based exams are of low quality because of some human factors such as instability and relatively narrow range of topics [1]. Further, it is observed that instructors usually need to spend a lot of time and energy in composing paper-based exams with multiple forms. Therefore, the use of computers for automatic production of paper-based exams from question banks is becoming more and more important. Methodology: The design and evaluation of X-Pro Milestone are done by considering a basic set of design principles that are based on a list of identified Functional and Non-Functional Requirements. Deriving those requirements is made possible by developing X-Pro Milestone using the Iterative and Incremental model from software engineering domain. Results: We demonstrate that X-Pro Milestone has a number of excellent characteristics compared to the exam-preparation and question banks tools available in market. Some of these characteristics are: ease of use and operation, user-friendly interface and good usability, high security and protection of the question bank-items, high stability, and reliability. Further, X-Pro Milestone makes initiating, maintaining and archiving Question-Banks and produced exams possible. Putting X-Pro Milestone into real use has showed that X-Pro Milestone is easy to be learned and effectively used. We demonstrate that X-Pro Milestone is a cost-effective alternative to online examining systems with more and richer features and with low infrastructure requirements.
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Introduction: MRI is a rapidly growing technique with more and more indica-tions and requests in the Republic of Guinea. Its correct prescription is a guar-antee for the satisfaction of the actors, both prescribers, radiologists and pa-tients. The main objective of this study was to evaluate the compliance of MRI examination requests at the Diagnostic Center of the National Social Se-curity Fund (CNSS) in Conakry. Material and Methods: This was a descriptive cross-sectional study of MRI prescription forms sent to the MRI unit of the CNSS Diagnostic Center from February 1 to May 1, 2021. The 8 compliance criteria established by the French High Authority for Health were used to evaluate the compliance of the examination requests. Results: A total of 7003 examination forms were sent to the facility, including 7% (n = 468) of MRIs. 56.2% of MRI requests were performed by specialists. We observed an overall compliance of 10%. Administrative and clinical compliance were missing in 24% and 38%, respectively. More specifically, the purpose of the examination was not mentioned in 60%, followed by the requesting department in 48.1% and the patient’s age in 35.1%. Conclusion: This study allowed us to highlight the gaps in establishing MRI requests. It would be important to organize an awareness campaign for prescribers on the usefulness of correctly filling an MRI request and to design templates to be filled out by prescribers.
文摘Cheat sheets are so named because they may be used by students without the instructor's knowledge to cheat on a test.Student learning is greatly enhanced by studying prior to an exam.Allowing students to prepare a cheat sheet for the exam helps structure this study time and deepens learning.The crib sheet is well defined:one double-sided page of A4.An award for the best and most creative cheat sheet allows the instructor to appreciate the students' efforts.Using the cheat sheet can not only reduces student anxiety during testing but also incease student learning efficiency.
文摘According to changed views on driver training and driverintroduced in the Netherlands. The exam consists of two parts: (l)instructor preparation, a competence-based instructor exam wasmultimedia theory tests; (2) a performance lesson for drivinginstruction and coaching. An implicit idea behind the innovated exam is that it can have a positive backwash effect on the quality ofdriver instructor preparation programs. This study aims to evaluate the reliability, validity and fairness of the theoretical tests, whichappear in different versions for successive groups of PDIs (prospective driving instructors). Data of 4,741 PDIs, enrolled during theperiod between January 2010 and October 2012, were used for analysis. The results of psychometric analyses show that the theory testsyielded reliable and fair decisions about instructor certification. The predictive validity of the theory tests for the final performanceassessment was low. Implications for the design and on-the-fly maintenance of exam item banks are discussed. Follow-up studies willfocus on the question, whether the improved instructor exam produces safer drivers in the end.
文摘BACKGROUND The association between elevatedγ-glutamyltransferase(GGT)at a certain point and incident cancer has been suggested;however,no study has evaluated the association between repeatedly elevated GGT and cancer incidence.AIM To investigate the effects of repeatedly elevated GGT on the incidence of digestive cancers.METHODS Participants who had undergone health screening from 2009 to 2012 and 4 consecutive previous examinations were enrolled.GGT points were calculated as the number of times participants met the criteria of quartile 4 of GGT in four serial measurements(0-4 points).Multivariable Cox proportional hazard regression models were applied.RESULTS In total,3559109 participants were included;among them,43574 digestive cancers developed during a median of 6.8 years of follow-up.The incidence of total digestive cancers increased in a dose-response manner in men[adjusted hazard ratio(aHR)compared with those with 0 GGT points=1.28 and 95%confidence interval(CI)=1.24-1.33 in those with 1 point;aHR=1.40 and 95%CI=1.35-1.46 in those with 2 points;aHR=1.52 and 95%CI=1.46-1.58 in those with 3 points;aHR=1.88 and 95%CI=1.83-1.94 in those with 4 points;P for trend<0.001].This trend was more prominent in men than in women and those with healthy habits(no smoking,no alcohol consumption,and a low body mass index)than in those with unhealthy habits.CONCLUSION Repeatedly elevated GGT levels were associated with an increased risk of incident digestive cancer in a dose-responsive manner,particularly in men and those with healthy habits.Repeated GGT measurements may be a good biomarker of incident digestive cancer and could help physicians identify high-risk populations.
文摘BACKGROUND System based practice(SBP) milestones require trainees to effectively navigate the larger health care system for optimal patient care. In gastroenterology training programs, the assessment of SBP is difficult due to high volume, high acuity inpatient care, as well as inconsistent direct supervision. Nevertheless,structured assessment is required for training programs. We hypothesized that objective structured clinical examination(OSCE) would be an effective tool for assessment of SBP.AIM To develop a novel method for SBP milestone assessment of gastroenterology fellows using the OSCE.METHODS For this observational study, we created 4 OSCE stations: Counseling an impaired colleague, handoff after overnight call, a feeding tube placement discussion, and giving feedback to a medical student on a progress note. Twentysix first year fellows from 7 programs participated. All fellows encountered identical case presentations. Checklists were completed by trained standardized patients who interacted with each fellow participant. A report with individual and composite scores was generated and forwarded to program directors to utilize in formative assessment. Fellows also received immediate feedback from a faculty observer and completed a post-session program evaluation survey.RESULTS Survey response rate was 100%. The average composite score across SBP milestones for all cases were 6.22(SBP1), 4.34(SBP2), 3.35(SBP3), and 6.42(SBP4)out of 9. The lowest composite score was in SBP 3, which asks fellows to advocate for cost effective care. This highest score was in patient care 2, which asks fellows to develop comprehensive management plans. Discrepancies were identified between the fellows’ perceived performance in their self-assessments and Standardized Patient checklist evaluations for each case. Eighty-seven percent of fellows agreed that OSCEs are an important component of their clinical training,and 83% stated that the cases were similar to actual clinical encounters. All participating fellows stated that the immediate feedback was "very useful." One hundred percent of the fellows stated they would incorporate OSCE learning into their clinical practice.CONCLUSION OSCEs may be used for standardized evaluation of SBP milestones. Trainees scored lower on SBP milestones than other more concrete milestones. Training programs should consider OSCEs for assessment of SBP.
文摘Aim It is our opinion that the CDC and the WHO have underestimated cross-contamination under examination gloves in dental clinics while wearing jewelry, such as finger rings. These agencies only "recommend" removing jewelry, and only washing hands for 15 seconds with soap and warm water before donning gloves. This study examined several washing procedures and finger rings using simulated microbes. Methodology A gloved robber hand manikin was made and fitted with a flesh disposable vinyl glove. Four fingers were fitted with rings or no ring, dusted with simulated microbes, and washed with a scrub brush for 5, 15, and 25 seconds under 20℃ and 40℃ water alone, or with liquid hand soap. Light levels (in lux) of fluorescent powder before and after washing were measured and delta scores calculated for changes in light levels, equivalent to effectiveness of hand washing procedures. A full-factorial, 3-factor analysis of variance (ANOVA) was used to test for differences among levels of the three study factors-time, temperature, and soap use. Tukey's post hoc honestly significant difference (HSD) test was applied to significant factors to examine pair-wise differences between factor levels. Results It was found that the longer the hands with rings were washed with a scrub brush under flowing water, the more simulated microbes were removed. By 25 seconds, all methods were essentially the same. Simulated microbes were more difficult to remove from the palm compared to the back of the hand. The liquid hand soap used in this study was more effective with warm water than cold. When given a choice of washing with cold water up to 15 seconds, it would be preferable not to use soap to remove simulated microbes. Qualitatively, the outer surface of finger rings were more effectively cleaned than the crevice below the ring, and the ring with a stone setting appeared to accumulate and retain simulated microbes more than other rings. Conclusion The most effective treatment was washing with warm water and liquid soap. Longer times were more effective. Rings should not be worn under examination gloves due to difficulty cleaning in the crevice under the ring, and the well-known consequences of cross-contamination between the patient and the health care worker.
文摘The main objective of this research is to provide a solution for online exam systems by using face recognition to authenticate learners for attending an online exam. More importantly, the system continuously (with short time intervals), checks for learner identity during the whole exam period to ensure that the learner who started the exam is the same one who continued until the end and prevent the possibility of cheating by looking at adjacent PC or reading from an external paper. The system will issue an early warning to the learners if suspicious behavior has been noticed by the system. The proposed system has been presented to eight e-learning instructors and experts in addition to 32 students to gather feedback and to study the impact and the benefit of such system in e-learning environment.
文摘Telemedicine is a branch of healthcare that uses communication technology to deliver medical information and services between patients and healthcare providers. The applicability of telemedicine is vast and increasingly relevant. There is a lack of research on utilizing telemedicine for remote evaluation of the airway. The primary aim of this pilot study was to validate a telemedical airway exam as a viable alternative to an in-person evaluation. Three anesthesiologists evaluated 48 volunteers by telemedicine and live examination. The telemedical exam consisted of transmitting still images of four established, predictive parameters of difficult airways: Mallampati score;neck extension;ability to prognath;and thyromental distance. Each subject’s telemedical and face-to-face scores were compared to determine their degree of correlation. Still images were taken using standardized positioning with four pictures of mouth opening, neck extension, prognath, and thyromental distance. Data were analyzed using Wilcoxon signed-rank tests and free-marginal multirater kappa analysis. Average respective scores for live versus telemedicine examination were as follows: Mallampati scores were 1.73 versus 2.54;neck extension scores were 3.77 versus 3.60;thyromental distance (measured in finger breadths) was 2.95 versus 2.92;and prognath scores were 0.97 versus 0.94. There was no difference in grading of thyromental distance or prognathy ability between live and telemedical exams, and interrater reliability was very good for both parameters. This study supports telemedicine as a reliable tool for preoperative anesthesia airway exams to identify airway difficulties. This may be especially useful as an alternative in patients with COVID-19 undergoing urgent surgery.
文摘This paper briefly discusses the causes which have led to the present situation ,most of the students study only for the exam itself,regard their grades in the exam as their lifeblood ,and the attitude towards study and exam at all levels of education .
文摘This paper is aimed at exploring the cultural reasons underlying the civil service examinations,which can be concludedas"Tri-Cs",namely the well-established agricultural civilization,cadre culture and family-oriented concept.Through in-depthanalyses,the author strives to clarify the possible reasons for this exam fever and help delineate a clearer picture of the essentials ofChinese culture.
文摘Solutions to the differential equation in Smith’s Prize Examination taken by Maxwell are discussed. It was a competitive examination using which skill full students were identified and James Clerk Maxwell was one of them. He later formulated the theory of Electromagnetism and predicted the light speed & its value was subsequently confirmed by experiments. Light travel in a direction perpendicular to oscillating electric and magnetic field through a vacuum from sun. In the same exam paper, Maxwell answered the question related to Stokes Theorem of vector calculus which was used in the formalism of Electromagnetic theory.
文摘Using Seidman’s retention formula as a theoretical foundation, this study investigated historical data from a Bachelor of Science (BSN) nursing program to determine whether the admission variables of the preprogram grade point averages (GPA), American College Testing (ACT) scores, anatomy and physiology course grades, and/or the Health Education System Inc. (HESI) Exit Exam scores could predict completing the nursing program, as well as passing the NCLEX-RN. A significant relationship (p < 0.01) was identified between the preprogram GPA, ACT scores, anatomy grades, and the HESI Exit Exam scores with the completion of the BSN program and passing the NCLEX-RN.
文摘Enrollments in accounting programs and the demand for accounting graduates are increasing,but the number of candidates sitting for the CPA exam is decreasing.This study compares characteristics of students at a mid-size regional university who plan to sit for the CPA exam with those who do not.In addition,reasons offered by students for their plans to take or not take the CPA exam are explored.The study finds that a student’s desired career path,as well as their mother’s educational level,is significantly related to their intention to sit for the exam.Career alignment or misalignments were the primary factors shaping a student’s plan to sit for the CPA exam.The proportion of students intending to sit for the CPA exam decreases with class level,and the majority of students intend to work outside of public accounting.This study will be of interest to the profession and public as the decline in CPA examination candidates coincides with a higher than average percentage of CPAs projected to retire in the next three years.