Effectiveness of Histopathological Examination of Ultrasound-guided Puncture Biopsy Samples for Diagnosis of Extrapulmonary Tuberculosis

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.

An Empirical Study of the Socratic Method in Nongraded English Teaching in Senior High School Under the Background of the New National College Entrance Examination

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.

Research on the Evaluation of the Implementation Effect of Curriculum Examination Reform: Taking the Course of “Introduction to Language” as an Example

“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.

Outcomes of 957 preterm neonatal fundus examinations in a Guangzhou NICU through 2008 to 2011

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.

Analysis on Factors Influencing Sustainable Development of Self-study Examination of Agricultural Science Disciplines

Based on existing problems in the course of development of self-study examination of agricultural science disciplines, this paper analyzes logical conditions for its sustainable development. Major logical conditions include requirement for free and comprehensive development of individuals; requirement for social institutional evolution and change; requirement for fairness and justice of education and development; as well as requirement for better-established organization system and higher social reputation. Finally, it presents basic measures for sustainable development of self-study examination of agricultural science disciplines, including carrying on reasonable core elements of self-study examination system, adjusting structure of discipline, improving social assistance system, and expanding service space.

Complementary examinations other than neuroimaging and neurosonology in acute stroke

The etiologic diagnosis of cerebrovascular diseases requires non-routine complementary examinations to be performed. Thus, in specific cases, after neuroimaging(computed tomography/magnetic resonance imaging cerebral scan sequences) and neurosonology(Doppler test of the supra-aortic trunks, transcranial echography and echocardiography), which academically allow us to classify the patients according to their etiologic stroke subtype, further examinations must be used to make a correct etiologic diagnostic. The present review aims to update knowledge about the usefulness of the different tests of blood and urine, plain chest radiography, X-ray of the spine, skull and abdomen, lumbar puncture, electroencephalography, evoked potentials, polysomnography, and pathologic examination after biopsy of the artery, skin, muscles, nerves, meninges, and brain, in the management of patients who have suffered an acute stroke.

Teaching of the sensitive examinations: An international survey

Background: The teaching of the sensitive examinations—i.e. that of the female breast, female pelvis, female and male rectum and male genitalia—is a challenging part of the undergraduate curriculum. There are no studies to date detailing how national and international medical schools teach all of these examinations. Purposes: This research sought to document the teaching strategies used by national and international medical schools regarding the sensitive examinations. Methods: The sensitive examinations surveyed are the: 1) Female breast;2) Female pelvis;3) Male genitalia;4) Female and male rectum. The term “female sensitive examinations” is used to refer to female breast and female pelvis examinations. This was a questionnaire study, which polled national New Zealand medical schools as well as international medical schools. Questions included: a) sensitive examination teaching method;b) stress reduction strategies;c) perceived graduating student confidence. Results: A total of 104 medical schools participated in this survey in 2010. Artificial manikin usage was the most common technique utilized for each sensitive examination (60% of all schools, 95% CI 55%-65%), whether as the sole teaching method or in combination with other methods. The next most common technique was teaching associates (49% of schools, 95% CI 44%-54%). The female breast and pelvis sensitive examinations used the teaching associate program more frequently than the male genital examination and female and male rectal examination. Regardless of teaching method, most schools believed their graduating students were confident. Stress management teaching was used in most schools, in conjunction with teaching associate sessions. Conclusion: Manikins were the most commonly used teaching component of a teaching programme on sensitive examinations. Irrespective of teaching method, most schools believed their students were confident upon graduation.

Test anxiety in objective structured clinical examinations (OSCEs) compared with traditional assessment methods in undergraduate midwifery students

BACKGROUND: Final comprehensive exam is the most important examination for midwifery students to evaluate their professional ability and Test anxiety is a common phenomenon among college students. Because test anxiety is one of the problems of educational systems, this study was performed to compare test anxiety in objective structured clinical examinations (OS-CEs) and traditional assessment methods (TAM) among Undergraduate Midwifery Students. Methods: In this descriptive-analytical study, 52 students of Babol Midwifery College were participated in the study. 20 students were evaluated using TAM in November 2010, and 32 students were evaluated using the OSCE method in July 2011. Data were collected via a two-component questionnaire including demographic data and the test anxiety inventory (TAI). Results: All of midwifery students were women;the mean age of students, ages of father and mother’s were 23.1 ± 0.7, 52.3 ± 3.5 and 47.8 ± 4.9 years, respectively. Most of the students were single (61.5%). The mean education levels of father and mother’s were 11.6 ± 4.5 and 9.9 ± 4.0 years, respectively. The mean score of test anxiety in students was 42.51 ± 13.16. The most of participants did have moderate test anxiety (56.9%), two present not had any test anxiety, 37.3% had low test anxiety, and 3.9% had severe test anxiety. In sum, 98% had some degrees of test anxiety. There were the statistical differences in the mean score of text anxiety in OSCEs Compared with TAM in Undergraduate Midwifery Students (39.38 ± 13.81 vs. 47.35 ± 10.67, P = 0.033). Also, the mean severity of anxiety was different in two groups. The mean of moderate/severe test anxiety was more in TAM compared with OSCEs (52.57% vs. 49.56%, p = 0.000). The test anxiety had a positive correlation with father’s education, mother’s education (0.286, p = 0.042), father’s age, mother’s age, marital status, residency (0.292, p = 0.042). Also, there are negative correlations with student age, satisfaction, total Grade Point Average (GPA) (-0.387, p = 0.007), final score, type of assessment (-0.298, p = 0.033). There is a significant difference between the severity anxiety residency in total (p = 0.10) and OSCEs (p = 0.049) groups, mother’s education in total (p = 0.005) and OSCEs groups (0.012) and GPA (p = 0.028). Conclusion: OSCEs were superior to TAM in the reduction of test anxiety in midwifery students. The prevalence of test anxiety was in TAM than OSCEs method;therefore, using OSCEs is acknowledged as an effective assessment tool and is seen as the gold standard for evaluating clinical performance.

The current situation and issues there of related to nursing care at the time of medical examinations for children with developmental disabilities including autism

The objective of this study is to clarify the details regarding nursing care that is currently provided in terms of the situation regarding medical examinations for children with developmental disabilities and to discuss necessary nursing care. I conducted semi-structured interviews among 13 parents brining up children with developmental disabilities and analyzed the content of verbatim reports both qualitatively and functionally. Regarding those situations when they feel difficult at the time of undergoing medical examinations at the medical institute, the following four categories were extracted: painful treatment;difficulty in predicting;difficulty in communicating;and trouble in the waiting room. Regarding nursing care felt necessary at the time of undergoing medical examinations, the following six categories were extracted: technique while suppressing pain to a minimum;involvement in providing perspective;adjustment of surrounding environment;provision of opportunities to get acclimatized;provision of warm support;and understanding of patient characteristics. Many difficulties regarding medical examinations were revealed and it was found that they have concerns with regard to health management. It has been suggested that it is important to adjust the surrounding environment during medical examinations.

Induced Electromagnetic Fields Estimation in Spine Examinations of MRI Patients: A Re-Evaluation of Existing Clinical Protocols at a Hospital in Accra, Ghana

Patients undergoing Magnetic Resonance Imaging (MRI) are exposed to strong, non-uniform static magnetic fields outside of the central imaging region, in which the movement of the body may induce electric currents in tissues which could possibly be harmful. The purpose of this study was to re-evaluate existing clinical protocols by determining the induced electromagnetic (EM) fields in MRI spine examinations. The study covered 120 MRI spine examinations at the MRI Unit of a hospital in Accra, Ghana. A numerical model based on Faraday’s equation was developed using the finite difference method (FDM) and MATLAB software to compute, first, a test simulation of induced EM field intensities and then actual measurements of induced fields on the spine. The simulation results were peak induced electric field, 0.39 V/m and current density, 0.039 A/m2. Patient results were;calculated maximum velocity, 0.29 m/s;peak induced electric field strength, 0.44 V/m, and current density, 0.043 A/m2. The levels of induced EM-fields were such that they would not pose any potential health hazards to the patients as these values were well below the recommended guidance levels set by the Directive IEC 60601-2-33 of the European Parliament.

ISHD:Intelligent Standing Human Detection of Video Surveillance for the Smart Examination Environment

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.

Improving testicular examinations on paediatric patients in the emergency department:A quality improvement study to improve early diagnosis of testicular torsion

Objective:Male paediatric patients presenting with abdominal and/or testicular pain are common in the emergency department.As a time-sensitive diagnosis,the importance of early recognition,referral,and definitive management is critical.Missed or delayed diagnoses and management of testicular torsion can result in significant long-term sequelae including impaired fertility and psychological burden.In this quality improvement study,we utilised educational posters aiming to improve awareness of testicular torsion as a differential for abdominal pain and therefore,improve the quality of testicular examinations performed in the emergency department.Methods:Observational pre-and post-intervention study was conducted at a tertiary hospital emergency department.A pre-interventional retrospective review of the electronic medical records was conducted.All male patients under 16-years-old presenting with“abdominal pain”or“testicular problem”were included.We assessed the rate of testicular examination and the quality of the examination based on four domains:Cremasteric reflex,lie,swelling,and hardness.Educational posters targeting both patients and clinicians were placed around the emergency department.Subsequent review of the electronic medical records post-intervention was performed assessing the same domains.Results:A total of 235 presentations were analysed with 124 in the pre-intervention group and 111 in the post-intervention group.Overall rate of documented testicular examinations increased by 14%(p=0.032).The quality of testicular examinations also improved from an average of 0.85 domains documented to 2.29 post-intervention(p<0.001).Subgroup analysis found doctors in training had a greater improvement in both rate and quality of documented testicular examination.Conclusion:Our study demonstrated the value of continuing education in promoting awareness of testicular torsion in the emergency department.We found a clear improvement in the quality of clinical documentation of a time-sensitive condition which may infer a decreased risk of missed and delayed diagnosis of testicular torsion.

Brief Introduction to Shanghai Municipal Computer Applications Capability Examinations

At present,the world Hi-tech hasbecoming the locomotive of the econom-ic development.In Hi-tech,computerinformation technology has taken up afore running position.Meanwhile,com-puters technology goes deep into manyareas such as economy,finance,trade,business,culture life and family life. Thus,the popularity of computer ap-plications technology becomes charac-terizing the important feature of thesocial development.And mastering com-puter technology also becomes a nece-ssary basis of individual,work and life.

Comparison of detection results of hypoxic-ischemic encephalopathy at different degrees in infant patients between brain electrical activity mapping, transcranial Doppler sonography and computer tomography examinations

BACKGROUND： It has been proved that brain electrical activity mapping （BEAM） and transcranial Doppler （TCD） detection can reflect the function of brain cell and its diseased degree of infant patients with moderate to severe hypoxic-ischemic encephalopathy （HIE）. OBJECTIVE： To observe the abnormal results of HIE at different degrees detected with BEAM and TCD in infant patients, and compare the detection results at the same time point between BEAM, TCD and computer tomography （CT） examinations. DESIGN ： Contrast observation SETTING： Departments of Neuro-electrophysiology and Pediatrics, Second Affiliated Hospital of Qiqihar Medical College. PARTICIPANTS： Totally 416 infant patients with HIE who received treatment in the Department of Newborn Infants, Second Affiliated Hospital of Qiqihar Medical College during January 2001 and December 2005. The infant patients, 278 male and 138 female, were at embryonic 37 to 42 weeks and weighing 2.0 to 4.1 kg, and they were diagnosed with CT and met the diagnostic criteria of HIE of newborn infants compiled by Department of Neonatology, Pediatric Academy, Chinese Medical Association. According to diagnostic criteria, 130 patients were mild abnormal, 196 moderate abnormal and 90 severe abnormal. The relatives of all the infant patients were informed of the experiment. METHOOS： BEAM and TCD examinations were performed in the involved 416 infant patients with HIE at different degrees with DYD2000 16-channel BEAM instrument and EME-2000 ultrasonograph before preliminary diagnosis treatment （within 1 month after birth） and 1,3,6,12 and 24 months after birth, and detected results were compared between BEAM, TCD and CT examinations. MAIN OUTCOME MEASURES： Comparison of detection results of HIE at different time points in infant patients between BEAM. TCD and CT examinations. RESULTS： All the 416 infant patients with HIE participated in the result analysis. （1） Comparison of the detected results in infant patients with mild HIE at different time points after birth between BEAM, TCD and CT examinations： BEAM examination showed that the recovery was delayed, and the abnormal rate of BEAM examination was significantly higher than that of CT examination 1 and 3 months after birth [55.4%（72/130）vs. 17.0% （22/130 ）,x^2=41.66 ;29.2% （ 38/130 ） vs. 6.2% （ 8/130 ）, x^2=23.77, P 〈 0.01 ], exceptional patients had mild abnormality and reached the normal level in about 6 months. TCD examination showed that the disease condition significantly improved and infant patients with HIE basically recovered 1 or 2 months after birth, while CT examination showed that infant patients recovered 3 or 4 months after birth. （2） Comparison of detection results of infant patients with moderate HIE at different time points between BEAM, TCD and CT examinations： The abnormal rate of BEAM examination was significantly higher than that of CT examination 1,3,6 and 12 months after birth [90.8% （178/196）,78.6% （154/196）,x^2=4.32,P 〈 0.05;64.3% （126/196）,43.9% （86/196） ,x^2=16.44 ;44.9% （88/196） ,22.4% （44/196）,x^2=22.11 ;21.4% （42/196）, 10.2% （20/196）,x^2=9.27, P 〈 0.01]. BEAM examination showed that there was still one patient who did not completely recovered in the 24^th month due to the relatives of infant patients did not combine the treatment,. TCD examination showed that the abnormal rate was 23.1%（30/196）in the 1^st month after birth, and all the patients recovered to the normal in the 3^rd month after birth, while CT examination showed that mild abnormality still existed in the 24^th month after birth （1.0% ,2/196）. （3） Comparison of detection results of infant patients with severe HIE at different time points between BEAM, TCD and CT examinations： The abnormal rate of BEAM examination was significantly higher than that of CT examination in the 1^st, 3^rd, 6^th and 12^th months after birth[86.7% （78/90）,44.4% （40/90）,x^2=35.53;62.2% （56/90）,31.1% （28/90）,x^2=17.51 ;37.8% （34/90）,6.7% （6/90）, x^2=27.14, P 〈 0.01]. BEAM examination showed that mild abnormality still existed in 4 infant patients in the 24^th month after birth. TCD examination showed that the abnormal rate was 11.1% （10/90） in the 3^rd month after birth, and all the infant patients recovered in the 6^th month after birth. CT examination showed that the abnormal rate was 6.7%（6/90） in the 12^th month after birth, and all of infant patients recovered to the normal in the 24^th month after birth.CONCLUSION ： BEAM is the direct index to detect brain function of infant patients with HIE, and positive reaction is still very sensitive in the tracking detection of convalescent period. The positive rate of morphological reaction in CT examination is superior to that in TCD examination, and the positive rate is very high in the acute period of HIE in examination.

Contribution of Simulation to the Skills Laboratory for the Learning of Obstetrical Examination in an African Setting with Limited Resources

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 Chi2 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.

A Holistic Approach to Enhance FRCS General Surgery Examination Training Using Adult Learning Model: A Non-Profit Initiative

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.

The Infection Control Measures Taken in MRI Examination During the COVID-19 Pandemic Prevention and Control Period

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.

The IOMT-Based Risk-Free Approach to Lung Disorders Detection from Exhaled Breath Examination

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.